International Journal of Environmental Research and Public Health Latest open access articles published in Int. J. Environ. Res. Public Health at https://www.mdpi.com/journal/ijerph https://www.mdpi.com/journal/ijerph MDPI en Creative Commons Attribution (CC-BY) MDPI support@mdpi.com IJERPH, Vol. 17, Pages 6937: An Introduction to Probabilistic Record Linkage with a Focus on Linkage Processing for WTC Registries https://www.mdpi.com/1660-4601/17/18/6937 Since its post-World War II inception, the science of record linkage has grown exponentially and is used across industrial, governmental, and academic agencies. The academic fields that rely on record linkage are diverse, ranging from history to public health to demography. In this paper, we introduce the different types of data linkage and give a historical context to their development. We then introduce the three types of underlying models for probabilistic record linkage: Fellegi-Sunter-based methods, machine learning methods, and Bayesian methods. Practical considerations, such as data standardization and privacy concerns, are then discussed. Finally, recommendations are given for organizations developing or maintaining record linkage programs, with an emphasis on organizations measuring long-term complications of disasters, such as 9/11. IJERPH, Vol. 17, Pages 6937: An Introduction to Probabilistic Record Linkage with a Focus on Linkage Processing for WTC Registries

International Journal of Environmental Research and Public Health doi: 10.3390/ijerph17186937

Authors: Asher Resnick Brite Brackbill Cone

Since its post-World War II inception, the science of record linkage has grown exponentially and is used across industrial, governmental, and academic agencies. The academic fields that rely on record linkage are diverse, ranging from history to public health to demography. In this paper, we introduce the different types of data linkage and give a historical context to their development. We then introduce the three types of underlying models for probabilistic record linkage: Fellegi-Sunter-based methods, machine learning methods, and Bayesian methods. Practical considerations, such as data standardization and privacy concerns, are then discussed. Finally, recommendations are given for organizations developing or maintaining record linkage programs, with an emphasis on organizations measuring long-term complications of disasters, such as 9/11.

]]>
An Introduction to Probabilistic Record Linkage with a Focus on Linkage Processing for WTC Registries Asher Resnick Brite Brackbill Cone doi: 10.3390/ijerph17186937 International Journal of Environmental Research and Public Health 2020-09-22 International Journal of Environmental Research and Public Health 2020-09-22 17 18 Review 6937 10.3390/ijerph17186937 https://www.mdpi.com/1660-4601/17/18/6937
IJERPH, Vol. 17, Pages 6936: Are Advanced Glycation End Products in Skin Associated with Vascular Dysfunction Markers? A Meta-Analysis https://www.mdpi.com/1660-4601/17/18/6936 Evidence exists regarding the association between advanced glycation end products and different cardiovascular disease subclinical processes, such as arterial stiffness and atherosclerosis. With this systematic review and meta-analysis, we aimed to provide a synthesis of the evidence regarding the association of arterial stiffness measured by pulse wave velocity and atherosclerosis measured by carotid intima media thickness with skin autofluorescence. A systematic search was performed using: MEDLINE (PubMed), SCOPUS, and Web of Science, until 30 March 2020. Cross-sectional studies or baseline data from prospective longitudinal studies were considered. The DerSimonian and Laird method was used to calculate the pooled estimates of correlation coefficients and the corresponding 95% confidence intervals (CI) for the association of pulse wave velocity and carotid intima media thickness with skin autofluorescence. Twenty-five studies were included in the systematic review and meta-analysis, including 6306 subjects. The pooled correlation coefficient was 0.25 (95% CI: 0.18, 0.31) for pulse wave velocity and skin autofluorescence, and 0.31 (95% CI: 0.25, 0.38) for carotid intima media thickness and skin autofluorescence. This systematic review and meta-analysis provide a synthesis of the evidence showing a positive weak association of pulse wave velocity and carotid intima media thickness with skin autofluorescence. IJERPH, Vol. 17, Pages 6936: Are Advanced Glycation End Products in Skin Associated with Vascular Dysfunction Markers? A Meta-Analysis

International Journal of Environmental Research and Public Health doi: 10.3390/ijerph17186936

Authors: Alicia Saz-Lara Celia Álvarez-Bueno Vicente Martínez-Vizcaíno Blanca Notario-Pacheco Irene Sequí-Dominguez Iván Cavero-Redondo

Evidence exists regarding the association between advanced glycation end products and different cardiovascular disease subclinical processes, such as arterial stiffness and atherosclerosis. With this systematic review and meta-analysis, we aimed to provide a synthesis of the evidence regarding the association of arterial stiffness measured by pulse wave velocity and atherosclerosis measured by carotid intima media thickness with skin autofluorescence. A systematic search was performed using: MEDLINE (PubMed), SCOPUS, and Web of Science, until 30 March 2020. Cross-sectional studies or baseline data from prospective longitudinal studies were considered. The DerSimonian and Laird method was used to calculate the pooled estimates of correlation coefficients and the corresponding 95% confidence intervals (CI) for the association of pulse wave velocity and carotid intima media thickness with skin autofluorescence. Twenty-five studies were included in the systematic review and meta-analysis, including 6306 subjects. The pooled correlation coefficient was 0.25 (95% CI: 0.18, 0.31) for pulse wave velocity and skin autofluorescence, and 0.31 (95% CI: 0.25, 0.38) for carotid intima media thickness and skin autofluorescence. This systematic review and meta-analysis provide a synthesis of the evidence showing a positive weak association of pulse wave velocity and carotid intima media thickness with skin autofluorescence.

]]>
Are Advanced Glycation End Products in Skin Associated with Vascular Dysfunction Markers? A Meta-Analysis Alicia Saz-Lara Celia Álvarez-Bueno Vicente Martínez-Vizcaíno Blanca Notario-Pacheco Irene Sequí-Dominguez Iván Cavero-Redondo doi: 10.3390/ijerph17186936 International Journal of Environmental Research and Public Health 2020-09-22 International Journal of Environmental Research and Public Health 2020-09-22 17 18 Review 6936 10.3390/ijerph17186936 https://www.mdpi.com/1660-4601/17/18/6936
IJERPH, Vol. 17, Pages 6935: Effectiveness of SaBang-DolGi Walking Exercise Program on Physical and Mental Health of Menopausal Women https://www.mdpi.com/1660-4601/17/18/6935 Objective: We investigated the effectiveness of a 12-week SaBang-DolGi walking exercise program on the physical and mental health of menopausal women and aimed to provide the basic data needed to develop health promotion programs for the active and healthy aging of menopausal women. Materials and methods: The participants comprised 40 women aged 50–65 years who were divided into two randomly selected groups in training sessions (exercising group, n = 21 and control group, n = 19). A physical (grip, muscle and endurance) test and mental health test (simple mental health test II) were conducted using questionnaires with the aim of examining subjects’ physical and mental health before and after exercise. Results: After the intervention, the participants experienced positive changes in the physical dimension, with significant enhancements particularly in mental well-being and menopause-related health and subdomains. Controlled and regular exercise for 12 weeks was significantly correlated with a positive change in vitality and mental health. Conclusions: We found that the SaBang-DolGi walking exercise program helps to promote the physical and mental health of menopausal women who are exposed to the various stresses and depressions that accompany physical deterioration; the program was found to encourage active and healthy aging. IJERPH, Vol. 17, Pages 6935: Effectiveness of SaBang-DolGi Walking Exercise Program on Physical and Mental Health of Menopausal Women

International Journal of Environmental Research and Public Health doi: 10.3390/ijerph17186935

Authors: Noh Kim Kim Yi

Objective: We investigated the effectiveness of a 12-week SaBang-DolGi walking exercise program on the physical and mental health of menopausal women and aimed to provide the basic data needed to develop health promotion programs for the active and healthy aging of menopausal women. Materials and methods: The participants comprised 40 women aged 50–65 years who were divided into two randomly selected groups in training sessions (exercising group, n = 21 and control group, n = 19). A physical (grip, muscle and endurance) test and mental health test (simple mental health test II) were conducted using questionnaires with the aim of examining subjects’ physical and mental health before and after exercise. Results: After the intervention, the participants experienced positive changes in the physical dimension, with significant enhancements particularly in mental well-being and menopause-related health and subdomains. Controlled and regular exercise for 12 weeks was significantly correlated with a positive change in vitality and mental health. Conclusions: We found that the SaBang-DolGi walking exercise program helps to promote the physical and mental health of menopausal women who are exposed to the various stresses and depressions that accompany physical deterioration; the program was found to encourage active and healthy aging.

]]>
Effectiveness of SaBang-DolGi Walking Exercise Program on Physical and Mental Health of Menopausal Women Noh Kim Kim Yi doi: 10.3390/ijerph17186935 International Journal of Environmental Research and Public Health 2020-09-22 International Journal of Environmental Research and Public Health 2020-09-22 17 18 Article 6935 10.3390/ijerph17186935 https://www.mdpi.com/1660-4601/17/18/6935
IJERPH, Vol. 17, Pages 6933: Unveiling COVID-19 from CHEST X-Ray with Deep Learning: A Hurdles Race with Small Data https://www.mdpi.com/1660-4601/17/18/6933 The possibility to use widespread and simple chest X-ray (CXR) imaging for early screening of COVID-19 patients is attracting much interest from both the clinical and the AI community. In this study we provide insights and also raise warnings on what is reasonable to expect by applying deep learning to COVID classification of CXR images. We provide a methodological guide and critical reading of an extensive set of statistical results that can be obtained using currently available datasets. In particular, we take the challenge posed by current small size COVID data and show how significant can be the bias introduced by transfer-learning using larger public non-COVID CXR datasets. We also contribute by providing results on a medium size COVID CXR dataset, just collected by one of the major emergency hospitals in Northern Italy during the peak of the COVID pandemic. These novel data allow us to contribute to validate the generalization capacity of preliminary results circulating in the scientific community. Our conclusions shed some light into the possibility to effectively discriminate COVID using CXR. IJERPH, Vol. 17, Pages 6933: Unveiling COVID-19 from CHEST X-Ray with Deep Learning: A Hurdles Race with Small Data

International Journal of Environmental Research and Public Health doi: 10.3390/ijerph17186933

Authors: Enzo Tartaglione Carlo Alberto Barbano Claudio Berzovini Marco Calandri Marco Grangetto

The possibility to use widespread and simple chest X-ray (CXR) imaging for early screening of COVID-19 patients is attracting much interest from both the clinical and the AI community. In this study we provide insights and also raise warnings on what is reasonable to expect by applying deep learning to COVID classification of CXR images. We provide a methodological guide and critical reading of an extensive set of statistical results that can be obtained using currently available datasets. In particular, we take the challenge posed by current small size COVID data and show how significant can be the bias introduced by transfer-learning using larger public non-COVID CXR datasets. We also contribute by providing results on a medium size COVID CXR dataset, just collected by one of the major emergency hospitals in Northern Italy during the peak of the COVID pandemic. These novel data allow us to contribute to validate the generalization capacity of preliminary results circulating in the scientific community. Our conclusions shed some light into the possibility to effectively discriminate COVID using CXR.

]]>
Unveiling COVID-19 from CHEST X-Ray with Deep Learning: A Hurdles Race with Small Data Enzo Tartaglione Carlo Alberto Barbano Claudio Berzovini Marco Calandri Marco Grangetto doi: 10.3390/ijerph17186933 International Journal of Environmental Research and Public Health 2020-09-22 International Journal of Environmental Research and Public Health 2020-09-22 17 18 Article 6933 10.3390/ijerph17186933 https://www.mdpi.com/1660-4601/17/18/6933
IJERPH, Vol. 17, Pages 6934: Personal Music Players Use and Other Noise Hazards among Children 11 to 12 Years Old https://www.mdpi.com/1660-4601/17/18/6934 : Exposure to loud music—due to widespread personal music players (PMPs) and noisy leisure activities—are major risk factors for noise induced hearing loss (NIHL) in adolescents. However, there is little evidence of the impact of noise on the hearing of younger children. This study aimed to explore an association between PMP use and hearing, and to identify other sources of noise among children. The study sample consisted of 1032 children aged 11–12 years old. Hearing thresholds were determined from 0.5 to 8 kHz. PMP use and other noise exposures were evaluated using a survey. We found that 82% of the children had a PMP, and 78% were exposed to noise when playing computer games. An audiometric notch was documented in 1.3% of the children. Only 11.5% of the children ever used hearing protection while engaged in noisy activities. We found no convincing evidence of an association between PMP use and hearing thresholds, although our results suggest that tinnitus may be an early sign of NIHL in young children. The study shows a need to provide children, their parents, and educators with knowledge of how to take care of hearing, including how to avoid and minimize noise exposure. IJERPH, Vol. 17, Pages 6934: Personal Music Players Use and Other Noise Hazards among Children 11 to 12 Years Old

International Journal of Environmental Research and Public Health doi: 10.3390/ijerph17186934

Authors: Swierniak Gos Skarzynski Czajka Skarzynski

: Exposure to loud music—due to widespread personal music players (PMPs) and noisy leisure activities—are major risk factors for noise induced hearing loss (NIHL) in adolescents. However, there is little evidence of the impact of noise on the hearing of younger children. This study aimed to explore an association between PMP use and hearing, and to identify other sources of noise among children. The study sample consisted of 1032 children aged 11–12 years old. Hearing thresholds were determined from 0.5 to 8 kHz. PMP use and other noise exposures were evaluated using a survey. We found that 82% of the children had a PMP, and 78% were exposed to noise when playing computer games. An audiometric notch was documented in 1.3% of the children. Only 11.5% of the children ever used hearing protection while engaged in noisy activities. We found no convincing evidence of an association between PMP use and hearing thresholds, although our results suggest that tinnitus may be an early sign of NIHL in young children. The study shows a need to provide children, their parents, and educators with knowledge of how to take care of hearing, including how to avoid and minimize noise exposure.

]]>
Personal Music Players Use and Other Noise Hazards among Children 11 to 12 Years Old Swierniak Gos Skarzynski Czajka Skarzynski doi: 10.3390/ijerph17186934 International Journal of Environmental Research and Public Health 2020-09-22 International Journal of Environmental Research and Public Health 2020-09-22 17 18 Article 6934 10.3390/ijerph17186934 https://www.mdpi.com/1660-4601/17/18/6934
IJERPH, Vol. 17, Pages 6932: Thermal Sensation in Older People with and Without Dementia Living in Residential Care: New Assessment Approaches to Thermal Comfort Using Infrared Thermography https://www.mdpi.com/1660-4601/17/18/6932 The temperature of the indoor environment is important for health and wellbeing, especially at the extremes of age. The study aim was to understand the relationship between self-reported thermal sensation and extremity skin temperature in care home residents with and without dementia. The Abbreviated Mental Test (AMT) was used to discriminate residents to two categories, those with, and those without, dementia. After residents settled and further explanation of the study given (approximately 15 min), measurements included: tympanic membrane temperature, thermal sensation rating and infrared thermal mapping of non-dominant hand and forearm. Sixty-nine afebrile adults (60–101 years of age) were studied in groups of two to five, in mean ambient temperatures of 21.4–26.6 °C (median 23.6 °C). Significant differences were observed between groups; thermal sensation rating (p = 0.02), tympanic temperature (p = 0.01), fingertip skin temperature (p = 0.01) and temperature gradients; fingertip-wrist p = 0.001 and fingertip-distal forearm, p = 0.001. Residents with dementia were in significantly lower air temperatures (p = 0.001). Although equal numbers of residents per group rated the environment as ‘neutral’ (comfortable), resident ratings for ‘cool/cold’ were more frequent amongst those with dementia compared with no dementia. In parallel, extremity (hand) thermograms revealed visual temperature demarcation, variously across fingertip, wrist, and forearm commensurate with peripheral vasoconstriction. Infrared thermography provided a quantitative and qualitative method to measure and observe hand skin temperature across multiple regions of interest alongside thermal sensation self-report. As an imaging modality, infrared thermography has potential as an additional assessment technology with clinical utility to identify vulnerable residents who may be unable to communicate verbally, or reliably, their satisfaction with indoor environmental conditions. IJERPH, Vol. 17, Pages 6932: Thermal Sensation in Older People with and Without Dementia Living in Residential Care: New Assessment Approaches to Thermal Comfort Using Infrared Thermography

International Journal of Environmental Research and Public Health doi: 10.3390/ijerph17186932

Authors: Childs Elliott Khatab Hampshaw Fowler-Davis Willmott Ali

The temperature of the indoor environment is important for health and wellbeing, especially at the extremes of age. The study aim was to understand the relationship between self-reported thermal sensation and extremity skin temperature in care home residents with and without dementia. The Abbreviated Mental Test (AMT) was used to discriminate residents to two categories, those with, and those without, dementia. After residents settled and further explanation of the study given (approximately 15 min), measurements included: tympanic membrane temperature, thermal sensation rating and infrared thermal mapping of non-dominant hand and forearm. Sixty-nine afebrile adults (60–101 years of age) were studied in groups of two to five, in mean ambient temperatures of 21.4–26.6 °C (median 23.6 °C). Significant differences were observed between groups; thermal sensation rating (p = 0.02), tympanic temperature (p = 0.01), fingertip skin temperature (p = 0.01) and temperature gradients; fingertip-wrist p = 0.001 and fingertip-distal forearm, p = 0.001. Residents with dementia were in significantly lower air temperatures (p = 0.001). Although equal numbers of residents per group rated the environment as ‘neutral’ (comfortable), resident ratings for ‘cool/cold’ were more frequent amongst those with dementia compared with no dementia. In parallel, extremity (hand) thermograms revealed visual temperature demarcation, variously across fingertip, wrist, and forearm commensurate with peripheral vasoconstriction. Infrared thermography provided a quantitative and qualitative method to measure and observe hand skin temperature across multiple regions of interest alongside thermal sensation self-report. As an imaging modality, infrared thermography has potential as an additional assessment technology with clinical utility to identify vulnerable residents who may be unable to communicate verbally, or reliably, their satisfaction with indoor environmental conditions.

]]>
Thermal Sensation in Older People with and Without Dementia Living in Residential Care: New Assessment Approaches to Thermal Comfort Using Infrared Thermography Childs Elliott Khatab Hampshaw Fowler-Davis Willmott Ali doi: 10.3390/ijerph17186932 International Journal of Environmental Research and Public Health 2020-09-22 International Journal of Environmental Research and Public Health 2020-09-22 17 18 Article 6932 10.3390/ijerph17186932 https://www.mdpi.com/1660-4601/17/18/6932
IJERPH, Vol. 17, Pages 6930: The Visible Behaviour of Drowning Persons: A Pilot Observational Study Using Analytic Software and a Nominal Group Technique https://www.mdpi.com/1660-4601/17/18/6930 Although drowning is a common phenomenon, the behaviour of drowning persons is poorly understood. The purpose of this study is to provide a quantitative and qualitative analysis of this behaviour. This was an observational study of drowning videos observed by 20 international experts in the field of water safety. For quantitative analysis, each video was analysed with Lince observation software by four participants. A Nominal Group Technique generated input for the qualitative analysis and the two principal investigators conducted a post-hoc analysis. A total of 87.5% of the 23 videos showed drowning in swimming pools, 50% of the drowned persons were male, and 58.3% were children or teenagers. Nineteen persons were rescued before unconsciousness and showed just the beginning of downing behaviour. Another five were rescued after unconsciousness, which allowed the observation of their drowning behaviour from the beginning to the end. Significant differences were found comparing both groups regarding the length of disappearances underwater, number, and length of resurfacing (resp. p = 0.003, 0.016, 0.005) and the interval from the beginning of the incident to the rescue (p = 0.004). All persons drowned within 2 min. The qualitative analysis showed previously suggested behaviour patterns (immediate disappearance n = 5, distress n = 6, instinctive drowning response n = 6, climbing ladder motion n = 3) but also a striking new pattern (backward water milling n = 19). This study confirms previous assumptions of drowning behaviour and provides novel evidence-based information about the large variety of visible behaviours of drowning persons. New behaviours, which mainly include high-frequency resurfacing during a struggle for less than 2 min and backward water milling, have been recognised in this study. IJERPH, Vol. 17, Pages 6930: The Visible Behaviour of Drowning Persons: A Pilot Observational Study Using Analytic Software and a Nominal Group Technique

International Journal of Environmental Research and Public Health doi: 10.3390/ijerph17186930

Authors: Carballo-Fazanes Bierens the International Expert Group to Study Drowning Behaviour

Although drowning is a common phenomenon, the behaviour of drowning persons is poorly understood. The purpose of this study is to provide a quantitative and qualitative analysis of this behaviour. This was an observational study of drowning videos observed by 20 international experts in the field of water safety. For quantitative analysis, each video was analysed with Lince observation software by four participants. A Nominal Group Technique generated input for the qualitative analysis and the two principal investigators conducted a post-hoc analysis. A total of 87.5% of the 23 videos showed drowning in swimming pools, 50% of the drowned persons were male, and 58.3% were children or teenagers. Nineteen persons were rescued before unconsciousness and showed just the beginning of downing behaviour. Another five were rescued after unconsciousness, which allowed the observation of their drowning behaviour from the beginning to the end. Significant differences were found comparing both groups regarding the length of disappearances underwater, number, and length of resurfacing (resp. p = 0.003, 0.016, 0.005) and the interval from the beginning of the incident to the rescue (p = 0.004). All persons drowned within 2 min. The qualitative analysis showed previously suggested behaviour patterns (immediate disappearance n = 5, distress n = 6, instinctive drowning response n = 6, climbing ladder motion n = 3) but also a striking new pattern (backward water milling n = 19). This study confirms previous assumptions of drowning behaviour and provides novel evidence-based information about the large variety of visible behaviours of drowning persons. New behaviours, which mainly include high-frequency resurfacing during a struggle for less than 2 min and backward water milling, have been recognised in this study.

]]>
The Visible Behaviour of Drowning Persons: A Pilot Observational Study Using Analytic Software and a Nominal Group Technique Carballo-Fazanes Bierens the International Expert Group to Study Drowning Behaviour doi: 10.3390/ijerph17186930 International Journal of Environmental Research and Public Health 2020-09-22 International Journal of Environmental Research and Public Health 2020-09-22 17 18 Article 6930 10.3390/ijerph17186930 https://www.mdpi.com/1660-4601/17/18/6930
IJERPH, Vol. 17, Pages 6931: Effects of PM2.5 on Third Grade Students’ Proficiency in Math and English Language Arts https://www.mdpi.com/1660-4601/17/18/6931 Fine particulate air pollution is harmful to children in myriad ways. While evidence is mounting that chronic exposures are associated with reduced academic proficiency, no research has examined the frequency of peak exposures. It is also unknown if pollution exposures influence academic proficiency to the same degree in all schools or if the level of children’s social disadvantage in schools modifies the effects, such that some schools’ academic proficiency levels are more sensitive to exposures. We address these gaps by examining the percentage of third grade students who tested below the grade level in math and English language arts (ELA) in Salt Lake County, Utah primary schools (n = 156), where fine particulate pollution is a serious health threat. More frequent peak exposures were associated with reduced math and ELA proficiency, as was greater school disadvantage. High frequency peak exposures were more strongly linked to lower math proficiency in more advantaged schools. Findings highlight the need for policies to reduce the number of days with peak air pollution. IJERPH, Vol. 17, Pages 6931: Effects of PM2.5 on Third Grade Students’ Proficiency in Math and English Language Arts

International Journal of Environmental Research and Public Health doi: 10.3390/ijerph17186931

Authors: Mullen Grineski Collins Mendoza

Fine particulate air pollution is harmful to children in myriad ways. While evidence is mounting that chronic exposures are associated with reduced academic proficiency, no research has examined the frequency of peak exposures. It is also unknown if pollution exposures influence academic proficiency to the same degree in all schools or if the level of children’s social disadvantage in schools modifies the effects, such that some schools’ academic proficiency levels are more sensitive to exposures. We address these gaps by examining the percentage of third grade students who tested below the grade level in math and English language arts (ELA) in Salt Lake County, Utah primary schools (n = 156), where fine particulate pollution is a serious health threat. More frequent peak exposures were associated with reduced math and ELA proficiency, as was greater school disadvantage. High frequency peak exposures were more strongly linked to lower math proficiency in more advantaged schools. Findings highlight the need for policies to reduce the number of days with peak air pollution.

]]>
Effects of PM2.5 on Third Grade Students’ Proficiency in Math and English Language Arts Mullen Grineski Collins Mendoza doi: 10.3390/ijerph17186931 International Journal of Environmental Research and Public Health 2020-09-22 International Journal of Environmental Research and Public Health 2020-09-22 17 18 Article 6931 10.3390/ijerph17186931 https://www.mdpi.com/1660-4601/17/18/6931
IJERPH, Vol. 17, Pages 6929: Exploring Volatile Organic Compound Exposure and Its Association with Wheezing in Children under 36 Months: A Cross-Sectional Study in South Lisbon, Portugal https://www.mdpi.com/1660-4601/17/18/6929 Air quality and other environmental factors are gaining importance in public health policies. Some volatile organic compounds (VOCs) have been associated with asthma and symptoms of respiratory disease such as wheezing. The aim of this study was to measure the concentration of Total VOCs and assess their possible association with the occurrence of wheezing episodes in children under 36 months of age, in a region south of Lisbon, Portugal. A cross-sectional study was performed from October 2015 to March 2016. The sample of children under 36 months of age was selected by convenience, by inviting parents to take part in the study. A survey was applied to collect information on bedroom features, as well as to verify the occurrence of wheezing episodes. The indoor air quality parameters of bedrooms were measured using three 3M Quest® EVM-7 environmental monitors. In total, 34.4% of infants had had wheezing episodes since birth, with 86.7% of these presenting at least one episode in the previous 12 months. Total VOC levels were above the reference values in 48% of the analyzed bedrooms. No significant association of VOC exposure in a domestic setting with episodes of wheezing was found. However, children living in households with smokers were 4 times more likely to develop wheezing episodes. Thus, this study provides relevant information that warrants further studies to assess infant exposure to indoor air pollution and parental smoking in a residential context. IJERPH, Vol. 17, Pages 6929: Exploring Volatile Organic Compound Exposure and Its Association with Wheezing in Children under 36 Months: A Cross-Sectional Study in South Lisbon, Portugal

International Journal of Environmental Research and Public Health doi: 10.3390/ijerph17186929

Authors: Rodrigues dos Santos Gregório Castanheira Fernandes

Air quality and other environmental factors are gaining importance in public health policies. Some volatile organic compounds (VOCs) have been associated with asthma and symptoms of respiratory disease such as wheezing. The aim of this study was to measure the concentration of Total VOCs and assess their possible association with the occurrence of wheezing episodes in children under 36 months of age, in a region south of Lisbon, Portugal. A cross-sectional study was performed from October 2015 to March 2016. The sample of children under 36 months of age was selected by convenience, by inviting parents to take part in the study. A survey was applied to collect information on bedroom features, as well as to verify the occurrence of wheezing episodes. The indoor air quality parameters of bedrooms were measured using three 3M Quest® EVM-7 environmental monitors. In total, 34.4% of infants had had wheezing episodes since birth, with 86.7% of these presenting at least one episode in the previous 12 months. Total VOC levels were above the reference values in 48% of the analyzed bedrooms. No significant association of VOC exposure in a domestic setting with episodes of wheezing was found. However, children living in households with smokers were 4 times more likely to develop wheezing episodes. Thus, this study provides relevant information that warrants further studies to assess infant exposure to indoor air pollution and parental smoking in a residential context.

]]>
Exploring Volatile Organic Compound Exposure and Its Association with Wheezing in Children under 36 Months: A Cross-Sectional Study in South Lisbon, Portugal Rodrigues dos Santos Gregório Castanheira Fernandes doi: 10.3390/ijerph17186929 International Journal of Environmental Research and Public Health 2020-09-22 International Journal of Environmental Research and Public Health 2020-09-22 17 18 Article 6929 10.3390/ijerph17186929 https://www.mdpi.com/1660-4601/17/18/6929
IJERPH, Vol. 17, Pages 6928: Gaelic4Girls—The Effectiveness of a 10-Week Multicomponent Community Sports-Based Physical Activity Intervention for 8 to 12-Year-Old Girls https://www.mdpi.com/1660-4601/17/18/6928 Girls are less active than boys throughout childhood and adolescence, with limited research focusing on female community sports-based programs. This study aims to assess the effectiveness of a multi-component, community sports-based intervention for increasing girl’s physical activity (PA) levels, fundamental movement skill (FMS) proficiency, and psychological wellbeing, as relative to a second treatment group (the traditionally delivered national comparative program), and a third control group. One hundred and twenty female-only participants (mean age = 10.75 ± 1.44 years), aged 8 to 12 years old from three Ladies Gaelic Football (LGF) community sports clubs (rural and suburban) were allocated to one of three conditions: (1) Intervention Group 1 (n = 43) received a novel, specifically tailored, research-informed Gaelic4Girls (G4G) intervention; (2) Intervention Group 2 (n = 44) used the traditionally delivered, national G4G program, as run by the Ladies Gaelic Football (LGF) Association of Ireland; and (3) Control Group 3 (n = 33) received no G4G intervention (group 1 or 2) conditions and were expected to carry out their usual LGF community sports activities. Primary outcome measurements (at both pre- and 10-week follow up) examining the effectiveness of the G4G intervention included (1) PA, (2) FMS and (3) Psychological correlates (enjoyment levels, self-efficacy, peer and parental support). Following a two (pre to post) by three (intervention group 1, intervention group 2, and control group 3) mixed-model ANOVA, it was highlighted that intervention group 1 significantly increased in PA (p = 0.003), FMS proficiency (p = 0.005) and several psychological correlates of PA (p ≤ 0.005). The findings demonstrate that the 10-week, specifically tailored, research-informed G4G intervention is a feasible and efficacious program, leading to a positive effect on the physical and psychological wellbeing of pre-adolescent Irish girls, relative to the traditionally delivered national G4G comparative program and control group conditions. IJERPH, Vol. 17, Pages 6928: Gaelic4Girls—The Effectiveness of a 10-Week Multicomponent Community Sports-Based Physical Activity Intervention for 8 to 12-Year-Old Girls

International Journal of Environmental Research and Public Health doi: 10.3390/ijerph17186928

Authors: Farmer Cahill O’Brien

Girls are less active than boys throughout childhood and adolescence, with limited research focusing on female community sports-based programs. This study aims to assess the effectiveness of a multi-component, community sports-based intervention for increasing girl’s physical activity (PA) levels, fundamental movement skill (FMS) proficiency, and psychological wellbeing, as relative to a second treatment group (the traditionally delivered national comparative program), and a third control group. One hundred and twenty female-only participants (mean age = 10.75 ± 1.44 years), aged 8 to 12 years old from three Ladies Gaelic Football (LGF) community sports clubs (rural and suburban) were allocated to one of three conditions: (1) Intervention Group 1 (n = 43) received a novel, specifically tailored, research-informed Gaelic4Girls (G4G) intervention; (2) Intervention Group 2 (n = 44) used the traditionally delivered, national G4G program, as run by the Ladies Gaelic Football (LGF) Association of Ireland; and (3) Control Group 3 (n = 33) received no G4G intervention (group 1 or 2) conditions and were expected to carry out their usual LGF community sports activities. Primary outcome measurements (at both pre- and 10-week follow up) examining the effectiveness of the G4G intervention included (1) PA, (2) FMS and (3) Psychological correlates (enjoyment levels, self-efficacy, peer and parental support). Following a two (pre to post) by three (intervention group 1, intervention group 2, and control group 3) mixed-model ANOVA, it was highlighted that intervention group 1 significantly increased in PA (p = 0.003), FMS proficiency (p = 0.005) and several psychological correlates of PA (p ≤ 0.005). The findings demonstrate that the 10-week, specifically tailored, research-informed G4G intervention is a feasible and efficacious program, leading to a positive effect on the physical and psychological wellbeing of pre-adolescent Irish girls, relative to the traditionally delivered national G4G comparative program and control group conditions.

]]>
Gaelic4Girls—The Effectiveness of a 10-Week Multicomponent Community Sports-Based Physical Activity Intervention for 8 to 12-Year-Old Girls Farmer Cahill O’Brien doi: 10.3390/ijerph17186928 International Journal of Environmental Research and Public Health 2020-09-22 International Journal of Environmental Research and Public Health 2020-09-22 17 18 Article 6928 10.3390/ijerph17186928 https://www.mdpi.com/1660-4601/17/18/6928
IJERPH, Vol. 17, Pages 6923: Correlation of Caries Prevalence, Oral Health Behavior and Sweets Nutritional Habits among 10 to 19-Year-Old Cluj-Napoca Romanian Adolescents https://www.mdpi.com/1660-4601/17/18/6923 Background and objectives: The primary oral disease during adolescence is dental caries. Less is known about the caries prevalence, oral health behavior, and sweets nutritional habits in Romanian adolescents. The objective of this study was to assess the actual caries prevalence among Romanian adolescents in a representative area of Romania, Cluj, and to correlate with oral hygiene behaviors and dietary sugary foods intake. Materials and methods: We have done a cross-sectional study of 650 adolescents aged 10 to 19-years-old (average age 15.3 ± 2.8). We performed the oral dental examination according to the WHO methodology, calculated the number of decayed, missing (due to caries), and filled teeth (DMFT index), assessed the oral hygiene and dietary behaviors using a two-section valid questionnaire and statistically analyzed the interrelation between DMFT, oral hygiene and eating behaviors by multivariate statistical analysis. Results: (a) The caries prevalence in the adolescent population enrolled in the study was 95.5%; (b) the mean DMFT was 3.13 ± 2.0, without significant differences between the urban and rural adolescents (p = 0.253); lower in females than males (p < 0.050), (c) more than one third (33.7%, n = 219) of teenagers are seldom or never brush their teeth in the evening; (c) 40.6% of adolescents are missing the regular annual dental check-ups leading to an increased DMFT as shown in the multivariate analysis (p = 0.038); and (d) there is an increased prevalence of caries with age (p = 0.020), and with sugary sweetened beverages consumption (p = 0.028). Conclusions: Our study evidenced a persistent high caries prevalence in Romanian teenagers. Their dietary habits and irregular dental check-up were associated with the occurrence of dental conditions. IJERPH, Vol. 17, Pages 6923: Correlation of Caries Prevalence, Oral Health Behavior and Sweets Nutritional Habits among 10 to 19-Year-Old Cluj-Napoca Romanian Adolescents

International Journal of Environmental Research and Public Health doi: 10.3390/ijerph17186923

Authors: Cosmin Tudoroniu Monica Popa Simona Maria Iacob Anca Lucia Pop Bogdana Adriana Năsui

Background and objectives: The primary oral disease during adolescence is dental caries. Less is known about the caries prevalence, oral health behavior, and sweets nutritional habits in Romanian adolescents. The objective of this study was to assess the actual caries prevalence among Romanian adolescents in a representative area of Romania, Cluj, and to correlate with oral hygiene behaviors and dietary sugary foods intake. Materials and methods: We have done a cross-sectional study of 650 adolescents aged 10 to 19-years-old (average age 15.3 ± 2.8). We performed the oral dental examination according to the WHO methodology, calculated the number of decayed, missing (due to caries), and filled teeth (DMFT index), assessed the oral hygiene and dietary behaviors using a two-section valid questionnaire and statistically analyzed the interrelation between DMFT, oral hygiene and eating behaviors by multivariate statistical analysis. Results: (a) The caries prevalence in the adolescent population enrolled in the study was 95.5%; (b) the mean DMFT was 3.13 ± 2.0, without significant differences between the urban and rural adolescents (p = 0.253); lower in females than males (p < 0.050), (c) more than one third (33.7%, n = 219) of teenagers are seldom or never brush their teeth in the evening; (c) 40.6% of adolescents are missing the regular annual dental check-ups leading to an increased DMFT as shown in the multivariate analysis (p = 0.038); and (d) there is an increased prevalence of caries with age (p = 0.020), and with sugary sweetened beverages consumption (p = 0.028). Conclusions: Our study evidenced a persistent high caries prevalence in Romanian teenagers. Their dietary habits and irregular dental check-up were associated with the occurrence of dental conditions.

]]>
Correlation of Caries Prevalence, Oral Health Behavior and Sweets Nutritional Habits among 10 to 19-Year-Old Cluj-Napoca Romanian Adolescents Cosmin Tudoroniu Monica Popa Simona Maria Iacob Anca Lucia Pop Bogdana Adriana Năsui doi: 10.3390/ijerph17186923 International Journal of Environmental Research and Public Health 2020-09-22 International Journal of Environmental Research and Public Health 2020-09-22 17 18 Article 6923 10.3390/ijerph17186923 https://www.mdpi.com/1660-4601/17/18/6923
IJERPH, Vol. 17, Pages 6927: A Qualitative Study of a Mindfulness-Based Intervention in Educational Contexts in Chile: An Approach Based on Adolescents’ Voices https://www.mdpi.com/1660-4601/17/18/6927 The application of mindfulness-based interventions in school settings has increased considerably in recent years, showing that differences between the characteristics of programmes can impact on the receptivity and effectiveness of mindfulness training. However, few studies have explored the learning process from the perspective of the children and adolescents who participate in mindfulness practice. The goal of this paper is to analyse the subjective experience of a group of adolescents following the completion of a mindfulness-based intervention developed for schools in Chile. The intervention studied is the “.b curriculum”, which is part of the Mindfulness in School Project (MiSP) developed in the UK. Twenty adolescents participated in semi-structured interviews within their school, in which three key areas were explored: pedagogy, perceived effects, and mechanisms of action, each of them being analysed from the perspective of thematic analysis. The results support the view that pedagogy is a very relevant consideration in the implementation, development, and efficacy of mindfulness-based interventions within the school context. We propose that the inclusion of structure, contents, process/mindful practices, and teachers’ expertise provides the pedagogical-relational framework required for students to successfully develop mindfulness skills, which enables them to experience their cognitive, emotional, and somatic effects. These effects are linked to self-regulation strategies, based on paying attention to one’s somatic experience with kindness and curiosity, which works as an attentional anchor. It is hoped that these results will contribute to the spread of mindfulness research in adolescents in Latin America, thus facilitating cross-cultural and international comparisons. IJERPH, Vol. 17, Pages 6927: A Qualitative Study of a Mindfulness-Based Intervention in Educational Contexts in Chile: An Approach Based on Adolescents’ Voices

International Journal of Environmental Research and Public Health doi: 10.3390/ijerph17186927

Authors: Álvaro I. Langer Sebastián Medeiros Nelson Valdés-Sánchez Rodrigo Brito Christoph Steinebach Cristian Cid-Parra Antonella Magni Mariane Krause

The application of mindfulness-based interventions in school settings has increased considerably in recent years, showing that differences between the characteristics of programmes can impact on the receptivity and effectiveness of mindfulness training. However, few studies have explored the learning process from the perspective of the children and adolescents who participate in mindfulness practice. The goal of this paper is to analyse the subjective experience of a group of adolescents following the completion of a mindfulness-based intervention developed for schools in Chile. The intervention studied is the “.b curriculum”, which is part of the Mindfulness in School Project (MiSP) developed in the UK. Twenty adolescents participated in semi-structured interviews within their school, in which three key areas were explored: pedagogy, perceived effects, and mechanisms of action, each of them being analysed from the perspective of thematic analysis. The results support the view that pedagogy is a very relevant consideration in the implementation, development, and efficacy of mindfulness-based interventions within the school context. We propose that the inclusion of structure, contents, process/mindful practices, and teachers’ expertise provides the pedagogical-relational framework required for students to successfully develop mindfulness skills, which enables them to experience their cognitive, emotional, and somatic effects. These effects are linked to self-regulation strategies, based on paying attention to one’s somatic experience with kindness and curiosity, which works as an attentional anchor. It is hoped that these results will contribute to the spread of mindfulness research in adolescents in Latin America, thus facilitating cross-cultural and international comparisons.

]]>
A Qualitative Study of a Mindfulness-Based Intervention in Educational Contexts in Chile: An Approach Based on Adolescents’ Voices Álvaro I. Langer Sebastián Medeiros Nelson Valdés-Sánchez Rodrigo Brito Christoph Steinebach Cristian Cid-Parra Antonella Magni Mariane Krause doi: 10.3390/ijerph17186927 International Journal of Environmental Research and Public Health 2020-09-22 International Journal of Environmental Research and Public Health 2020-09-22 17 18 Article 6927 10.3390/ijerph17186927 https://www.mdpi.com/1660-4601/17/18/6927
IJERPH, Vol. 17, Pages 6926: A Review of Maternal Nutrition during Pregnancy and Impact on the Offspring through Development: Evidence from Animal Models of Over-and Undernutrition https://www.mdpi.com/1660-4601/17/18/6926 Similarities in offspring phenotype due to maternal under- or over-nutrition during gestation have been observed in studies conducted at University of Wyoming. In these studies, ewes were either nutrient-restricted (NR) from early to mid-gestation, or fed an obesogenic diet (MO) from preconception through term. Offspring necropsies occurred at mid-gestation, late-gestation, and after parturition. At mid gestation, body weights of NR fetuses were ~30% lighter than controls, whereas MO fetuses were ~30% heavier than those of controls. At birth, lambs born to NR, MO, and control ewes exhibited similar weights. This was a consequence of accelerated fetal growth rates in NR ewes, and reduced fetal growth rates in MO ewes in late gestation, when compared to their respective controls. These fetal growth patterns resulted in remarkably similar effects of increased susceptibility to obesity, cardiovascular disease, and glucose intolerance in offspring programmed mostly during fetal stages of development. These data provide evidence that maternal under- and over-nutrition similarly induce the development of the same cadre of physical and metabolic problems in postnatal life. IJERPH, Vol. 17, Pages 6926: A Review of Maternal Nutrition during Pregnancy and Impact on the Offspring through Development: Evidence from Animal Models of Over-and Undernutrition

International Journal of Environmental Research and Public Health doi: 10.3390/ijerph17186926

Authors: Odhiambo Pankey Ghnenis Ford

Similarities in offspring phenotype due to maternal under- or over-nutrition during gestation have been observed in studies conducted at University of Wyoming. In these studies, ewes were either nutrient-restricted (NR) from early to mid-gestation, or fed an obesogenic diet (MO) from preconception through term. Offspring necropsies occurred at mid-gestation, late-gestation, and after parturition. At mid gestation, body weights of NR fetuses were ~30% lighter than controls, whereas MO fetuses were ~30% heavier than those of controls. At birth, lambs born to NR, MO, and control ewes exhibited similar weights. This was a consequence of accelerated fetal growth rates in NR ewes, and reduced fetal growth rates in MO ewes in late gestation, when compared to their respective controls. These fetal growth patterns resulted in remarkably similar effects of increased susceptibility to obesity, cardiovascular disease, and glucose intolerance in offspring programmed mostly during fetal stages of development. These data provide evidence that maternal under- and over-nutrition similarly induce the development of the same cadre of physical and metabolic problems in postnatal life.

]]>
A Review of Maternal Nutrition during Pregnancy and Impact on the Offspring through Development: Evidence from Animal Models of Over-and Undernutrition Odhiambo Pankey Ghnenis Ford doi: 10.3390/ijerph17186926 International Journal of Environmental Research and Public Health 2020-09-22 International Journal of Environmental Research and Public Health 2020-09-22 17 18 Conference Report 6926 10.3390/ijerph17186926 https://www.mdpi.com/1660-4601/17/18/6926
IJERPH, Vol. 17, Pages 6925: Prevalence of Arterial Hypertension and Characteristics of Nocturnal Blood Pressure Profile of Asthma Patients According to Therapy and Severity of the Disease: The BADA Study https://www.mdpi.com/1660-4601/17/18/6925 Background: several studies report an increased risk for asthmatic subjects to develop arterial hypertension and the relationship between these two diseases, frequently co-existing, still has some unclear aspects. Methods: The BADA (blood pressure levels, clinical features and markers of subclinical cardiovascular damage of asthma patients) study is aimed to evaluate the prevalence of the cardiovascular comorbidities of asthma and their impact on the clinical outcome. The main exclusion criteria were the presence of other respiratory diseases, current smoking, any contraindication to ambulatory blood pressure monitoring (ABPM). Results: The overall percentage of asthmatics having also hypertension was 75% (30 patients) vs 45% (18 patients) of the control group (p: 0.012). Reduced level of FEV1 (but not inhaled steroid therapy) was associated to newly-diagnosed hypertension (p: 0.0002), higher day SBP levels (p: 0.003), higher day DBP levels (p: 0.03), higher 24 h-SBP levels (p: 0.005) and higher 24h-DBP levels (p: 0.03). The regression analysis performed taking into account sex, age, diabetes, fasting glucose, and body mass index confirms the independent role played by asthma: odds ratio (OR): 3.66 (CI: 1.29–11.1). Conclusions: hypertension is highly prevalent in asthma; the use of ABPM has allowed the detection of a considerable number of unrecognized hypertensives. IJERPH, Vol. 17, Pages 6925: Prevalence of Arterial Hypertension and Characteristics of Nocturnal Blood Pressure Profile of Asthma Patients According to Therapy and Severity of the Disease: The BADA Study

International Journal of Environmental Research and Public Health doi: 10.3390/ijerph17186925

Authors: Di Raimondo Musiari Benfante Battaglia Rizzo Tuttolomondo Scichilone Pinto

Background: several studies report an increased risk for asthmatic subjects to develop arterial hypertension and the relationship between these two diseases, frequently co-existing, still has some unclear aspects. Methods: The BADA (blood pressure levels, clinical features and markers of subclinical cardiovascular damage of asthma patients) study is aimed to evaluate the prevalence of the cardiovascular comorbidities of asthma and their impact on the clinical outcome. The main exclusion criteria were the presence of other respiratory diseases, current smoking, any contraindication to ambulatory blood pressure monitoring (ABPM). Results: The overall percentage of asthmatics having also hypertension was 75% (30 patients) vs 45% (18 patients) of the control group (p: 0.012). Reduced level of FEV1 (but not inhaled steroid therapy) was associated to newly-diagnosed hypertension (p: 0.0002), higher day SBP levels (p: 0.003), higher day DBP levels (p: 0.03), higher 24 h-SBP levels (p: 0.005) and higher 24h-DBP levels (p: 0.03). The regression analysis performed taking into account sex, age, diabetes, fasting glucose, and body mass index confirms the independent role played by asthma: odds ratio (OR): 3.66 (CI: 1.29–11.1). Conclusions: hypertension is highly prevalent in asthma; the use of ABPM has allowed the detection of a considerable number of unrecognized hypertensives.

]]>
Prevalence of Arterial Hypertension and Characteristics of Nocturnal Blood Pressure Profile of Asthma Patients According to Therapy and Severity of the Disease: The BADA Study Di Raimondo Musiari Benfante Battaglia Rizzo Tuttolomondo Scichilone Pinto doi: 10.3390/ijerph17186925 International Journal of Environmental Research and Public Health 2020-09-22 International Journal of Environmental Research and Public Health 2020-09-22 17 18 Article 6925 10.3390/ijerph17186925 https://www.mdpi.com/1660-4601/17/18/6925
IJERPH, Vol. 17, Pages 6924: Public Awareness and Behaviour in Great Britain in the Context of Sunlight Exposure and Vitamin D: Results from the First Large-Scale and Representative Survey https://www.mdpi.com/1660-4601/17/18/6924 In recent years, UK public health messages about the risks of sunlight exposure (skin cancer) have been increasingly balanced by messages about its benefits (vitamin D production). Currently, data about the effects of this shift on public knowledge, awareness, and behaviour are scant. Thus, the objective of this paper is to report the findings of the first large-scale and representative survey of the awareness, knowledge, and behaviour of adults in Great Britain (England, Scotland, and Wales) (n = 2024) with respect to sunlight exposure, vitamin D, and sunburn and skin cancer. The findings suggest that the public in Great Britain is much more aware of public promotion of the risks of sunlight exposure than its benefits. That said, knowledge about sunlight exposure and vitamin D is fairly strong, though not with respect to the detail of the ‘little and often’ approach. However, the survey also suggests that levels of sunlight exposure among the public are often excessive. The survey indicates that knowledge and behaviour are both less satisfactory among men and people in lower socio-economic groups. The paper concludes with recommendations for public health communications and for research in this area. IJERPH, Vol. 17, Pages 6924: Public Awareness and Behaviour in Great Britain in the Context of Sunlight Exposure and Vitamin D: Results from the First Large-Scale and Representative Survey

International Journal of Environmental Research and Public Health doi: 10.3390/ijerph17186924

Authors: Burchell Rhodes Webb

In recent years, UK public health messages about the risks of sunlight exposure (skin cancer) have been increasingly balanced by messages about its benefits (vitamin D production). Currently, data about the effects of this shift on public knowledge, awareness, and behaviour are scant. Thus, the objective of this paper is to report the findings of the first large-scale and representative survey of the awareness, knowledge, and behaviour of adults in Great Britain (England, Scotland, and Wales) (n = 2024) with respect to sunlight exposure, vitamin D, and sunburn and skin cancer. The findings suggest that the public in Great Britain is much more aware of public promotion of the risks of sunlight exposure than its benefits. That said, knowledge about sunlight exposure and vitamin D is fairly strong, though not with respect to the detail of the ‘little and often’ approach. However, the survey also suggests that levels of sunlight exposure among the public are often excessive. The survey indicates that knowledge and behaviour are both less satisfactory among men and people in lower socio-economic groups. The paper concludes with recommendations for public health communications and for research in this area.

]]>
Public Awareness and Behaviour in Great Britain in the Context of Sunlight Exposure and Vitamin D: Results from the First Large-Scale and Representative Survey Burchell Rhodes Webb doi: 10.3390/ijerph17186924 International Journal of Environmental Research and Public Health 2020-09-22 International Journal of Environmental Research and Public Health 2020-09-22 17 18 Article 6924 10.3390/ijerph17186924 https://www.mdpi.com/1660-4601/17/18/6924
IJERPH, Vol. 17, Pages 6922: Leaders’ Future Orientation and Public Health Investment Intention: A Moderated Mediation Model of Self-Efficacy and Perceived Social Support https://www.mdpi.com/1660-4601/17/18/6922 Prior studies have investigated the issue of public health and health policy from economic, environmental, and healthcare perspectives. Research on public health from leaders’ perspective may also help to advance our knowledge about leaders’ perceptions, attitudes, and behavioral intentions toward public health management. Therefore, this study is based on social ideal theory, social cognitive theory, and social trust theory to investigate the influence of leaders’ future orientation on public health investment intention with the mediating role of leaders’ self-efficacy and the moderating role of perceived social support. Using a structural equation modeling with a sample data of 381 leaders of government agencies in Vietnam, empirical results indicate that leaders’ future orientation has a positive influence on public health investment intention. Furthermore, self-efficacy is found to have a positive mediating effect in the relationship between leaders’ future orientation and public health investment intention. In addition, perceived social support positively moderates the link between leaders’ future orientation and self-efficacy. Perceived social support also moderates the indirect effect of leaders’ future orientation on public health investment intention through self-efficacy. On one hand, this study contributes to theoretical research by clarifying the effects of leaders’ perceptions, and cognitive and behavioral intentions toward public health investment. Findings of this study may have implications for researchers who may have interest in studying the issue of public health management from leaders’ viewpoints. On the other hand, this study contributes to practitioners since understanding how leaders’ characteristics affect public health investment will enhance the quality of policy makers’ decision-making in improving public health for citizens and society. IJERPH, Vol. 17, Pages 6922: Leaders’ Future Orientation and Public Health Investment Intention: A Moderated Mediation Model of Self-Efficacy and Perceived Social Support

International Journal of Environmental Research and Public Health doi: 10.3390/ijerph17186922

Authors: Jianming Wang Tsung Piao Chou Chia-Pin Chen Xiangzhi Bu

Prior studies have investigated the issue of public health and health policy from economic, environmental, and healthcare perspectives. Research on public health from leaders’ perspective may also help to advance our knowledge about leaders’ perceptions, attitudes, and behavioral intentions toward public health management. Therefore, this study is based on social ideal theory, social cognitive theory, and social trust theory to investigate the influence of leaders’ future orientation on public health investment intention with the mediating role of leaders’ self-efficacy and the moderating role of perceived social support. Using a structural equation modeling with a sample data of 381 leaders of government agencies in Vietnam, empirical results indicate that leaders’ future orientation has a positive influence on public health investment intention. Furthermore, self-efficacy is found to have a positive mediating effect in the relationship between leaders’ future orientation and public health investment intention. In addition, perceived social support positively moderates the link between leaders’ future orientation and self-efficacy. Perceived social support also moderates the indirect effect of leaders’ future orientation on public health investment intention through self-efficacy. On one hand, this study contributes to theoretical research by clarifying the effects of leaders’ perceptions, and cognitive and behavioral intentions toward public health investment. Findings of this study may have implications for researchers who may have interest in studying the issue of public health management from leaders’ viewpoints. On the other hand, this study contributes to practitioners since understanding how leaders’ characteristics affect public health investment will enhance the quality of policy makers’ decision-making in improving public health for citizens and society.

]]>
Leaders’ Future Orientation and Public Health Investment Intention: A Moderated Mediation Model of Self-Efficacy and Perceived Social Support Jianming Wang Tsung Piao Chou Chia-Pin Chen Xiangzhi Bu doi: 10.3390/ijerph17186922 International Journal of Environmental Research and Public Health 2020-09-22 International Journal of Environmental Research and Public Health 2020-09-22 17 18 Article 6922 10.3390/ijerph17186922 https://www.mdpi.com/1660-4601/17/18/6922
IJERPH, Vol. 17, Pages 6921: “My Friends Are at the Bottom of My Schedule”: A Qualitative Study on Social Health among Nursing Students during Clinical Placement https://www.mdpi.com/1660-4601/17/18/6921 Clinical placement is an essential component for nursing students, allowing them to transfer professional knowledge into practice. The quality of life among nursing students and nurses was reviewed to examine its impact on the quality of provided care. However, it is unclear how social health among nursing students is affected during clinical placement. Final-year students who had finished clinical placement were invited to participate in this qualitative study. Twenty-one in-depth interviews were conducted and transcribed verbatim for thematic analysis. Two main themes, i.e., contributors to lack of social health, and manifestations of lack of social health, emerged from seven sub-themes. Students experienced different challenges during the clinical placement, but some of these did contribute to effects on their social health. Lack of social health might further influence career development after graduation. Supportive strategies from colleagues, nursing colleges and hospitals might potentially improve students’ social health during the clinical placement. IJERPH, Vol. 17, Pages 6921: “My Friends Are at the Bottom of My Schedule”: A Qualitative Study on Social Health among Nursing Students during Clinical Placement

International Journal of Environmental Research and Public Health doi: 10.3390/ijerph17186921

Authors: Tam Mao Cheong Van

Clinical placement is an essential component for nursing students, allowing them to transfer professional knowledge into practice. The quality of life among nursing students and nurses was reviewed to examine its impact on the quality of provided care. However, it is unclear how social health among nursing students is affected during clinical placement. Final-year students who had finished clinical placement were invited to participate in this qualitative study. Twenty-one in-depth interviews were conducted and transcribed verbatim for thematic analysis. Two main themes, i.e., contributors to lack of social health, and manifestations of lack of social health, emerged from seven sub-themes. Students experienced different challenges during the clinical placement, but some of these did contribute to effects on their social health. Lack of social health might further influence career development after graduation. Supportive strategies from colleagues, nursing colleges and hospitals might potentially improve students’ social health during the clinical placement.

]]>
“My Friends Are at the Bottom of My Schedule”: A Qualitative Study on Social Health among Nursing Students during Clinical Placement Tam Mao Cheong Van doi: 10.3390/ijerph17186921 International Journal of Environmental Research and Public Health 2020-09-22 International Journal of Environmental Research and Public Health 2020-09-22 17 18 Article 6921 10.3390/ijerph17186921 https://www.mdpi.com/1660-4601/17/18/6921
IJERPH, Vol. 17, Pages 6920: Radiological Outcomes of Bone-Level and Tissue-Level Dental Implants: Systematic Review https://www.mdpi.com/1660-4601/17/18/6920 Background: to assess the radiological marginal bone loss between bone-level or tissue-level dental implants through a systematic review of literature until September 2019. Methods: MEDLINE, Embase and other database were searched by two independent authors including only English articles. Results: The search provided 1028 records and, after removing the duplicates through titles and abstracts screening, 45 full-text articles were assessed for eligibility. For qualitative analysis 20 articles were included, 17 articles of them for quantitative analysis counting a total of 1161 patients (mean age 54.4 years) and 2933 implants, 1427 inserted at Tissue-level (TL) and 1506 inserted at Bone-level (BL). The survival rate and the success rate were more than 90%, except for 2 studies with a success rate of 88% and 86.2%. No studies reported any differences between groups in term of success and survival rates. Three studies showed that BL-implants had statistically less marginal bone loss (p < 0.05). Only one study reported statistically less marginal bone loss in TL-implants (p < 0.05). Conclusion: In the most part of the studies, differences between implant types in marginal bone loss were not statistically significant after a variable period of follow-up ranged between 1 and 5 years. IJERPH, Vol. 17, Pages 6920: Radiological Outcomes of Bone-Level and Tissue-Level Dental Implants: Systematic Review

International Journal of Environmental Research and Public Health doi: 10.3390/ijerph17186920

Authors: Saverio Cosola Simone Marconcini Michela Boccuzzi Giovanni Battista Menchini Fabris Ugo Covani Miguel Peñarrocha-Diago David Peñarrocha-Oltra

Background: to assess the radiological marginal bone loss between bone-level or tissue-level dental implants through a systematic review of literature until September 2019. Methods: MEDLINE, Embase and other database were searched by two independent authors including only English articles. Results: The search provided 1028 records and, after removing the duplicates through titles and abstracts screening, 45 full-text articles were assessed for eligibility. For qualitative analysis 20 articles were included, 17 articles of them for quantitative analysis counting a total of 1161 patients (mean age 54.4 years) and 2933 implants, 1427 inserted at Tissue-level (TL) and 1506 inserted at Bone-level (BL). The survival rate and the success rate were more than 90%, except for 2 studies with a success rate of 88% and 86.2%. No studies reported any differences between groups in term of success and survival rates. Three studies showed that BL-implants had statistically less marginal bone loss (p < 0.05). Only one study reported statistically less marginal bone loss in TL-implants (p < 0.05). Conclusion: In the most part of the studies, differences between implant types in marginal bone loss were not statistically significant after a variable period of follow-up ranged between 1 and 5 years.

]]>
Radiological Outcomes of Bone-Level and Tissue-Level Dental Implants: Systematic Review Saverio Cosola Simone Marconcini Michela Boccuzzi Giovanni Battista Menchini Fabris Ugo Covani Miguel Peñarrocha-Diago David Peñarrocha-Oltra doi: 10.3390/ijerph17186920 International Journal of Environmental Research and Public Health 2020-09-22 International Journal of Environmental Research and Public Health 2020-09-22 17 18 Review 6920 10.3390/ijerph17186920 https://www.mdpi.com/1660-4601/17/18/6920
IJERPH, Vol. 17, Pages 6918: Impact of Individual Headache Types on the Work and Work Efficiency of Headache Sufferers https://www.mdpi.com/1660-4601/17/18/6918 Background: Headaches have not only medical but also great socioeconomic significance, therefore, it is necessary to evaluate the overall impact of headaches on a patient’s life, including their work and work efficiency. The aim of this study was to determine the impact of individual headache types on work and work efficiency. Methods: This research was designed as a cross-sectional study performed by administering a questionnaire among employees. The questionnaire consisted of general questions, questions about headache features, and questions about the impact of headaches on work. Results: Monthly absence from work was mostly represented by migraine sufferers (7.1%), significantly more than with sufferers with tension-type headaches (2.23%; p = 0.019) and other headache types (2.15%; p = 0.025). Migraine sufferers (30.2%) worked in spite of a headache for more than 25 h, which was more frequent than with sufferers from tension-type and other-type headaches (13.4%). On average, headache sufferers reported work efficiency ranging from 66% to 90%. With regard to individual headache types, this range was significantly more frequent in subjects with tension-type headaches, whereas 91–100% efficiency was significantly more frequent in subjects with other headache types. Lower efficiency, i.e., 0–40% and 41–65%, was significantly more frequent with migraine sufferers. Conclusions: Headaches, especially migraines, significantly affect the work and work efficiency of headache sufferers by reducing their productivity. Loss is greater due to reduced efficiency than due to absenteeism. IJERPH, Vol. 17, Pages 6918: Impact of Individual Headache Types on the Work and Work Efficiency of Headache Sufferers

International Journal of Environmental Research and Public Health doi: 10.3390/ijerph17186918

Authors: Svetlana Simić Tamara Rabi-Žikić José R. Villar José Luis Calvo-Rolle Dragan Simić Svetislav D. Simić

Background: Headaches have not only medical but also great socioeconomic significance, therefore, it is necessary to evaluate the overall impact of headaches on a patient’s life, including their work and work efficiency. The aim of this study was to determine the impact of individual headache types on work and work efficiency. Methods: This research was designed as a cross-sectional study performed by administering a questionnaire among employees. The questionnaire consisted of general questions, questions about headache features, and questions about the impact of headaches on work. Results: Monthly absence from work was mostly represented by migraine sufferers (7.1%), significantly more than with sufferers with tension-type headaches (2.23%; p = 0.019) and other headache types (2.15%; p = 0.025). Migraine sufferers (30.2%) worked in spite of a headache for more than 25 h, which was more frequent than with sufferers from tension-type and other-type headaches (13.4%). On average, headache sufferers reported work efficiency ranging from 66% to 90%. With regard to individual headache types, this range was significantly more frequent in subjects with tension-type headaches, whereas 91–100% efficiency was significantly more frequent in subjects with other headache types. Lower efficiency, i.e., 0–40% and 41–65%, was significantly more frequent with migraine sufferers. Conclusions: Headaches, especially migraines, significantly affect the work and work efficiency of headache sufferers by reducing their productivity. Loss is greater due to reduced efficiency than due to absenteeism.

]]>
Impact of Individual Headache Types on the Work and Work Efficiency of Headache Sufferers Svetlana Simić Tamara Rabi-Žikić José R. Villar José Luis Calvo-Rolle Dragan Simić Svetislav D. Simić doi: 10.3390/ijerph17186918 International Journal of Environmental Research and Public Health 2020-09-22 International Journal of Environmental Research and Public Health 2020-09-22 17 18 Article 6918 10.3390/ijerph17186918 https://www.mdpi.com/1660-4601/17/18/6918
IJERPH, Vol. 17, Pages 6915: Assessing 3-D Spatial Extent of Near-Road Air Pollution around a Signalized Intersection Using Drone Monitoring and WRF-CFD Modeling https://www.mdpi.com/1660-4601/17/18/6915 In this study, we have assessed the three-dimensional (3-D) spatial extent of near-road air pollution around a signalized intersection in a densely populated area using collaborating methodologies of stationary measurements, drone monitoring, and atmospheric dispersion modeling. Stationary measurement data collected in the roadside apartment building showed a substantial effect of emitted pollutants, such as nitrogen oxides (NOx), black carbon (BC), and ultrafine particles (UFPs), especially during the morning rush hours. Vertical drone monitoring near the road intersection exhibited a steeper decreasing trend with increasing altitude for BC concentration rather than for fine particulate matter (PM2.5) concentration below the apartment building height. Atmospheric NOx dispersion was simulated using the weather research and forecasting (WRF) and computational fluid dynamics (CFD) models for the drone measurement periods. Based on the agreement between the measured BC and simulated NOx concentrations, we concluded that the air pollution around the road intersection has adverse effects on the health of residents living within the 3-D spatial extent within at least 120 m horizontally and a half of building height vertically during the morning rush hours. The comparability between drone monitoring and WRF-CFD modeling can further guarantee the identification of air pollution hotspots using the methods. IJERPH, Vol. 17, Pages 6915: Assessing 3-D Spatial Extent of Near-Road Air Pollution around a Signalized Intersection Using Drone Monitoring and WRF-CFD Modeling

International Journal of Environmental Research and Public Health doi: 10.3390/ijerph17186915

Authors: Seung-Hyeop Lee Kyung-Hwan Kwak

In this study, we have assessed the three-dimensional (3-D) spatial extent of near-road air pollution around a signalized intersection in a densely populated area using collaborating methodologies of stationary measurements, drone monitoring, and atmospheric dispersion modeling. Stationary measurement data collected in the roadside apartment building showed a substantial effect of emitted pollutants, such as nitrogen oxides (NOx), black carbon (BC), and ultrafine particles (UFPs), especially during the morning rush hours. Vertical drone monitoring near the road intersection exhibited a steeper decreasing trend with increasing altitude for BC concentration rather than for fine particulate matter (PM2.5) concentration below the apartment building height. Atmospheric NOx dispersion was simulated using the weather research and forecasting (WRF) and computational fluid dynamics (CFD) models for the drone measurement periods. Based on the agreement between the measured BC and simulated NOx concentrations, we concluded that the air pollution around the road intersection has adverse effects on the health of residents living within the 3-D spatial extent within at least 120 m horizontally and a half of building height vertically during the morning rush hours. The comparability between drone monitoring and WRF-CFD modeling can further guarantee the identification of air pollution hotspots using the methods.

]]>
Assessing 3-D Spatial Extent of Near-Road Air Pollution around a Signalized Intersection Using Drone Monitoring and WRF-CFD Modeling Seung-Hyeop Lee Kyung-Hwan Kwak doi: 10.3390/ijerph17186915 International Journal of Environmental Research and Public Health 2020-09-22 International Journal of Environmental Research and Public Health 2020-09-22 17 18 Article 6915 10.3390/ijerph17186915 https://www.mdpi.com/1660-4601/17/18/6915
IJERPH, Vol. 17, Pages 6919: The Analysis of the Frequency of Leukoplakia in Reference of Tobacco Smoking among Northern Polish Population https://www.mdpi.com/1660-4601/17/18/6919 Objective: The aim of the study was an updated analysis of the frequency of leukoplakia in reference to tobacco smoking among the northern Polish population. Material and Methods: Medical records of 5720 patients who suffer from abnormalities and oral mucosa diseases between January 2015–December 2018 were analyzed. Among them, 416 medical charts of patients with leukoplakia were selected. The study group consisted of 196 women and 220 men aged between 21–86 years (average 45.6 years). The analysis was conducted in terms of age, gender, and smoking tobacco. The basic criterion for inclusion in the study was the presence of oral leukoplakia confirmed by histopathological examination, recorded in the chart. Information about the patient’s active smoking was obtained from documented medical interviews. An active smoker was defined as a patient who smoked 10 or more cigarettes a day for at least the previous six months. The study used parametric and non-parametric statistical methods. Results: The highest incidence of leukoplakia was found in the age group 41–60 (46.6%), where the vast majority were active smokers (85.1%), and mostly men (86.2%). However, among patients with leukoplakia, the highest prevalence of smoking was found in the age group 21–40 years (86.8%) in women, where out of 38 patients with leukoplakia, 33 were active smokers. More patients with leukoplakia were observed in groups of smokers and it was statistically significant. Homogeneous form was the most commonly diagnosed form of leukoplakia in our study; it was found in almost 95% of cases. Leukoplakia was mainly observed on the cheeks. Changes on the gums, the alveolar process or the bottom of the tongue and mouth were rarely found. Conclusion: Our studies revealed that there is a statistically significant correlation between tobacco smoking and the presence of oral leukoplakia among the northern Polish population. It should be noted that dentists, in particular, are capable of early diagnosis and implementation of appropriate treatment of leukoplakia and, most often, crucial elimination of the main risk factor, which is smoking, and the implementation of effective tobacco control interventions. IJERPH, Vol. 17, Pages 6919: The Analysis of the Frequency of Leukoplakia in Reference of Tobacco Smoking among Northern Polish Population

International Journal of Environmental Research and Public Health doi: 10.3390/ijerph17186919

Authors: Aida Kusiak Adrian Maj Dominika Cichońska Barbara Kochańska Aleksandra Cydejko Dariusz Świetlik

Objective: The aim of the study was an updated analysis of the frequency of leukoplakia in reference to tobacco smoking among the northern Polish population. Material and Methods: Medical records of 5720 patients who suffer from abnormalities and oral mucosa diseases between January 2015–December 2018 were analyzed. Among them, 416 medical charts of patients with leukoplakia were selected. The study group consisted of 196 women and 220 men aged between 21–86 years (average 45.6 years). The analysis was conducted in terms of age, gender, and smoking tobacco. The basic criterion for inclusion in the study was the presence of oral leukoplakia confirmed by histopathological examination, recorded in the chart. Information about the patient’s active smoking was obtained from documented medical interviews. An active smoker was defined as a patient who smoked 10 or more cigarettes a day for at least the previous six months. The study used parametric and non-parametric statistical methods. Results: The highest incidence of leukoplakia was found in the age group 41–60 (46.6%), where the vast majority were active smokers (85.1%), and mostly men (86.2%). However, among patients with leukoplakia, the highest prevalence of smoking was found in the age group 21–40 years (86.8%) in women, where out of 38 patients with leukoplakia, 33 were active smokers. More patients with leukoplakia were observed in groups of smokers and it was statistically significant. Homogeneous form was the most commonly diagnosed form of leukoplakia in our study; it was found in almost 95% of cases. Leukoplakia was mainly observed on the cheeks. Changes on the gums, the alveolar process or the bottom of the tongue and mouth were rarely found. Conclusion: Our studies revealed that there is a statistically significant correlation between tobacco smoking and the presence of oral leukoplakia among the northern Polish population. It should be noted that dentists, in particular, are capable of early diagnosis and implementation of appropriate treatment of leukoplakia and, most often, crucial elimination of the main risk factor, which is smoking, and the implementation of effective tobacco control interventions.

]]>
The Analysis of the Frequency of Leukoplakia in Reference of Tobacco Smoking among Northern Polish Population Aida Kusiak Adrian Maj Dominika Cichońska Barbara Kochańska Aleksandra Cydejko Dariusz Świetlik doi: 10.3390/ijerph17186919 International Journal of Environmental Research and Public Health 2020-09-22 International Journal of Environmental Research and Public Health 2020-09-22 17 18 Article 6919 10.3390/ijerph17186919 https://www.mdpi.com/1660-4601/17/18/6919
IJERPH, Vol. 17, Pages 6917: Association between Primary Healthcare and Medical Expenditures in a Context of Hospital-Oriented Healthcare System in China: A National Panel Dataset, 2012–2016 https://www.mdpi.com/1660-4601/17/18/6917 Total health expenditure in China has grown considerably since a new round of health system reform was enacted in 2009. Researchers have shown that strengthening primary healthcare may be an option for countries to solve the rapid expansion of their medical expenditures. This study was designed to explore the association between the strength of primary healthcare and medical expenditures, in the context of the hospital-oriented healthcare system in China. A longitudinal ecological study was conducted using a 5-year panel dataset of 27 provinces in mainland China. The linear mixed effects regression model was used to assess the effects of primary healthcare-related metrics on medical expenditures, controlling for the provincial level specialty care physician supply and socio-economic parameters. All of the three primary healthcare-related metrics showed negative associations with the two medical expenditure parameters. Primary care physicians per 10,000 population was significantly associated with the per capita hospital medical expenditures (p < 0.05), and the percentage of public health expenditure in total health expenditure was significantly associated with both per capita total medical expenditure and per capita hospital medical expenditures (p < 0.01 for both). Our study found negative associations between the primary healthcare capacity and medical expenditure in the context of hospital-oriented healthcare systems in China, adding to the previous evidence that primary healthcare may play a positive role in reducing medical expenditure. Policies on increasing the primary care physician supply and the public share of total health expenditure should be conducted to strengthen the primary healthcare system. With the gradual advance of medical reform and the policy inclination to primary healthcare, this will play a more important role in controlling the rapid growth of medical expenditure. IJERPH, Vol. 17, Pages 6917: Association between Primary Healthcare and Medical Expenditures in a Context of Hospital-Oriented Healthcare System in China: A National Panel Dataset, 2012–2016

International Journal of Environmental Research and Public Health doi: 10.3390/ijerph17186917

Authors: Mengping Zhou Jingyi Liao Nan Hu Li Kuang

Total health expenditure in China has grown considerably since a new round of health system reform was enacted in 2009. Researchers have shown that strengthening primary healthcare may be an option for countries to solve the rapid expansion of their medical expenditures. This study was designed to explore the association between the strength of primary healthcare and medical expenditures, in the context of the hospital-oriented healthcare system in China. A longitudinal ecological study was conducted using a 5-year panel dataset of 27 provinces in mainland China. The linear mixed effects regression model was used to assess the effects of primary healthcare-related metrics on medical expenditures, controlling for the provincial level specialty care physician supply and socio-economic parameters. All of the three primary healthcare-related metrics showed negative associations with the two medical expenditure parameters. Primary care physicians per 10,000 population was significantly associated with the per capita hospital medical expenditures (p < 0.05), and the percentage of public health expenditure in total health expenditure was significantly associated with both per capita total medical expenditure and per capita hospital medical expenditures (p < 0.01 for both). Our study found negative associations between the primary healthcare capacity and medical expenditure in the context of hospital-oriented healthcare systems in China, adding to the previous evidence that primary healthcare may play a positive role in reducing medical expenditure. Policies on increasing the primary care physician supply and the public share of total health expenditure should be conducted to strengthen the primary healthcare system. With the gradual advance of medical reform and the policy inclination to primary healthcare, this will play a more important role in controlling the rapid growth of medical expenditure.

]]>
Association between Primary Healthcare and Medical Expenditures in a Context of Hospital-Oriented Healthcare System in China: A National Panel Dataset, 2012–2016 Mengping Zhou Jingyi Liao Nan Hu Li Kuang doi: 10.3390/ijerph17186917 International Journal of Environmental Research and Public Health 2020-09-22 International Journal of Environmental Research and Public Health 2020-09-22 17 18 Article 6917 10.3390/ijerph17186917 https://www.mdpi.com/1660-4601/17/18/6917
IJERPH, Vol. 17, Pages 6916: Clinical Application of Mindfulness-Oriented Meditation: A Preliminary Study in Children with ADHD https://www.mdpi.com/1660-4601/17/18/6916 Mindfulness-oriented meditation (MOM) is a self-regulatory training used for attentional and behavioral problems. With its focus on attention, MOM is a promising form of training that is gaining empirical support as a complementary or alternative intervention for attention deficit/hyperactivity disorder (ADHD). In this study, we tested the preliminary efficacy of MOM training in children with ADHD, by comparing its efficacy with an active control condition (Emotion Education Program, EEP). Twenty-five children with ADHD aged 7–11 years participated in MOM training (n = 15) or EEP (n = 10) 3 times per week for 8 weeks. Neuropsychological and academic measures and behavioral, emotional, and mindfulness ratings were collected before and after the two programs. On average, MOM training had positive effects on neuropsychological measures, as evidenced by a significant mean improvement in all outcome measures after training. Moreover, positive effects on ADHD symptoms were found only in the MOM group. Although they are preliminary, our results documented that MOM training promotes changes in neuropsychological measures and in certain behavioral symptoms, suggesting it as a promising tool for ameliorating cognitive and clinical manifestations of ADHD. IJERPH, Vol. 17, Pages 6916: Clinical Application of Mindfulness-Oriented Meditation: A Preliminary Study in Children with ADHD

International Journal of Environmental Research and Public Health doi: 10.3390/ijerph17186916

Authors: Ornella Santonastaso Vittoria Zaccari Cristiano Crescentini Franco Fabbro Viviana Capurso Stefano Vicari Deny Menghini

Mindfulness-oriented meditation (MOM) is a self-regulatory training used for attentional and behavioral problems. With its focus on attention, MOM is a promising form of training that is gaining empirical support as a complementary or alternative intervention for attention deficit/hyperactivity disorder (ADHD). In this study, we tested the preliminary efficacy of MOM training in children with ADHD, by comparing its efficacy with an active control condition (Emotion Education Program, EEP). Twenty-five children with ADHD aged 7–11 years participated in MOM training (n = 15) or EEP (n = 10) 3 times per week for 8 weeks. Neuropsychological and academic measures and behavioral, emotional, and mindfulness ratings were collected before and after the two programs. On average, MOM training had positive effects on neuropsychological measures, as evidenced by a significant mean improvement in all outcome measures after training. Moreover, positive effects on ADHD symptoms were found only in the MOM group. Although they are preliminary, our results documented that MOM training promotes changes in neuropsychological measures and in certain behavioral symptoms, suggesting it as a promising tool for ameliorating cognitive and clinical manifestations of ADHD.

]]>
Clinical Application of Mindfulness-Oriented Meditation: A Preliminary Study in Children with ADHD Ornella Santonastaso Vittoria Zaccari Cristiano Crescentini Franco Fabbro Viviana Capurso Stefano Vicari Deny Menghini doi: 10.3390/ijerph17186916 International Journal of Environmental Research and Public Health 2020-09-22 International Journal of Environmental Research and Public Health 2020-09-22 17 18 Article 6916 10.3390/ijerph17186916 https://www.mdpi.com/1660-4601/17/18/6916
IJERPH, Vol. 17, Pages 6913: A Call for Leadership and Management Competency Development for Directors of Medical Services—Evidence from the Chinese Public Hospital System https://www.mdpi.com/1660-4601/17/18/6913 Background: A competent medical leadership and management workforce is key to the effectiveness and efficiency of health service provision and to leading and managing the health system reform agenda in China. However, the traditional recruitment and promotion approach of relying on clinical performance and seniority provides limited incentive for competency development and improvement. Methods: A three-component survey including the use of a validated management competency assessment tool was conducted with Directors of Medical Services (n = 143) and Deputy Directors of Medical Services (n = 152) from three categories of hospital in Jinan, Shandong Province, China. Results: The survey identified the inadequacy of formal and informal management training received by hospital medical leaders before commencing their management positions and confirms that the low self-perceived competency level across two medical management level and three hospitals was beyond acceptable. The study also indicates that the informal and formal education provided to Chinese medical leaders have not been effective in developing the required management competencies. Conclusions: The study suggests two system level approaches (health and higher education systems) and one organization level approach to formulate overall medical leadership and management workforce development strategies to encourages continuous management competency development and self-improvement among clinical leaders in China. IJERPH, Vol. 17, Pages 6913: A Call for Leadership and Management Competency Development for Directors of Medical Services—Evidence from the Chinese Public Hospital System

International Journal of Environmental Research and Public Health doi: 10.3390/ijerph17186913

Authors: Zhanming Liang Peter Howard Jian Wang Min Xu

Background: A competent medical leadership and management workforce is key to the effectiveness and efficiency of health service provision and to leading and managing the health system reform agenda in China. However, the traditional recruitment and promotion approach of relying on clinical performance and seniority provides limited incentive for competency development and improvement. Methods: A three-component survey including the use of a validated management competency assessment tool was conducted with Directors of Medical Services (n = 143) and Deputy Directors of Medical Services (n = 152) from three categories of hospital in Jinan, Shandong Province, China. Results: The survey identified the inadequacy of formal and informal management training received by hospital medical leaders before commencing their management positions and confirms that the low self-perceived competency level across two medical management level and three hospitals was beyond acceptable. The study also indicates that the informal and formal education provided to Chinese medical leaders have not been effective in developing the required management competencies. Conclusions: The study suggests two system level approaches (health and higher education systems) and one organization level approach to formulate overall medical leadership and management workforce development strategies to encourages continuous management competency development and self-improvement among clinical leaders in China.

]]>
A Call for Leadership and Management Competency Development for Directors of Medical Services—Evidence from the Chinese Public Hospital System Zhanming Liang Peter Howard Jian Wang Min Xu doi: 10.3390/ijerph17186913 International Journal of Environmental Research and Public Health 2020-09-22 International Journal of Environmental Research and Public Health 2020-09-22 17 18 Article 6913 10.3390/ijerph17186913 https://www.mdpi.com/1660-4601/17/18/6913
IJERPH, Vol. 17, Pages 6914: Chest CT Computerized Aided Quantification of PNEUMONIA Lesions in COVID-19 Infection: A Comparison among Three Commercial Software https://www.mdpi.com/1660-4601/17/18/6914 Purpose: To compare different commercial software in the quantification of Pneumonia Lesions in COVID-19 infection and to stratify the patients based on the disease severity using on chest computed tomography (CT) images. Materials and methods: We retrospectively examined 162 patients with confirmed COVID-19 infection by reverse transcriptase-polymerase chain reaction (RT-PCR) test. All cases were evaluated separately by radiologists (visually) and by using three computer software programs: (1) Thoracic VCAR software, GE Healthcare, United States; (2) Myrian, Intrasense, France; (3) InferRead, InferVision Europe, Wiesbaden, Germany. The degree of lesions was visually scored by the radiologist using a score on 5 levels (none, mild, moderate, severe, and critic). The parameters obtained using the computer tools included healthy residual lung parenchyma, ground-glass opacity area, and consolidation volume. Intraclass coefficient (ICC), Spearman correlation analysis, and non-parametric tests were performed. Results: Thoracic VCAR software was not able to perform volumes segmentation in 26/162 (16.0%) cases, Myrian software in 12/162 (7.4%) patients while InferRead software in 61/162 (37.7%) patients. A great variability (ICC ranged for 0.17 to 0.51) was detected among the quantitative measurements of the residual healthy lung parenchyma volume, GGO, and consolidations volumes calculated by different computer tools. The overall radiological severity score was moderately correlated with the residual healthy lung parenchyma volume obtained by ThoracicVCAR or Myrian software, with the GGO area obtained by the ThoracicVCAR tool and with consolidation volume obtained by Myrian software. Quantified volumes by InferRead software had a low correlation with the overall radiological severity score. Conclusions: Computer-aided pneumonia quantification could be an easy and feasible way to stratify COVID-19 cases according to severity; however, a great variability among quantitative measurements provided by computer tools should be considered. IJERPH, Vol. 17, Pages 6914: Chest CT Computerized Aided Quantification of PNEUMONIA Lesions in COVID-19 Infection: A Comparison among Three Commercial Software

International Journal of Environmental Research and Public Health doi: 10.3390/ijerph17186914

Authors: Roberto Grassi Salvatore Cappabianca Fabrizio Urraro Beatrice Feragalli Alessandro Montanelli Gianluigi Patelli Vincenza Granata Giuliana Giacobbe Gaetano Maria Russo Assunta Grillo Angela De Lisio Cesare Paura Alfredo Clemente Giuliano Gagliardi Simona Magliocchetti Diletta Cozzi Roberta Fusco Maria Paola Belfiore Roberta Grassi Vittorio Miele

Purpose: To compare different commercial software in the quantification of Pneumonia Lesions in COVID-19 infection and to stratify the patients based on the disease severity using on chest computed tomography (CT) images. Materials and methods: We retrospectively examined 162 patients with confirmed COVID-19 infection by reverse transcriptase-polymerase chain reaction (RT-PCR) test. All cases were evaluated separately by radiologists (visually) and by using three computer software programs: (1) Thoracic VCAR software, GE Healthcare, United States; (2) Myrian, Intrasense, France; (3) InferRead, InferVision Europe, Wiesbaden, Germany. The degree of lesions was visually scored by the radiologist using a score on 5 levels (none, mild, moderate, severe, and critic). The parameters obtained using the computer tools included healthy residual lung parenchyma, ground-glass opacity area, and consolidation volume. Intraclass coefficient (ICC), Spearman correlation analysis, and non-parametric tests were performed. Results: Thoracic VCAR software was not able to perform volumes segmentation in 26/162 (16.0%) cases, Myrian software in 12/162 (7.4%) patients while InferRead software in 61/162 (37.7%) patients. A great variability (ICC ranged for 0.17 to 0.51) was detected among the quantitative measurements of the residual healthy lung parenchyma volume, GGO, and consolidations volumes calculated by different computer tools. The overall radiological severity score was moderately correlated with the residual healthy lung parenchyma volume obtained by ThoracicVCAR or Myrian software, with the GGO area obtained by the ThoracicVCAR tool and with consolidation volume obtained by Myrian software. Quantified volumes by InferRead software had a low correlation with the overall radiological severity score. Conclusions: Computer-aided pneumonia quantification could be an easy and feasible way to stratify COVID-19 cases according to severity; however, a great variability among quantitative measurements provided by computer tools should be considered.

]]>
Chest CT Computerized Aided Quantification of PNEUMONIA Lesions in COVID-19 Infection: A Comparison among Three Commercial Software Roberto Grassi Salvatore Cappabianca Fabrizio Urraro Beatrice Feragalli Alessandro Montanelli Gianluigi Patelli Vincenza Granata Giuliana Giacobbe Gaetano Maria Russo Assunta Grillo Angela De Lisio Cesare Paura Alfredo Clemente Giuliano Gagliardi Simona Magliocchetti Diletta Cozzi Roberta Fusco Maria Paola Belfiore Roberta Grassi Vittorio Miele doi: 10.3390/ijerph17186914 International Journal of Environmental Research and Public Health 2020-09-22 International Journal of Environmental Research and Public Health 2020-09-22 17 18 Article 6914 10.3390/ijerph17186914 https://www.mdpi.com/1660-4601/17/18/6914
IJERPH, Vol. 17, Pages 6912: Health Risks and Potential Sources of Contamination of Groundwater Used by Public Schools in Vhuronga 1, Limpopo Province, South Africa https://www.mdpi.com/1660-4601/17/18/6912 Public schools in most rural areas of South Africa depend on untreated groundwater due to unreliable water supply by the municipalities. This has the potential to cause water-related health problems to school children. Temperature, pH, and electrical conductivity (EC) were measured in situ. Chemical (fluoride, chloride, sulphate, phosphate, nitrate, magnesium, calcium, sodium, and potassium) and microbial (Escherichia coliform (E. coli), Salmonella typhimurium, and Shigella flexneri) water quality parameters were analysed in groundwater samples from 10 public schools in Vhuronga 1 to determine suitability for use. Quantitative microbial risk assessment was carried out to determine risks of infection and illness due to consumption of groundwater. Correlation analysis was used to identify potential sources of contamination. All physical and most chemical water quality parameters were within guidelines for domestic water use. A high proportion of schools had high levels of microbial organisms. Risks of infection per day were relatively low for all schools. The annual risks of infection due to E. coli and Shigella flexneri for most schools was high, with maximum values of 89.11 and 83.75%, respectively. Maximum risks of illness per year were 31.19, 30.37, and 29.31% for E. coli, Salmonella typhimurium, and Shigella flexneri, respectively. Correlation analysis indicated potential contamination of groundwater by agricultural activities, domestic waste, and faecal contamination from pit latrines. Preventive and mitigation measures to minimise such risks, including locating boreholes at safe distances from pit latrines, prevention/minimisation of pollution of groundwater from agricultural activities, and point-of-use treatment of groundwater by the schools are therefore essential. IJERPH, Vol. 17, Pages 6912: Health Risks and Potential Sources of Contamination of Groundwater Used by Public Schools in Vhuronga 1, Limpopo Province, South Africa

International Journal of Environmental Research and Public Health doi: 10.3390/ijerph17186912

Authors: John Ogony Odiyo Mashudu Maxwell Mathoni Rachel Makungo

Public schools in most rural areas of South Africa depend on untreated groundwater due to unreliable water supply by the municipalities. This has the potential to cause water-related health problems to school children. Temperature, pH, and electrical conductivity (EC) were measured in situ. Chemical (fluoride, chloride, sulphate, phosphate, nitrate, magnesium, calcium, sodium, and potassium) and microbial (Escherichia coliform (E. coli), Salmonella typhimurium, and Shigella flexneri) water quality parameters were analysed in groundwater samples from 10 public schools in Vhuronga 1 to determine suitability for use. Quantitative microbial risk assessment was carried out to determine risks of infection and illness due to consumption of groundwater. Correlation analysis was used to identify potential sources of contamination. All physical and most chemical water quality parameters were within guidelines for domestic water use. A high proportion of schools had high levels of microbial organisms. Risks of infection per day were relatively low for all schools. The annual risks of infection due to E. coli and Shigella flexneri for most schools was high, with maximum values of 89.11 and 83.75%, respectively. Maximum risks of illness per year were 31.19, 30.37, and 29.31% for E. coli, Salmonella typhimurium, and Shigella flexneri, respectively. Correlation analysis indicated potential contamination of groundwater by agricultural activities, domestic waste, and faecal contamination from pit latrines. Preventive and mitigation measures to minimise such risks, including locating boreholes at safe distances from pit latrines, prevention/minimisation of pollution of groundwater from agricultural activities, and point-of-use treatment of groundwater by the schools are therefore essential.

]]>
Health Risks and Potential Sources of Contamination of Groundwater Used by Public Schools in Vhuronga 1, Limpopo Province, South Africa John Ogony Odiyo Mashudu Maxwell Mathoni Rachel Makungo doi: 10.3390/ijerph17186912 International Journal of Environmental Research and Public Health 2020-09-22 International Journal of Environmental Research and Public Health 2020-09-22 17 18 Article 6912 10.3390/ijerph17186912 https://www.mdpi.com/1660-4601/17/18/6912
IJERPH, Vol. 17, Pages 6882: The Role of Specific Warm-up during Bench Press and Squat Exercises: A Novel Approach https://www.mdpi.com/1660-4601/17/18/6882 The current study aims to verify the effects of three specific warm-ups on squat and bench press resistance training. Forty resistance-trained males (19–30 years) performed 3 × 6 repetitions with 80% of maximal dynamic strength (designated as training load) after one of the following warm-ups (48 h between): (i) 2 × 6 repetitions with 40% and 80% of the training load (WU), (ii) 6 × 80% of training load (WU80), or (iii) 6 × 40% of the training load (WU40). Mean propulsive velocity (MPV), velocity loss (VL), peak velocity (PV), time to achieve PV, power, work, heart rates, and ratings of perceived exertion were analyzed. In squat exercises, higher MPV were found in WU80 compared with WU40 (2nd set: 0.69 ± 0.09 vs. 0.67 ± 0.06 m.s−1, p = 0.02, ES = 0.80; 3rd set: 0.68 ± 0.09 vs. 0.66 ± 0.07 m.s−1, p = 0.05, ES = 0.51). In bench press exercises, time to PV was lower in WU compared with WU40 (1st set: 574.77 ± 233.46 vs. 694.50 ± 211.71 m.s−1, p < 0.01, ES = 0.69; 2nd set: 533.19 ± 272.22 vs. 662.31 ± 257.51 m.s−1, p = 0.04, ES = 0.43) and total work was higher (4749.90 ± 1312.99 vs. 4631.80 ± 1355.01 j, p = 0.01, ES = 0.54). The results showed that force outputs were mainly optimized by WU80 in squat training and by WU in bench press training. Moreover, warming-up with few repetitions and low loads is not enough to optimize squat and bench press performances. IJERPH, Vol. 17, Pages 6882: The Role of Specific Warm-up during Bench Press and Squat Exercises: A Novel Approach

International Journal of Environmental Research and Public Health doi: 10.3390/ijerph17186882

Authors: Bruno Ribeiro Ana Pereira Pedro P. Neves António C. Sousa Ricardo Ferraz Mário C. Marques Daniel A. Marinho Henrique P. Neiva

The current study aims to verify the effects of three specific warm-ups on squat and bench press resistance training. Forty resistance-trained males (19–30 years) performed 3 × 6 repetitions with 80% of maximal dynamic strength (designated as training load) after one of the following warm-ups (48 h between): (i) 2 × 6 repetitions with 40% and 80% of the training load (WU), (ii) 6 × 80% of training load (WU80), or (iii) 6 × 40% of the training load (WU40). Mean propulsive velocity (MPV), velocity loss (VL), peak velocity (PV), time to achieve PV, power, work, heart rates, and ratings of perceived exertion were analyzed. In squat exercises, higher MPV were found in WU80 compared with WU40 (2nd set: 0.69 ± 0.09 vs. 0.67 ± 0.06 m.s−1, p = 0.02, ES = 0.80; 3rd set: 0.68 ± 0.09 vs. 0.66 ± 0.07 m.s−1, p = 0.05, ES = 0.51). In bench press exercises, time to PV was lower in WU compared with WU40 (1st set: 574.77 ± 233.46 vs. 694.50 ± 211.71 m.s−1, p < 0.01, ES = 0.69; 2nd set: 533.19 ± 272.22 vs. 662.31 ± 257.51 m.s−1, p = 0.04, ES = 0.43) and total work was higher (4749.90 ± 1312.99 vs. 4631.80 ± 1355.01 j, p = 0.01, ES = 0.54). The results showed that force outputs were mainly optimized by WU80 in squat training and by WU in bench press training. Moreover, warming-up with few repetitions and low loads is not enough to optimize squat and bench press performances.

]]>
The Role of Specific Warm-up during Bench Press and Squat Exercises: A Novel Approach Bruno Ribeiro Ana Pereira Pedro P. Neves António C. Sousa Ricardo Ferraz Mário C. Marques Daniel A. Marinho Henrique P. Neiva doi: 10.3390/ijerph17186882 International Journal of Environmental Research and Public Health 2020-09-22 International Journal of Environmental Research and Public Health 2020-09-22 17 18 Article 6882 10.3390/ijerph17186882 https://www.mdpi.com/1660-4601/17/18/6882
IJERPH, Vol. 17, Pages 6911: Graphene Oxide–ZnO Nanocomposites for Removal of Aluminum and Copper Ions from Acid Mine Drainage Wastewater https://www.mdpi.com/1660-4601/17/18/6911 Adsorption technologies are a focus of interest for the removal of pollutants in water treatment systems. These removal methods offer several design, operation and efficiency advantages over other wastewater remediation technologies. Particularly, graphene oxide (GO) has attracted great attention due to its high surface area and its effectiveness in removing heavy metals. In this work, we study the functionalization of GO with zinc oxide nanoparticles (ZnO) to improve the removal capacity of aluminum (Al) and copper (Cu) in acidic waters. Experiments were performed at different pH conditions (with and without pH adjustment). In both cases, decorated GO (GO/ZnO) nanocomposites showed an improvement in the removal capacity compared with non-functionalized GO, even when the pH of zero charge (pHPZC) was higher for GO/ZnO (5.57) than for GO (3.98). In adsorption experiments without pH adjustment, the maximum removal capacities for Al and Cu were 29.1 mg/g and 45.5 mg/g, respectively. The maximum removal percentages of the studied cations (Al and Cu) were higher than 88%. Further, under more acidic conditions (pH 4), the maximum sorption capacities using GO/ZnO as adsorbent were 19.9 mg/g and 33.5 mg/g for Al and Cu, respectively. Moreover, the removal percentages reach 95.6% for Al and 92.9% for Cu. This shows that decoration with ZnO nanoparticles is a good option for improving the sorption capacity of GO for Cu removal and to a lesser extent for Al, even when the pH was not favorable in terms of electrostatic affinity for cations. These findings contribute to a better understanding of the potential and effectiveness of GO functionalization with ZnO nanoparticles to treat acidic waters contaminated with heavy metals and its applicability for wastewater remediation. IJERPH, Vol. 17, Pages 6911: Graphene Oxide–ZnO Nanocomposites for Removal of Aluminum and Copper Ions from Acid Mine Drainage Wastewater

International Journal of Environmental Research and Public Health doi: 10.3390/ijerph17186911

Authors: Carolina Rodríguez Camila Tapia Enzo Leiva-Aravena Eduardo Leiva

Adsorption technologies are a focus of interest for the removal of pollutants in water treatment systems. These removal methods offer several design, operation and efficiency advantages over other wastewater remediation technologies. Particularly, graphene oxide (GO) has attracted great attention due to its high surface area and its effectiveness in removing heavy metals. In this work, we study the functionalization of GO with zinc oxide nanoparticles (ZnO) to improve the removal capacity of aluminum (Al) and copper (Cu) in acidic waters. Experiments were performed at different pH conditions (with and without pH adjustment). In both cases, decorated GO (GO/ZnO) nanocomposites showed an improvement in the removal capacity compared with non-functionalized GO, even when the pH of zero charge (pHPZC) was higher for GO/ZnO (5.57) than for GO (3.98). In adsorption experiments without pH adjustment, the maximum removal capacities for Al and Cu were 29.1 mg/g and 45.5 mg/g, respectively. The maximum removal percentages of the studied cations (Al and Cu) were higher than 88%. Further, under more acidic conditions (pH 4), the maximum sorption capacities using GO/ZnO as adsorbent were 19.9 mg/g and 33.5 mg/g for Al and Cu, respectively. Moreover, the removal percentages reach 95.6% for Al and 92.9% for Cu. This shows that decoration with ZnO nanoparticles is a good option for improving the sorption capacity of GO for Cu removal and to a lesser extent for Al, even when the pH was not favorable in terms of electrostatic affinity for cations. These findings contribute to a better understanding of the potential and effectiveness of GO functionalization with ZnO nanoparticles to treat acidic waters contaminated with heavy metals and its applicability for wastewater remediation.

]]>
Graphene Oxide–ZnO Nanocomposites for Removal of Aluminum and Copper Ions from Acid Mine Drainage Wastewater Carolina Rodríguez Camila Tapia Enzo Leiva-Aravena Eduardo Leiva doi: 10.3390/ijerph17186911 International Journal of Environmental Research and Public Health 2020-09-21 International Journal of Environmental Research and Public Health 2020-09-21 17 18 Communication 6911 10.3390/ijerph17186911 https://www.mdpi.com/1660-4601/17/18/6911
IJERPH, Vol. 17, Pages 6910: Spatial-Temporal Differentiation Analysis of Agricultural Land Use Intensity and Its Driving Factors at the County Scale: A Case Study in Hubei Province, China https://www.mdpi.com/1660-4601/17/18/6910 Scientifically characterizing the spatial-temporal distribution characteristics of agricultural land use intensity and analyzing its driving factors are of great significance to the formulation of relevant agricultural land use intensity management policies, the realization of food safety and health, and the achievement of sustainable development goals. Taking Hubei Province as an example, and taking counties as the basic evaluation unit, this paper establishes an agricultural land use intensity evaluation system, explores the spatial autocorrelation of agricultural land use intensity in each county and analyzes the driving factors of agricultural land use intensity. The results show that the agricultural land use intensity in Hubei Province increased as a whole from 2000 to 2016, and the spatial agglomeration about the agricultural land use intensity in Hubei Province experienced a process of continuous growth and a fluctuating decline; the maximum of the Global Moran’s I was 0.430174 (in 2007) and the minimum was 0.148651 (in 2001). In terms of Local Moran’s I, H-H agglomeration units were mainly concentrated in two regions: One comprising the cities of Huanggang, Huangshi and Ezhou, and the other the cities of Xiangyang and Suizhou; the phenomenon is particularly obvious after 2005. On the other hand, factors such as the multiple cropping index (MCI) that reflect farmers’ willingness to engage in agricultural production have a great impact on agricultural land use intensity, the influence of the structure of the industry on agricultural land use intensity varies with the degree of influence of different industries on farmers’ income, and agricultural fiscal expenditure (AFE) has not effectively promoted the intensification of agricultural land use. The present research has important significance for enhancing insights into the sustainable improvement of agricultural land use intensity and for realizing risk control of agricultural land use and development. IJERPH, Vol. 17, Pages 6910: Spatial-Temporal Differentiation Analysis of Agricultural Land Use Intensity and Its Driving Factors at the County Scale: A Case Study in Hubei Province, China

International Journal of Environmental Research and Public Health doi: 10.3390/ijerph17186910

Authors: Yu Wang Zhang Wei

Scientifically characterizing the spatial-temporal distribution characteristics of agricultural land use intensity and analyzing its driving factors are of great significance to the formulation of relevant agricultural land use intensity management policies, the realization of food safety and health, and the achievement of sustainable development goals. Taking Hubei Province as an example, and taking counties as the basic evaluation unit, this paper establishes an agricultural land use intensity evaluation system, explores the spatial autocorrelation of agricultural land use intensity in each county and analyzes the driving factors of agricultural land use intensity. The results show that the agricultural land use intensity in Hubei Province increased as a whole from 2000 to 2016, and the spatial agglomeration about the agricultural land use intensity in Hubei Province experienced a process of continuous growth and a fluctuating decline; the maximum of the Global Moran’s I was 0.430174 (in 2007) and the minimum was 0.148651 (in 2001). In terms of Local Moran’s I, H-H agglomeration units were mainly concentrated in two regions: One comprising the cities of Huanggang, Huangshi and Ezhou, and the other the cities of Xiangyang and Suizhou; the phenomenon is particularly obvious after 2005. On the other hand, factors such as the multiple cropping index (MCI) that reflect farmers’ willingness to engage in agricultural production have a great impact on agricultural land use intensity, the influence of the structure of the industry on agricultural land use intensity varies with the degree of influence of different industries on farmers’ income, and agricultural fiscal expenditure (AFE) has not effectively promoted the intensification of agricultural land use. The present research has important significance for enhancing insights into the sustainable improvement of agricultural land use intensity and for realizing risk control of agricultural land use and development.

]]>
Spatial-Temporal Differentiation Analysis of Agricultural Land Use Intensity and Its Driving Factors at the County Scale: A Case Study in Hubei Province, China Yu Wang Zhang Wei doi: 10.3390/ijerph17186910 International Journal of Environmental Research and Public Health 2020-09-21 International Journal of Environmental Research and Public Health 2020-09-21 17 18 Article 6910 10.3390/ijerph17186910 https://www.mdpi.com/1660-4601/17/18/6910
IJERPH, Vol. 17, Pages 6905: Burnout and Time Perspective of Blue-Collar Workers at the Shipyard https://www.mdpi.com/1660-4601/17/18/6905 Background: The aim of the research was to investigate the association between time perspective in relation to burnout and successful ageing of blue-collar workers with physically highly demanding work and low autonomy. Shipyard blue-collar workers usually do predominantly manual labor versus white-collar workers, whose jobs do not usually involve physical work. Methods: 497 participants workers in a shipyard in the north of Spain. Ages were between 20 and 69 (M = 46.62, SD = 10.79). We used the Zimbardo Time Perspective Instrument (ZTPI), Spanish version, and the Maslach Burnout Inventory–General Survey (MBI-GS). Results: Emotional exhaustion factor obtained a coefficient of 0.97; cynicism factor of 0.83; and professional efficacy factor of p = 0.86. The mean of the three reliability coefficients was 0.887. With respect to the five factors of the ZTPI questionnaire: the negative past factor obtained a coefficient of p = 0.91; that of positive past p = 0.81; the present hedonistic of 0.878; the future of p = 0.83; and the fatalistic present of p = 0.90. The mean of the five coefficients, was p = 0.86. Conclusions: Within shipyard workers, burnout is associated with a negative past and negative future time perspective. This makes shipyard workers at a higher risk of developing burnout and this can have serious consequences for the sustainable employability of these blue-collar workers. IJERPH, Vol. 17, Pages 6905: Burnout and Time Perspective of Blue-Collar Workers at the Shipyard

International Journal of Environmental Research and Public Health doi: 10.3390/ijerph17186905

Authors: Sarah Detaille Adela Reig-Botella Miguel Clemente Jaime López-Golpe Annet De Lange

Background: The aim of the research was to investigate the association between time perspective in relation to burnout and successful ageing of blue-collar workers with physically highly demanding work and low autonomy. Shipyard blue-collar workers usually do predominantly manual labor versus white-collar workers, whose jobs do not usually involve physical work. Methods: 497 participants workers in a shipyard in the north of Spain. Ages were between 20 and 69 (M = 46.62, SD = 10.79). We used the Zimbardo Time Perspective Instrument (ZTPI), Spanish version, and the Maslach Burnout Inventory–General Survey (MBI-GS). Results: Emotional exhaustion factor obtained a coefficient of 0.97; cynicism factor of 0.83; and professional efficacy factor of p = 0.86. The mean of the three reliability coefficients was 0.887. With respect to the five factors of the ZTPI questionnaire: the negative past factor obtained a coefficient of p = 0.91; that of positive past p = 0.81; the present hedonistic of 0.878; the future of p = 0.83; and the fatalistic present of p = 0.90. The mean of the five coefficients, was p = 0.86. Conclusions: Within shipyard workers, burnout is associated with a negative past and negative future time perspective. This makes shipyard workers at a higher risk of developing burnout and this can have serious consequences for the sustainable employability of these blue-collar workers.

]]>
Burnout and Time Perspective of Blue-Collar Workers at the Shipyard Sarah Detaille Adela Reig-Botella Miguel Clemente Jaime López-Golpe Annet De Lange doi: 10.3390/ijerph17186905 International Journal of Environmental Research and Public Health 2020-09-21 International Journal of Environmental Research and Public Health 2020-09-21 17 18 Article 6905 10.3390/ijerph17186905 https://www.mdpi.com/1660-4601/17/18/6905
IJERPH, Vol. 17, Pages 6909: Construction of the Infection Curve of Local Cases of COVID-19 in Hong Kong using Back-Projection https://www.mdpi.com/1660-4601/17/18/6909 This study aimed to estimate the infection curve of local cases of the coronavirus disease (COVID-19) in Hong Kong and identify major events and preventive measures associated with the trajectory of the infection curve in the first two waves. The daily number of onset local cases was used to estimate the daily number of infections based on back-projection. The estimated infection curve was examined to identify the preventive measures or major events associated with its trajectory. Until 30 April 2020, there were 422 confirmed local cases. The infection curve of the local cases in Hong Kong was constructed and used for evaluating the impacts of various policies and events in a narrative manner. Social gatherings and some pre-implementation announcements on inbound traveler policies coincided with peaks on the infection curve. IJERPH, Vol. 17, Pages 6909: Construction of the Infection Curve of Local Cases of COVID-19 in Hong Kong using Back-Projection

International Journal of Environmental Research and Public Health doi: 10.3390/ijerph17186909

Authors: Pui Hing Chau Wei Ying Li Paul S. F. Yip

This study aimed to estimate the infection curve of local cases of the coronavirus disease (COVID-19) in Hong Kong and identify major events and preventive measures associated with the trajectory of the infection curve in the first two waves. The daily number of onset local cases was used to estimate the daily number of infections based on back-projection. The estimated infection curve was examined to identify the preventive measures or major events associated with its trajectory. Until 30 April 2020, there were 422 confirmed local cases. The infection curve of the local cases in Hong Kong was constructed and used for evaluating the impacts of various policies and events in a narrative manner. Social gatherings and some pre-implementation announcements on inbound traveler policies coincided with peaks on the infection curve.

]]>
Construction of the Infection Curve of Local Cases of COVID-19 in Hong Kong using Back-Projection Pui Hing Chau Wei Ying Li Paul S. F. Yip doi: 10.3390/ijerph17186909 International Journal of Environmental Research and Public Health 2020-09-21 International Journal of Environmental Research and Public Health 2020-09-21 17 18 Article 6909 10.3390/ijerph17186909 https://www.mdpi.com/1660-4601/17/18/6909
IJERPH, Vol. 17, Pages 6901: Factors Associated with Dietary Control and Physical Activity in the Management of Metabolic Syndrome in Korean Menopausal Women https://www.mdpi.com/1660-4601/17/18/6901 The increased prevalence of metabolic syndrome (MetS) among menopausal women necessitates successful management strategies such as applying dietary restrictions and engaging in physical activity to improve their health and quality of life. We investigate factors associated with dietary control and physical activity in 564 menopausal Korean women classified as having MetS who partook in the 2016 and 2017 Korean National Health and Nutrition Examination Survey (KNHANES). To determine socio-demographic characteristics, lifestyle features, and MetS-related characteristics associated with dietary control and physical activity, multiple logistic regression analysis was performed. Of the women with MetS 36.1% applied diet control and 39.5% engaged in physical activity. Women who applied dietary control strategies to improve their health were more likely to be in the 40–49 age group (odds ratio (OR): 3.38; 95% confidence interval (CI): 1.25–9.18), to engage in physical activity (OR: 2.24; CI: 1.43–3.52), and to take hypertension medication (OR: 1.66; CI: 1.04–2.67) or diabetes mellitus medication (OR: 2.99; CI: 1.80–4.97). Physically active menopausal women with MetS were more likely to also engage in dieting (OR: 2.32; CI: 1.42–3.51). Accordingly, suggestions can be provided to healthcare workers in designing, not only individual approaches to lifestyle modification but also comprehensive interventions including dietary control and physical activity for menopausal MetS women. Health-care interventions like dietary control, which provide additional support to vulnerable MetS women, should target women aged 60 or above or those who do not take medicines for hypertension and diabetes mellitus. IJERPH, Vol. 17, Pages 6901: Factors Associated with Dietary Control and Physical Activity in the Management of Metabolic Syndrome in Korean Menopausal Women

International Journal of Environmental Research and Public Health doi: 10.3390/ijerph17186901

Authors: Guna Lee Hye Young Choi

The increased prevalence of metabolic syndrome (MetS) among menopausal women necessitates successful management strategies such as applying dietary restrictions and engaging in physical activity to improve their health and quality of life. We investigate factors associated with dietary control and physical activity in 564 menopausal Korean women classified as having MetS who partook in the 2016 and 2017 Korean National Health and Nutrition Examination Survey (KNHANES). To determine socio-demographic characteristics, lifestyle features, and MetS-related characteristics associated with dietary control and physical activity, multiple logistic regression analysis was performed. Of the women with MetS 36.1% applied diet control and 39.5% engaged in physical activity. Women who applied dietary control strategies to improve their health were more likely to be in the 40–49 age group (odds ratio (OR): 3.38; 95% confidence interval (CI): 1.25–9.18), to engage in physical activity (OR: 2.24; CI: 1.43–3.52), and to take hypertension medication (OR: 1.66; CI: 1.04–2.67) or diabetes mellitus medication (OR: 2.99; CI: 1.80–4.97). Physically active menopausal women with MetS were more likely to also engage in dieting (OR: 2.32; CI: 1.42–3.51). Accordingly, suggestions can be provided to healthcare workers in designing, not only individual approaches to lifestyle modification but also comprehensive interventions including dietary control and physical activity for menopausal MetS women. Health-care interventions like dietary control, which provide additional support to vulnerable MetS women, should target women aged 60 or above or those who do not take medicines for hypertension and diabetes mellitus.

]]>
Factors Associated with Dietary Control and Physical Activity in the Management of Metabolic Syndrome in Korean Menopausal Women Guna Lee Hye Young Choi doi: 10.3390/ijerph17186901 International Journal of Environmental Research and Public Health 2020-09-21 International Journal of Environmental Research and Public Health 2020-09-21 17 18 Article 6901 10.3390/ijerph17186901 https://www.mdpi.com/1660-4601/17/18/6901
IJERPH, Vol. 17, Pages 6908: Does Happiness Launch More Businesses? Affect, Gender, and Entrepreneurial Intention https://www.mdpi.com/1660-4601/17/18/6908 In one of the first studies to examine how positive affect, negative affect, gender, and gender roles interact with entrepreneurial intention, we conducted an online survey of 849 adults from the western, midwestern, and southern regions of the United States. A higher positive affect was associated with greater intention to start a business, however, lower levels of negative affect were not. As in previous studies, women showed less entrepreneurial intention than men, however, the presence of positive affect had a larger positive impact on women’s entrepreneurial intention than men’s. Contrary to expectations, acceptance of traditional gender roles interacted with entrepreneurial intention such that women’s entrepreneurial intention increased as their support of traditional gender roles increased, and for men, entrepreneurial intention decreased slightly as acceptance of traditional gender roles increased. IJERPH, Vol. 17, Pages 6908: Does Happiness Launch More Businesses? Affect, Gender, and Entrepreneurial Intention

International Journal of Environmental Research and Public Health doi: 10.3390/ijerph17186908

Authors: Gloria Sweida Cynthia L. Sherman

In one of the first studies to examine how positive affect, negative affect, gender, and gender roles interact with entrepreneurial intention, we conducted an online survey of 849 adults from the western, midwestern, and southern regions of the United States. A higher positive affect was associated with greater intention to start a business, however, lower levels of negative affect were not. As in previous studies, women showed less entrepreneurial intention than men, however, the presence of positive affect had a larger positive impact on women’s entrepreneurial intention than men’s. Contrary to expectations, acceptance of traditional gender roles interacted with entrepreneurial intention such that women’s entrepreneurial intention increased as their support of traditional gender roles increased, and for men, entrepreneurial intention decreased slightly as acceptance of traditional gender roles increased.

]]>
Does Happiness Launch More Businesses? Affect, Gender, and Entrepreneurial Intention Gloria Sweida Cynthia L. Sherman doi: 10.3390/ijerph17186908 International Journal of Environmental Research and Public Health 2020-09-21 International Journal of Environmental Research and Public Health 2020-09-21 17 18 Article 6908 10.3390/ijerph17186908 https://www.mdpi.com/1660-4601/17/18/6908
IJERPH, Vol. 17, Pages 6907: Three Diagnoses for Problematic Hypersexuality; Which Criteria Predict Help-Seeking Behavior? https://www.mdpi.com/1660-4601/17/18/6907 This study aimed to assess the best combination of indicators of problematic hypersexuality (PH), in a survey (n = 58,158) targeting individuals wondering if they were sex addicted. The survey allowed for testing of criteria from three theoretical models used to conceptualize PH. Factor analyses for women and men yielded an interpretable grouping of indicators consisting of four factors. In subsequent logistic regressions, these factors were used as predictors for experiencing the need for help for PH. The factors Negative Effects and Extreme positively predicted experiencing the need for help, with Negative Effects as the most important predictor for both women and men. This factor included, among others, withdrawal symptoms and loss of pleasure. The Sexual Desire factor negatively predicted the need for help, suggesting that for the targeted population more sexual desire leads to less PH. The Coping factor did not predict experiencing the need for help. Outcomes show that a combination of indicators from different theoretical models best indicates the presence of PH. Therefore, a measurement instrument to assess existence and severity of PH should consist of such a combination. Theoretically, this study suggests that a more comprehensive model for PH is needed, surpassing existing conceptualizations of PH. IJERPH, Vol. 17, Pages 6907: Three Diagnoses for Problematic Hypersexuality; Which Criteria Predict Help-Seeking Behavior?

International Journal of Environmental Research and Public Health doi: 10.3390/ijerph17186907

Authors: Piet van Tuijl Aerjen Tamminga Gert-Jan Meerkerk Peter Verboon Ruslan Leontjevas Jacques van Lankveld

This study aimed to assess the best combination of indicators of problematic hypersexuality (PH), in a survey (n = 58,158) targeting individuals wondering if they were sex addicted. The survey allowed for testing of criteria from three theoretical models used to conceptualize PH. Factor analyses for women and men yielded an interpretable grouping of indicators consisting of four factors. In subsequent logistic regressions, these factors were used as predictors for experiencing the need for help for PH. The factors Negative Effects and Extreme positively predicted experiencing the need for help, with Negative Effects as the most important predictor for both women and men. This factor included, among others, withdrawal symptoms and loss of pleasure. The Sexual Desire factor negatively predicted the need for help, suggesting that for the targeted population more sexual desire leads to less PH. The Coping factor did not predict experiencing the need for help. Outcomes show that a combination of indicators from different theoretical models best indicates the presence of PH. Therefore, a measurement instrument to assess existence and severity of PH should consist of such a combination. Theoretically, this study suggests that a more comprehensive model for PH is needed, surpassing existing conceptualizations of PH.

]]>
Three Diagnoses for Problematic Hypersexuality; Which Criteria Predict Help-Seeking Behavior? Piet van Tuijl Aerjen Tamminga Gert-Jan Meerkerk Peter Verboon Ruslan Leontjevas Jacques van Lankveld doi: 10.3390/ijerph17186907 International Journal of Environmental Research and Public Health 2020-09-21 International Journal of Environmental Research and Public Health 2020-09-21 17 18 Article 6907 10.3390/ijerph17186907 https://www.mdpi.com/1660-4601/17/18/6907
IJERPH, Vol. 17, Pages 6896: Prenatal Maternal Cortisol Levels and Infant Birth Weight in a Predominately Low-Income Hispanic Cohort https://www.mdpi.com/1660-4601/17/18/6896 Infant birth weight influences numerous health outcomes throughout the life course including childhood obesity and metabolic morbidities. Maternal experience of stress, both before and during pregnancy, has been hypothesized to influence fetal growth and birth outcomes. However, these associations currently are not fully understood, due to conflicting results in the published literature. Salivary cortisol is often used as a biological biomarker to assess the diurnal pattern of the hypothalamic–pituitary–adrenal axis (HPA-axis) functioning. Cortisol metrics include both the total cortisol concentration secreted during waking hours, reflected by the area under the curve (AUC), and cortisol dynamics, which include the diurnal cortisol slope (DCS) and the cortisol awakening response (CAR). This study examined the association of these cortisol metrics measured during the third trimester of pregnancy and infant birth weight among 240 mother-infant dyads participating in the Maternal and Developmental Risks from Environmental and Social Stressors (MADRES) pregnancy cohort study, which is predominately comprised of Hispanic low-income women. There were no significant associations with the maternal biological stress response and infant birth weight in this study. More research is needed in larger studies to better understand how the biological stress response influences birth weight in populations facing health disparities. IJERPH, Vol. 17, Pages 6896: Prenatal Maternal Cortisol Levels and Infant Birth Weight in a Predominately Low-Income Hispanic Cohort

International Journal of Environmental Research and Public Health doi: 10.3390/ijerph17186896

Authors: Alicia K. Peterson Claudia M. Toledo-Corral Thomas A. Chavez Christine H. Naya Mark Johnson Sandrah P. Eckel Deborah Lerner Brendan H. Grubbs Shohreh F. Farzan Genevieve F. Dunton Theresa M. Bastain Carrie V. Breton

Infant birth weight influences numerous health outcomes throughout the life course including childhood obesity and metabolic morbidities. Maternal experience of stress, both before and during pregnancy, has been hypothesized to influence fetal growth and birth outcomes. However, these associations currently are not fully understood, due to conflicting results in the published literature. Salivary cortisol is often used as a biological biomarker to assess the diurnal pattern of the hypothalamic–pituitary–adrenal axis (HPA-axis) functioning. Cortisol metrics include both the total cortisol concentration secreted during waking hours, reflected by the area under the curve (AUC), and cortisol dynamics, which include the diurnal cortisol slope (DCS) and the cortisol awakening response (CAR). This study examined the association of these cortisol metrics measured during the third trimester of pregnancy and infant birth weight among 240 mother-infant dyads participating in the Maternal and Developmental Risks from Environmental and Social Stressors (MADRES) pregnancy cohort study, which is predominately comprised of Hispanic low-income women. There were no significant associations with the maternal biological stress response and infant birth weight in this study. More research is needed in larger studies to better understand how the biological stress response influences birth weight in populations facing health disparities.

]]>
Prenatal Maternal Cortisol Levels and Infant Birth Weight in a Predominately Low-Income Hispanic Cohort Alicia K. Peterson Claudia M. Toledo-Corral Thomas A. Chavez Christine H. Naya Mark Johnson Sandrah P. Eckel Deborah Lerner Brendan H. Grubbs Shohreh F. Farzan Genevieve F. Dunton Theresa M. Bastain Carrie V. Breton doi: 10.3390/ijerph17186896 International Journal of Environmental Research and Public Health 2020-09-21 International Journal of Environmental Research and Public Health 2020-09-21 17 18 Article 6896 10.3390/ijerph17186896 https://www.mdpi.com/1660-4601/17/18/6896
IJERPH, Vol. 17, Pages 6906: Occupational Safety and Work-Related Injury Control Efforts in Qatar: Lessons Learned from a Rapidly Developing Economy https://www.mdpi.com/1660-4601/17/18/6906 Work-related injury (WRI) control is an integral part of occupational safety. In rapidly developing Gulf countries such as Qatar with a predominantly expatriate workforce, WRI control is a complex issue often seen in conjunction with the implementation of labour laws and labour rights. We aimed to implement a public health approach to facilitate efforts to achieve long-term WRI control in Qatar. A range of initiatives helped to gain visibility and momentum for this important public health problem, including identifying and engaging with key stakeholders, workers’ surveys, steps to establish a unified injury database, and the implementation of a WRI identification tool in the electronic medical records. A contemporaneous improved enforcement of existent occupational safety regulations through heightened worksite inspections and efforts to improve living conditions for migrant workers also took place. WRIs are not only a Qatar-specific problem; the same issues are faced by neighbouring Gulf countries and other rapidly developing economies with large expatriate worker populations. These strategies are also useful starting points for similar countries interested in nurturing a safe, healthy and productive workforce. IJERPH, Vol. 17, Pages 6906: Occupational Safety and Work-Related Injury Control Efforts in Qatar: Lessons Learned from a Rapidly Developing Economy

International Journal of Environmental Research and Public Health doi: 10.3390/ijerph17186906

Authors: Rafael J. Consunji Amber Mehmood Nazia Hirani Ayman El-Menyar Aisha Abeid Adnan A. Hyder Hassan Al-Thani Ruben Peralta

Work-related injury (WRI) control is an integral part of occupational safety. In rapidly developing Gulf countries such as Qatar with a predominantly expatriate workforce, WRI control is a complex issue often seen in conjunction with the implementation of labour laws and labour rights. We aimed to implement a public health approach to facilitate efforts to achieve long-term WRI control in Qatar. A range of initiatives helped to gain visibility and momentum for this important public health problem, including identifying and engaging with key stakeholders, workers’ surveys, steps to establish a unified injury database, and the implementation of a WRI identification tool in the electronic medical records. A contemporaneous improved enforcement of existent occupational safety regulations through heightened worksite inspections and efforts to improve living conditions for migrant workers also took place. WRIs are not only a Qatar-specific problem; the same issues are faced by neighbouring Gulf countries and other rapidly developing economies with large expatriate worker populations. These strategies are also useful starting points for similar countries interested in nurturing a safe, healthy and productive workforce.

]]>
Occupational Safety and Work-Related Injury Control Efforts in Qatar: Lessons Learned from a Rapidly Developing Economy Rafael J. Consunji Amber Mehmood Nazia Hirani Ayman El-Menyar Aisha Abeid Adnan A. Hyder Hassan Al-Thani Ruben Peralta doi: 10.3390/ijerph17186906 International Journal of Environmental Research and Public Health 2020-09-21 International Journal of Environmental Research and Public Health 2020-09-21 17 18 Article 6906 10.3390/ijerph17186906 https://www.mdpi.com/1660-4601/17/18/6906
IJERPH, Vol. 17, Pages 6904: Social Justice Pedagogies in School Health and Physical Education—Building Relationships, Teaching for Social Cohesion and Addressing Social Inequities https://www.mdpi.com/1660-4601/17/18/6904 A focus on equity and social justice in school health and physical education (HPE) is pertinent in an era where there are growing concerns about the impact of neoliberal globalization and the precariousness of society. The aim of the present study was to identify school HPE teaching practices that promote social justice and more equitable health outcomes. Data were generated through 20 HPE lesson observations and post-lesson interviews with 13 HPE teachers across schools in Sweden, Norway, and New Zealand. The data were analysed following the principles of thematic analysis. In this paper, we present and discuss findings related to three overall themes: (i) relationships; (ii) teaching for social cohesion; (iii) and explicitly teaching about, and acting on, social inequities. Collectively, these themes represent examples of the enactment of social justice pedagogies in HPE practice. To conclude, we point out the difficulty of enacting social justice pedagogies and that social justice pedagogies may not always transform structures nor make a uniform difference to all students. However, on the basis of our findings, we are reaffirmed in our view that HPE teachers can make a difference when it comes to contributing to more socially just and equitable outcomes in HPE and beyond. IJERPH, Vol. 17, Pages 6904: Social Justice Pedagogies in School Health and Physical Education—Building Relationships, Teaching for Social Cohesion and Addressing Social Inequities

International Journal of Environmental Research and Public Health doi: 10.3390/ijerph17186904

Authors: Göran Gerdin Lena Larsson Katarina Schenker Susanne Linnér Kjersti Mordal Moen Knut Westlie Wayne Smith Rod Philpot

A focus on equity and social justice in school health and physical education (HPE) is pertinent in an era where there are growing concerns about the impact of neoliberal globalization and the precariousness of society. The aim of the present study was to identify school HPE teaching practices that promote social justice and more equitable health outcomes. Data were generated through 20 HPE lesson observations and post-lesson interviews with 13 HPE teachers across schools in Sweden, Norway, and New Zealand. The data were analysed following the principles of thematic analysis. In this paper, we present and discuss findings related to three overall themes: (i) relationships; (ii) teaching for social cohesion; (iii) and explicitly teaching about, and acting on, social inequities. Collectively, these themes represent examples of the enactment of social justice pedagogies in HPE practice. To conclude, we point out the difficulty of enacting social justice pedagogies and that social justice pedagogies may not always transform structures nor make a uniform difference to all students. However, on the basis of our findings, we are reaffirmed in our view that HPE teachers can make a difference when it comes to contributing to more socially just and equitable outcomes in HPE and beyond.

]]>
Social Justice Pedagogies in School Health and Physical Education—Building Relationships, Teaching for Social Cohesion and Addressing Social Inequities Göran Gerdin Lena Larsson Katarina Schenker Susanne Linnér Kjersti Mordal Moen Knut Westlie Wayne Smith Rod Philpot doi: 10.3390/ijerph17186904 International Journal of Environmental Research and Public Health 2020-09-21 International Journal of Environmental Research and Public Health 2020-09-21 17 18 Article 6904 10.3390/ijerph17186904 https://www.mdpi.com/1660-4601/17/18/6904
IJERPH, Vol. 17, Pages 6903: Prevalence and Spatial Distribution of Animal Brucellosis in Central Punjab, Pakistan https://www.mdpi.com/1660-4601/17/18/6903 Brucellosis is an important zoonotic disease of animals and humans caused by bacteria of the genus Brucella. Brucellae are Gram-negative intracellular bacteria which infect a wide variety of animals including goats, sheep, buffaloes, cows, pigs, and wildlife. The objectives of this study were to determine the seroprevalence and spatial distribution of brucellosis in Central Punjab, Pakistan. A total of 1083 blood samples of goats, sheep, buffaloes, and cows were collected from 38 villages of four districts (Kasur, Faisalabad, Lahore, and Okara) of Punjab, Pakistan, and screened for brucellosis by Rose Bengal Plate test (RBPT) and PCR confirmed. Epidemiological, demographic data and GPS coordinates for every sample were collected. By using interpolation of the Aeronautical Reconnaissance Coverage Geographic Information System (Arc GIS), a surface plot was generated applying inverse distance weight (IDW). It was found that 35 (3.23%) serum samples were positive for brucellosis. In eight (61.5%), six (75%), seven (87.5%), and eight (89%) villages, positive goats, sheep, buffaloes, and cattle were detected, respectively. In general, older animals are more often positive for brucellosis. In goats bucks were more often RBPT positive than females while in sheep, buffaloes, and cattle more females were positive. The spatial distribution of brucellosis shows that it is widely distributed in the western region of the study area in goats and in the South-West region in sheep. Similarly, for buffaloes it is restricted to the south-east and north-west regions, and in cattle brucellosis is present in western region of study area only. Reflected by this study, brucellosis poses a risk for livestock in developing countries due to lack of awareness by officials, owners, and consumers, and control measures are missing. A risk map of brucellosis was generated to develop effective strategies for awareness rising and to improve the quality of control programs in Pakistan. IJERPH, Vol. 17, Pages 6903: Prevalence and Spatial Distribution of Animal Brucellosis in Central Punjab, Pakistan

International Journal of Environmental Research and Public Health doi: 10.3390/ijerph17186903

Authors: Usama Saeed Shahzad Ali Tooba Latif Muhammad Rizwan Attaullah Anam Iftikhar Syed Ghulam Mohayud Din Hashmi Aman Ullah Khan Iahtasham Khan Falk Melzer Hosny El-Adawy Heinrich Neubauer

Brucellosis is an important zoonotic disease of animals and humans caused by bacteria of the genus Brucella. Brucellae are Gram-negative intracellular bacteria which infect a wide variety of animals including goats, sheep, buffaloes, cows, pigs, and wildlife. The objectives of this study were to determine the seroprevalence and spatial distribution of brucellosis in Central Punjab, Pakistan. A total of 1083 blood samples of goats, sheep, buffaloes, and cows were collected from 38 villages of four districts (Kasur, Faisalabad, Lahore, and Okara) of Punjab, Pakistan, and screened for brucellosis by Rose Bengal Plate test (RBPT) and PCR confirmed. Epidemiological, demographic data and GPS coordinates for every sample were collected. By using interpolation of the Aeronautical Reconnaissance Coverage Geographic Information System (Arc GIS), a surface plot was generated applying inverse distance weight (IDW). It was found that 35 (3.23%) serum samples were positive for brucellosis. In eight (61.5%), six (75%), seven (87.5%), and eight (89%) villages, positive goats, sheep, buffaloes, and cattle were detected, respectively. In general, older animals are more often positive for brucellosis. In goats bucks were more often RBPT positive than females while in sheep, buffaloes, and cattle more females were positive. The spatial distribution of brucellosis shows that it is widely distributed in the western region of the study area in goats and in the South-West region in sheep. Similarly, for buffaloes it is restricted to the south-east and north-west regions, and in cattle brucellosis is present in western region of study area only. Reflected by this study, brucellosis poses a risk for livestock in developing countries due to lack of awareness by officials, owners, and consumers, and control measures are missing. A risk map of brucellosis was generated to develop effective strategies for awareness rising and to improve the quality of control programs in Pakistan.

]]>
Prevalence and Spatial Distribution of Animal Brucellosis in Central Punjab, Pakistan Usama Saeed Shahzad Ali Tooba Latif Muhammad Rizwan Attaullah Anam Iftikhar Syed Ghulam Mohayud Din Hashmi Aman Ullah Khan Iahtasham Khan Falk Melzer Hosny El-Adawy Heinrich Neubauer doi: 10.3390/ijerph17186903 International Journal of Environmental Research and Public Health 2020-09-21 International Journal of Environmental Research and Public Health 2020-09-21 17 18 Article 6903 10.3390/ijerph17186903 https://www.mdpi.com/1660-4601/17/18/6903
IJERPH, Vol. 17, Pages 6902: Can Physical and/or Sexual Abuse Play a Role in the Female Choice of a Partner? A Cross-Sectional, Correlational Pilot Study https://www.mdpi.com/1660-4601/17/18/6902 The present study aims to evaluate the relationship in women between a history of physical/sexual abuse and the preferences regarding the choice of a partner for a short/long-term relationship in terms of male facial dimorphism, and to assess their sexual functioning. We enrolled 48 abused women and 60 non-abused women. Facial preferences were evaluated with the Morphing test. Sexual functioning was measured with the Female Sexual Function Index (FSFI). Regarding the choice for a short-term partner, abused and non-abused women did not show any differences, and both groups chose a less masculine male face. On the other hand, regarding the choice for a long-term partner, abused women showed a preference for an average male face, whilst non-abused women preferred a less masculine face. The sexual functioning of abused women was found significantly dysfunctional in all domains of the FSFI. These data, generated from a small but highly selected cohort, demonstrated that physical/sexual abuse may be associated with a more rational and conscious choice of a male partner for a long-term relationship, but not with an instinctive one, as the choice of an occasional partner. In addition, the sexual functioning of abused women appears to be compromised by the traumatic experience. IJERPH, Vol. 17, Pages 6902: Can Physical and/or Sexual Abuse Play a Role in the Female Choice of a Partner? A Cross-Sectional, Correlational Pilot Study

International Journal of Environmental Research and Public Health doi: 10.3390/ijerph17186902

Authors: Erika Limoncin Caterina Solano Giacomo Ciocca Daniele Mollaioli Elena Colonnello Andrea Sansone Filippo Maria Nimbi Chiara Simonelli Renata Tambelli Emmanuele Angelo Jannini

The present study aims to evaluate the relationship in women between a history of physical/sexual abuse and the preferences regarding the choice of a partner for a short/long-term relationship in terms of male facial dimorphism, and to assess their sexual functioning. We enrolled 48 abused women and 60 non-abused women. Facial preferences were evaluated with the Morphing test. Sexual functioning was measured with the Female Sexual Function Index (FSFI). Regarding the choice for a short-term partner, abused and non-abused women did not show any differences, and both groups chose a less masculine male face. On the other hand, regarding the choice for a long-term partner, abused women showed a preference for an average male face, whilst non-abused women preferred a less masculine face. The sexual functioning of abused women was found significantly dysfunctional in all domains of the FSFI. These data, generated from a small but highly selected cohort, demonstrated that physical/sexual abuse may be associated with a more rational and conscious choice of a male partner for a long-term relationship, but not with an instinctive one, as the choice of an occasional partner. In addition, the sexual functioning of abused women appears to be compromised by the traumatic experience.

]]>
Can Physical and/or Sexual Abuse Play a Role in the Female Choice of a Partner? A Cross-Sectional, Correlational Pilot Study Erika Limoncin Caterina Solano Giacomo Ciocca Daniele Mollaioli Elena Colonnello Andrea Sansone Filippo Maria Nimbi Chiara Simonelli Renata Tambelli Emmanuele Angelo Jannini doi: 10.3390/ijerph17186902 International Journal of Environmental Research and Public Health 2020-09-21 International Journal of Environmental Research and Public Health 2020-09-21 17 18 Article 6902 10.3390/ijerph17186902 https://www.mdpi.com/1660-4601/17/18/6902
IJERPH, Vol. 17, Pages 6897: Physical Activity of Children with Visual Impairments during Different Segments of the School Day https://www.mdpi.com/1660-4601/17/18/6897 Schools provide opportunities for children with visual impairments (VI) to accumulate recommended daily moderate-to-vigorous-intensity physical activity (MVPA). This study aimed to determine physical activity (PA) across the school day among special school children with VI in China. The study objectively measured the MVPA levels of children with VI during the recess, lunchtime, physical education (PE) classes, before-school, and after-school periods segments on PE days and non-PE days. Moreover, this research compared the gender, age, and body mass index (BMI) differences in MVPA during each segment. A total of 70 children with VI aged 7–17 years (mean age = 13.7; SD = 3.4) from the special school participated in this study. Accelerometers were utilized to measure the MVPA of children with VI. The participants with VI accumulated significantly more MVPA time on PE days than on non-PE days. Before-school periods and structured PE classes showed higher percentages of MVPA time than recess, lunch break, and after-school periods during the school day. Children with VI aged 7–12 years old were significantly more physically active than those aged 13–17 years old during recess, lunch break, and after-school periods. In conclusion, PA interventions during structured PE classes are recommended. Special attention should be provided to children with VI as they grow up to increase their MVPA. IJERPH, Vol. 17, Pages 6897: Physical Activity of Children with Visual Impairments during Different Segments of the School Day

International Journal of Environmental Research and Public Health doi: 10.3390/ijerph17186897

Authors: Jing Qi Jian Wei Xu Wei De Shao

Schools provide opportunities for children with visual impairments (VI) to accumulate recommended daily moderate-to-vigorous-intensity physical activity (MVPA). This study aimed to determine physical activity (PA) across the school day among special school children with VI in China. The study objectively measured the MVPA levels of children with VI during the recess, lunchtime, physical education (PE) classes, before-school, and after-school periods segments on PE days and non-PE days. Moreover, this research compared the gender, age, and body mass index (BMI) differences in MVPA during each segment. A total of 70 children with VI aged 7–17 years (mean age = 13.7; SD = 3.4) from the special school participated in this study. Accelerometers were utilized to measure the MVPA of children with VI. The participants with VI accumulated significantly more MVPA time on PE days than on non-PE days. Before-school periods and structured PE classes showed higher percentages of MVPA time than recess, lunch break, and after-school periods during the school day. Children with VI aged 7–12 years old were significantly more physically active than those aged 13–17 years old during recess, lunch break, and after-school periods. In conclusion, PA interventions during structured PE classes are recommended. Special attention should be provided to children with VI as they grow up to increase their MVPA.

]]>
Physical Activity of Children with Visual Impairments during Different Segments of the School Day Jing Qi Jian Wei Xu Wei De Shao doi: 10.3390/ijerph17186897 International Journal of Environmental Research and Public Health 2020-09-21 International Journal of Environmental Research and Public Health 2020-09-21 17 18 Article 6897 10.3390/ijerph17186897 https://www.mdpi.com/1660-4601/17/18/6897
IJERPH, Vol. 17, Pages 6900: Burden of Mesothelioma Deaths by National Income Category: Current Status and Future Implications https://www.mdpi.com/1660-4601/17/18/6900 Background: This study compares estimates of the global-level mesothelioma burden with a focus on how existing national mortality data were utilized and further assesses the interrelationship of country-level mesothelioma burden and asbestos use with national income status. Methods: Country-level mesothelioma deaths in the WHO Mortality Database as of December 2019 were analyzed by national income category of countries in terms of data availability and reliability. Numbers of mesothelioma deaths from the study of Odgerel et al. were reanalyzed to assess country-level mesothelioma death burdens by national income status. Results: Among 80 high-income countries, 54 (68%) reported mesothelioma to the WHO and 26 (32%) did not, and among 60 upper middle-income countries, the respective numbers (proportions) were 39 (65%) countries and 21 (35%) countries, respectively. In contrast, among 78 low- and lower middle-income countries, only 11 (14%) reported mesothelioma deaths while 67 (86%) did not. Of the mesothelioma deaths, 29,854 (78%) were attributed to high- and upper middle-income countries, and 8534 (22%) were attributed to low- and lower middle- income countries. Conclusions: The global mesothelioma burden, based on reported numbers, is currently shouldered predominantly by high-income countries; however, mesothelioma burdens will likely manifest soon in upper middle-income and eventually in low and lower middle-income countries. IJERPH, Vol. 17, Pages 6900: Burden of Mesothelioma Deaths by National Income Category: Current Status and Future Implications

International Journal of Environmental Research and Public Health doi: 10.3390/ijerph17186900

Authors: Odgerel Chimed-Ochir Diana Arachi Tim Driscoll Ro-Ting Lin Jukka Takala Ken Takahashi

Background: This study compares estimates of the global-level mesothelioma burden with a focus on how existing national mortality data were utilized and further assesses the interrelationship of country-level mesothelioma burden and asbestos use with national income status. Methods: Country-level mesothelioma deaths in the WHO Mortality Database as of December 2019 were analyzed by national income category of countries in terms of data availability and reliability. Numbers of mesothelioma deaths from the study of Odgerel et al. were reanalyzed to assess country-level mesothelioma death burdens by national income status. Results: Among 80 high-income countries, 54 (68%) reported mesothelioma to the WHO and 26 (32%) did not, and among 60 upper middle-income countries, the respective numbers (proportions) were 39 (65%) countries and 21 (35%) countries, respectively. In contrast, among 78 low- and lower middle-income countries, only 11 (14%) reported mesothelioma deaths while 67 (86%) did not. Of the mesothelioma deaths, 29,854 (78%) were attributed to high- and upper middle-income countries, and 8534 (22%) were attributed to low- and lower middle- income countries. Conclusions: The global mesothelioma burden, based on reported numbers, is currently shouldered predominantly by high-income countries; however, mesothelioma burdens will likely manifest soon in upper middle-income and eventually in low and lower middle-income countries.

]]>
Burden of Mesothelioma Deaths by National Income Category: Current Status and Future Implications Odgerel Chimed-Ochir Diana Arachi Tim Driscoll Ro-Ting Lin Jukka Takala Ken Takahashi doi: 10.3390/ijerph17186900 International Journal of Environmental Research and Public Health 2020-09-21 International Journal of Environmental Research and Public Health 2020-09-21 17 18 Article 6900 10.3390/ijerph17186900 https://www.mdpi.com/1660-4601/17/18/6900
IJERPH, Vol. 17, Pages 6899: Relationships between Exercise Modality and Activity Restriction, Quality of Life, and Hematopoietic Profile in Korean Breast Cancer Survivors https://www.mdpi.com/1660-4601/17/18/6899 This study aimed to examine the relationships between activity restriction, quality of life (QoL), and hematopoietic profile in breast cancer survivors according to exercise modality. The subjects in this study were 187 female breast cancer survivors among a total of 32,631 participants in the Korea National Health and Nutrition Examination Survey, which was conducted from 2016 to 2018. The selected subjects participated in a questionnaire survey and blood analysis. A cross-analysis was conducted to determine the relationship between participation in various modality of exercise (e.g., aerobic exercise, resistance exercise, walking exercise). The phi coefficients or Cramer’s V value for activity restriction and QoL were calculated; an independent t-test was conducted to evaluate the differences between hematopoietic profiles based on the modality of exercise. Statistically significant correlations were seen between obesity and aerobic exercise and walking frequency, as well as between diabetes and aerobic exercise and activity restriction. With respect to QoL, there was a statistically significant correlation between participation in aerobic exercise and exercise ability, participation in aerobic exercise and anxiety/depression, participation in resistance exercise and subjective health status, participation in resistance exercise and exercise ability, and participation in weekly walking exercise and self-care ability. Regarding hemodynamic changes, red blood cells increased significantly in breast cancer survivors who participated in weekly resistance exercise compared to in those who did not. In conclusion, exercise participation had a positive effect on activity restriction, QoL, and hematopoietic profile in breast cancer survivors; in particular, some modalities of aerobic exercise were more effective. IJERPH, Vol. 17, Pages 6899: Relationships between Exercise Modality and Activity Restriction, Quality of Life, and Hematopoietic Profile in Korean Breast Cancer Survivors

International Journal of Environmental Research and Public Health doi: 10.3390/ijerph17186899

Authors: MunHee Kim Wi-Young So Jiyoun Kim

This study aimed to examine the relationships between activity restriction, quality of life (QoL), and hematopoietic profile in breast cancer survivors according to exercise modality. The subjects in this study were 187 female breast cancer survivors among a total of 32,631 participants in the Korea National Health and Nutrition Examination Survey, which was conducted from 2016 to 2018. The selected subjects participated in a questionnaire survey and blood analysis. A cross-analysis was conducted to determine the relationship between participation in various modality of exercise (e.g., aerobic exercise, resistance exercise, walking exercise). The phi coefficients or Cramer’s V value for activity restriction and QoL were calculated; an independent t-test was conducted to evaluate the differences between hematopoietic profiles based on the modality of exercise. Statistically significant correlations were seen between obesity and aerobic exercise and walking frequency, as well as between diabetes and aerobic exercise and activity restriction. With respect to QoL, there was a statistically significant correlation between participation in aerobic exercise and exercise ability, participation in aerobic exercise and anxiety/depression, participation in resistance exercise and subjective health status, participation in resistance exercise and exercise ability, and participation in weekly walking exercise and self-care ability. Regarding hemodynamic changes, red blood cells increased significantly in breast cancer survivors who participated in weekly resistance exercise compared to in those who did not. In conclusion, exercise participation had a positive effect on activity restriction, QoL, and hematopoietic profile in breast cancer survivors; in particular, some modalities of aerobic exercise were more effective.

]]>
Relationships between Exercise Modality and Activity Restriction, Quality of Life, and Hematopoietic Profile in Korean Breast Cancer Survivors MunHee Kim Wi-Young So Jiyoun Kim doi: 10.3390/ijerph17186899 International Journal of Environmental Research and Public Health 2020-09-21 International Journal of Environmental Research and Public Health 2020-09-21 17 18 Article 6899 10.3390/ijerph17186899 https://www.mdpi.com/1660-4601/17/18/6899
IJERPH, Vol. 17, Pages 6898: Blood Lead Concentrations and Mortality in Korean Adults: the Korea National Health and Nutrition Examination Survey with Mortality Follow-Up https://www.mdpi.com/1660-4601/17/18/6898 Previous studies have consistently reported an increase in mortality risk, even at low levels of blood lead. The average blood lead concentration in the Korean population has steadily decreased but is still higher than that of developed countries. The purpose of this study was to examine the associations between mortality and blood lead concentrations for adults in Korea. We used the Korea National Health and Nutrition Examination Survey (2008–2013) linked Cause of Death data, which are followed by 2018. A total of 7308 subjects who aged over 30 at the baseline examination were included in the analyses. Cox proportional hazard model was used to estimate the hazard ratios of mortality from non-accidental causes and cancer mortality. The estimated hazard ratios (95% CI) for comparison of the second and third tertile group with the lowest tertile group were 2.01 (1.20, 3.40) and 1.91 (1.13, 3.23) for non-accidental mortality and 3.42 (95% CI: 1.65, 7.08) and 2.27 (95% CI: 1.09, 4.70) for cancer mortality, respectively. The dose–response relationship also showed significant increase in the risk of mortality at blood lead level between 1.5 and 6.0 μg/dL. Our findings suggest that potent policies to lower lead exposure are required for the general Korean population. IJERPH, Vol. 17, Pages 6898: Blood Lead Concentrations and Mortality in Korean Adults: the Korea National Health and Nutrition Examination Survey with Mortality Follow-Up

International Journal of Environmental Research and Public Health doi: 10.3390/ijerph17186898

Authors: Garam Byun Sera Kim Soo-Yeon Kim Dahyun Park Min-Jeong Shin Hannah Oh Jong-Tae Lee

Previous studies have consistently reported an increase in mortality risk, even at low levels of blood lead. The average blood lead concentration in the Korean population has steadily decreased but is still higher than that of developed countries. The purpose of this study was to examine the associations between mortality and blood lead concentrations for adults in Korea. We used the Korea National Health and Nutrition Examination Survey (2008–2013) linked Cause of Death data, which are followed by 2018. A total of 7308 subjects who aged over 30 at the baseline examination were included in the analyses. Cox proportional hazard model was used to estimate the hazard ratios of mortality from non-accidental causes and cancer mortality. The estimated hazard ratios (95% CI) for comparison of the second and third tertile group with the lowest tertile group were 2.01 (1.20, 3.40) and 1.91 (1.13, 3.23) for non-accidental mortality and 3.42 (95% CI: 1.65, 7.08) and 2.27 (95% CI: 1.09, 4.70) for cancer mortality, respectively. The dose–response relationship also showed significant increase in the risk of mortality at blood lead level between 1.5 and 6.0 μg/dL. Our findings suggest that potent policies to lower lead exposure are required for the general Korean population.

]]>
Blood Lead Concentrations and Mortality in Korean Adults: the Korea National Health and Nutrition Examination Survey with Mortality Follow-Up Garam Byun Sera Kim Soo-Yeon Kim Dahyun Park Min-Jeong Shin Hannah Oh Jong-Tae Lee doi: 10.3390/ijerph17186898 International Journal of Environmental Research and Public Health 2020-09-21 International Journal of Environmental Research and Public Health 2020-09-21 17 18 Article 6898 10.3390/ijerph17186898 https://www.mdpi.com/1660-4601/17/18/6898
IJERPH, Vol. 17, Pages 6895: Healthcare at Your Fingertips: The Acceptance and Adoption of Mobile Medical Treatment Services among Chinese Users https://www.mdpi.com/1660-4601/17/18/6895 Mobile health (mHealth) services have recently been receiving increasing attention. However, there is a lack of knowledge about how users accept and adopt mobile medical treatment (MMT) services, some of the most promising mHealth services that aim to extend the patient–physician relationship beyond the conventional clinic environment. To fill this research gap, this study proposes a research model for predicting consumers’ acceptance behavior toward MMT services based on the Technology Acceptance Model (TAM). A survey was conducted among 303 Chinese MMT service users to evaluate the proposed model and relevant hypotheses using partial least squares. Several key findings were summarized from the results: (1) the attitude toward using MMT, technology anxiety, and trust are significantly associated with users’ behavioral intention to use MMT services; (2) the perceived ease of use, perceived usefulness, and trust significantly influence users’ attitude toward using MMT services; (3) the perceived interactivity, perceived personalization, and privacy concerns have significant impacts on users’ perceptions of ease of use, usefulness, and trust toward MMT services. The current findings have both theoretical and practical implications that may guide practitioners and researchers to better understand consumers’ acceptance of MMT services. IJERPH, Vol. 17, Pages 6895: Healthcare at Your Fingertips: The Acceptance and Adoption of Mobile Medical Treatment Services among Chinese Users

International Journal of Environmental Research and Public Health doi: 10.3390/ijerph17186895

Authors: Qingchuan Li

Mobile health (mHealth) services have recently been receiving increasing attention. However, there is a lack of knowledge about how users accept and adopt mobile medical treatment (MMT) services, some of the most promising mHealth services that aim to extend the patient–physician relationship beyond the conventional clinic environment. To fill this research gap, this study proposes a research model for predicting consumers’ acceptance behavior toward MMT services based on the Technology Acceptance Model (TAM). A survey was conducted among 303 Chinese MMT service users to evaluate the proposed model and relevant hypotheses using partial least squares. Several key findings were summarized from the results: (1) the attitude toward using MMT, technology anxiety, and trust are significantly associated with users’ behavioral intention to use MMT services; (2) the perceived ease of use, perceived usefulness, and trust significantly influence users’ attitude toward using MMT services; (3) the perceived interactivity, perceived personalization, and privacy concerns have significant impacts on users’ perceptions of ease of use, usefulness, and trust toward MMT services. The current findings have both theoretical and practical implications that may guide practitioners and researchers to better understand consumers’ acceptance of MMT services.

]]>
Healthcare at Your Fingertips: The Acceptance and Adoption of Mobile Medical Treatment Services among Chinese Users Qingchuan Li doi: 10.3390/ijerph17186895 International Journal of Environmental Research and Public Health 2020-09-21 International Journal of Environmental Research and Public Health 2020-09-21 17 18 Article 6895 10.3390/ijerph17186895 https://www.mdpi.com/1660-4601/17/18/6895
IJERPH, Vol. 17, Pages 6894: The Health Impact of Surgical Techniques and Assistive Methods Used in Cesarean Deliveries: A Systemic Review https://www.mdpi.com/1660-4601/17/18/6894 Cesarean delivery is one of the most frequently performed surgeries in women throughout the world. However, the most optimal technique to minimize maternal and fetal morbidities is still being debated due to various clinical situations and surgeons’ preferences. The contentious topics are the use of vacuum devices other than traditional fundal pressure to assist in the delivery of the fetal head and the techniques of uterine repair used during cesarean deliveries. There are two well-described techniques for suturing the uterus: The uterus can be repaired either temporarily exteriorized (out of abdominal cavity) or in situ (within the peritoneal cavity). Numerous studies have attempted to compare these two techniques in different aspects, including operative time, blood loss, and maternal and fetal outcomes. This review provides an overview of the assistive method of vacuum devices compared with fundal pressure, and the two surgical techniques for uterine repair following cesarean delivery. This descriptive literature review was performed to address important issues for clinical practitioners. It aims to compare the advantages and disadvantages of the assistive methods and surgical techniques used in cesarean deliveries. All of the articles were retrieved from the databases Medline and PubMed using the search terms cesarean delivery, vacuum, and exteriorization. The searching results revealed that after exclusion, there were 9 and 13 eligible articles for vacuum assisted cesarean delivery and uterine exteriorization, respectively. Although several studies have concluded vacuum assistance for fetal extraction as a simple, effective, and beneficial method during fetal head delivery during cesarean delivery, further research is still required to clarify the safety of vacuum assistance. In general, compared to the use of in situ uterine repairs during cesarean delivery, uterine exteriorization for repairs may have benefits of less blood loss and shorter operative time. However, it may also carry a higher risk of intraoperative complications such as nausea and vomiting, uterine atony, and a longer time to the return of bowel function. Clinicians should consider these factors during shared decision-making with their pregnant patients to determine the most suitable techniques for cesarean deliveries. IJERPH, Vol. 17, Pages 6894: The Health Impact of Surgical Techniques and Assistive Methods Used in Cesarean Deliveries: A Systemic Review

International Journal of Environmental Research and Public Health doi: 10.3390/ijerph17186894

Authors: Li-Hsuan Wang Kok-Min Seow Li-Ru Chen Kuo-Hu Chen

Cesarean delivery is one of the most frequently performed surgeries in women throughout the world. However, the most optimal technique to minimize maternal and fetal morbidities is still being debated due to various clinical situations and surgeons’ preferences. The contentious topics are the use of vacuum devices other than traditional fundal pressure to assist in the delivery of the fetal head and the techniques of uterine repair used during cesarean deliveries. There are two well-described techniques for suturing the uterus: The uterus can be repaired either temporarily exteriorized (out of abdominal cavity) or in situ (within the peritoneal cavity). Numerous studies have attempted to compare these two techniques in different aspects, including operative time, blood loss, and maternal and fetal outcomes. This review provides an overview of the assistive method of vacuum devices compared with fundal pressure, and the two surgical techniques for uterine repair following cesarean delivery. This descriptive literature review was performed to address important issues for clinical practitioners. It aims to compare the advantages and disadvantages of the assistive methods and surgical techniques used in cesarean deliveries. All of the articles were retrieved from the databases Medline and PubMed using the search terms cesarean delivery, vacuum, and exteriorization. The searching results revealed that after exclusion, there were 9 and 13 eligible articles for vacuum assisted cesarean delivery and uterine exteriorization, respectively. Although several studies have concluded vacuum assistance for fetal extraction as a simple, effective, and beneficial method during fetal head delivery during cesarean delivery, further research is still required to clarify the safety of vacuum assistance. In general, compared to the use of in situ uterine repairs during cesarean delivery, uterine exteriorization for repairs may have benefits of less blood loss and shorter operative time. However, it may also carry a higher risk of intraoperative complications such as nausea and vomiting, uterine atony, and a longer time to the return of bowel function. Clinicians should consider these factors during shared decision-making with their pregnant patients to determine the most suitable techniques for cesarean deliveries.

]]>
The Health Impact of Surgical Techniques and Assistive Methods Used in Cesarean Deliveries: A Systemic Review Li-Hsuan Wang Kok-Min Seow Li-Ru Chen Kuo-Hu Chen doi: 10.3390/ijerph17186894 International Journal of Environmental Research and Public Health 2020-09-21 International Journal of Environmental Research and Public Health 2020-09-21 17 18 Review 6894 10.3390/ijerph17186894 https://www.mdpi.com/1660-4601/17/18/6894
IJERPH, Vol. 17, Pages 6890: The Association between the Mental Health Nurse-to-Registered Nurse Ratio and Patient Outcomes in Psychiatric Inpatient Wards: A Systematic Review https://www.mdpi.com/1660-4601/17/18/6890 Nursing skill mix in inpatient mental health wards varies considerably between countries. Some countries have an all-registered mental health nurse workforce; others have a mix of registered mental health and registered nurses. Understanding the optimal nursing skill mix in mental health inpatient units would inform service planning. This report aims to examine the association between the registered mental health nurse-to-registered nurse ratio and psychiatric readmission (or referral to community crisis services) in adult mental health inpatients. A systematic review was performed. We searched key databases for observational and experimental studies. Two researchers completed title-and-abstract and full-text screening. Our search identified 7956 citations. A full-text review of four papers was undertaken. No studies met our inclusion criteria. We report an empty review. Despite the obvious importance of the research question for the safe staffing of inpatient mental health services, there are no studies that have tested this association. IJERPH, Vol. 17, Pages 6890: The Association between the Mental Health Nurse-to-Registered Nurse Ratio and Patient Outcomes in Psychiatric Inpatient Wards: A Systematic Review

International Journal of Environmental Research and Public Health doi: 10.3390/ijerph17186890

Authors: Nompilo Moyo Martin Jones Diana Kushemererwa Sandesh Pantha Sue Gilbert Lorena Romero Richard Gray

Nursing skill mix in inpatient mental health wards varies considerably between countries. Some countries have an all-registered mental health nurse workforce; others have a mix of registered mental health and registered nurses. Understanding the optimal nursing skill mix in mental health inpatient units would inform service planning. This report aims to examine the association between the registered mental health nurse-to-registered nurse ratio and psychiatric readmission (or referral to community crisis services) in adult mental health inpatients. A systematic review was performed. We searched key databases for observational and experimental studies. Two researchers completed title-and-abstract and full-text screening. Our search identified 7956 citations. A full-text review of four papers was undertaken. No studies met our inclusion criteria. We report an empty review. Despite the obvious importance of the research question for the safe staffing of inpatient mental health services, there are no studies that have tested this association.

]]>
The Association between the Mental Health Nurse-to-Registered Nurse Ratio and Patient Outcomes in Psychiatric Inpatient Wards: A Systematic Review Nompilo Moyo Martin Jones Diana Kushemererwa Sandesh Pantha Sue Gilbert Lorena Romero Richard Gray doi: 10.3390/ijerph17186890 International Journal of Environmental Research and Public Health 2020-09-21 International Journal of Environmental Research and Public Health 2020-09-21 17 18 Review 6890 10.3390/ijerph17186890 https://www.mdpi.com/1660-4601/17/18/6890
IJERPH, Vol. 17, Pages 6893: Social Determinants of Breastfeeding Preferences among Black Mothers Living with HIV in Two North American Cities https://www.mdpi.com/1660-4601/17/18/6893 The study is motivated by the need to understand the social determinants of breastfeeding attitudes among HIV-positive African, Caribbean, and Black (ACB) mothers. To address the central issue identified in this study, analysis was conducted with datasets from two North American cities, where unique country-specific guidelines complicate infant feeding discourse, decisions, and practices for HIV-positive mothers. These national infant feeding guidelines in Canada and the US present a source of conflict and tension for ACB mothers as they try to navigate the spaces between contradictory cultural expectations and national guidelines. Analyses in this paper were drawn from a broader mixed methods study guided by a community-based participatory research (CBPR) approach to examine infant feeding practices among HIV-positive Black mothers in three countries. The survey were distributed through Qualtrics and SPSS was used for data cleaning and analysis. Results revealed a direct correlation between social determinants and breastfeeding attitude. Country of residence, relatives’ opinion, healthcare providers’ advice and HIV-related stigma had statistically significant association with breastfeeding attitude. While the two countries’ guidelines, which recommend exclusive formula feeding, are cardinal in preventing vertical transmission, they can also be a source of stress. We recommend due consideration of the cultural contexts of women’s lives in infant feeding guidelines, to ensure inclusion of diverse women. IJERPH, Vol. 17, Pages 6893: Social Determinants of Breastfeeding Preferences among Black Mothers Living with HIV in Two North American Cities

International Journal of Environmental Research and Public Health doi: 10.3390/ijerph17186893

Authors: Josephine Etowa Egbe Etowa Hilary Nare Ikenna Mbagwu Jean Hannan

The study is motivated by the need to understand the social determinants of breastfeeding attitudes among HIV-positive African, Caribbean, and Black (ACB) mothers. To address the central issue identified in this study, analysis was conducted with datasets from two North American cities, where unique country-specific guidelines complicate infant feeding discourse, decisions, and practices for HIV-positive mothers. These national infant feeding guidelines in Canada and the US present a source of conflict and tension for ACB mothers as they try to navigate the spaces between contradictory cultural expectations and national guidelines. Analyses in this paper were drawn from a broader mixed methods study guided by a community-based participatory research (CBPR) approach to examine infant feeding practices among HIV-positive Black mothers in three countries. The survey were distributed through Qualtrics and SPSS was used for data cleaning and analysis. Results revealed a direct correlation between social determinants and breastfeeding attitude. Country of residence, relatives’ opinion, healthcare providers’ advice and HIV-related stigma had statistically significant association with breastfeeding attitude. While the two countries’ guidelines, which recommend exclusive formula feeding, are cardinal in preventing vertical transmission, they can also be a source of stress. We recommend due consideration of the cultural contexts of women’s lives in infant feeding guidelines, to ensure inclusion of diverse women.

]]>
Social Determinants of Breastfeeding Preferences among Black Mothers Living with HIV in Two North American Cities Josephine Etowa Egbe Etowa Hilary Nare Ikenna Mbagwu Jean Hannan doi: 10.3390/ijerph17186893 International Journal of Environmental Research and Public Health 2020-09-21 International Journal of Environmental Research and Public Health 2020-09-21 17 18 Article 6893 10.3390/ijerph17186893 https://www.mdpi.com/1660-4601/17/18/6893
IJERPH, Vol. 17, Pages 6892: Knowledge, Attitudes and Perceptions about Cervical Cancer Risk, Prevention and Human Papilloma Virus (HPV) in Vulnerable Women in Greece https://www.mdpi.com/1660-4601/17/18/6892 Cervical cancer can be largely preventable through primary and secondary prevention activities. Following the financial crisis in Greece since 2011 and the increased number of refugees/migrants since 2015 the proportion of vulnerable population groups in Greece increased greatly and the ability of the healthcare sector to respond and to cover the health needs of the population is put under tremendous stress. A cross-sectional study was designed to assess the characteristics of vulnerable women in Greece regarding cervical cancer risk factors, prevention through screening activities and Human Papilloma Virus (HPV) knowledge. Two cohorts of women aged 18 to 70 years were studied (142 in 2012 and 122 in 2017) who completed an interviewer-administered questionnaire based on the behavioural model for vulnerable populations. According to this model, the factors that affect the behaviour of women in relation with their knowledge, attitudes and beliefs towards cervical cancer and the HPV vaccine in our study sample are categorised in predisposing factors (age, educational status, nationality menopausal status and housing) and enabling factors (lack of insurance coverage). Results from both univariate and multivariate analyses show that older age, low educational background, refugee/migrant or ethnic minority (Roma) background, menopausal status, housing conditions and lack of insurance coverage are linked with insufficient knowledge on risk factors for cervical cancer and false attitudes and perceptions on cervical cancer preventive activities (Pap smear and HPV vaccine). This is the first study in Greece showing the lack of knowledge and the poor attitudes and perceptions on cervical cancer screening and the HPV vaccine in various groups of vulnerable women. Our results indicate the need of health education and intervention activities according to the characteristics and needs of each group. IJERPH, Vol. 17, Pages 6892: Knowledge, Attitudes and Perceptions about Cervical Cancer Risk, Prevention and Human Papilloma Virus (HPV) in Vulnerable Women in Greece

International Journal of Environmental Research and Public Health doi: 10.3390/ijerph17186892

Authors: Elena Riza Argiro Karakosta Thomas Tsiampalis Despoina Lazarou Angeliki Karachaliou Spyridon Ntelis Vasilios Karageorgiou Theodora Psaltopoulou

Cervical cancer can be largely preventable through primary and secondary prevention activities. Following the financial crisis in Greece since 2011 and the increased number of refugees/migrants since 2015 the proportion of vulnerable population groups in Greece increased greatly and the ability of the healthcare sector to respond and to cover the health needs of the population is put under tremendous stress. A cross-sectional study was designed to assess the characteristics of vulnerable women in Greece regarding cervical cancer risk factors, prevention through screening activities and Human Papilloma Virus (HPV) knowledge. Two cohorts of women aged 18 to 70 years were studied (142 in 2012 and 122 in 2017) who completed an interviewer-administered questionnaire based on the behavioural model for vulnerable populations. According to this model, the factors that affect the behaviour of women in relation with their knowledge, attitudes and beliefs towards cervical cancer and the HPV vaccine in our study sample are categorised in predisposing factors (age, educational status, nationality menopausal status and housing) and enabling factors (lack of insurance coverage). Results from both univariate and multivariate analyses show that older age, low educational background, refugee/migrant or ethnic minority (Roma) background, menopausal status, housing conditions and lack of insurance coverage are linked with insufficient knowledge on risk factors for cervical cancer and false attitudes and perceptions on cervical cancer preventive activities (Pap smear and HPV vaccine). This is the first study in Greece showing the lack of knowledge and the poor attitudes and perceptions on cervical cancer screening and the HPV vaccine in various groups of vulnerable women. Our results indicate the need of health education and intervention activities according to the characteristics and needs of each group.

]]>
Knowledge, Attitudes and Perceptions about Cervical Cancer Risk, Prevention and Human Papilloma Virus (HPV) in Vulnerable Women in Greece Elena Riza Argiro Karakosta Thomas Tsiampalis Despoina Lazarou Angeliki Karachaliou Spyridon Ntelis Vasilios Karageorgiou Theodora Psaltopoulou doi: 10.3390/ijerph17186892 International Journal of Environmental Research and Public Health 2020-09-21 International Journal of Environmental Research and Public Health 2020-09-21 17 18 Article 6892 10.3390/ijerph17186892 https://www.mdpi.com/1660-4601/17/18/6892
IJERPH, Vol. 17, Pages 6891: Factors that Influence the Decision to Seek Help in a Police Population https://www.mdpi.com/1660-4601/17/18/6891 Police officers face many competing pressures and demands. Exposure to potentially traumatic incidents and significant job-related stressors can place many at higher risk of developing physical and mental health problems. The police culture exerts a pronounced influence on officers, preventing some from asking for or receiving assistance. The stigma of being perceived as weak or incompetent, concerns about being labelled unfit for duty, and worry that accessing psychological support will impact future career advancement can affect the decision to seek help. The Enhanced Critical Incident Technique was utilized to investigate the following research question: What helps or hinders the decision to access psychological services in a police population? Qualitative interviews were conducted with 20 serving Royal Canadian Mounted Police officers in the lower mainland of British Columbia, Canada. The findings encompass five main themes: the importance of systemic factors, access to information and education, quality and influence of relationships, individual characteristics, and organizational processes that will increase the likelihood of accessing mental health services. The results contribute to the empirical literature by enhancing what is known about elements that influence an officers’ decision to seek psychological services, and factors that can enable officers to overcome barriers. IJERPH, Vol. 17, Pages 6891: Factors that Influence the Decision to Seek Help in a Police Population

International Journal of Environmental Research and Public Health doi: 10.3390/ijerph17186891

Authors: Carolyn Burns Marla Buchanan

Police officers face many competing pressures and demands. Exposure to potentially traumatic incidents and significant job-related stressors can place many at higher risk of developing physical and mental health problems. The police culture exerts a pronounced influence on officers, preventing some from asking for or receiving assistance. The stigma of being perceived as weak or incompetent, concerns about being labelled unfit for duty, and worry that accessing psychological support will impact future career advancement can affect the decision to seek help. The Enhanced Critical Incident Technique was utilized to investigate the following research question: What helps or hinders the decision to access psychological services in a police population? Qualitative interviews were conducted with 20 serving Royal Canadian Mounted Police officers in the lower mainland of British Columbia, Canada. The findings encompass five main themes: the importance of systemic factors, access to information and education, quality and influence of relationships, individual characteristics, and organizational processes that will increase the likelihood of accessing mental health services. The results contribute to the empirical literature by enhancing what is known about elements that influence an officers’ decision to seek psychological services, and factors that can enable officers to overcome barriers.

]]>
Factors that Influence the Decision to Seek Help in a Police Population Carolyn Burns Marla Buchanan doi: 10.3390/ijerph17186891 International Journal of Environmental Research and Public Health 2020-09-21 International Journal of Environmental Research and Public Health 2020-09-21 17 18 Article 6891 10.3390/ijerph17186891 https://www.mdpi.com/1660-4601/17/18/6891
IJERPH, Vol. 17, Pages 6889: Quality of Life Changes in Acute Coronary Syndromes Patients: A Systematic Review and Meta-Analysis https://www.mdpi.com/1660-4601/17/18/6889 There is little up-to-date evidence about changes in quality of life following treatment for acute coronary syndrome (ACS) patients. The main aim of this review was to assess the changes in QoL in ACS patients after treatment. We undertook a systematic review and meta-analysis of quantitative studies. The search included studies that described the change of QoL of ACS patients after receiving treatment options such as percutaneous coronary intervention (PCI), coronary artery bypass grafting (CABG) and medical therapy (MT). We synthesized findings using content analysis and pooled the estimates using meta-analysis. We used the PRISMA guidelines to select and appraise the studies and report the findings. Twenty-nine (29) articles were included in the review. We found a significant improvement of QoL in ACS patients after receiving treatment. Particularly, the meta-analytic association found that the mean QoL of patients diagnosed with ACS was higher after receiving treatment compared to baseline (overall pooled mean difference = 31.88; 95% CI = 31.64–52.11, I2 = 98) with patients on PCI having slightly lower QoL gains (pooled mean difference = 30.22; 95% CI = 29.9–30.53, I2 = 0%) compared to those on CABG (pooled mean difference = 34.01; 95% CI = 33.66–34.37, I2 = 0%). The review confirmed that QoL of ACS patients improved after receiving treatment therapies although varied by the treatment options and patients’ preferences. This suggests the need to perform further study on the QoL, patient preferences and physicians’ decision to prescription of treatment options. IJERPH, Vol. 17, Pages 6889: Quality of Life Changes in Acute Coronary Syndromes Patients: A Systematic Review and Meta-Analysis

International Journal of Environmental Research and Public Health doi: 10.3390/ijerph17186889

Authors: Billingsley Kaambwa Hailay Abrha Gesesew Matthew Horsfall Derek Chew

There is little up-to-date evidence about changes in quality of life following treatment for acute coronary syndrome (ACS) patients. The main aim of this review was to assess the changes in QoL in ACS patients after treatment. We undertook a systematic review and meta-analysis of quantitative studies. The search included studies that described the change of QoL of ACS patients after receiving treatment options such as percutaneous coronary intervention (PCI), coronary artery bypass grafting (CABG) and medical therapy (MT). We synthesized findings using content analysis and pooled the estimates using meta-analysis. We used the PRISMA guidelines to select and appraise the studies and report the findings. Twenty-nine (29) articles were included in the review. We found a significant improvement of QoL in ACS patients after receiving treatment. Particularly, the meta-analytic association found that the mean QoL of patients diagnosed with ACS was higher after receiving treatment compared to baseline (overall pooled mean difference = 31.88; 95% CI = 31.64–52.11, I2 = 98) with patients on PCI having slightly lower QoL gains (pooled mean difference = 30.22; 95% CI = 29.9–30.53, I2 = 0%) compared to those on CABG (pooled mean difference = 34.01; 95% CI = 33.66–34.37, I2 = 0%). The review confirmed that QoL of ACS patients improved after receiving treatment therapies although varied by the treatment options and patients’ preferences. This suggests the need to perform further study on the QoL, patient preferences and physicians’ decision to prescription of treatment options.

]]>
Quality of Life Changes in Acute Coronary Syndromes Patients: A Systematic Review and Meta-Analysis Billingsley Kaambwa Hailay Abrha Gesesew Matthew Horsfall Derek Chew doi: 10.3390/ijerph17186889 International Journal of Environmental Research and Public Health 2020-09-21 International Journal of Environmental Research and Public Health 2020-09-21 17 18 Review 6889 10.3390/ijerph17186889 https://www.mdpi.com/1660-4601/17/18/6889
IJERPH, Vol. 17, Pages 6888: Tracking and Analyzing Public Emotion Evolutions During COVID-19: A Case Study from the Event-Driven Perspective on Microblogs https://www.mdpi.com/1660-4601/17/18/6888 Objective: Coronavirus disease 2019 (COVID-19) has caused substantial panic worldwide since its outbreak in December 2019. This study uses social networks to track the evolution of public emotion during COVID-19 in China and analyzes the root causes of these public emotions from an event-driven perspective. Methods: A dataset was constructed using microblogs (n = 125,672) labeled with COVID-19-related super topics (n = 680) from 40,891 users from 1 December 2019 to 17 February 2020. Based on the skeleton and key change points of COVID-19 extracted from microblogging contents, we tracked the public’s emotional evolution modes (accumulated emotions, emotion covariances, and emotion transitions) by time phase and further extracted the details of dominant social events. Results: Public emotions showed different evolution modes during different phases of COVID-19. Events about the development of COVID-19 remained hot, but generally declined, and public attention shifted to other aspects of the epidemic (e.g., encouragement, support, and treatment). Conclusions: These findings suggest that the public’s feedback on COVID-19 predated official accounts on the microblog platform. There were clear differences in the trending events that large users (users with many fans and readings) and common users paid attention to during each phase of COVID-19. IJERPH, Vol. 17, Pages 6888: Tracking and Analyzing Public Emotion Evolutions During COVID-19: A Case Study from the Event-Driven Perspective on Microblogs

International Journal of Environmental Research and Public Health doi: 10.3390/ijerph17186888

Authors: Qi Li Cong Wei Jianning Dang Lei Cao Li Liu

Objective: Coronavirus disease 2019 (COVID-19) has caused substantial panic worldwide since its outbreak in December 2019. This study uses social networks to track the evolution of public emotion during COVID-19 in China and analyzes the root causes of these public emotions from an event-driven perspective. Methods: A dataset was constructed using microblogs (n = 125,672) labeled with COVID-19-related super topics (n = 680) from 40,891 users from 1 December 2019 to 17 February 2020. Based on the skeleton and key change points of COVID-19 extracted from microblogging contents, we tracked the public’s emotional evolution modes (accumulated emotions, emotion covariances, and emotion transitions) by time phase and further extracted the details of dominant social events. Results: Public emotions showed different evolution modes during different phases of COVID-19. Events about the development of COVID-19 remained hot, but generally declined, and public attention shifted to other aspects of the epidemic (e.g., encouragement, support, and treatment). Conclusions: These findings suggest that the public’s feedback on COVID-19 predated official accounts on the microblog platform. There were clear differences in the trending events that large users (users with many fans and readings) and common users paid attention to during each phase of COVID-19.

]]>
Tracking and Analyzing Public Emotion Evolutions During COVID-19: A Case Study from the Event-Driven Perspective on Microblogs Qi Li Cong Wei Jianning Dang Lei Cao Li Liu doi: 10.3390/ijerph17186888 International Journal of Environmental Research and Public Health 2020-09-21 International Journal of Environmental Research and Public Health 2020-09-21 17 18 Article 6888 10.3390/ijerph17186888 https://www.mdpi.com/1660-4601/17/18/6888
IJERPH, Vol. 17, Pages 6886: The Effectiveness of Patient-Centred Medical Home-Based Models of Care versus Standard Primary Care in Chronic Disease Management: A Systematic Review and Meta-Analysis of Randomised and Non-Randomised Controlled Trials https://www.mdpi.com/1660-4601/17/18/6886 Patient-centred care by a coordinated primary care team may be more effective than standard care in chronic disease management. We synthesised evidence to determine whether patient-centred medical home (PCMH)-based care models are more effective than standard general practitioner (GP) care in improving biomedical, hospital, and economic outcomes. MEDLINE, CINAHL, Embase, Cochrane Library, and Scopus were searched to identify randomised (RCTs) and non-randomised controlled trials that evaluated two or more principles of PCMH among primary care patients with chronic diseases. Study selection, data extraction, quality assessment using Joanna Briggs Institute (JBI) appraisal tools, and grading of evidence using Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) approach were conducted independently. A quantitative synthesis, where possible, was pooled using random effects models and the effect size estimates of standardised mean differences (SMDs) and odds ratios (ORs) with 95% confidence intervals were reported. Of the 13,820 citations, we identified 78 eligible RCTs and 7 quasi trials which included 60,617 patients. The findings suggested that PCMH-based care was associated with significant improvements in depression episodes (SMD −0.24; 95% CI −0.35, −0.14; I2 = 76%) and increased odds of remission (OR 1.79; 95% CI 1.46, 2.21; I2 = 0%). There were significant improvements in the health-related quality of life (SMD 0.10; 95% CI 0.04, 0.15; I2 = 51%), self-management outcomes (SMD 0.24; 95% CI 0.03, 0.44; I2 = 83%), and hospital admissions (OR 0.83; 95% CI 0.70, 0.98; I2 = 0%). In terms of biomedical outcomes, with exception to total cholesterol, PCMH-based care led to significant improvements in blood pressure, glycated haemoglobin, and low-density lipoprotein cholesterol outcomes. The incremental cost of PCMH care was identified to be small and significantly higher than standard care (SMD 0.17; 95% CI 0.08, 0.26; I2 = 82%). The quality of individual studies ranged from “fair” to “good” by meeting at least 60% of items on the quality appraisal checklist. Additionally, moderate to high heterogeneity across studies in outcomes resulted in downgrading the included studies as moderate or low grade of evidence. PCMH-based care has been found to be superior to standard GP care in chronic disease management. Results of the review have important implications that may inform patient, practice, and policy-level changes. IJERPH, Vol. 17, Pages 6886: The Effectiveness of Patient-Centred Medical Home-Based Models of Care versus Standard Primary Care in Chronic Disease Management: A Systematic Review and Meta-Analysis of Randomised and Non-Randomised Controlled Trials

International Journal of Environmental Research and Public Health doi: 10.3390/ijerph17186886

Authors: James Rufus John Hir Jani Kath Peters Kingsley Agho W. Kathy Tannous

Patient-centred care by a coordinated primary care team may be more effective than standard care in chronic disease management. We synthesised evidence to determine whether patient-centred medical home (PCMH)-based care models are more effective than standard general practitioner (GP) care in improving biomedical, hospital, and economic outcomes. MEDLINE, CINAHL, Embase, Cochrane Library, and Scopus were searched to identify randomised (RCTs) and non-randomised controlled trials that evaluated two or more principles of PCMH among primary care patients with chronic diseases. Study selection, data extraction, quality assessment using Joanna Briggs Institute (JBI) appraisal tools, and grading of evidence using Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) approach were conducted independently. A quantitative synthesis, where possible, was pooled using random effects models and the effect size estimates of standardised mean differences (SMDs) and odds ratios (ORs) with 95% confidence intervals were reported. Of the 13,820 citations, we identified 78 eligible RCTs and 7 quasi trials which included 60,617 patients. The findings suggested that PCMH-based care was associated with significant improvements in depression episodes (SMD −0.24; 95% CI −0.35, −0.14; I2 = 76%) and increased odds of remission (OR 1.79; 95% CI 1.46, 2.21; I2 = 0%). There were significant improvements in the health-related quality of life (SMD 0.10; 95% CI 0.04, 0.15; I2 = 51%), self-management outcomes (SMD 0.24; 95% CI 0.03, 0.44; I2 = 83%), and hospital admissions (OR 0.83; 95% CI 0.70, 0.98; I2 = 0%). In terms of biomedical outcomes, with exception to total cholesterol, PCMH-based care led to significant improvements in blood pressure, glycated haemoglobin, and low-density lipoprotein cholesterol outcomes. The incremental cost of PCMH care was identified to be small and significantly higher than standard care (SMD 0.17; 95% CI 0.08, 0.26; I2 = 82%). The quality of individual studies ranged from “fair” to “good” by meeting at least 60% of items on the quality appraisal checklist. Additionally, moderate to high heterogeneity across studies in outcomes resulted in downgrading the included studies as moderate or low grade of evidence. PCMH-based care has been found to be superior to standard GP care in chronic disease management. Results of the review have important implications that may inform patient, practice, and policy-level changes.

]]>
The Effectiveness of Patient-Centred Medical Home-Based Models of Care versus Standard Primary Care in Chronic Disease Management: A Systematic Review and Meta-Analysis of Randomised and Non-Randomised Controlled Trials James Rufus John Hir Jani Kath Peters Kingsley Agho W. Kathy Tannous doi: 10.3390/ijerph17186886 International Journal of Environmental Research and Public Health 2020-09-21 International Journal of Environmental Research and Public Health 2020-09-21 17 18 Article 6886 10.3390/ijerph17186886 https://www.mdpi.com/1660-4601/17/18/6886
IJERPH, Vol. 17, Pages 6887: Daily Physical Activity and Sedentary Time Assessed by Acceleration Based on Mean Amplitude Deviation among Older People https://www.mdpi.com/1660-4601/17/18/6887 Accelerometer-derived estimates of physical activity (PA) and sedentary time have been an important methodological focus. However, little is known about the daily activities among older people during their normal lives. Furthermore, some older individuals would like to be more active, yet experience an unmet PA need, which is defined as the desire to engage in more PA but without the opportunity to act on the desire. This study examined the intensity of daily PA and sedentary behavior measured with accelerometers among older people, and whether PA differs between weekdays and weekends and those with and without the experience of unmet PA need, measured with self-reports. A total of 174 community-dwelling older people (64% female) aged 75 to 90 years used an accelerometer for 7 consecutive days during waking hours, and the results were classified for sedentary behavior (thresholds of 0.0167 g), light activity (0.091 g), and moderate-to-vigorous activity (MVPA, 0.414 g) based on mean amplitude deviation (g). We found that during weekdays, older people engaged slightly more in light activity and had less sedentary time than during weekends. In total, 7.6% of the participants perceived an unmet PA need. Accordingly, those with unmet PA needs spent less time in MVPA, especially during weekdays, and they might benefit from PA-enabling interventions. IJERPH, Vol. 17, Pages 6887: Daily Physical Activity and Sedentary Time Assessed by Acceleration Based on Mean Amplitude Deviation among Older People

International Journal of Environmental Research and Public Health doi: 10.3390/ijerph17186887

Authors: Ying Gao Timo Rantalainen Taija Finni Erja Portegijs Johanna Eronen Taina Rantanen Merja Rantakokko

Accelerometer-derived estimates of physical activity (PA) and sedentary time have been an important methodological focus. However, little is known about the daily activities among older people during their normal lives. Furthermore, some older individuals would like to be more active, yet experience an unmet PA need, which is defined as the desire to engage in more PA but without the opportunity to act on the desire. This study examined the intensity of daily PA and sedentary behavior measured with accelerometers among older people, and whether PA differs between weekdays and weekends and those with and without the experience of unmet PA need, measured with self-reports. A total of 174 community-dwelling older people (64% female) aged 75 to 90 years used an accelerometer for 7 consecutive days during waking hours, and the results were classified for sedentary behavior (thresholds of 0.0167 g), light activity (0.091 g), and moderate-to-vigorous activity (MVPA, 0.414 g) based on mean amplitude deviation (g). We found that during weekdays, older people engaged slightly more in light activity and had less sedentary time than during weekends. In total, 7.6% of the participants perceived an unmet PA need. Accordingly, those with unmet PA needs spent less time in MVPA, especially during weekdays, and they might benefit from PA-enabling interventions.

]]>
Daily Physical Activity and Sedentary Time Assessed by Acceleration Based on Mean Amplitude Deviation among Older People Ying Gao Timo Rantalainen Taija Finni Erja Portegijs Johanna Eronen Taina Rantanen Merja Rantakokko doi: 10.3390/ijerph17186887 International Journal of Environmental Research and Public Health 2020-09-21 International Journal of Environmental Research and Public Health 2020-09-21 17 18 Article 6887 10.3390/ijerph17186887 https://www.mdpi.com/1660-4601/17/18/6887
IJERPH, Vol. 17, Pages 6885: Effects of Tetraselmis chuii Microalgae Supplementation on Ergospirometric, Haematological and Biochemical Parameters in Amateur Soccer Players https://www.mdpi.com/1660-4601/17/18/6885 This study aimed to analyse the effects of Tetraselmis chuii (TC) microalgae supplementation during thirty days on ergospirometric, haematological and biochemical parameters in amateur soccer players. Thirty-two amateur soccer players divided into a control group (CG; n = 16; 22.36 ± 1.36 years; 68.36 ± 3.53 kg) and a supplemented group (SG; n = 16; 22.23 ± 2.19 years; 69.30 ± 5.56 kg) participated in the double-blind study. SG ingested 200 mg of the TC per day, while CG ingested 200 mg per day of lactose powder. Supplementation was carried out for thirty days. The participants performed a maximal treadmill test until exhaustion. The ergospirometric values at different ventilatory thresholds and haematological values were obtained after the test. Heart rate decreased after supplementation with TC (p < 0.05). Oxygen pulse, relative and absolute maximum oxygen consumption increased in SG (pre vs. post; 19.04 ± 2.53 vs. 22.08 ± 2.25; 53.56 ± 3.26 vs. 56.74 ± 3.43; 3.72 ± 0.35 vs. 3.99 ± 0.25; p < 0.05). Haemoglobin and mean corpuscular haemoglobin increased in SG (pre vs. post; 15.12 ± 0.87 vs. 16.58 ± 0.74 p < 0.01; 28.03 ± 1.57 vs. 30.82 ± 1.21; p < 0.05). On the other hand, haematocrit and mean platelet volume decreased in SG (p < 0.05). TC supplementation elicited improvements in ergospirometric and haematological values in amateur soccer players. TC supplementation could be valuable for improving performance in amateur athletes. IJERPH, Vol. 17, Pages 6885: Effects of Tetraselmis chuii Microalgae Supplementation on Ergospirometric, Haematological and Biochemical Parameters in Amateur Soccer Players

International Journal of Environmental Research and Public Health doi: 10.3390/ijerph17186885

Authors: Víctor Toro Jesús Siquier-Coll Ignacio Bartolomé María C. Robles-Gil Javier Rodrigo Marcos Maynar-Mariño

This study aimed to analyse the effects of Tetraselmis chuii (TC) microalgae supplementation during thirty days on ergospirometric, haematological and biochemical parameters in amateur soccer players. Thirty-two amateur soccer players divided into a control group (CG; n = 16; 22.36 ± 1.36 years; 68.36 ± 3.53 kg) and a supplemented group (SG; n = 16; 22.23 ± 2.19 years; 69.30 ± 5.56 kg) participated in the double-blind study. SG ingested 200 mg of the TC per day, while CG ingested 200 mg per day of lactose powder. Supplementation was carried out for thirty days. The participants performed a maximal treadmill test until exhaustion. The ergospirometric values at different ventilatory thresholds and haematological values were obtained after the test. Heart rate decreased after supplementation with TC (p < 0.05). Oxygen pulse, relative and absolute maximum oxygen consumption increased in SG (pre vs. post; 19.04 ± 2.53 vs. 22.08 ± 2.25; 53.56 ± 3.26 vs. 56.74 ± 3.43; 3.72 ± 0.35 vs. 3.99 ± 0.25; p < 0.05). Haemoglobin and mean corpuscular haemoglobin increased in SG (pre vs. post; 15.12 ± 0.87 vs. 16.58 ± 0.74 p < 0.01; 28.03 ± 1.57 vs. 30.82 ± 1.21; p < 0.05). On the other hand, haematocrit and mean platelet volume decreased in SG (p < 0.05). TC supplementation elicited improvements in ergospirometric and haematological values in amateur soccer players. TC supplementation could be valuable for improving performance in amateur athletes.

]]>
Effects of Tetraselmis chuii Microalgae Supplementation on Ergospirometric, Haematological and Biochemical Parameters in Amateur Soccer Players Víctor Toro Jesús Siquier-Coll Ignacio Bartolomé María C. Robles-Gil Javier Rodrigo Marcos Maynar-Mariño doi: 10.3390/ijerph17186885 International Journal of Environmental Research and Public Health 2020-09-21 International Journal of Environmental Research and Public Health 2020-09-21 17 18 Article 6885 10.3390/ijerph17186885 https://www.mdpi.com/1660-4601/17/18/6885
IJERPH, Vol. 17, Pages 6884: Social Support and Well-Being of Chinese Special Education Teachers—An Emotional Labor Perspective https://www.mdpi.com/1660-4601/17/18/6884 Due to their high expectations, teachers often hide their real emotions and play a role that conforms to public expectations of educational work. Special education teachers face a group of students with physical and mental disabilities who have high heterogeneity and require individualized services every day. Using social support theory, this study discusses special education teachers’ emotional labor and well-being. A total of 439 special education teachers in China participated in this study. We collected data at two different time-points and verified the research hypotheses with hierarchical regression and structural equation modeling analysis. The research findings show the mediating role of emotional labor in social support and well-being. It is, therefore, suggested that schools should pay more attention to special education teachers’ mental health and provide them with regular guidance and support. IJERPH, Vol. 17, Pages 6884: Social Support and Well-Being of Chinese Special Education Teachers—An Emotional Labor Perspective

International Journal of Environmental Research and Public Health doi: 10.3390/ijerph17186884

Authors: Tung-Ju Wu Lian-Yi Wang Jia-Ying Gao An-Pin Wei

Due to their high expectations, teachers often hide their real emotions and play a role that conforms to public expectations of educational work. Special education teachers face a group of students with physical and mental disabilities who have high heterogeneity and require individualized services every day. Using social support theory, this study discusses special education teachers’ emotional labor and well-being. A total of 439 special education teachers in China participated in this study. We collected data at two different time-points and verified the research hypotheses with hierarchical regression and structural equation modeling analysis. The research findings show the mediating role of emotional labor in social support and well-being. It is, therefore, suggested that schools should pay more attention to special education teachers’ mental health and provide them with regular guidance and support.

]]>
Social Support and Well-Being of Chinese Special Education Teachers—An Emotional Labor Perspective Tung-Ju Wu Lian-Yi Wang Jia-Ying Gao An-Pin Wei doi: 10.3390/ijerph17186884 International Journal of Environmental Research and Public Health 2020-09-21 International Journal of Environmental Research and Public Health 2020-09-21 17 18 Article 6884 10.3390/ijerph17186884 https://www.mdpi.com/1660-4601/17/18/6884
IJERPH, Vol. 17, Pages 6883: Work–Family Conflict, Emotional Responses, Workplace Deviance, and Well-Being among Construction Professionals: A Sequential Mediation Model https://www.mdpi.com/1660-4601/17/18/6883 Given the dynamic, complex, and highly demanding project environment, construction professionals are particularly likely to experience a high level of work–family conflict. Taking an emotional resource perspective and on the basis of affective events theory, this study tested negative affect and emotional exhaustion as sequential mediators between two directions of work–family conflict and workplace well-being or deviance behavior. The theoretical model was examined using data collected at two time points from 143 construction professionals through regression analysis and bootstrapping. The results indicate that work–family conflict was positively related to deviant behavior and negatively related to workplace well-being. The findings demonstrate that the mediation effects of emotional exhaustion between work–family conflict and workplace well-being or deviant behavior were significant and that the sequential mediating effects of negative affect and emotional exhaustion in the relationship between work–family conflict and workplace well-being or deviant behavior were significant. Moreover, different impacts of work interference with family and family interference with work on job-related attitudes and behavior were observed. These findings highlight the importance of emotional experience to understand the negative impact of work–family conflict in the temporary project context. IJERPH, Vol. 17, Pages 6883: Work–Family Conflict, Emotional Responses, Workplace Deviance, and Well-Being among Construction Professionals: A Sequential Mediation Model

International Journal of Environmental Research and Public Health doi: 10.3390/ijerph17186883

Authors: Yan Chen Feilian Zhang Yan Wang Junwei Zheng

Given the dynamic, complex, and highly demanding project environment, construction professionals are particularly likely to experience a high level of work–family conflict. Taking an emotional resource perspective and on the basis of affective events theory, this study tested negative affect and emotional exhaustion as sequential mediators between two directions of work–family conflict and workplace well-being or deviance behavior. The theoretical model was examined using data collected at two time points from 143 construction professionals through regression analysis and bootstrapping. The results indicate that work–family conflict was positively related to deviant behavior and negatively related to workplace well-being. The findings demonstrate that the mediation effects of emotional exhaustion between work–family conflict and workplace well-being or deviant behavior were significant and that the sequential mediating effects of negative affect and emotional exhaustion in the relationship between work–family conflict and workplace well-being or deviant behavior were significant. Moreover, different impacts of work interference with family and family interference with work on job-related attitudes and behavior were observed. These findings highlight the importance of emotional experience to understand the negative impact of work–family conflict in the temporary project context.

]]>
Work–Family Conflict, Emotional Responses, Workplace Deviance, and Well-Being among Construction Professionals: A Sequential Mediation Model Yan Chen Feilian Zhang Yan Wang Junwei Zheng doi: 10.3390/ijerph17186883 International Journal of Environmental Research and Public Health 2020-09-21 International Journal of Environmental Research and Public Health 2020-09-21 17 18 Article 6883 10.3390/ijerph17186883 https://www.mdpi.com/1660-4601/17/18/6883
IJERPH, Vol. 17, Pages 6881: Association between Sexual Habits and Sexually Transmitted Infections at a Specialised Centre in Granada (Spain) https://www.mdpi.com/1660-4601/17/18/6881 Sexually transmitted infections are an important public health issue. The purpose of this study is to analyse the association between different sexual habits and the prevalence of sexually transmitted infections in the population of Granada who consult with a specialised centre. An observational, cross-sectional study was conducted based on the medical records of 678 people from the Sexually Transmitted Diseases and Sexual Orientation Centre of Granada, who were diagnosed positively or negatively with a sexually transmitted infection, during the 2000−2014 period. Sociodemographic and clinical data, as well as data on frequency and type of sexual habits, frequency of condom use and sexually transmitted infection positive or negative diagnosis were collected. Univariate and bivariate analyses were conducted. The most popular sexual habits were vaginal intercourse, oral sex (mouth–vagina and mouth–penis) and the least popular were anus–mouth and anal sex. The use of condom is frequent in vaginal and anal sex and less frequent in oral sex. Sexually transmitted infection is associated with mouth–penis (p = 0.004) and mouth–vagina (p = 0.023) oral sex and anal sex (p = 0.031). It is observed that there is a relationship between the presence of STIs and oral sex practices, people having such practices being the ones who use condoms less frequently. There is also a relationship between anal sex and the prevalence of STIs, although in such sexual practice the use of condom does prevail. IJERPH, Vol. 17, Pages 6881: Association between Sexual Habits and Sexually Transmitted Infections at a Specialised Centre in Granada (Spain)

International Journal of Environmental Research and Public Health doi: 10.3390/ijerph17186881

Authors: Raquel Casado Santa-Bárbara César Hueso-Montoro Adelina Martín-Salvador María Adelaida Álvarez-Serrano María Gázquez-López María Ángeles Pérez-Morente

Sexually transmitted infections are an important public health issue. The purpose of this study is to analyse the association between different sexual habits and the prevalence of sexually transmitted infections in the population of Granada who consult with a specialised centre. An observational, cross-sectional study was conducted based on the medical records of 678 people from the Sexually Transmitted Diseases and Sexual Orientation Centre of Granada, who were diagnosed positively or negatively with a sexually transmitted infection, during the 2000−2014 period. Sociodemographic and clinical data, as well as data on frequency and type of sexual habits, frequency of condom use and sexually transmitted infection positive or negative diagnosis were collected. Univariate and bivariate analyses were conducted. The most popular sexual habits were vaginal intercourse, oral sex (mouth–vagina and mouth–penis) and the least popular were anus–mouth and anal sex. The use of condom is frequent in vaginal and anal sex and less frequent in oral sex. Sexually transmitted infection is associated with mouth–penis (p = 0.004) and mouth–vagina (p = 0.023) oral sex and anal sex (p = 0.031). It is observed that there is a relationship between the presence of STIs and oral sex practices, people having such practices being the ones who use condoms less frequently. There is also a relationship between anal sex and the prevalence of STIs, although in such sexual practice the use of condom does prevail.

]]>
Association between Sexual Habits and Sexually Transmitted Infections at a Specialised Centre in Granada (Spain) Raquel Casado Santa-Bárbara César Hueso-Montoro Adelina Martín-Salvador María Adelaida Álvarez-Serrano María Gázquez-López María Ángeles Pérez-Morente doi: 10.3390/ijerph17186881 International Journal of Environmental Research and Public Health 2020-09-21 International Journal of Environmental Research and Public Health 2020-09-21 17 18 Brief Report 6881 10.3390/ijerph17186881 https://www.mdpi.com/1660-4601/17/18/6881
IJERPH, Vol. 17, Pages 6880: Theoretical Boundary Conditions of Partner Buffering in Romantic Relationships https://www.mdpi.com/1660-4601/17/18/6880 Attachment insecurity is consequential for both personal and relationship wellbeing. Some research has documented that partner buffering can downregulate insecure individuals’ immediate feelings of distress, allowing them to feel more secure at least temporarily. The benefits of partner buffering, however, may be limited by several contextual factors. In this article, we identify boundary conditions that may curb or amplify the benefits of partner buffering for both targets (those who receive buffering) and agents (those who enact buffering). We suggest that motivation, ability, and timing may all affect partner buffering outcomes for targets and agents. If partner buffering is delivered in an adaptive way that does not reinforce the target’s insecure tendencies, it may help insecure targets learn that they can trust and depend on their partners (agents), which may facilitate greater security in targets. We recommend that future research consider these contextual factors and examine partner buffering as an inherently dyadic relationship process capable of enhancing attachment security. IJERPH, Vol. 17, Pages 6880: Theoretical Boundary Conditions of Partner Buffering in Romantic Relationships

International Journal of Environmental Research and Public Health doi: 10.3390/ijerph17186880

Authors: Jami Eller Jeffry A. Simpson

Attachment insecurity is consequential for both personal and relationship wellbeing. Some research has documented that partner buffering can downregulate insecure individuals’ immediate feelings of distress, allowing them to feel more secure at least temporarily. The benefits of partner buffering, however, may be limited by several contextual factors. In this article, we identify boundary conditions that may curb or amplify the benefits of partner buffering for both targets (those who receive buffering) and agents (those who enact buffering). We suggest that motivation, ability, and timing may all affect partner buffering outcomes for targets and agents. If partner buffering is delivered in an adaptive way that does not reinforce the target’s insecure tendencies, it may help insecure targets learn that they can trust and depend on their partners (agents), which may facilitate greater security in targets. We recommend that future research consider these contextual factors and examine partner buffering as an inherently dyadic relationship process capable of enhancing attachment security.

]]>
Theoretical Boundary Conditions of Partner Buffering in Romantic Relationships Jami Eller Jeffry A. Simpson doi: 10.3390/ijerph17186880 International Journal of Environmental Research and Public Health 2020-09-21 International Journal of Environmental Research and Public Health 2020-09-21 17 18 Review 6880 10.3390/ijerph17186880 https://www.mdpi.com/1660-4601/17/18/6880
IJERPH, Vol. 17, Pages 6879: Feeling Connected after Experiencing Digital Nature: A Survey Study https://www.mdpi.com/1660-4601/17/18/6879 Digital nature can provide a substitute for real nature for those who have limited access to green space, or are confined to their homes, for example during the worldwide COVID-19 lockdown. In a large-scale online survey, respondents (N = 1203) watched videos of digital nature, varying in terms of type of nature (wild versus tended nature) and spaciousness. Results show a significant increase of feelings of connectedness to the community after watching digital nature. Furthermore, tended nature scenes elicited more social aspirations than wild nature scenes. A multiple regression model further shows that living further away from nature was a significant predictor for loneliness scores, while number of nature interactions during a week was not. Results of this study confirm the importance of nature interaction for mental and social wellbeing for the general population and stress the potential of digital nature as a complementary strategy. These findings are of particular relevance to those who lack access to nature due to old age and related mobility constraints or a lockdown. IJERPH, Vol. 17, Pages 6879: Feeling Connected after Experiencing Digital Nature: A Survey Study

International Journal of Environmental Research and Public Health doi: 10.3390/ijerph17186879

Authors: Josca van Houwelingen-Snippe Thomas J. L. van Rompay Somaya Ben Allouch

Digital nature can provide a substitute for real nature for those who have limited access to green space, or are confined to their homes, for example during the worldwide COVID-19 lockdown. In a large-scale online survey, respondents (N = 1203) watched videos of digital nature, varying in terms of type of nature (wild versus tended nature) and spaciousness. Results show a significant increase of feelings of connectedness to the community after watching digital nature. Furthermore, tended nature scenes elicited more social aspirations than wild nature scenes. A multiple regression model further shows that living further away from nature was a significant predictor for loneliness scores, while number of nature interactions during a week was not. Results of this study confirm the importance of nature interaction for mental and social wellbeing for the general population and stress the potential of digital nature as a complementary strategy. These findings are of particular relevance to those who lack access to nature due to old age and related mobility constraints or a lockdown.

]]>
Feeling Connected after Experiencing Digital Nature: A Survey Study Josca van Houwelingen-Snippe Thomas J. L. van Rompay Somaya Ben Allouch doi: 10.3390/ijerph17186879 International Journal of Environmental Research and Public Health 2020-09-21 International Journal of Environmental Research and Public Health 2020-09-21 17 18 Article 6879 10.3390/ijerph17186879 https://www.mdpi.com/1660-4601/17/18/6879
IJERPH, Vol. 17, Pages 6878: Physical Activity Change during COVID-19 Confinement https://www.mdpi.com/1660-4601/17/18/6878 Background: The lockdown and social distancing caused by COVID-19 may influence common health behavior. The unprecedent worldwide confinement, in which Spain has been one of the most affected—with severe rules governing confinement—may have changed physical activity (PA) and sedentary habits due to prolonged stays at home. Purpose: The aim of this study is to evaluate how self-reported PA and sedentary time (ST) have changed during confinement in the Spanish population. Methods: 3800 healthy adults (age 18–64 years) residing in Spain answered the international physical activity questionnaire short (IPAQ-S) twice between 23 March and 1 April (confinement). Data analysis was carried out taking into consideration meeting general PA recommendations before confinement, age and gender. Results: Self-reported PA decreased significantly during confinement in our sample. Vigorous physical activities (VPA) and walking time decreased by 16.8% (p < 0.001) and 58.2% (p < 0.001), respectively, whereas ST increased by 23.8% (p < 0.001). The percent of people fulfilling the 75 min/week of VPA recommendation decreased by 10.7% (p < 0.001) while the percent of people who reached 150 min/week of moderate activity barely changed (1.4%). The group that performed the most VPA before confinement showed the greatest decrease (30.5%, p < 0.001). Men reduced time in VPA more than women (21% vs 9%, respectively) who even increased time in moderate PA by 11% (p < 0.05) and reported less increase in ST than men (35% vs 25.3%, respectively). Conclusion: The Spanish adult population, especially young people, students and very active men, decreased daily self-reported PA and increased ST during COVID-19 confinement. IJERPH, Vol. 17, Pages 6878: Physical Activity Change during COVID-19 Confinement

International Journal of Environmental Research and Public Health doi: 10.3390/ijerph17186878

Authors: Arkaitz Castañeda-Babarro Ane Arbillaga-Etxarri Borja Gutiérrez-Santamaría Aitor Coca

Background: The lockdown and social distancing caused by COVID-19 may influence common health behavior. The unprecedent worldwide confinement, in which Spain has been one of the most affected—with severe rules governing confinement—may have changed physical activity (PA) and sedentary habits due to prolonged stays at home. Purpose: The aim of this study is to evaluate how self-reported PA and sedentary time (ST) have changed during confinement in the Spanish population. Methods: 3800 healthy adults (age 18–64 years) residing in Spain answered the international physical activity questionnaire short (IPAQ-S) twice between 23 March and 1 April (confinement). Data analysis was carried out taking into consideration meeting general PA recommendations before confinement, age and gender. Results: Self-reported PA decreased significantly during confinement in our sample. Vigorous physical activities (VPA) and walking time decreased by 16.8% (p < 0.001) and 58.2% (p < 0.001), respectively, whereas ST increased by 23.8% (p < 0.001). The percent of people fulfilling the 75 min/week of VPA recommendation decreased by 10.7% (p < 0.001) while the percent of people who reached 150 min/week of moderate activity barely changed (1.4%). The group that performed the most VPA before confinement showed the greatest decrease (30.5%, p < 0.001). Men reduced time in VPA more than women (21% vs 9%, respectively) who even increased time in moderate PA by 11% (p < 0.05) and reported less increase in ST than men (35% vs 25.3%, respectively). Conclusion: The Spanish adult population, especially young people, students and very active men, decreased daily self-reported PA and increased ST during COVID-19 confinement.

]]>
Physical Activity Change during COVID-19 Confinement Arkaitz Castañeda-Babarro Ane Arbillaga-Etxarri Borja Gutiérrez-Santamaría Aitor Coca doi: 10.3390/ijerph17186878 International Journal of Environmental Research and Public Health 2020-09-21 International Journal of Environmental Research and Public Health 2020-09-21 17 18 Article 6878 10.3390/ijerph17186878 https://www.mdpi.com/1660-4601/17/18/6878
IJERPH, Vol. 17, Pages 6877: Prevalence Studies on CKDu Need Stringent Reporting on Outcomes to Enhance Comparability https://www.mdpi.com/1660-4601/17/18/6877 Prevalence studies on Chronic Kidney Disease of unknown etiology (CKDu) need stringent reporting on outcomes following existing guidelines. Only by doing so, the much-needed comparisons between occupations, regions and climates for the elucidation of the etiology/etiologies of CKDu, and subsequently for its prevention, are possible. We, here, comment on methodological issues in a recently published study on rice farmers from West Java, Indonesia. IJERPH, Vol. 17, Pages 6877: Prevalence Studies on CKDu Need Stringent Reporting on Outcomes to Enhance Comparability

International Journal of Environmental Research and Public Health doi: 10.3390/ijerph17186877

Authors: Kristina Jakobsson Jason Glaser Catharina Wesseling

Prevalence studies on Chronic Kidney Disease of unknown etiology (CKDu) need stringent reporting on outcomes following existing guidelines. Only by doing so, the much-needed comparisons between occupations, regions and climates for the elucidation of the etiology/etiologies of CKDu, and subsequently for its prevention, are possible. We, here, comment on methodological issues in a recently published study on rice farmers from West Java, Indonesia.

]]>
Prevalence Studies on CKDu Need Stringent Reporting on Outcomes to Enhance Comparability Kristina Jakobsson Jason Glaser Catharina Wesseling doi: 10.3390/ijerph17186877 International Journal of Environmental Research and Public Health 2020-09-21 International Journal of Environmental Research and Public Health 2020-09-21 17 18 Comment 6877 10.3390/ijerph17186877 https://www.mdpi.com/1660-4601/17/18/6877
IJERPH, Vol. 17, Pages 6876: Factors Associated with Latent Tuberculosis Infection among the Hospital Employees in a Tertiary Hospital of Northeastern Thailand https://www.mdpi.com/1660-4601/17/18/6876 Latent tuberculosis infection (LTBI) can develop into tuberculosis (TB). The WHO requires the discovery and management of LTBI among high-risk groups. Health care workers (HCWs) constitute a high-risk group. Factors associated with LTBI among HCWs in Thailand need further study. The current study aimed to explore the factors related to LTBI among Thai HCWs. A hospital-based, matched case-control study was conducted. All cases and controls were HCWs at a tertiary hospital in northeastern Thailand. Between 2017 and 2019, a total of 85 cases of interferon-γ release assays (IGRAs)-proven LTBI, and 170 control subjects were selected from a hospital (two controls per case). The two recruited controls were individually matched with LTBI cases by sex and age (±5 years). Secondary data were obtained from the occupational health and safety office. Case HCWs had a higher proportion of significant factors than control HCWs (i.e., working closely with pulmonary TB—94.1% vs. 88.8%, and working in the area of aerosol-generating procedures (AGPs) 81.2% vs. 69.4%). The bivariate conditional logistic regression showed that the occurrence of LTBI in HCWs was statistically significant (p-value < 0.05), particularly with respect to: workplaces of AGPs (crude OR = 1.90, 95% CI: 1.01–3.58, p = 0.041); among HCWs performing AGPs (crude OR = 2.04, 95% CI: 1.20, 3.48, p = 0.007); and, absent Bacille Calmette-Guérin (BCG) scar (crude OR = 2.59, 95% CI: 1.50–4.47, p = 0.001). Based on the multivariable conditional logistics analysis, HCWs who performed AGPs while contacting TB cases had a statistically significant association with LTBI (adjusted OR = 1.82, 95% CI: 1.04–3.20, p = 0.035). HCWs who reported the absence of a BCG scar had a statistically significant association with LTBI (adjusted OR = 2.49, 95% CI: 1.65–5.36, p = 0.001), whereas other factors including close contact with TB (adjusted OR = 2.44, 95% CI: 0.74, 8.09, p = 0.123) were not significantly associated with LTBI. In conclusion, HCWs who performed AGPs and were absent a BCG scar had a significant association with LTBI, while other factors played a less critical role. IJERPH, Vol. 17, Pages 6876: Factors Associated with Latent Tuberculosis Infection among the Hospital Employees in a Tertiary Hospital of Northeastern Thailand

International Journal of Environmental Research and Public Health doi: 10.3390/ijerph17186876

Authors: Patimaporn Chanpho Naesinee Chaiear Supot Kamsa-ard

Latent tuberculosis infection (LTBI) can develop into tuberculosis (TB). The WHO requires the discovery and management of LTBI among high-risk groups. Health care workers (HCWs) constitute a high-risk group. Factors associated with LTBI among HCWs in Thailand need further study. The current study aimed to explore the factors related to LTBI among Thai HCWs. A hospital-based, matched case-control study was conducted. All cases and controls were HCWs at a tertiary hospital in northeastern Thailand. Between 2017 and 2019, a total of 85 cases of interferon-γ release assays (IGRAs)-proven LTBI, and 170 control subjects were selected from a hospital (two controls per case). The two recruited controls were individually matched with LTBI cases by sex and age (±5 years). Secondary data were obtained from the occupational health and safety office. Case HCWs had a higher proportion of significant factors than control HCWs (i.e., working closely with pulmonary TB—94.1% vs. 88.8%, and working in the area of aerosol-generating procedures (AGPs) 81.2% vs. 69.4%). The bivariate conditional logistic regression showed that the occurrence of LTBI in HCWs was statistically significant (p-value < 0.05), particularly with respect to: workplaces of AGPs (crude OR = 1.90, 95% CI: 1.01–3.58, p = 0.041); among HCWs performing AGPs (crude OR = 2.04, 95% CI: 1.20, 3.48, p = 0.007); and, absent Bacille Calmette-Guérin (BCG) scar (crude OR = 2.59, 95% CI: 1.50–4.47, p = 0.001). Based on the multivariable conditional logistics analysis, HCWs who performed AGPs while contacting TB cases had a statistically significant association with LTBI (adjusted OR = 1.82, 95% CI: 1.04–3.20, p = 0.035). HCWs who reported the absence of a BCG scar had a statistically significant association with LTBI (adjusted OR = 2.49, 95% CI: 1.65–5.36, p = 0.001), whereas other factors including close contact with TB (adjusted OR = 2.44, 95% CI: 0.74, 8.09, p = 0.123) were not significantly associated with LTBI. In conclusion, HCWs who performed AGPs and were absent a BCG scar had a significant association with LTBI, while other factors played a less critical role.

]]>
Factors Associated with Latent Tuberculosis Infection among the Hospital Employees in a Tertiary Hospital of Northeastern Thailand Patimaporn Chanpho Naesinee Chaiear Supot Kamsa-ard doi: 10.3390/ijerph17186876 International Journal of Environmental Research and Public Health 2020-09-21 International Journal of Environmental Research and Public Health 2020-09-21 17 18 Article 6876 10.3390/ijerph17186876 https://www.mdpi.com/1660-4601/17/18/6876
IJERPH, Vol. 17, Pages 6875: Go Zika Go: A Feasibility Protocol of a Modified Ride-on Car Intervention for Children with Congenital Zika Syndrome in Brazil https://www.mdpi.com/1660-4601/17/18/6875 Children with congenital Zika syndrome (CZS) present severe motor disability and can benefit from early powered mobility. The Go Zika Go project uses modified ride-on toy cars, which may advance the body functions, activities, and participation of children. This paper describes the study protocol aiming to assess the feasibility of a modified ride-on car intervention for children with CZS in Brazil. A mixed-methods design with a multiple 1-week baseline, 3-month intervention, and 1-month follow-up will be implemented. Modified ride-on car training sessions will be conducted three times a week at the participants’ home or in the clinic. The primary outcome will be a narrative description of study feasibility (photovoice method, focus groups, parent feasibility questionnaire and assessment of learning powered mobility). Secondary outcomes will be switch activation, driving sessions journal, social-cognitive interactions, mobility (pediatric evaluation of disability inventory computer adaptive test), goal attainment scaling (GAS), and participation (young children’s participation and environment measure). Go Zika Go is expected to be viable and to improve function, activity, and participation of children with CZS, providing a low-cost, evidence-based rehabilitation option that will be relevant to early child development in a global perspective. IJERPH, Vol. 17, Pages 6875: Go Zika Go: A Feasibility Protocol of a Modified Ride-on Car Intervention for Children with Congenital Zika Syndrome in Brazil

International Journal of Environmental Research and Public Health doi: 10.3390/ijerph17186875

Authors: Egmar Longo Ana Carolina De Campos Amanda Spinola Barreto Dinara Laiana de Lima Nascimento Coutinho Monique Leite Galvão Coelho Carolina Corsi Karolinne Souza Monteiro Samuel Wood Logan

Children with congenital Zika syndrome (CZS) present severe motor disability and can benefit from early powered mobility. The Go Zika Go project uses modified ride-on toy cars, which may advance the body functions, activities, and participation of children. This paper describes the study protocol aiming to assess the feasibility of a modified ride-on car intervention for children with CZS in Brazil. A mixed-methods design with a multiple 1-week baseline, 3-month intervention, and 1-month follow-up will be implemented. Modified ride-on car training sessions will be conducted three times a week at the participants’ home or in the clinic. The primary outcome will be a narrative description of study feasibility (photovoice method, focus groups, parent feasibility questionnaire and assessment of learning powered mobility). Secondary outcomes will be switch activation, driving sessions journal, social-cognitive interactions, mobility (pediatric evaluation of disability inventory computer adaptive test), goal attainment scaling (GAS), and participation (young children’s participation and environment measure). Go Zika Go is expected to be viable and to improve function, activity, and participation of children with CZS, providing a low-cost, evidence-based rehabilitation option that will be relevant to early child development in a global perspective.

]]>
Go Zika Go: A Feasibility Protocol of a Modified Ride-on Car Intervention for Children with Congenital Zika Syndrome in Brazil Egmar Longo Ana Carolina De Campos Amanda Spinola Barreto Dinara Laiana de Lima Nascimento Coutinho Monique Leite Galvão Coelho Carolina Corsi Karolinne Souza Monteiro Samuel Wood Logan doi: 10.3390/ijerph17186875 International Journal of Environmental Research and Public Health 2020-09-21 International Journal of Environmental Research and Public Health 2020-09-21 17 18 Protocol 6875 10.3390/ijerph17186875 https://www.mdpi.com/1660-4601/17/18/6875
IJERPH, Vol. 17, Pages 6870: Increased Mortality Risk in People with Type 2 Diabetes Mellitus in Lithuania https://www.mdpi.com/1660-4601/17/18/6870 This retrospective cohort study aimed to analyze overall and cause-specific mortality risk in people with type 2 diabetes mellitus (T2DM) in Lithuania. Information on the diagnosis of T2DM and glucose-lowering medication was obtained from the National Health Insurance Fund database, causes of death–from death certificates. Sex, age, and calendar period-standardized mortality ratios (SMRs) were calculated. In addition, 89,512 patients were followed-up between 2010 and 2017, contributing to the observation period of 592,321 person-years. Overall mortality risk was increased for both sexes (overall SMR = 1.35, 95% confidence interval (CI) 1.34–1.37). Greatest mortality risk was in the age group of 40–49 years at diabetes diagnosis (SMR = 1.68, 95% CI 1.60–1.76) and among those who had died before the age of 50 (SMR = 22.04, 95% CI 18.82–25.81). Patients treated with insulin only had the highest SMR (2.43, 95% CI 2.32–2.55). Mortality risk increased with increasing diabetes duration and was higher in women in all these groups. The highest cause-specific SMRs were infection-related causes (SMR = 1.44), particularly septicemia (SMR = 1.78), diseases of the circulatory system (SMR = 1.42), especially ischemic heart (SMR = 1.46) and cerebrovascular diseases (SMR = 1.38), as well as diseases of the digestive system (SMR = 1.35). Cancer mortality risk was elevated for women (SMR = 1.13), but not for men (SMR = 0.93). In conclusion, people with T2DM had an excess mortality risk, which was higher in women compared to men, younger people, in those who were diagnosed with T2DM at a younger age, had longer diabetes duration, and who required treatment with insulin. IJERPH, Vol. 17, Pages 6870: Increased Mortality Risk in People with Type 2 Diabetes Mellitus in Lithuania

International Journal of Environmental Research and Public Health doi: 10.3390/ijerph17186870

Authors: Donata Linkeviciute-Ulinskiene Auguste Kaceniene Audrius Dulskas Ausvydas Patasius Lina Zabuliene Giedre Smailyte

This retrospective cohort study aimed to analyze overall and cause-specific mortality risk in people with type 2 diabetes mellitus (T2DM) in Lithuania. Information on the diagnosis of T2DM and glucose-lowering medication was obtained from the National Health Insurance Fund database, causes of death–from death certificates. Sex, age, and calendar period-standardized mortality ratios (SMRs) were calculated. In addition, 89,512 patients were followed-up between 2010 and 2017, contributing to the observation period of 592,321 person-years. Overall mortality risk was increased for both sexes (overall SMR = 1.35, 95% confidence interval (CI) 1.34–1.37). Greatest mortality risk was in the age group of 40–49 years at diabetes diagnosis (SMR = 1.68, 95% CI 1.60–1.76) and among those who had died before the age of 50 (SMR = 22.04, 95% CI 18.82–25.81). Patients treated with insulin only had the highest SMR (2.43, 95% CI 2.32–2.55). Mortality risk increased with increasing diabetes duration and was higher in women in all these groups. The highest cause-specific SMRs were infection-related causes (SMR = 1.44), particularly septicemia (SMR = 1.78), diseases of the circulatory system (SMR = 1.42), especially ischemic heart (SMR = 1.46) and cerebrovascular diseases (SMR = 1.38), as well as diseases of the digestive system (SMR = 1.35). Cancer mortality risk was elevated for women (SMR = 1.13), but not for men (SMR = 0.93). In conclusion, people with T2DM had an excess mortality risk, which was higher in women compared to men, younger people, in those who were diagnosed with T2DM at a younger age, had longer diabetes duration, and who required treatment with insulin.

]]>
Increased Mortality Risk in People with Type 2 Diabetes Mellitus in Lithuania Donata Linkeviciute-Ulinskiene Auguste Kaceniene Audrius Dulskas Ausvydas Patasius Lina Zabuliene Giedre Smailyte doi: 10.3390/ijerph17186870 International Journal of Environmental Research and Public Health 2020-09-20 International Journal of Environmental Research and Public Health 2020-09-20 17 18 Article 6870 10.3390/ijerph17186870 https://www.mdpi.com/1660-4601/17/18/6870
IJERPH, Vol. 17, Pages 6871: Gender, Physical Self-Perception and Overall Physical Fitness in Secondary School Students: A Multiple Mediation Model https://www.mdpi.com/1660-4601/17/18/6871 Background: Physical self-perception is often related with better physical fitness perception in adolescents. Moreover, it is an important social cognitive perspective to provide suitable mental health in this population. However, this relationship is unequal between boys and girls. The physical fitness is a marker of health in young population. The aims of the present study were the following: (1) to compare physical self-perception and self-reported overall physical fitness (OPF) between boys and girls (gender) and body mass index (BMI) status, and (2) to determine the mediating role of all physical self-perception subscales (except physical condition) and BMI status in the link between gender and OPF in adolescent students. Methods: This cross-sectional study consisted of 85 adolescent students of secondary school between 12 and 17 years of age; 41 were boys (Mage = 14.6, SD = 1.7) and 44 were girls (Mage = 14.4, SD = 1.6). Adolescent participants completed all clinical characteristics by body composition measures (age, body weight, body height, and BMI). Physical self-perception was assessed by the physical self-perception profile (PSPP) whereas the international fitness scale (IFIS) was used to predict the self-reported OPF of adolescents in the present study. Results: Gender (boys and girls) differed significantly in all PSPP subscales and OPF, whereas the BMI status (underweight = 19 students, normal weight = 53 students, overweight/obese = 13 students) showed significant differences in all clinical characteristics, physical condition (PSPP), and OPF. A multiple mediation analysis was performed using bias corrected bootstrap. This multiple mediation analysis revealed that all PSPP subscales were significant mediators between gender and OPF: attractive body (p = 0.013), sport competence (p = 0.009), physical strength (p = 0.002), and self-confidence (p = 0.002). The total direct effect of gender on OPF was significant (p = 0.002). Moreover, the multiple mediation estimated a completely standardized indirect of X on Y for attractive body (effect = 0.109), sport competence (effect = 0.066), physical strength (effect = 0.130), and self-confidence (effect = 0.193). Conclusions: These findings contribute to understanding the link between gender and OPF in adolescent students and the mediation of physical self-perception and OPF in this relationship. In addition, strategies focused to improve self-confidence and physical self-perception are necessary in female adolescent students, because boys showed better physical self-perception in all PSPP subscales. Girls are a risk group because they report low physical self-confidence with their respective insecurity feelings and psychological disorders. Thus, personal physical self-perception must be considered as an important social cognitive perspective to provide suitable mental health in children and adolescents. IJERPH, Vol. 17, Pages 6871: Gender, Physical Self-Perception and Overall Physical Fitness in Secondary School Students: A Multiple Mediation Model

International Journal of Environmental Research and Public Health doi: 10.3390/ijerph17186871

Authors: Pedro Jesús Ruiz-Montero Oscar Chiva-Bartoll Antonio Baena-Extremera David Hortigüela-Alcalá

Background: Physical self-perception is often related with better physical fitness perception in adolescents. Moreover, it is an important social cognitive perspective to provide suitable mental health in this population. However, this relationship is unequal between boys and girls. The physical fitness is a marker of health in young population. The aims of the present study were the following: (1) to compare physical self-perception and self-reported overall physical fitness (OPF) between boys and girls (gender) and body mass index (BMI) status, and (2) to determine the mediating role of all physical self-perception subscales (except physical condition) and BMI status in the link between gender and OPF in adolescent students. Methods: This cross-sectional study consisted of 85 adolescent students of secondary school between 12 and 17 years of age; 41 were boys (Mage = 14.6, SD = 1.7) and 44 were girls (Mage = 14.4, SD = 1.6). Adolescent participants completed all clinical characteristics by body composition measures (age, body weight, body height, and BMI). Physical self-perception was assessed by the physical self-perception profile (PSPP) whereas the international fitness scale (IFIS) was used to predict the self-reported OPF of adolescents in the present study. Results: Gender (boys and girls) differed significantly in all PSPP subscales and OPF, whereas the BMI status (underweight = 19 students, normal weight = 53 students, overweight/obese = 13 students) showed significant differences in all clinical characteristics, physical condition (PSPP), and OPF. A multiple mediation analysis was performed using bias corrected bootstrap. This multiple mediation analysis revealed that all PSPP subscales were significant mediators between gender and OPF: attractive body (p = 0.013), sport competence (p = 0.009), physical strength (p = 0.002), and self-confidence (p = 0.002). The total direct effect of gender on OPF was significant (p = 0.002). Moreover, the multiple mediation estimated a completely standardized indirect of X on Y for attractive body (effect = 0.109), sport competence (effect = 0.066), physical strength (effect = 0.130), and self-confidence (effect = 0.193). Conclusions: These findings contribute to understanding the link between gender and OPF in adolescent students and the mediation of physical self-perception and OPF in this relationship. In addition, strategies focused to improve self-confidence and physical self-perception are necessary in female adolescent students, because boys showed better physical self-perception in all PSPP subscales. Girls are a risk group because they report low physical self-confidence with their respective insecurity feelings and psychological disorders. Thus, personal physical self-perception must be considered as an important social cognitive perspective to provide suitable mental health in children and adolescents.

]]>
Gender, Physical Self-Perception and Overall Physical Fitness in Secondary School Students: A Multiple Mediation Model Pedro Jesús Ruiz-Montero Oscar Chiva-Bartoll Antonio Baena-Extremera David Hortigüela-Alcalá doi: 10.3390/ijerph17186871 International Journal of Environmental Research and Public Health 2020-09-20 International Journal of Environmental Research and Public Health 2020-09-20 17 18 Article 6871 10.3390/ijerph17186871 https://www.mdpi.com/1660-4601/17/18/6871
IJERPH, Vol. 17, Pages 6874: In Search of Concrete Outcomes—A Systematic Review on the Effectiveness of Educational Interventions on Reducing Acute Occupational Injuries https://www.mdpi.com/1660-4601/17/18/6874 Education is a common strategy used to prevent occupational injuries. However, its effectiveness is often measured using surrogate measures instead of true injury outcomes. To evaluate the effectiveness of workplace educational interventions, we selectively analyzed studies that reported injury outcomes (PROSPERO ID: CRD42019140631). We searched databases for peer-reviewed journal articles and sources of grey literature such as abstracts, registered trials, and theses published between 2000 and 2019. Studies on educational interventions that reported fatal or non-fatal occupational injury outcomes were selected. Two reviewers independently and in duplicate screened the studies, extracted data, and assessed risk of bias. Heterogeneity in the data precluded meta-analysis, and the results were reviewed narratively. In total, 35 studies were included. Of which, 17 found a significant reduction in injuries, most of which featured a multifaceted approach or non-didactic education. The remaining studies either described equivocal results or did not report statistical significance. Overall, interventions in the manufacturing industry were more effective than those in the construction sector. Risk of bias among included studies was moderate to high. In conclusion, educational interventions could be an effective part of multifaceted injury prevention programs. However, over-reliance on didactic education alone is not advised. IJERPH, Vol. 17, Pages 6874: In Search of Concrete Outcomes—A Systematic Review on the Effectiveness of Educational Interventions on Reducing Acute Occupational Injuries

International Journal of Environmental Research and Public Health doi: 10.3390/ijerph17186874

Authors: Jim Li Max Pang Jennifer Smith Colleen Pawliuk Ian Pike

Education is a common strategy used to prevent occupational injuries. However, its effectiveness is often measured using surrogate measures instead of true injury outcomes. To evaluate the effectiveness of workplace educational interventions, we selectively analyzed studies that reported injury outcomes (PROSPERO ID: CRD42019140631). We searched databases for peer-reviewed journal articles and sources of grey literature such as abstracts, registered trials, and theses published between 2000 and 2019. Studies on educational interventions that reported fatal or non-fatal occupational injury outcomes were selected. Two reviewers independently and in duplicate screened the studies, extracted data, and assessed risk of bias. Heterogeneity in the data precluded meta-analysis, and the results were reviewed narratively. In total, 35 studies were included. Of which, 17 found a significant reduction in injuries, most of which featured a multifaceted approach or non-didactic education. The remaining studies either described equivocal results or did not report statistical significance. Overall, interventions in the manufacturing industry were more effective than those in the construction sector. Risk of bias among included studies was moderate to high. In conclusion, educational interventions could be an effective part of multifaceted injury prevention programs. However, over-reliance on didactic education alone is not advised.

]]>
In Search of Concrete Outcomes—A Systematic Review on the Effectiveness of Educational Interventions on Reducing Acute Occupational Injuries Jim Li Max Pang Jennifer Smith Colleen Pawliuk Ian Pike doi: 10.3390/ijerph17186874 International Journal of Environmental Research and Public Health 2020-09-20 International Journal of Environmental Research and Public Health 2020-09-20 17 18 Review 6874 10.3390/ijerph17186874 https://www.mdpi.com/1660-4601/17/18/6874
IJERPH, Vol. 17, Pages 6873: Predicting Daily Sheltering Arrangements among Youth Experiencing Homelessness Using Diary Measurements Collected by Ecological Momentary Assessment https://www.mdpi.com/1660-4601/17/18/6873 Youths experiencing homelessness (YEH) often cycle between various sheltering locations including spending nights on the streets, in shelters and with others. Few studies have explored the patterns of daily sheltering over time. A total of 66 participants completed 724 ecological momentary assessments that assessed daily sleeping arrangements. Analyses applied a hypothesis-generating machine learning algorithm (component-wise gradient boosting) to build interpretable models that would select only the best predictors of daily sheltering from a large set of 92 variables while accounting for the correlated nature of the data. Sheltering was examined as a three-category outcome comparing nights spent literally homeless, unstably housed or at a shelter. The final model retained 15 predictors. These predictors included (among others) specific stressors (e.g., not having a place to stay, parenting and hunger), discrimination (by a friend or nonspecified other; due to race or homelessness), being arrested and synthetic cannabinoids use (a.k.a., “kush”). The final model demonstrated success in classifying the categorical outcome. These results have implications for developing just-in-time adaptive interventions for improving the lives of YEH. IJERPH, Vol. 17, Pages 6873: Predicting Daily Sheltering Arrangements among Youth Experiencing Homelessness Using Diary Measurements Collected by Ecological Momentary Assessment

International Journal of Environmental Research and Public Health doi: 10.3390/ijerph17186873

Authors: Robert Suchting Michael S. Businelle Stephen W. Hwang Nikhil S. Padhye Yijiong Yang Diane M. Santa Maria

Youths experiencing homelessness (YEH) often cycle between various sheltering locations including spending nights on the streets, in shelters and with others. Few studies have explored the patterns of daily sheltering over time. A total of 66 participants completed 724 ecological momentary assessments that assessed daily sleeping arrangements. Analyses applied a hypothesis-generating machine learning algorithm (component-wise gradient boosting) to build interpretable models that would select only the best predictors of daily sheltering from a large set of 92 variables while accounting for the correlated nature of the data. Sheltering was examined as a three-category outcome comparing nights spent literally homeless, unstably housed or at a shelter. The final model retained 15 predictors. These predictors included (among others) specific stressors (e.g., not having a place to stay, parenting and hunger), discrimination (by a friend or nonspecified other; due to race or homelessness), being arrested and synthetic cannabinoids use (a.k.a., “kush”). The final model demonstrated success in classifying the categorical outcome. These results have implications for developing just-in-time adaptive interventions for improving the lives of YEH.

]]>
Predicting Daily Sheltering Arrangements among Youth Experiencing Homelessness Using Diary Measurements Collected by Ecological Momentary Assessment Robert Suchting Michael S. Businelle Stephen W. Hwang Nikhil S. Padhye Yijiong Yang Diane M. Santa Maria doi: 10.3390/ijerph17186873 International Journal of Environmental Research and Public Health 2020-09-20 International Journal of Environmental Research and Public Health 2020-09-20 17 18 Article 6873 10.3390/ijerph17186873 https://www.mdpi.com/1660-4601/17/18/6873
IJERPH, Vol. 17, Pages 6872: Gender Influence on Students, Parents, and Teachers’ Perceptions of What Children and Adolescents in Germany Need to Cycle to School: A Concept Mapping Study https://www.mdpi.com/1660-4601/17/18/6872 Active commuting to school is highly recommended for several reasons, and in the decision-making process for doing so, a child interacts with parents and teachers. Until now, these three interactors’ gender-specific perspectives on children and adolescents’ need for cycling to school have been unavailable. Thus, our concept mapping study analyzed the needs of 12- to 15-year-olds in Germany for cycling to and from school daily, as perceived by students, parents, and teachers stratified by gender. From November 2019 to February 2020, 136 students, 58 parents, and 29 teachers participated. Although 87.8% of girls and 100% of boys owned a bicycle, only 44.4% of girls and 72.9% of boys cycled to school. On average, girls cycled to school on 1.6 ± 2.0 days a week and boys on 2.7 ± 2.0 days a week. A “bicycle and related equipment,” the “way to school,” and “personal factors” were reported needs, perceived by students and teachers of both genders and by mothers. Girls reported the additional gender-specific need for “social behavior in road traffic,” mothers and female teachers reported “role of parents,” and female teachers reported a “sense of safety.” This study’s findings could inspire the development of school-based bicycle interventions. IJERPH, Vol. 17, Pages 6872: Gender Influence on Students, Parents, and Teachers’ Perceptions of What Children and Adolescents in Germany Need to Cycle to School: A Concept Mapping Study

International Journal of Environmental Research and Public Health doi: 10.3390/ijerph17186872

Authors: Dorothea M. I. Schönbach Catherina Vondung Lisan M. Hidding Teatske M. Altenburg Mai J. M. Chinapaw Yolanda Demetriou

Active commuting to school is highly recommended for several reasons, and in the decision-making process for doing so, a child interacts with parents and teachers. Until now, these three interactors’ gender-specific perspectives on children and adolescents’ need for cycling to school have been unavailable. Thus, our concept mapping study analyzed the needs of 12- to 15-year-olds in Germany for cycling to and from school daily, as perceived by students, parents, and teachers stratified by gender. From November 2019 to February 2020, 136 students, 58 parents, and 29 teachers participated. Although 87.8% of girls and 100% of boys owned a bicycle, only 44.4% of girls and 72.9% of boys cycled to school. On average, girls cycled to school on 1.6 ± 2.0 days a week and boys on 2.7 ± 2.0 days a week. A “bicycle and related equipment,” the “way to school,” and “personal factors” were reported needs, perceived by students and teachers of both genders and by mothers. Girls reported the additional gender-specific need for “social behavior in road traffic,” mothers and female teachers reported “role of parents,” and female teachers reported a “sense of safety.” This study’s findings could inspire the development of school-based bicycle interventions.

]]>
Gender Influence on Students, Parents, and Teachers’ Perceptions of What Children and Adolescents in Germany Need to Cycle to School: A Concept Mapping Study Dorothea M. I. Schönbach Catherina Vondung Lisan M. Hidding Teatske M. Altenburg Mai J. M. Chinapaw Yolanda Demetriou doi: 10.3390/ijerph17186872 International Journal of Environmental Research and Public Health 2020-09-20 International Journal of Environmental Research and Public Health 2020-09-20 17 18 Article 6872 10.3390/ijerph17186872 https://www.mdpi.com/1660-4601/17/18/6872
IJERPH, Vol. 17, Pages 6869: The Experience of Do-Not-Resuscitate Orders and End-of-Life Care Discussions among Physicians https://www.mdpi.com/1660-4601/17/18/6869 Physicians have a responsibility to discuss do-not-resuscitate (DNR) decisions and end-of-life (EOL) care with patients and family members. The aim of this study was to explore the DNR and EOL care discussion experience among physicians in Taiwan. A qualitative study was conducted with 16 physicians recruited from the departments of hospice care, surgery, internal medicine, emergency, and the intensive care unit. The interview guidelines included their DNR experience and process and EOL care discussions, as well as their concerns, difficulties, or worries in discussions. Thematic analysis was used to analyze data. Four themes were identified. First, family members had multiple roles in the decision process. Second, the characteristics of the units, including time urgency and relationships with patients and family members, influenced physicians’ work. Third, the process included preparation, exploration, information delivery, barrier solution, and execution. Fourth, physicians shared reflections on their ability and the conflicts between law, medical professionals, and the best interests of patients. Physicians must consider not only patients’ but also family members’ opinions and surmount several barriers in decision-making. They also experienced negative and positive impacts from these discussions. IJERPH, Vol. 17, Pages 6869: The Experience of Do-Not-Resuscitate Orders and End-of-Life Care Discussions among Physicians

International Journal of Environmental Research and Public Health doi: 10.3390/ijerph17186869

Authors: Sheng-Yu Fan Jyh-Gang Hsieh

Physicians have a responsibility to discuss do-not-resuscitate (DNR) decisions and end-of-life (EOL) care with patients and family members. The aim of this study was to explore the DNR and EOL care discussion experience among physicians in Taiwan. A qualitative study was conducted with 16 physicians recruited from the departments of hospice care, surgery, internal medicine, emergency, and the intensive care unit. The interview guidelines included their DNR experience and process and EOL care discussions, as well as their concerns, difficulties, or worries in discussions. Thematic analysis was used to analyze data. Four themes were identified. First, family members had multiple roles in the decision process. Second, the characteristics of the units, including time urgency and relationships with patients and family members, influenced physicians’ work. Third, the process included preparation, exploration, information delivery, barrier solution, and execution. Fourth, physicians shared reflections on their ability and the conflicts between law, medical professionals, and the best interests of patients. Physicians must consider not only patients’ but also family members’ opinions and surmount several barriers in decision-making. They also experienced negative and positive impacts from these discussions.

]]>
The Experience of Do-Not-Resuscitate Orders and End-of-Life Care Discussions among Physicians Sheng-Yu Fan Jyh-Gang Hsieh doi: 10.3390/ijerph17186869 International Journal of Environmental Research and Public Health 2020-09-20 International Journal of Environmental Research and Public Health 2020-09-20 17 18 Article 6869 10.3390/ijerph17186869 https://www.mdpi.com/1660-4601/17/18/6869
IJERPH, Vol. 17, Pages 6868: Estimation on Fixed-Bed Column Parameters of Breakthrough Behaviors for Gold Recovery by Adsorption onto Modified/Functionalized Amberlite XAD7 https://www.mdpi.com/1660-4601/17/18/6868 The objective of this paper was to evaluate the potential of a new adsorbent material to recover Au (III) from real wastewater, in a column with a fixed bed in a dynamic regime. The material was obtained through functionalization, by impregnation of the commercial resin, Amberlite XAD 7 type, with L-glutamic acid, which has active groups –NH2 and –COOH. The goal of the experiments was to follow the correlation of fixed-bed column specific adsorption parameters (the effluent volume, the amounts of adsorbent, heights of the adsorbent layer in column) with the time necessary to cross the column. The experimental data obtained were modeled, using the Bohart–Adams, Yoon–Nelson Thomas and Clark models, to establish the mechanism of the Au (III) recovery process, in a dynamic regime. Also, we established the number of cycles for adsorption–desorption for which the new material can be used. We used 5% HNO3 (5%) as desorption agent in five adsorption–desorption cycles, until the process was no longer efficient. The degree of desorption varied between 84% and 34% from cycle 1 to cycle 5. IJERPH, Vol. 17, Pages 6868: Estimation on Fixed-Bed Column Parameters of Breakthrough Behaviors for Gold Recovery by Adsorption onto Modified/Functionalized Amberlite XAD7

International Journal of Environmental Research and Public Health doi: 10.3390/ijerph17186868

Authors: Adina Negrea Maria Mihailescu Giannin Mosoarca Mihaela Ciopec Narcis Duteanu Petru Negrea Vasile Minzatu

The objective of this paper was to evaluate the potential of a new adsorbent material to recover Au (III) from real wastewater, in a column with a fixed bed in a dynamic regime. The material was obtained through functionalization, by impregnation of the commercial resin, Amberlite XAD 7 type, with L-glutamic acid, which has active groups –NH2 and –COOH. The goal of the experiments was to follow the correlation of fixed-bed column specific adsorption parameters (the effluent volume, the amounts of adsorbent, heights of the adsorbent layer in column) with the time necessary to cross the column. The experimental data obtained were modeled, using the Bohart–Adams, Yoon–Nelson Thomas and Clark models, to establish the mechanism of the Au (III) recovery process, in a dynamic regime. Also, we established the number of cycles for adsorption–desorption for which the new material can be used. We used 5% HNO3 (5%) as desorption agent in five adsorption–desorption cycles, until the process was no longer efficient. The degree of desorption varied between 84% and 34% from cycle 1 to cycle 5.

]]>
Estimation on Fixed-Bed Column Parameters of Breakthrough Behaviors for Gold Recovery by Adsorption onto Modified/Functionalized Amberlite XAD7 Adina Negrea Maria Mihailescu Giannin Mosoarca Mihaela Ciopec Narcis Duteanu Petru Negrea Vasile Minzatu doi: 10.3390/ijerph17186868 International Journal of Environmental Research and Public Health 2020-09-20 International Journal of Environmental Research and Public Health 2020-09-20 17 18 Article 6868 10.3390/ijerph17186868 https://www.mdpi.com/1660-4601/17/18/6868
IJERPH, Vol. 17, Pages 6867: How Older People Experience the Age-Friendliness of Their City: Development of the Age-Friendly Cities and Communities Questionnaire https://www.mdpi.com/1660-4601/17/18/6867 The World Health Organization engages cities and communities all over the world in becoming age-friendly. There is a need for assessing the age-friendliness of cities and communities by means of a transparently constructed and validated tool which measures the construct as a whole. The aim of this study was to develop a questionnaire measuring age-friendliness, providing full transparency and reproducibility. The development and validation of the Age Friendly Cities and Communities Questionnaire (AFCCQ) followed the criteria of the COnsensus-based Standards for selection of health Measurement INstruments (COSMIN). Four phases were followed: (1) development of the conceptual model, themes and items; (2) initial (qualitative) validation; (3) psychometric validation, and (4) translating the instrument using the forward-backward translation method. This rigorous process of development and validation resulted in a valid, psychometrically sound, comprehensive 23-item questionnaire. This questionnaire can be used to measure older people’s experiences regarding the eight domains of the WHO Age-Friendly Cities model, and an additional financial domain. The AFCCQ allows practitioners and researchers to capture the age-friendliness of a city or community in a numerical fashion, which helps monitor the age-friendliness and the potential impact of policies or social programmes. The AFCCQ was created in Dutch and translated into British-English. IJERPH, Vol. 17, Pages 6867: How Older People Experience the Age-Friendliness of Their City: Development of the Age-Friendly Cities and Communities Questionnaire

International Journal of Environmental Research and Public Health doi: 10.3390/ijerph17186867

Authors: Jeroen Dikken Rudy F.M. van den Hoven Willeke H. van Staalduinen Loes M.T. Hulsebosch-Janssen Joost van Hoof

The World Health Organization engages cities and communities all over the world in becoming age-friendly. There is a need for assessing the age-friendliness of cities and communities by means of a transparently constructed and validated tool which measures the construct as a whole. The aim of this study was to develop a questionnaire measuring age-friendliness, providing full transparency and reproducibility. The development and validation of the Age Friendly Cities and Communities Questionnaire (AFCCQ) followed the criteria of the COnsensus-based Standards for selection of health Measurement INstruments (COSMIN). Four phases were followed: (1) development of the conceptual model, themes and items; (2) initial (qualitative) validation; (3) psychometric validation, and (4) translating the instrument using the forward-backward translation method. This rigorous process of development and validation resulted in a valid, psychometrically sound, comprehensive 23-item questionnaire. This questionnaire can be used to measure older people’s experiences regarding the eight domains of the WHO Age-Friendly Cities model, and an additional financial domain. The AFCCQ allows practitioners and researchers to capture the age-friendliness of a city or community in a numerical fashion, which helps monitor the age-friendliness and the potential impact of policies or social programmes. The AFCCQ was created in Dutch and translated into British-English.

]]>
How Older People Experience the Age-Friendliness of Their City: Development of the Age-Friendly Cities and Communities Questionnaire Jeroen Dikken Rudy F.M. van den Hoven Willeke H. van Staalduinen Loes M.T. Hulsebosch-Janssen Joost van Hoof doi: 10.3390/ijerph17186867 International Journal of Environmental Research and Public Health 2020-09-20 International Journal of Environmental Research and Public Health 2020-09-20 17 18 Article 6867 10.3390/ijerph17186867 https://www.mdpi.com/1660-4601/17/18/6867
IJERPH, Vol. 17, Pages 6866: Movement Behaviors and Perceived Loneliness and Sadness within Alaskan Adolescents https://www.mdpi.com/1660-4601/17/18/6866 Physical activity, screen use, and sleep are behaviors that integrate across the whole day. However, the accumulative influence of meeting recommendations for these 24-h movement behaviors on the mental health of Alaskan adolescents has not been examined. The purpose of this study was to examine the associations between movement behaviors, loneliness, and sadness within Alaskan adolescents. Data were obtained from the 2019 Alaska Youth Risk Behavior Survey (YRBS). The number of adolescents participating in the 2019 Alaska YRBS was 1897. Associations between meeting recommendations for movement behaviors with loneliness and sadness were examined using weighted logistic regression models, adjusted for age, sex, race/ethnicity, and body mass index (BMI). Approximately 5.0% of the sample met recommendations for all three movement behaviors. Meeting 2 or 3 movement behavior recommendations was associated with lower odds of loneliness (odds ratio (OR) range = 0.23 to 0.44, p < 0.01). Additionally, meeting 1 to 3 movement behavior recommendations was associated with lower odds of sadness (OR range = 0.29 to 0.52, p < 0.05). Joint association analyses determined that these relationships were primarily driven by meeting the sleep recommendation for loneliness and meeting the screen use recommendation for sadness. The results support use of multiple movement-based behavior programming to attenuate feelings of loneliness and sadness within Alaskan adolescents. IJERPH, Vol. 17, Pages 6866: Movement Behaviors and Perceived Loneliness and Sadness within Alaskan Adolescents

International Journal of Environmental Research and Public Health doi: 10.3390/ijerph17186866

Authors: Ryan D. Burns Yang Bai Christopher D. Pfledderer Timothy A. Brusseau Wonwoo Byun

Physical activity, screen use, and sleep are behaviors that integrate across the whole day. However, the accumulative influence of meeting recommendations for these 24-h movement behaviors on the mental health of Alaskan adolescents has not been examined. The purpose of this study was to examine the associations between movement behaviors, loneliness, and sadness within Alaskan adolescents. Data were obtained from the 2019 Alaska Youth Risk Behavior Survey (YRBS). The number of adolescents participating in the 2019 Alaska YRBS was 1897. Associations between meeting recommendations for movement behaviors with loneliness and sadness were examined using weighted logistic regression models, adjusted for age, sex, race/ethnicity, and body mass index (BMI). Approximately 5.0% of the sample met recommendations for all three movement behaviors. Meeting 2 or 3 movement behavior recommendations was associated with lower odds of loneliness (odds ratio (OR) range = 0.23 to 0.44, p < 0.01). Additionally, meeting 1 to 3 movement behavior recommendations was associated with lower odds of sadness (OR range = 0.29 to 0.52, p < 0.05). Joint association analyses determined that these relationships were primarily driven by meeting the sleep recommendation for loneliness and meeting the screen use recommendation for sadness. The results support use of multiple movement-based behavior programming to attenuate feelings of loneliness and sadness within Alaskan adolescents.

]]>
Movement Behaviors and Perceived Loneliness and Sadness within Alaskan Adolescents Ryan D. Burns Yang Bai Christopher D. Pfledderer Timothy A. Brusseau Wonwoo Byun doi: 10.3390/ijerph17186866 International Journal of Environmental Research and Public Health 2020-09-20 International Journal of Environmental Research and Public Health 2020-09-20 17 18 Article 6866 10.3390/ijerph17186866 https://www.mdpi.com/1660-4601/17/18/6866
IJERPH, Vol. 17, Pages 6865: The Protective Association of Trait and Ability Emotional Intelligence with Adolescent Tobacco Use https://www.mdpi.com/1660-4601/17/18/6865 The present study is one of the first to analyze the predictive capacity of both trait and ability Emotional Intelligence (EI) based on the Mayer and Salovey model, in relation to tobacco use in a sample of Spanish adolescents. In this study, 799 students between the ages of 12 and 16 participated. A self-report on trait EI, an EI peak performance test, and questions about habits relating to tobacco use were administered. This cross-sectional study developed a quantitative and correlation-type methodology. The main results of the regression analyses, once the sex and age of the participants were controlled, revealed negative associations between the factors of clarity and emotional repair of the trait EI with respect to the variables of tobacco use, and a positive association was found for them and emotional attention. By comparison, with respect to ability EI, emotional perception and understanding were inversely related to adolescent tobacco use. These results underscore the importance of EI skills as protective factors against early initiation and subsequent tobacco abuse. IJERPH, Vol. 17, Pages 6865: The Protective Association of Trait and Ability Emotional Intelligence with Adolescent Tobacco Use

International Journal of Environmental Research and Public Health doi: 10.3390/ijerph17186865

Authors: Sara González-Yubero Susana Lázaro-Visa Raquel Palomera Martín

The present study is one of the first to analyze the predictive capacity of both trait and ability Emotional Intelligence (EI) based on the Mayer and Salovey model, in relation to tobacco use in a sample of Spanish adolescents. In this study, 799 students between the ages of 12 and 16 participated. A self-report on trait EI, an EI peak performance test, and questions about habits relating to tobacco use were administered. This cross-sectional study developed a quantitative and correlation-type methodology. The main results of the regression analyses, once the sex and age of the participants were controlled, revealed negative associations between the factors of clarity and emotional repair of the trait EI with respect to the variables of tobacco use, and a positive association was found for them and emotional attention. By comparison, with respect to ability EI, emotional perception and understanding were inversely related to adolescent tobacco use. These results underscore the importance of EI skills as protective factors against early initiation and subsequent tobacco abuse.

]]>
The Protective Association of Trait and Ability Emotional Intelligence with Adolescent Tobacco Use Sara González-Yubero Susana Lázaro-Visa Raquel Palomera Martín doi: 10.3390/ijerph17186865 International Journal of Environmental Research and Public Health 2020-09-20 International Journal of Environmental Research and Public Health 2020-09-20 17 18 Article 6865 10.3390/ijerph17186865 https://www.mdpi.com/1660-4601/17/18/6865
IJERPH, Vol. 17, Pages 6863: A Historical Analysis of Randomized Controlled Trials in Rotator Cuff Tears https://www.mdpi.com/1660-4601/17/18/6863 Background and objectives: Our research aimed to evaluate the quality of reporting of randomized controlled trials (RCTs) linked to rotator cuff (RC) tears. The present study analyzed factors connected to the quality of the RCTs and trends in the quality of reporting through time. Materials and Methods: The online databases used to search all RCTs on the topic of RC surgery completed until March 2020 were PubMed and Ovid (MEDLINE). The quality of reporting was evaluated using the modified Coleman methodology score (MCMS) and the consolidated standards of reporting trials (CONSORT). Results: The online search found 957 articles. Finally, 183 studies were included in the quantitative synthesis. A total of 97 (53%) of 183 studies had a level of evidence I and 86 (47%) of 183 studies had a level of evidence II, according to the Oxford Center of Evidence Based Medicine (EBM). A statistically significant difference in MCMS between articles written before 2010 and articles written after 2010 was found. Articles written after 2010 had, on average, the highest Coleman score. The average number of CONSORT checklist items for each article across all analyzed RCTs was 21.67. The 37 studies completed up to 2010 averaged a number of checklist items of 19.97 and the studies completed between 2011 and 2019 averaged a number of checklist items of 22.10. A statistically significant difference in the number of checklist items between articles written before 2010 and articles written after 2010 was found. Articles written after 2010 had on average more checklist items. However, low correlation (0.26) between the number of checklist items for each article and the respective Coleman score was found. On the other hand, articles with the CONSORT diagram had a significantly high Coleman score. Conclusions: An improvement in the quantity and quality of RCTs relating to RC surgery over the analyzed period was found. IJERPH, Vol. 17, Pages 6863: A Historical Analysis of Randomized Controlled Trials in Rotator Cuff Tears

International Journal of Environmental Research and Public Health doi: 10.3390/ijerph17186863

Authors: Vincenzo Candela Umile Giuseppe Longo Calogero Di Naro Gabriella Facchinetti Anna Marchetti Gaia Sciotti Giulia Santamaria Ilaria Piergentili Maria Grazia De Marinis Ara Nazarian Vincenzo Denaro

Background and objectives: Our research aimed to evaluate the quality of reporting of randomized controlled trials (RCTs) linked to rotator cuff (RC) tears. The present study analyzed factors connected to the quality of the RCTs and trends in the quality of reporting through time. Materials and Methods: The online databases used to search all RCTs on the topic of RC surgery completed until March 2020 were PubMed and Ovid (MEDLINE). The quality of reporting was evaluated using the modified Coleman methodology score (MCMS) and the consolidated standards of reporting trials (CONSORT). Results: The online search found 957 articles. Finally, 183 studies were included in the quantitative synthesis. A total of 97 (53%) of 183 studies had a level of evidence I and 86 (47%) of 183 studies had a level of evidence II, according to the Oxford Center of Evidence Based Medicine (EBM). A statistically significant difference in MCMS between articles written before 2010 and articles written after 2010 was found. Articles written after 2010 had, on average, the highest Coleman score. The average number of CONSORT checklist items for each article across all analyzed RCTs was 21.67. The 37 studies completed up to 2010 averaged a number of checklist items of 19.97 and the studies completed between 2011 and 2019 averaged a number of checklist items of 22.10. A statistically significant difference in the number of checklist items between articles written before 2010 and articles written after 2010 was found. Articles written after 2010 had on average more checklist items. However, low correlation (0.26) between the number of checklist items for each article and the respective Coleman score was found. On the other hand, articles with the CONSORT diagram had a significantly high Coleman score. Conclusions: An improvement in the quantity and quality of RCTs relating to RC surgery over the analyzed period was found.

]]>
A Historical Analysis of Randomized Controlled Trials in Rotator Cuff Tears Vincenzo Candela Umile Giuseppe Longo Calogero Di Naro Gabriella Facchinetti Anna Marchetti Gaia Sciotti Giulia Santamaria Ilaria Piergentili Maria Grazia De Marinis Ara Nazarian Vincenzo Denaro doi: 10.3390/ijerph17186863 International Journal of Environmental Research and Public Health 2020-09-20 International Journal of Environmental Research and Public Health 2020-09-20 17 18 Review 6863 10.3390/ijerph17186863 https://www.mdpi.com/1660-4601/17/18/6863
IJERPH, Vol. 17, Pages 6864: Are the Parents’ and Their Children’s Physical Activity and Mode of Commuting Associated? Analysis by Gender and Age Group https://www.mdpi.com/1660-4601/17/18/6864 Background: Some studies have reported a positive parent–child association between physical activity (PA), but few have examined the difference in these associations concerning both genders. The objective of this study was to establish the association between moderate to vigorous physical activity (MVPA) and mode of commuting (MC) of the parents with their children by gender and age group. Methods: This cross-sectional study included 686 mothers and fathers (43.4 ± 6.5 years old) and their children (children 9.7 ± 1.7 y. and adolescents 14.0 ± 1.7 y.). Each participant completed a questionnaire on PA and MC. Chi-square test, odds ratio for categorical variables, and lineal regressions for continuous variables were used to examine the parent–child associations. Results: An inverse association was found between fathers–children in the weekend MVPA in children and between mothers–adolescents in out-of-school and weekend MVPA. An inverse association was found in MVPA between mothers-girls, and the different parents’ MC to work was positively associated with the MC to school in children and adolescents except for the association AC parents–adolescents. The AC was mainly associated between mothers and girls and boys. Conclusions: A weak association in parent–child MVPA but a strong association in MC between parent–child was found. IJERPH, Vol. 17, Pages 6864: Are the Parents’ and Their Children’s Physical Activity and Mode of Commuting Associated? Analysis by Gender and Age Group

International Journal of Environmental Research and Public Health doi: 10.3390/ijerph17186864

Authors: Fernando Rodríguez-Rodríguez Francisco Javier Huertas-Delgado Yaira Barranco-Ruiz María Jesús Aranda-Balboa Palma Chillón

Background: Some studies have reported a positive parent–child association between physical activity (PA), but few have examined the difference in these associations concerning both genders. The objective of this study was to establish the association between moderate to vigorous physical activity (MVPA) and mode of commuting (MC) of the parents with their children by gender and age group. Methods: This cross-sectional study included 686 mothers and fathers (43.4 ± 6.5 years old) and their children (children 9.7 ± 1.7 y. and adolescents 14.0 ± 1.7 y.). Each participant completed a questionnaire on PA and MC. Chi-square test, odds ratio for categorical variables, and lineal regressions for continuous variables were used to examine the parent–child associations. Results: An inverse association was found between fathers–children in the weekend MVPA in children and between mothers–adolescents in out-of-school and weekend MVPA. An inverse association was found in MVPA between mothers-girls, and the different parents’ MC to work was positively associated with the MC to school in children and adolescents except for the association AC parents–adolescents. The AC was mainly associated between mothers and girls and boys. Conclusions: A weak association in parent–child MVPA but a strong association in MC between parent–child was found.

]]>
Are the Parents’ and Their Children’s Physical Activity and Mode of Commuting Associated? Analysis by Gender and Age Group Fernando Rodríguez-Rodríguez Francisco Javier Huertas-Delgado Yaira Barranco-Ruiz María Jesús Aranda-Balboa Palma Chillón doi: 10.3390/ijerph17186864 International Journal of Environmental Research and Public Health 2020-09-20 International Journal of Environmental Research and Public Health 2020-09-20 17 18 Article 6864 10.3390/ijerph17186864 https://www.mdpi.com/1660-4601/17/18/6864
IJERPH, Vol. 17, Pages 6862: Does Coastal Local Government Competition Increase Coastal Water Pollution? Evidence from China https://www.mdpi.com/1660-4601/17/18/6862 China has formulated many policies and regulations for the management of the coastal water environment. However, the coastal water environment has not been significantly improved. The perspective of local government competition can provide an explanation for this phenomenon. This study uses panel data comprising 48 coastal cities in China from 2004 to 2017 as bases explore the impact of coastal local government competition on coastal water pollution by using a two-way fixed-effects panel regression model. Results show that coastal local government competition increased coastal water pollution. However, a sub-sample estimation based on fiscal pressure shows that coastal local government competition only increased the coastal water pollution of the high fiscal pressure group, and its impact on the coastal water pollution in the low financial pressure group failed to pass the significance test. In addition, sub-sample estimation based on different periods shows that the impact of coastal local government competition on coastal water pollution was not significant before 2008, but showed a significant positive impact after 2008. IJERPH, Vol. 17, Pages 6862: Does Coastal Local Government Competition Increase Coastal Water Pollution? Evidence from China

International Journal of Environmental Research and Public Health doi: 10.3390/ijerph17186862

Authors: Weiteng Shen Qiuguang Hu Xuan Yu Bernadette Tadala Imwa

China has formulated many policies and regulations for the management of the coastal water environment. However, the coastal water environment has not been significantly improved. The perspective of local government competition can provide an explanation for this phenomenon. This study uses panel data comprising 48 coastal cities in China from 2004 to 2017 as bases explore the impact of coastal local government competition on coastal water pollution by using a two-way fixed-effects panel regression model. Results show that coastal local government competition increased coastal water pollution. However, a sub-sample estimation based on fiscal pressure shows that coastal local government competition only increased the coastal water pollution of the high fiscal pressure group, and its impact on the coastal water pollution in the low financial pressure group failed to pass the significance test. In addition, sub-sample estimation based on different periods shows that the impact of coastal local government competition on coastal water pollution was not significant before 2008, but showed a significant positive impact after 2008.

]]>
Does Coastal Local Government Competition Increase Coastal Water Pollution? Evidence from China Weiteng Shen Qiuguang Hu Xuan Yu Bernadette Tadala Imwa doi: 10.3390/ijerph17186862 International Journal of Environmental Research and Public Health 2020-09-20 International Journal of Environmental Research and Public Health 2020-09-20 17 18 Article 6862 10.3390/ijerph17186862 https://www.mdpi.com/1660-4601/17/18/6862
IJERPH, Vol. 17, Pages 6861: Vancomycin for Dialytic Therapy in Critically Ill Patients: Analysis of Its Reduction and the Factors Associated with Subtherapeutic Concentrations https://www.mdpi.com/1660-4601/17/18/6861 This study aimed to evaluate the reduction in vancomycin through intermittent haemodialysis (IHD) and prolonged haemodialysis (PHD) in acute kidney injury (AKI) patients with sepsis and to identify the variables associated with subtherapeutic concentrations. A prospective study was performed in patients admitted at an intensive care unit (ICU) of a Brazilian hospital. Blood samples were collected at the start of dialytic therapy, after 2 and 4 h of treatment and at the end of therapy to determine the serum concentration of vancomycin and thus perform pharmacokinetic evaluation and PK/PD modelling. Twenty-seven patients treated with IHD, 17 treated with PHD for 6 h and 11 treated with PHD for 10 h were included. The reduction in serum concentrations of vancomycin after 2 h of therapy was 26.65 ± 12.64% and at the end of dialysis was 45.78 ± 12.79%, higher in the 10-h PHD group, 57.70% (40, 48–64, 30%) (p = 0.037). The ratio of the area under the curve to minimal inhibitory concentration (AUC/MIC) at 24 h in the PHD group was significantly smaller than at 10 h (p = 0.047). In the logistic regression, PHD was a risk factor for an AUC/MIC ratio less than 400 (OR = 11.59, p = 0.033), while a higher serum concentration of vancomycin at T0 was a protective factor (OR = 0.791, p = 0.009). In conclusion, subtherapeutic concentrations of vancomycin in acute kidney injury (AKI) patients in dialysis were elevated and may be related to a higher risk of bacterial resistance and mortality, besides pointing out the necessity of additional doses of vancomycin during dialytic therapy, mainly in PHD. IJERPH, Vol. 17, Pages 6861: Vancomycin for Dialytic Therapy in Critically Ill Patients: Analysis of Its Reduction and the Factors Associated with Subtherapeutic Concentrations

International Journal of Environmental Research and Public Health doi: 10.3390/ijerph17186861

Authors: Fernanda Moreira de Freitas Welder Zamoner Pamela Falbo dos Reis André Luís Balbi Daniela Ponce

This study aimed to evaluate the reduction in vancomycin through intermittent haemodialysis (IHD) and prolonged haemodialysis (PHD) in acute kidney injury (AKI) patients with sepsis and to identify the variables associated with subtherapeutic concentrations. A prospective study was performed in patients admitted at an intensive care unit (ICU) of a Brazilian hospital. Blood samples were collected at the start of dialytic therapy, after 2 and 4 h of treatment and at the end of therapy to determine the serum concentration of vancomycin and thus perform pharmacokinetic evaluation and PK/PD modelling. Twenty-seven patients treated with IHD, 17 treated with PHD for 6 h and 11 treated with PHD for 10 h were included. The reduction in serum concentrations of vancomycin after 2 h of therapy was 26.65 ± 12.64% and at the end of dialysis was 45.78 ± 12.79%, higher in the 10-h PHD group, 57.70% (40, 48–64, 30%) (p = 0.037). The ratio of the area under the curve to minimal inhibitory concentration (AUC/MIC) at 24 h in the PHD group was significantly smaller than at 10 h (p = 0.047). In the logistic regression, PHD was a risk factor for an AUC/MIC ratio less than 400 (OR = 11.59, p = 0.033), while a higher serum concentration of vancomycin at T0 was a protective factor (OR = 0.791, p = 0.009). In conclusion, subtherapeutic concentrations of vancomycin in acute kidney injury (AKI) patients in dialysis were elevated and may be related to a higher risk of bacterial resistance and mortality, besides pointing out the necessity of additional doses of vancomycin during dialytic therapy, mainly in PHD.

]]>
Vancomycin for Dialytic Therapy in Critically Ill Patients: Analysis of Its Reduction and the Factors Associated with Subtherapeutic Concentrations Fernanda Moreira de Freitas Welder Zamoner Pamela Falbo dos Reis André Luís Balbi Daniela Ponce doi: 10.3390/ijerph17186861 International Journal of Environmental Research and Public Health 2020-09-19 International Journal of Environmental Research and Public Health 2020-09-19 17 18 Article 6861 10.3390/ijerph17186861 https://www.mdpi.com/1660-4601/17/18/6861
IJERPH, Vol. 17, Pages 6860: Physical Activity in the Daily Life of Adolescents: Factors Affecting Healthy Choices from a Discrete Choice Experiment https://www.mdpi.com/1660-4601/17/18/6860 Physical activity improves peoples’ well-being and can help in preventing weight gain, obesity, and related non-communicable diseases. Promoting healthy behaviors in the daily travels and transport choices of adolescents is very important in early establishing healthy habits that imply routine physical activity. For designing and developing effective strategies, it is relevant to study adolescents’ preferences for physical activity and what factors in the social and environmental contexts affect their preferences. The paper investigates these aspects by means of a discrete choice experiment, using data from more than 4300 16–17 year-old adolescents in Italy. The results show that adolescents generally prefer walking for long time alone. However, females prefer cycling, while adolescents from lower educated families prefer motorized means of transport. Environmental factors affect the adolescents’ preferences: living nearby a green area is associated with more active and healthier choices in their short daily travels. Conversely, adolescents living closer to an industrial or high traffic area prefer to use motorized vehicles. Such findings have been discussed and policy implications presented, in order to support policymakers in designing cross-sectoral policies to promote healthy choices related to physical activity in adolescence. IJERPH, Vol. 17, Pages 6860: Physical Activity in the Daily Life of Adolescents: Factors Affecting Healthy Choices from a Discrete Choice Experiment

International Journal of Environmental Research and Public Health doi: 10.3390/ijerph17186860

Authors: Sabina De Rosis Ilaria Corazza Francesca Pennucci

Physical activity improves peoples’ well-being and can help in preventing weight gain, obesity, and related non-communicable diseases. Promoting healthy behaviors in the daily travels and transport choices of adolescents is very important in early establishing healthy habits that imply routine physical activity. For designing and developing effective strategies, it is relevant to study adolescents’ preferences for physical activity and what factors in the social and environmental contexts affect their preferences. The paper investigates these aspects by means of a discrete choice experiment, using data from more than 4300 16–17 year-old adolescents in Italy. The results show that adolescents generally prefer walking for long time alone. However, females prefer cycling, while adolescents from lower educated families prefer motorized means of transport. Environmental factors affect the adolescents’ preferences: living nearby a green area is associated with more active and healthier choices in their short daily travels. Conversely, adolescents living closer to an industrial or high traffic area prefer to use motorized vehicles. Such findings have been discussed and policy implications presented, in order to support policymakers in designing cross-sectoral policies to promote healthy choices related to physical activity in adolescence.

]]>
Physical Activity in the Daily Life of Adolescents: Factors Affecting Healthy Choices from a Discrete Choice Experiment Sabina De Rosis Ilaria Corazza Francesca Pennucci doi: 10.3390/ijerph17186860 International Journal of Environmental Research and Public Health 2020-09-19 International Journal of Environmental Research and Public Health 2020-09-19 17 18 Article 6860 10.3390/ijerph17186860 https://www.mdpi.com/1660-4601/17/18/6860
IJERPH, Vol. 17, Pages 6859: Transition Trajectories: Contexts, Difficulties and Consequences Reported by Young Transgender and Non-Binary Spaniards https://www.mdpi.com/1660-4601/17/18/6859 The transition process can have a significant impact on young transgender and non-binary individuals (TNBI), especially regarding their mental health. As such, this study aimed to explore the encountered difficulties and expectations of 225 young adults, between 14 and 25 years old, who identify themselves as TNBI. Four different aspects were analyzed: difficulties related to the transition process; main current difficulties; if the current difficulties are due to the participants’ sexual orientation or gender identity; and if participants feel the need of changing something in their lives. Several obstacles either before, during or after the transition process were identified; and these obstacles have serious consequences in TBNI’s mental health. Questions regarding legislation, discrimination, transphobia, lack of social support, the pathologization of transgenderism, low self-esteem, anxiety symptomatology, among others, were pointed out by the participants. The narratives collected and analyzed in the present study appear as important inputs to the literature, which can be translated into the basis of further investigations and the improvement of professional practices in the health field. IJERPH, Vol. 17, Pages 6859: Transition Trajectories: Contexts, Difficulties and Consequences Reported by Young Transgender and Non-Binary Spaniards

International Journal of Environmental Research and Public Health doi: 10.3390/ijerph17186859

Authors: Mariana Magalhães Marta E. Aparicio-García Isidro García-Nieto

The transition process can have a significant impact on young transgender and non-binary individuals (TNBI), especially regarding their mental health. As such, this study aimed to explore the encountered difficulties and expectations of 225 young adults, between 14 and 25 years old, who identify themselves as TNBI. Four different aspects were analyzed: difficulties related to the transition process; main current difficulties; if the current difficulties are due to the participants’ sexual orientation or gender identity; and if participants feel the need of changing something in their lives. Several obstacles either before, during or after the transition process were identified; and these obstacles have serious consequences in TBNI’s mental health. Questions regarding legislation, discrimination, transphobia, lack of social support, the pathologization of transgenderism, low self-esteem, anxiety symptomatology, among others, were pointed out by the participants. The narratives collected and analyzed in the present study appear as important inputs to the literature, which can be translated into the basis of further investigations and the improvement of professional practices in the health field.

]]>
Transition Trajectories: Contexts, Difficulties and Consequences Reported by Young Transgender and Non-Binary Spaniards Mariana Magalhães Marta E. Aparicio-García Isidro García-Nieto doi: 10.3390/ijerph17186859 International Journal of Environmental Research and Public Health 2020-09-19 International Journal of Environmental Research and Public Health 2020-09-19 17 18 Article 6859 10.3390/ijerph17186859 https://www.mdpi.com/1660-4601/17/18/6859
IJERPH, Vol. 17, Pages 6849: Physical Activity, Sport and Physical Education in Northern Ireland School Children: A Cross-Sectional Study https://www.mdpi.com/1660-4601/17/18/6849 Internationally, insufficient physical activity (PA) is a major health concern. Children in Northern Ireland (NI) are recorded as having the lowest levels of PA in the United Kingdom (UK). To date, validated and representative data on the PA levels of NI school children are limited. The aim of this study was to provide surveillance data on self-reported PA, sport and physical education (PE) participation of school children in NI. Differences between genders and factors associated with PA were also examined. A representative sample of primary (n = 446) and post-primary (n = 1508) children was surveyed in school using validated self-report measures. Findings suggest that PA levels are low, with a minority of children (13%) meeting the PA guidelines (primary pupils 20%, post-primary pupils 11%). NI school children have lower levels of PA, PE and sports participation than UK and European peers. A trend of age-related decline across all the domains of PA was apparent. The data presented highlighted that females are less likely to achieve PA guidelines, children from lower socio-economic background participate in school and community sport less often, and that enjoyment and social support are important variables in PA adherence. Policy solutions that would support implementation e.g., mandatory minimum PE time, whole school approaches to PA promotion and targeted investment in schools, particularly in areas of deprivation and for females, are suggested. IJERPH, Vol. 17, Pages 6849: Physical Activity, Sport and Physical Education in Northern Ireland School Children: A Cross-Sectional Study

International Journal of Environmental Research and Public Health doi: 10.3390/ijerph17186849

Authors: Sinead Connolly Angela Carlin Anne Johnston Catherine Woods Cormac Powell Sarahjane Belton Wesley O’Brien Jean Saunders Christina Duff Orlagh Farmer Marie Murphy

Internationally, insufficient physical activity (PA) is a major health concern. Children in Northern Ireland (NI) are recorded as having the lowest levels of PA in the United Kingdom (UK). To date, validated and representative data on the PA levels of NI school children are limited. The aim of this study was to provide surveillance data on self-reported PA, sport and physical education (PE) participation of school children in NI. Differences between genders and factors associated with PA were also examined. A representative sample of primary (n = 446) and post-primary (n = 1508) children was surveyed in school using validated self-report measures. Findings suggest that PA levels are low, with a minority of children (13%) meeting the PA guidelines (primary pupils 20%, post-primary pupils 11%). NI school children have lower levels of PA, PE and sports participation than UK and European peers. A trend of age-related decline across all the domains of PA was apparent. The data presented highlighted that females are less likely to achieve PA guidelines, children from lower socio-economic background participate in school and community sport less often, and that enjoyment and social support are important variables in PA adherence. Policy solutions that would support implementation e.g., mandatory minimum PE time, whole school approaches to PA promotion and targeted investment in schools, particularly in areas of deprivation and for females, are suggested.

]]>
Physical Activity, Sport and Physical Education in Northern Ireland School Children: A Cross-Sectional Study Sinead Connolly Angela Carlin Anne Johnston Catherine Woods Cormac Powell Sarahjane Belton Wesley O’Brien Jean Saunders Christina Duff Orlagh Farmer Marie Murphy doi: 10.3390/ijerph17186849 International Journal of Environmental Research and Public Health 2020-09-19 International Journal of Environmental Research and Public Health 2020-09-19 17 18 Article 6849 10.3390/ijerph17186849 https://www.mdpi.com/1660-4601/17/18/6849
IJERPH, Vol. 17, Pages 6858: Association between Perceived Neighborhood Built Environment and Walking and Cycling for Transport among Inhabitants from Latin America: The ELANS Study https://www.mdpi.com/1660-4601/17/18/6858 Purpose: This study aimed to examine the associations of the perceived neighborhood built environment with walking and cycling for transport in inhabitants from Latin American countries. Methods: This cross-sectional study involved 9218 participants (15–65 years) from the Latin American Study of Nutrition and Health, which included a nationally representative sample of eight countries. All participants completed the International Physical Activity Questionnaire-Long Form for measure walking and cycling for transport and the Neighborhood Environment Walkability Scale-Abbreviated. Furthermore, perceived proximity from home to public open spaces and shopping centers was assessed. Results: Perceived land use mix-access (OR: 1.32; 95%CI: 1.16,1.50) and the existence of many alternative routes in the neighbourhood (1.09 1.01,1.17) were associated with higher odds of reporting any walking for transport (≥10 min/week). Perceived slow speed of traffic (1.88 1.82,1.93) and few drivers exceeding the speed limits (1.92; 1.86,1.98) were also related to higher odds of reporting any walking for transport. The odds of reporting any cycling for transport (≥10 min/week) were higher in participants perceiving more walking/cycling facilities (1.87 1.76,1.99), and better aesthetics (1.22 1.09,1.38). Conclusions: Dissimilar perceived neighborhood built environment characteristics were associated with walking and cycling for transport among inhabitants from Latin America. IJERPH, Vol. 17, Pages 6858: Association between Perceived Neighborhood Built Environment and Walking and Cycling for Transport among Inhabitants from Latin America: The ELANS Study

International Journal of Environmental Research and Public Health doi: 10.3390/ijerph17186858

Authors: Gerson Ferrari André Oliveira Werneck Danilo Rodrigues da Silva Irina Kovalskys Georgina Gómez Attilio Rigotti Lilia Yadira Cortés Sanabria Martha García Rossina Pareja Marianella Herrera-Cuenca Ioná Zimberg Viviana Guajardo Michael Pratt Cristian Cofre Bolados Emilio Saldía Carlos Pires Adilson Marques Miguel Peralta Eduardo Rossato de Victo Mauro Fisberg on behalf of the ELANS Study Group

Purpose: This study aimed to examine the associations of the perceived neighborhood built environment with walking and cycling for transport in inhabitants from Latin American countries. Methods: This cross-sectional study involved 9218 participants (15–65 years) from the Latin American Study of Nutrition and Health, which included a nationally representative sample of eight countries. All participants completed the International Physical Activity Questionnaire-Long Form for measure walking and cycling for transport and the Neighborhood Environment Walkability Scale-Abbreviated. Furthermore, perceived proximity from home to public open spaces and shopping centers was assessed. Results: Perceived land use mix-access (OR: 1.32; 95%CI: 1.16,1.50) and the existence of many alternative routes in the neighbourhood (1.09 1.01,1.17) were associated with higher odds of reporting any walking for transport (≥10 min/week). Perceived slow speed of traffic (1.88 1.82,1.93) and few drivers exceeding the speed limits (1.92; 1.86,1.98) were also related to higher odds of reporting any walking for transport. The odds of reporting any cycling for transport (≥10 min/week) were higher in participants perceiving more walking/cycling facilities (1.87 1.76,1.99), and better aesthetics (1.22 1.09,1.38). Conclusions: Dissimilar perceived neighborhood built environment characteristics were associated with walking and cycling for transport among inhabitants from Latin America.

]]>
Association between Perceived Neighborhood Built Environment and Walking and Cycling for Transport among Inhabitants from Latin America: The ELANS Study Gerson Ferrari André Oliveira Werneck Danilo Rodrigues da Silva Irina Kovalskys Georgina Gómez Attilio Rigotti Lilia Yadira Cortés Sanabria Martha García Rossina Pareja Marianella Herrera-Cuenca Ioná Zimberg Viviana Guajardo Michael Pratt Cristian Cofre Bolados Emilio Saldía Carlos Pires Adilson Marques Miguel Peralta Eduardo Rossato de Victo Mauro Fisberg on behalf of the ELANS Study Group doi: 10.3390/ijerph17186858 International Journal of Environmental Research and Public Health 2020-09-19 International Journal of Environmental Research and Public Health 2020-09-19 17 18 Article 6858 10.3390/ijerph17186858 https://www.mdpi.com/1660-4601/17/18/6858
IJERPH, Vol. 17, Pages 6857: Farm to Early Care and Education Programming: A Descriptive Study of Challenges and Opportunities to Promote Healthful Foods to Young Children https://www.mdpi.com/1660-4601/17/18/6857 Interest in farm to early care and education (ECE) programming, which consists of gardening, nutrition education, and local food procurement, has been growing in the United States, as it may be a promising technique for promoting healthful foods to young children. However, there is limited information about current farm to ECE efforts in specific states, including Colorado, to support funding and resource needs. An online survey was distributed to licensed Colorado ECE providers in two phases to understand current participation in the farm to ECE as well as provider perspectives on benefits and barriers to programming. A total of 250 surveys were completed. Approximately 60% of ECE facilities participated in gardening and nutrition education with providers almost unanimously agreeing on the child-centric benefits of programming. Fewer facilities (37%) participated in local food procurement likely due to significant time, cost, and knowledge barriers. To increase participation in farm to ECE as a technique for promoting healthful foods to young children, future efforts should focus on innovative solutions to reduce ECE-specific barriers. IJERPH, Vol. 17, Pages 6857: Farm to Early Care and Education Programming: A Descriptive Study of Challenges and Opportunities to Promote Healthful Foods to Young Children

International Journal of Environmental Research and Public Health doi: 10.3390/ijerph17186857

Authors: Morgan L. McCloskey Hannah Kesterson Noereem Z. Mena Jennifer Dellaport Laura L. Bellows

Interest in farm to early care and education (ECE) programming, which consists of gardening, nutrition education, and local food procurement, has been growing in the United States, as it may be a promising technique for promoting healthful foods to young children. However, there is limited information about current farm to ECE efforts in specific states, including Colorado, to support funding and resource needs. An online survey was distributed to licensed Colorado ECE providers in two phases to understand current participation in the farm to ECE as well as provider perspectives on benefits and barriers to programming. A total of 250 surveys were completed. Approximately 60% of ECE facilities participated in gardening and nutrition education with providers almost unanimously agreeing on the child-centric benefits of programming. Fewer facilities (37%) participated in local food procurement likely due to significant time, cost, and knowledge barriers. To increase participation in farm to ECE as a technique for promoting healthful foods to young children, future efforts should focus on innovative solutions to reduce ECE-specific barriers.

]]>
Farm to Early Care and Education Programming: A Descriptive Study of Challenges and Opportunities to Promote Healthful Foods to Young Children Morgan L. McCloskey Hannah Kesterson Noereem Z. Mena Jennifer Dellaport Laura L. Bellows doi: 10.3390/ijerph17186857 International Journal of Environmental Research and Public Health 2020-09-19 International Journal of Environmental Research and Public Health 2020-09-19 17 18 Article 6857 10.3390/ijerph17186857 https://www.mdpi.com/1660-4601/17/18/6857
IJERPH, Vol. 17, Pages 6856: Social and Demographic Patterns of Health-Related Internet Use Among Adults in the United States: A Secondary Data Analysis of the Health Information National Trends Survey https://www.mdpi.com/1660-4601/17/18/6856 National surveys of U.S. adults have observed significant increases in health-related internet use (HRIU), but there are documented disparities. The study aims to identify social and demographic patterns of health-related internet use among U.S. adults. Using data from the Health Information National Trends Survey (HINTS) 4 cycle 3 and HINTS 5 cycle 1, we examined HRIU across healthcare, health information seeking, and participation on social media. Primary predictors were gender, race/ethnicity, age, education, income, and nativity with adjustments for smoking and survey year. We used multivariable logistic regression with survey weights to identify independent predictors of HRIU. Of the 4817 respondents, 43% had used the internet to find a doctor; 80% had looked online for health information. Only 20% had used social media for a health issue; 7% participated in an online health support group. In multivariable models, older and low SES participants were significantly less likely to use the internet to look for a provider, use the internet to look for health information for themselves or someone else, and less likely to use social media for health issues. Use of the internet for health-related purposes is vast but varies significantly by demographics and intended use. IJERPH, Vol. 17, Pages 6856: Social and Demographic Patterns of Health-Related Internet Use Among Adults in the United States: A Secondary Data Analysis of the Health Information National Trends Survey

International Journal of Environmental Research and Public Health doi: 10.3390/ijerph17186856

Authors: Rose Calixte Argelis Rivera Olutobi Oridota William Beauchamp Marlene Camacho-Rivera

National surveys of U.S. adults have observed significant increases in health-related internet use (HRIU), but there are documented disparities. The study aims to identify social and demographic patterns of health-related internet use among U.S. adults. Using data from the Health Information National Trends Survey (HINTS) 4 cycle 3 and HINTS 5 cycle 1, we examined HRIU across healthcare, health information seeking, and participation on social media. Primary predictors were gender, race/ethnicity, age, education, income, and nativity with adjustments for smoking and survey year. We used multivariable logistic regression with survey weights to identify independent predictors of HRIU. Of the 4817 respondents, 43% had used the internet to find a doctor; 80% had looked online for health information. Only 20% had used social media for a health issue; 7% participated in an online health support group. In multivariable models, older and low SES participants were significantly less likely to use the internet to look for a provider, use the internet to look for health information for themselves or someone else, and less likely to use social media for health issues. Use of the internet for health-related purposes is vast but varies significantly by demographics and intended use.

]]>
Social and Demographic Patterns of Health-Related Internet Use Among Adults in the United States: A Secondary Data Analysis of the Health Information National Trends Survey Rose Calixte Argelis Rivera Olutobi Oridota William Beauchamp Marlene Camacho-Rivera doi: 10.3390/ijerph17186856 International Journal of Environmental Research and Public Health 2020-09-19 International Journal of Environmental Research and Public Health 2020-09-19 17 18 Article 6856 10.3390/ijerph17186856 https://www.mdpi.com/1660-4601/17/18/6856
IJERPH, Vol. 17, Pages 6855: Antithrombotic Preventive Medication Prescription Redemption and Socioeconomic Status in Hungary in 2016: A Cross-Sectional Study https://www.mdpi.com/1660-4601/17/18/6855 This work was designed to investigate antithrombotic drug utilization and its link with the socioeconomic characteristics of specific population groups in Hungary by a comparative analysis of data for prescriptions by general practitioners and the redeemed prescriptions for antithrombotic drugs. Risk analysis capabilities were applied to estimate the relationships between socioeconomic status, which was characterized by quintiles of a multidimensional composite indicator (deprivation index), and mortality due to thromboembolic diseases as well as antithrombotic medications for the year 2016 at the district level in Hungary. According to our findings, although deprivation is a significant determinant of mortality due to thromboembolic diseases, clusters can be identified that represent exemptions to this rule: an eastern part of Hungary, consisting of two highly deprived counties, had significantly lower mortality than the country average; by contrast, the least-deprived northwestern part of the country, consisting of five counties, had significantly higher mortality than the country average. The fact that low socioeconomic status in general and poor adherence to antithrombotic drugs irrespective of socioeconomic status were associated with increased mortality indicates the importance of more efficient control of preventive medication and access to healthcare in all districts of the country to reduce mortality due to thromboembolic diseases. IJERPH, Vol. 17, Pages 6855: Antithrombotic Preventive Medication Prescription Redemption and Socioeconomic Status in Hungary in 2016: A Cross-Sectional Study

International Journal of Environmental Research and Public Health doi: 10.3390/ijerph17186855

Authors: Attila Juhász Csilla Nagy Orsolya Varga Klára Boruzs Mária Csernoch Zoltán Szabó Róza Ádány

This work was designed to investigate antithrombotic drug utilization and its link with the socioeconomic characteristics of specific population groups in Hungary by a comparative analysis of data for prescriptions by general practitioners and the redeemed prescriptions for antithrombotic drugs. Risk analysis capabilities were applied to estimate the relationships between socioeconomic status, which was characterized by quintiles of a multidimensional composite indicator (deprivation index), and mortality due to thromboembolic diseases as well as antithrombotic medications for the year 2016 at the district level in Hungary. According to our findings, although deprivation is a significant determinant of mortality due to thromboembolic diseases, clusters can be identified that represent exemptions to this rule: an eastern part of Hungary, consisting of two highly deprived counties, had significantly lower mortality than the country average; by contrast, the least-deprived northwestern part of the country, consisting of five counties, had significantly higher mortality than the country average. The fact that low socioeconomic status in general and poor adherence to antithrombotic drugs irrespective of socioeconomic status were associated with increased mortality indicates the importance of more efficient control of preventive medication and access to healthcare in all districts of the country to reduce mortality due to thromboembolic diseases.

]]>
Antithrombotic Preventive Medication Prescription Redemption and Socioeconomic Status in Hungary in 2016: A Cross-Sectional Study Attila Juhász Csilla Nagy Orsolya Varga Klára Boruzs Mária Csernoch Zoltán Szabó Róza Ádány doi: 10.3390/ijerph17186855 International Journal of Environmental Research and Public Health 2020-09-19 International Journal of Environmental Research and Public Health 2020-09-19 17 18 Article 6855 10.3390/ijerph17186855 https://www.mdpi.com/1660-4601/17/18/6855
IJERPH, Vol. 17, Pages 6854: Parents’ Perspectives on the Health Education Provided by Clinicians in Portuguese Pediatric Hospitals and Primary Care for Children Aged 1 to 10 Years https://www.mdpi.com/1660-4601/17/18/6854 This study aimed to analyze parents’ perspectives of the health education practice provided by health professionals to children and parents. This is a descriptive research with a qualitative approach, based on the conceptual framework of health education provided by health professionals to children/young people and families. The selection took place by non-probabilistic sampling of convenience, and was developed with parents/users of health units for pediatric hospitalization and primary health care in northern Portugal. Data were collected using semi-structured interviews with 20 parents from March to April 2019, and were analyzed using the content analysis technique. Health education was understood to enhance health, and the evaluation was carried out according to planning and partnership. The most frequent topics were food, the national vaccination plan, and accident prevention. The evaluation shown is very positive, pointing to the nurse as the professional of choice for this practice and thus contributing to the visibility of nursing. We can state that the perspectives of parents about the health education carried out by health professionals show a practice that values health; is adaptable to the complexity of the binomial child and parents; is capable of influencing health determinants with sustainability, efficacy, and effectiveness; and gives visibility to nurses’ positions as health educators. IJERPH, Vol. 17, Pages 6854: Parents’ Perspectives on the Health Education Provided by Clinicians in Portuguese Pediatric Hospitals and Primary Care for Children Aged 1 to 10 Years

International Journal of Environmental Research and Public Health doi: 10.3390/ijerph17186854

Authors: Anabela Pereira Joaquim Escola Vitor Rodrigues Carlos Almeida

This study aimed to analyze parents’ perspectives of the health education practice provided by health professionals to children and parents. This is a descriptive research with a qualitative approach, based on the conceptual framework of health education provided by health professionals to children/young people and families. The selection took place by non-probabilistic sampling of convenience, and was developed with parents/users of health units for pediatric hospitalization and primary health care in northern Portugal. Data were collected using semi-structured interviews with 20 parents from March to April 2019, and were analyzed using the content analysis technique. Health education was understood to enhance health, and the evaluation was carried out according to planning and partnership. The most frequent topics were food, the national vaccination plan, and accident prevention. The evaluation shown is very positive, pointing to the nurse as the professional of choice for this practice and thus contributing to the visibility of nursing. We can state that the perspectives of parents about the health education carried out by health professionals show a practice that values health; is adaptable to the complexity of the binomial child and parents; is capable of influencing health determinants with sustainability, efficacy, and effectiveness; and gives visibility to nurses’ positions as health educators.

]]>
Parents’ Perspectives on the Health Education Provided by Clinicians in Portuguese Pediatric Hospitals and Primary Care for Children Aged 1 to 10 Years Anabela Pereira Joaquim Escola Vitor Rodrigues Carlos Almeida doi: 10.3390/ijerph17186854 International Journal of Environmental Research and Public Health 2020-09-19 International Journal of Environmental Research and Public Health 2020-09-19 17 18 Article 6854 10.3390/ijerph17186854 https://www.mdpi.com/1660-4601/17/18/6854
IJERPH, Vol. 17, Pages 6853: Infectious or Recovered? Optimizing the Infectious Disease Detection Process for Epidemic Control and Prevention Based on Social Media https://www.mdpi.com/1660-4601/17/18/6853 Detecting the period of a disease is of great importance to building information management capacity in disease control and prevention. This paper aims to optimize the disease surveillance process by further identifying the infectious or recovered period of flu cases through social media. Specifically, this paper explores the potential of using public sentiment to detect flu periods at word level. At text level, we constructed a deep learning method to classify the flu period and improve the classification result with sentiment polarity. Three important findings are revealed. Firstly, bloggers in different periods express significantly different sentiments. Blogger sentiments in the recovered period are more positive than in the infectious period when measured by the interclass distance. Secondly, the optimized disease detection process can substantially improve the classification accuracy of flu periods from 0.876 to 0.926. Thirdly, our experimental results confirm that sentiment classification plays a crucial role in accuracy improvement. Precise identification of disease periods enhances the channels for the disease surveillance processes. Therefore, a disease outbreak can be predicted credibly when a larger population is monitored. The research method proposed in our work also provides decision making reference for proactive and effective epidemic control and prevention in real time. IJERPH, Vol. 17, Pages 6853: Infectious or Recovered? Optimizing the Infectious Disease Detection Process for Epidemic Control and Prevention Based on Social Media

International Journal of Environmental Research and Public Health doi: 10.3390/ijerph17186853

Authors: Siqing Shan Qi Yan Yigang Wei

Detecting the period of a disease is of great importance to building information management capacity in disease control and prevention. This paper aims to optimize the disease surveillance process by further identifying the infectious or recovered period of flu cases through social media. Specifically, this paper explores the potential of using public sentiment to detect flu periods at word level. At text level, we constructed a deep learning method to classify the flu period and improve the classification result with sentiment polarity. Three important findings are revealed. Firstly, bloggers in different periods express significantly different sentiments. Blogger sentiments in the recovered period are more positive than in the infectious period when measured by the interclass distance. Secondly, the optimized disease detection process can substantially improve the classification accuracy of flu periods from 0.876 to 0.926. Thirdly, our experimental results confirm that sentiment classification plays a crucial role in accuracy improvement. Precise identification of disease periods enhances the channels for the disease surveillance processes. Therefore, a disease outbreak can be predicted credibly when a larger population is monitored. The research method proposed in our work also provides decision making reference for proactive and effective epidemic control and prevention in real time.

]]>
Infectious or Recovered? Optimizing the Infectious Disease Detection Process for Epidemic Control and Prevention Based on Social Media Siqing Shan Qi Yan Yigang Wei doi: 10.3390/ijerph17186853 International Journal of Environmental Research and Public Health 2020-09-19 International Journal of Environmental Research and Public Health 2020-09-19 17 18 Article 6853 10.3390/ijerph17186853 https://www.mdpi.com/1660-4601/17/18/6853
IJERPH, Vol. 17, Pages 6852: Promoting Health-Related Cardiorespiratory Fitness in Physical Education: The Role of Class Intensity and Habitual Physical Activity https://www.mdpi.com/1660-4601/17/18/6852 Physical education (PE) has the potential to promote health-related fitness, however, its contribution is still not clear. The aim of this study was to assess whether students’ health-related cardiorespiratory fitness (CRF) improved from the beginning to the end of the school year, and to examine the role of PE class intensity and habitual physical activity (PA) in promoting students’ CRF. This observational study employed a longitudinal design. Participants were 212 7th and 8th grade students (105 boys), mean age 12.9 years old, followed during one school year, from September 2017 to June 2018. The Progressive Aerobic Cardiovascular Endurance Run (PACER) was used to assess CRF at baseline and follow-up. PA was measured using accelerometers. PE class intensity was assessed using the System for Observing Fitness Instruction Time. Findings indicated that from the beginning to the end of the school year, a greater percentage of participants were in the CRF healthy fitness zone (73.1% to 79.7%, p = 0.022). Among boys, participating in organized sports (B = 4.61, 95% confidence interval [CI]: 0.33, 8.88) and the percentage of PE time being very active (B = 0.90, 95% CI: 0.44, 1.35) were positively associated with the change in PACER laps. Among girls, daily vigorous PA (B = 0.38, 95% CI: 0.15, 0.60) and participating in organized sports (B = 4.10, 95% CI: 0.93, 7.27) were also positively associated with PACER change, while being overweight or obese (B = −5.11, 95% CI: −8.28, −1.93) was negatively associated. In conclusion, PE was demonstrated to have a positive role in the promotion of CRF, especially among boys, while for girls, habitual PA seems to have a greater contribution. Nevertheless, results and conclusions should be considered carefully, taking into account study limitations, such as the non-direct measures of PE class intensity, CRF, and school setting. IJERPH, Vol. 17, Pages 6852: Promoting Health-Related Cardiorespiratory Fitness in Physical Education: The Role of Class Intensity and Habitual Physical Activity

International Journal of Environmental Research and Public Health doi: 10.3390/ijerph17186852

Authors: Miguel Peralta Diana A. Santos Duarte Henriques-Neto Gerson Ferrari Hugo Sarmento Adilson Marques

Physical education (PE) has the potential to promote health-related fitness, however, its contribution is still not clear. The aim of this study was to assess whether students’ health-related cardiorespiratory fitness (CRF) improved from the beginning to the end of the school year, and to examine the role of PE class intensity and habitual physical activity (PA) in promoting students’ CRF. This observational study employed a longitudinal design. Participants were 212 7th and 8th grade students (105 boys), mean age 12.9 years old, followed during one school year, from September 2017 to June 2018. The Progressive Aerobic Cardiovascular Endurance Run (PACER) was used to assess CRF at baseline and follow-up. PA was measured using accelerometers. PE class intensity was assessed using the System for Observing Fitness Instruction Time. Findings indicated that from the beginning to the end of the school year, a greater percentage of participants were in the CRF healthy fitness zone (73.1% to 79.7%, p = 0.022). Among boys, participating in organized sports (B = 4.61, 95% confidence interval [CI]: 0.33, 8.88) and the percentage of PE time being very active (B = 0.90, 95% CI: 0.44, 1.35) were positively associated with the change in PACER laps. Among girls, daily vigorous PA (B = 0.38, 95% CI: 0.15, 0.60) and participating in organized sports (B = 4.10, 95% CI: 0.93, 7.27) were also positively associated with PACER change, while being overweight or obese (B = −5.11, 95% CI: −8.28, −1.93) was negatively associated. In conclusion, PE was demonstrated to have a positive role in the promotion of CRF, especially among boys, while for girls, habitual PA seems to have a greater contribution. Nevertheless, results and conclusions should be considered carefully, taking into account study limitations, such as the non-direct measures of PE class intensity, CRF, and school setting.

]]>
Promoting Health-Related Cardiorespiratory Fitness in Physical Education: The Role of Class Intensity and Habitual Physical Activity Miguel Peralta Diana A. Santos Duarte Henriques-Neto Gerson Ferrari Hugo Sarmento Adilson Marques doi: 10.3390/ijerph17186852 International Journal of Environmental Research and Public Health 2020-09-19 International Journal of Environmental Research and Public Health 2020-09-19 17 18 Article 6852 10.3390/ijerph17186852 https://www.mdpi.com/1660-4601/17/18/6852
IJERPH, Vol. 17, Pages 6851: Disparities in Dental Service Utilization among Adults in Chinese Megacities: Do Health Insurance and City of Residence Matter? https://www.mdpi.com/1660-4601/17/18/6851 The aims of the study were to present the prevalence of dental service utilization among adults (age between 18 and 65) in Chinese megacities and to examine the associations of health insurance and city of residence with dental visits. This study was a cross-sectional analysis of the 2019 New Era and Living Conditions in Megacities Survey data with a sample of 4835 participants aged 18–65 from 10 different megacities in China. The data including gross domestic product (GDP) per capita of each megacity obtained from the National Bureau of Statistics of China as a city-level characteristic. After adjusting sampling weights, approximately 24.28% of the participants had at least one dental visit per year. Findings from multilevel mixed-effects linear models showed that participants residing in megacities with higher GDP per capita (β = 0.07, p < 0.001) who had Urban Employee Basic Medical Insurance (β = 0.25, p < 0.001) or Urban Resident Basic Medical Insurance (β = 0.19, p < 0.01) had more frequent dental visits after adjusting demographic characteristics, socioeconomic status, health status, health behavior and attitude, and oral health indicators. Margins post-estimation model results demonstrated disparities in the predicted probability of having never visited a dentist by types of health insurance and city of residence. In conclusion, the prevalence of dental visits in China was found to be low. This study highlights socioeconomic inequalities in dental service utilization. There is a great need to develop more dental care programs and services and expand health insurance to cover dental care in China. IJERPH, Vol. 17, Pages 6851: Disparities in Dental Service Utilization among Adults in Chinese Megacities: Do Health Insurance and City of Residence Matter?

International Journal of Environmental Research and Public Health doi: 10.3390/ijerph17186851

Authors: Xiaomin Qu Xiang Qi Bei Wu

The aims of the study were to present the prevalence of dental service utilization among adults (age between 18 and 65) in Chinese megacities and to examine the associations of health insurance and city of residence with dental visits. This study was a cross-sectional analysis of the 2019 New Era and Living Conditions in Megacities Survey data with a sample of 4835 participants aged 18–65 from 10 different megacities in China. The data including gross domestic product (GDP) per capita of each megacity obtained from the National Bureau of Statistics of China as a city-level characteristic. After adjusting sampling weights, approximately 24.28% of the participants had at least one dental visit per year. Findings from multilevel mixed-effects linear models showed that participants residing in megacities with higher GDP per capita (β = 0.07, p < 0.001) who had Urban Employee Basic Medical Insurance (β = 0.25, p < 0.001) or Urban Resident Basic Medical Insurance (β = 0.19, p < 0.01) had more frequent dental visits after adjusting demographic characteristics, socioeconomic status, health status, health behavior and attitude, and oral health indicators. Margins post-estimation model results demonstrated disparities in the predicted probability of having never visited a dentist by types of health insurance and city of residence. In conclusion, the prevalence of dental visits in China was found to be low. This study highlights socioeconomic inequalities in dental service utilization. There is a great need to develop more dental care programs and services and expand health insurance to cover dental care in China.

]]>
Disparities in Dental Service Utilization among Adults in Chinese Megacities: Do Health Insurance and City of Residence Matter? Xiaomin Qu Xiang Qi Bei Wu doi: 10.3390/ijerph17186851 International Journal of Environmental Research and Public Health 2020-09-19 International Journal of Environmental Research and Public Health 2020-09-19 17 18 Article 6851 10.3390/ijerph17186851 https://www.mdpi.com/1660-4601/17/18/6851
IJERPH, Vol. 17, Pages 6850: Mediating Factors in Nursing Competency: A Structural Model Analysis for Nurses’ Communication, Self-Leadership, Self-Efficacy, and Nursing Performance https://www.mdpi.com/1660-4601/17/18/6850 This study examined the structural relationship among clinical nurses’ communication ability, self-leadership, self-efficacy, and nursing performance. A structural model analysis was applied to identify factors influencing nursing performance and analyze the effects of self-leadership and self-efficacy as mediators. A survey was conducted among clinical nurses working in general hospitals in Seoul, Gyeonggi, and Gangwon Province of the Republic of Korea. In the final analysis, data from 168 questionnaires were used. SPSS 24.0 and Amos 23.0 programs were used for frequency analysis, exploratory factor analysis, reliability analysis, correlation analysis, confirmatory factor analysis, structural equation model analysis, and mediating effect analysis through bootstrapping. The significance level was set at 5% for all analyses. First, the model’s fitness figures met the criteria for the appropriate judgment presented in previous studies, so the model between nurses’ communication ability, self-leadership, self-efficacy, and nursing performance was suitable for predicting a causal relationship. Second, the relationship between nurses’ communication ability and self-leadership had a statistically significant effect. Also, the relationship between communication ability and self-efficacy had a statistically significant effect. Third, nurses’ communication ability affected nursing performance through self-efficacy. IJERPH, Vol. 17, Pages 6850: Mediating Factors in Nursing Competency: A Structural Model Analysis for Nurses’ Communication, Self-Leadership, Self-Efficacy, and Nursing Performance

International Journal of Environmental Research and Public Health doi: 10.3390/ijerph17186850

Authors: Ae Young Kim In Ok Sim

This study examined the structural relationship among clinical nurses’ communication ability, self-leadership, self-efficacy, and nursing performance. A structural model analysis was applied to identify factors influencing nursing performance and analyze the effects of self-leadership and self-efficacy as mediators. A survey was conducted among clinical nurses working in general hospitals in Seoul, Gyeonggi, and Gangwon Province of the Republic of Korea. In the final analysis, data from 168 questionnaires were used. SPSS 24.0 and Amos 23.0 programs were used for frequency analysis, exploratory factor analysis, reliability analysis, correlation analysis, confirmatory factor analysis, structural equation model analysis, and mediating effect analysis through bootstrapping. The significance level was set at 5% for all analyses. First, the model’s fitness figures met the criteria for the appropriate judgment presented in previous studies, so the model between nurses’ communication ability, self-leadership, self-efficacy, and nursing performance was suitable for predicting a causal relationship. Second, the relationship between nurses’ communication ability and self-leadership had a statistically significant effect. Also, the relationship between communication ability and self-efficacy had a statistically significant effect. Third, nurses’ communication ability affected nursing performance through self-efficacy.

]]>
Mediating Factors in Nursing Competency: A Structural Model Analysis for Nurses’ Communication, Self-Leadership, Self-Efficacy, and Nursing Performance Ae Young Kim In Ok Sim doi: 10.3390/ijerph17186850 International Journal of Environmental Research and Public Health 2020-09-19 International Journal of Environmental Research and Public Health 2020-09-19 17 18 Article 6850 10.3390/ijerph17186850 https://www.mdpi.com/1660-4601/17/18/6850
IJERPH, Vol. 17, Pages 6848: Effects of Heavy Metals in Lake Water and Sediments on Bottom Invertebrates Inhabiting the Brackish Coastal Lake Łebsko on the Southern Baltic Coast https://www.mdpi.com/1660-4601/17/18/6848 Lake Łebsko is the largest and most productive coastal lake of the southern Baltic Sea to which it is permanently connected. The shoreline is well-developed, and the lake is divided into three parts: eastern, central, and western. Seawater intrusion affects most strongly the eastern part, where the Łeba River connects it with the sea. Samples of water and sediments were collected in 2014–2015. In the same places and time interval, bottom fauna was collected to determine the influence of environmental predictors on its qualitative-quantitative structure. Metals Cr (chromium), Pb (lead), Ni (nickel), Cu (copper), and Al (aluminium) in the samples were analyzed using inductively coupled plasma optical emission spectrometry. Most of the analyzed physicochemical variables of water were significantly higher in the eastern part: conductivity, salinity, sulfates (p < 0.0001) and chlorides (p = 0.01). Metal concentrations in water did not differ significantly between the lake parts, but in sediments they were generally higher in the western part. During the study, we detected significant changes in descriptors and abundance of the major groups of benthic fauna (Oligochaeta and Diptera), mostly between the eastern and western parts. BIO-ENV analysis showed that the benthic community of Lake Łebsko is shaped primarily by physicochemical variables of water (42% of the variance), linked with intrusion of seawater. Secondarily, the structure of the benthic community is affected by the amounts of heavy metals in sediments (31%) and water (12%). The findings can help us improve the principles of management of coastal lakes, including modification of hydrological conditions. IJERPH, Vol. 17, Pages 6848: Effects of Heavy Metals in Lake Water and Sediments on Bottom Invertebrates Inhabiting the Brackish Coastal Lake Łebsko on the Southern Baltic Coast

International Journal of Environmental Research and Public Health doi: 10.3390/ijerph17186848

Authors: Natalia Mrozińska Martyna Bąkowska

Lake Łebsko is the largest and most productive coastal lake of the southern Baltic Sea to which it is permanently connected. The shoreline is well-developed, and the lake is divided into three parts: eastern, central, and western. Seawater intrusion affects most strongly the eastern part, where the Łeba River connects it with the sea. Samples of water and sediments were collected in 2014–2015. In the same places and time interval, bottom fauna was collected to determine the influence of environmental predictors on its qualitative-quantitative structure. Metals Cr (chromium), Pb (lead), Ni (nickel), Cu (copper), and Al (aluminium) in the samples were analyzed using inductively coupled plasma optical emission spectrometry. Most of the analyzed physicochemical variables of water were significantly higher in the eastern part: conductivity, salinity, sulfates (p < 0.0001) and chlorides (p = 0.01). Metal concentrations in water did not differ significantly between the lake parts, but in sediments they were generally higher in the western part. During the study, we detected significant changes in descriptors and abundance of the major groups of benthic fauna (Oligochaeta and Diptera), mostly between the eastern and western parts. BIO-ENV analysis showed that the benthic community of Lake Łebsko is shaped primarily by physicochemical variables of water (42% of the variance), linked with intrusion of seawater. Secondarily, the structure of the benthic community is affected by the amounts of heavy metals in sediments (31%) and water (12%). The findings can help us improve the principles of management of coastal lakes, including modification of hydrological conditions.

]]>
Effects of Heavy Metals in Lake Water and Sediments on Bottom Invertebrates Inhabiting the Brackish Coastal Lake Łebsko on the Southern Baltic Coast Natalia Mrozińska Martyna Bąkowska doi: 10.3390/ijerph17186848 International Journal of Environmental Research and Public Health 2020-09-19 International Journal of Environmental Research and Public Health 2020-09-19 17 18 Article 6848 10.3390/ijerph17186848 https://www.mdpi.com/1660-4601/17/18/6848
IJERPH, Vol. 17, Pages 6847: Constructing and Communicating COVID-19 Stigma on Twitter: A Content Analysis of Tweets during the Early Stage of the COVID-19 Outbreak https://www.mdpi.com/1660-4601/17/18/6847 This study focuses on stigma communication about COVID-19 on Twitter in the early stage of the outbreak, given the lack of information and rapid global expansion of new cases during this period. Guided by the model of stigma communication, we examine four types of message content, namely mark, group labeling, responsibility, and peril, that are instrumental in forming stigma beliefs and sharing stigma messages. We also explore whether the presence of misinformation and conspiracy theories in COVID-19-related tweets is associated with the presence of COVID-19 stigma content. A total of 155,353 unique COVID-19-related tweets posted between December 31, 2019, and March 13, 2020, were identified, from which 7000 tweets were randomly selected for manual coding. Results showed that the peril of COVID-19 was mentioned the most often, followed by mark, responsibility, and group labeling content. Tweets with conspiracy theories were more likely to include group labeling and responsibility information, but less likely to mention COVID-19 peril. Public health agencies should be aware of the unintentional stigmatization of COVID-19 in public health messages and the urgency to engage and educate the public about the facts of COVID-19. IJERPH, Vol. 17, Pages 6847: Constructing and Communicating COVID-19 Stigma on Twitter: A Content Analysis of Tweets during the Early Stage of the COVID-19 Outbreak

International Journal of Environmental Research and Public Health doi: 10.3390/ijerph17186847

Authors: Yachao Li Sylvia Twersky Kelsey Ignace Mei Zhao Radhika Purandare Breeda Bennett-Jones Scott R. Weaver

This study focuses on stigma communication about COVID-19 on Twitter in the early stage of the outbreak, given the lack of information and rapid global expansion of new cases during this period. Guided by the model of stigma communication, we examine four types of message content, namely mark, group labeling, responsibility, and peril, that are instrumental in forming stigma beliefs and sharing stigma messages. We also explore whether the presence of misinformation and conspiracy theories in COVID-19-related tweets is associated with the presence of COVID-19 stigma content. A total of 155,353 unique COVID-19-related tweets posted between December 31, 2019, and March 13, 2020, were identified, from which 7000 tweets were randomly selected for manual coding. Results showed that the peril of COVID-19 was mentioned the most often, followed by mark, responsibility, and group labeling content. Tweets with conspiracy theories were more likely to include group labeling and responsibility information, but less likely to mention COVID-19 peril. Public health agencies should be aware of the unintentional stigmatization of COVID-19 in public health messages and the urgency to engage and educate the public about the facts of COVID-19.

]]>
Constructing and Communicating COVID-19 Stigma on Twitter: A Content Analysis of Tweets during the Early Stage of the COVID-19 Outbreak Yachao Li Sylvia Twersky Kelsey Ignace Mei Zhao Radhika Purandare Breeda Bennett-Jones Scott R. Weaver doi: 10.3390/ijerph17186847 International Journal of Environmental Research and Public Health 2020-09-19 International Journal of Environmental Research and Public Health 2020-09-19 17 18 Article 6847 10.3390/ijerph17186847 https://www.mdpi.com/1660-4601/17/18/6847
IJERPH, Vol. 17, Pages 6846: The Influence of Hippotherapy on the Body Posture in a Sitting Position among Children with Cerebral Palsy https://www.mdpi.com/1660-4601/17/18/6846 The purpose of this study was to assess the influence of hippotherapy (therapy with horses) on posture and body function among children with cerebral palsy. A case–control study included forty-five children aged 6–12 years, classified as Gross Motor Function Classification System (GMFCS) level I or II, with spastic diplegia or hemiplegia. The participants were randomly divided into three groups: study I (n = 15), study II (n = 15) and control (n = 15). The children from the study groups attended 30min hippotherapy sessions for 12 consecutive weeks, twice (study group I) or once (study group II) a week. The Sitting Assessment Scale (SAS) was used. A comparison of SAS showed an improvement in almost all the assessed categories among the children who participated in hippotherapy. In study group I, statistically significant differences were noted in the assessment of head position control, arm function (in both cases, p = 0.012) and trunk control (p = 0.005) and in study group II in the assessment of trunk control (p = 0.028). Hippotherapy has a positive influence on the body posture and function of individual body parts in a sitting position among children with cerebral palsy. IJERPH, Vol. 17, Pages 6846: The Influence of Hippotherapy on the Body Posture in a Sitting Position among Children with Cerebral Palsy

International Journal of Environmental Research and Public Health doi: 10.3390/ijerph17186846

Authors: Ewelina Matusiak-Wieczorek Elzbieta Dziankowska-Zaborszczyk Marek Synder Andrzej Borowski

The purpose of this study was to assess the influence of hippotherapy (therapy with horses) on posture and body function among children with cerebral palsy. A case–control study included forty-five children aged 6–12 years, classified as Gross Motor Function Classification System (GMFCS) level I or II, with spastic diplegia or hemiplegia. The participants were randomly divided into three groups: study I (n = 15), study II (n = 15) and control (n = 15). The children from the study groups attended 30min hippotherapy sessions for 12 consecutive weeks, twice (study group I) or once (study group II) a week. The Sitting Assessment Scale (SAS) was used. A comparison of SAS showed an improvement in almost all the assessed categories among the children who participated in hippotherapy. In study group I, statistically significant differences were noted in the assessment of head position control, arm function (in both cases, p = 0.012) and trunk control (p = 0.005) and in study group II in the assessment of trunk control (p = 0.028). Hippotherapy has a positive influence on the body posture and function of individual body parts in a sitting position among children with cerebral palsy.

]]>
The Influence of Hippotherapy on the Body Posture in a Sitting Position among Children with Cerebral Palsy Ewelina Matusiak-Wieczorek Elzbieta Dziankowska-Zaborszczyk Marek Synder Andrzej Borowski doi: 10.3390/ijerph17186846 International Journal of Environmental Research and Public Health 2020-09-19 International Journal of Environmental Research and Public Health 2020-09-19 17 18 Article 6846 10.3390/ijerph17186846 https://www.mdpi.com/1660-4601/17/18/6846
IJERPH, Vol. 17, Pages 6844: Inexpensive Home Infrared Living/Environment Sensor with Regional Thermal Information for Infant Physical and Psychological Development https://www.mdpi.com/1660-4601/17/18/6844 The use of home-based image sensors for biological and environmental monitoring provides novel insight into health and development but it is difficult to evaluate people during their normal activities in their home. Therefore, we developed a low-cost infrared (IR) technology-based motion, location, temperature and thermal environment detection system that can be used non-invasively for long-term studies in the home environment. We tested this technology along with the associated analysis algorithm to visualize the effects of parental care and thermal environment on developmental state change in a non-human primate model, the common marmoset (Callithrix jacchus). To validate this system, we first compared it to a manual analysis technique and we then assessed the development of circadian rhythms in common marmosets from postnatal day 15–45. The semi-automatically tracked biological indices of locomotion velocity (BV) and body surface temperature (BT) and the potential psychological index of place preference toward the door (BD), showed age-dependent shifts in circadian phase patterns. Although environmental variables appeared to affect circadian rhythm development, principal component analysis and signal superimposing imaging methods revealed a novel phasic pattern of BD-BT correlation day/night switching in animals older than postnatal day 38 (approximately equivalent to one year of age in humans). The origin of this switch was related to earlier development of body temperature (BT) rhythms and alteration of psychological behavior rhythms (BD) around earlier feeding times. We propose that this cost-effective, inclusive sensing and analytic technique has value for understanding developmental care conditions for which continual home non-invasive monitoring would be beneficial and further suggest the potential to adapt this technique for use in humans. IJERPH, Vol. 17, Pages 6844: Inexpensive Home Infrared Living/Environment Sensor with Regional Thermal Information for Infant Physical and Psychological Development

International Journal of Environmental Research and Public Health doi: 10.3390/ijerph17186844

Authors: Genta Karino Aya Senoo Tetsuya Kunikata Yoshimasa Kamei Hideo Yamanouchi Shun Nakamura Masanori Shukuya Ricki J. Colman Mamiko Koshiba

The use of home-based image sensors for biological and environmental monitoring provides novel insight into health and development but it is difficult to evaluate people during their normal activities in their home. Therefore, we developed a low-cost infrared (IR) technology-based motion, location, temperature and thermal environment detection system that can be used non-invasively for long-term studies in the home environment. We tested this technology along with the associated analysis algorithm to visualize the effects of parental care and thermal environment on developmental state change in a non-human primate model, the common marmoset (Callithrix jacchus). To validate this system, we first compared it to a manual analysis technique and we then assessed the development of circadian rhythms in common marmosets from postnatal day 15–45. The semi-automatically tracked biological indices of locomotion velocity (BV) and body surface temperature (BT) and the potential psychological index of place preference toward the door (BD), showed age-dependent shifts in circadian phase patterns. Although environmental variables appeared to affect circadian rhythm development, principal component analysis and signal superimposing imaging methods revealed a novel phasic pattern of BD-BT correlation day/night switching in animals older than postnatal day 38 (approximately equivalent to one year of age in humans). The origin of this switch was related to earlier development of body temperature (BT) rhythms and alteration of psychological behavior rhythms (BD) around earlier feeding times. We propose that this cost-effective, inclusive sensing and analytic technique has value for understanding developmental care conditions for which continual home non-invasive monitoring would be beneficial and further suggest the potential to adapt this technique for use in humans.

]]>
Inexpensive Home Infrared Living/Environment Sensor with Regional Thermal Information for Infant Physical and Psychological Development Genta Karino Aya Senoo Tetsuya Kunikata Yoshimasa Kamei Hideo Yamanouchi Shun Nakamura Masanori Shukuya Ricki J. Colman Mamiko Koshiba doi: 10.3390/ijerph17186844 International Journal of Environmental Research and Public Health 2020-09-19 International Journal of Environmental Research and Public Health 2020-09-19 17 18 Article 6844 10.3390/ijerph17186844 https://www.mdpi.com/1660-4601/17/18/6844
IJERPH, Vol. 17, Pages 6845: Differences between Clinical Protocols for the Treatment of Coronavirus Disease 2019 (COVID-19) in Andalusia, Spain https://www.mdpi.com/1660-4601/17/18/6845 Our objective was to compare clinical protocols for the treatment of the novel coronavirus disease 2019 (COVID-19) among different hospitals in Andalusia, Spain. We reviewed the current COVID-19 protocols of the 15 largest hospitals in Andalusia. Antiviral treatment, empirical antibacterial agents, adjunctive therapies, anticoagulant treatment, supportive care, hospital organization, and discharge recommendations were analyzed. All protocols included were the latest updates as of July 2020. Hydroxychloroquine in monotherapy was the most frequent antiviral drug recommended for mild respiratory illness with clinical risk factors (33.3%). Combined hydroxychloroquine with azithromycin or lopinavir/ritonavir was found in 40% of protocols. The recommended treatment for patients with mild and moderate pneumonias was different antiviral combinations including hydroxychloroquine plus azithromycin (93.3%) or hydroxychloroquine plus lopinavir/ritonavir (79.9%). Different combinations of hydroxychloroquine and lopinavir/ritonavir (46.7%) and triple therapy with hydroxychloroquine, azithromycin, and lopinavir/ritonavir (40%) were the most recommended treatments for patients with severe pneumonia. There were five corticosteroid regimens, which used dexamethasone, methylprednisolone, or prednisone, with different doses and treatment durations. Anakinra was included in seven protocols with six different regimens. All protocols included prophylactic heparin and therapeutic doses for thromboembolism. Higher prophylactic doses of heparin for high-risk patients and therapeutic doses for patients in critical condition were included in 53.3% and 33.3% of protocols, respectively. This study showed that COVID-19 protocols varied widely in several aspects (antiviral treatment, corticosteroids, anakinra, and anticoagulation for high risk of thrombosis or critical situation). Rigorous randomized clinical trials on the proposed treatments are needed to provide consistent evidence. IJERPH, Vol. 17, Pages 6845: Differences between Clinical Protocols for the Treatment of Coronavirus Disease 2019 (COVID-19) in Andalusia, Spain

International Journal of Environmental Research and Public Health doi: 10.3390/ijerph17186845

Authors: Luis M. Pérez-Belmonte María D. López-Carmona Juan L. Quevedo-Marín Michele Ricci Jesica Martín-Carmona Jaime Sanz-Cánovas Almudena López-Sampalo María D. Martín-Escalante M. Rosa. Bernal-López Ricardo Gómez-Huelgas

Our objective was to compare clinical protocols for the treatment of the novel coronavirus disease 2019 (COVID-19) among different hospitals in Andalusia, Spain. We reviewed the current COVID-19 protocols of the 15 largest hospitals in Andalusia. Antiviral treatment, empirical antibacterial agents, adjunctive therapies, anticoagulant treatment, supportive care, hospital organization, and discharge recommendations were analyzed. All protocols included were the latest updates as of July 2020. Hydroxychloroquine in monotherapy was the most frequent antiviral drug recommended for mild respiratory illness with clinical risk factors (33.3%). Combined hydroxychloroquine with azithromycin or lopinavir/ritonavir was found in 40% of protocols. The recommended treatment for patients with mild and moderate pneumonias was different antiviral combinations including hydroxychloroquine plus azithromycin (93.3%) or hydroxychloroquine plus lopinavir/ritonavir (79.9%). Different combinations of hydroxychloroquine and lopinavir/ritonavir (46.7%) and triple therapy with hydroxychloroquine, azithromycin, and lopinavir/ritonavir (40%) were the most recommended treatments for patients with severe pneumonia. There were five corticosteroid regimens, which used dexamethasone, methylprednisolone, or prednisone, with different doses and treatment durations. Anakinra was included in seven protocols with six different regimens. All protocols included prophylactic heparin and therapeutic doses for thromboembolism. Higher prophylactic doses of heparin for high-risk patients and therapeutic doses for patients in critical condition were included in 53.3% and 33.3% of protocols, respectively. This study showed that COVID-19 protocols varied widely in several aspects (antiviral treatment, corticosteroids, anakinra, and anticoagulation for high risk of thrombosis or critical situation). Rigorous randomized clinical trials on the proposed treatments are needed to provide consistent evidence.

]]>
Differences between Clinical Protocols for the Treatment of Coronavirus Disease 2019 (COVID-19) in Andalusia, Spain Luis M. Pérez-Belmonte María D. López-Carmona Juan L. Quevedo-Marín Michele Ricci Jesica Martín-Carmona Jaime Sanz-Cánovas Almudena López-Sampalo María D. Martín-Escalante M. Rosa. Bernal-López Ricardo Gómez-Huelgas doi: 10.3390/ijerph17186845 International Journal of Environmental Research and Public Health 2020-09-19 International Journal of Environmental Research and Public Health 2020-09-19 17 18 Article 6845 10.3390/ijerph17186845 https://www.mdpi.com/1660-4601/17/18/6845
IJERPH, Vol. 17, Pages 6843: Improvement in Psychodynamic Psychotherapy for Depression: A Qualitative Study of the Patients’ Perspective https://www.mdpi.com/1660-4601/17/18/6843 The patient’s perspective on improvement in psychotherapy is crucial for tailoring the therapy he or she is receiving. The present study aimed at exploring the factors aiding and the patients’ experiences of improvement in time-limited psychodynamic psychotherapy for depression. Semi-structured, in-depth interviews were conducted with ten adult patients who received up to 28 sessions of manualized psychodynamic psychotherapy in the Norwegian study “Mechanisms of change in psychotherapy” (the MOP study). The post-therapy interviews addressed the participants’ experiences from therapy. The data were analyzed with thematic content analysis and hermeneutic interpretation. The analysis identified four helpful dimensions: “Therapist activities” comprised supporting and acknowledging, advising and offering tips for everyday life, questioning and pressuring. “Patient activities” included opening up, caring for oneself and showing agency. “Facilitators” for improvement were learning from therapy, learning to receive therapy and agreed goals. “Achievements” comprised new perspectives and understandings, increased self-awareness and mastery and changed thinking and feeling. Improvements from psychodynamic therapy seemed reliant on the degree to which the therapy could activate and be relevant to the patients’ everyday life. Tailoring therapy for patients with depression should link the focus on symptoms and ways of thinking and feeling with their life circumstances. IJERPH, Vol. 17, Pages 6843: Improvement in Psychodynamic Psychotherapy for Depression: A Qualitative Study of the Patients’ Perspective

International Journal of Environmental Research and Public Health doi: 10.3390/ijerph17186843

Authors: André Løvgren Jan Ivar Røssberg Eivind Engebretsen Randi Ulberg

The patient’s perspective on improvement in psychotherapy is crucial for tailoring the therapy he or she is receiving. The present study aimed at exploring the factors aiding and the patients’ experiences of improvement in time-limited psychodynamic psychotherapy for depression. Semi-structured, in-depth interviews were conducted with ten adult patients who received up to 28 sessions of manualized psychodynamic psychotherapy in the Norwegian study “Mechanisms of change in psychotherapy” (the MOP study). The post-therapy interviews addressed the participants’ experiences from therapy. The data were analyzed with thematic content analysis and hermeneutic interpretation. The analysis identified four helpful dimensions: “Therapist activities” comprised supporting and acknowledging, advising and offering tips for everyday life, questioning and pressuring. “Patient activities” included opening up, caring for oneself and showing agency. “Facilitators” for improvement were learning from therapy, learning to receive therapy and agreed goals. “Achievements” comprised new perspectives and understandings, increased self-awareness and mastery and changed thinking and feeling. Improvements from psychodynamic therapy seemed reliant on the degree to which the therapy could activate and be relevant to the patients’ everyday life. Tailoring therapy for patients with depression should link the focus on symptoms and ways of thinking and feeling with their life circumstances.

]]>
Improvement in Psychodynamic Psychotherapy for Depression: A Qualitative Study of the Patients’ Perspective André Løvgren Jan Ivar Røssberg Eivind Engebretsen Randi Ulberg doi: 10.3390/ijerph17186843 International Journal of Environmental Research and Public Health 2020-09-19 International Journal of Environmental Research and Public Health 2020-09-19 17 18 Article 6843 10.3390/ijerph17186843 https://www.mdpi.com/1660-4601/17/18/6843
IJERPH, Vol. 17, Pages 6842: Developing an Environmental Health Sciences COVID-19 Research Agenda: Results from the NIEHS Disaster Research Response (DR2) Work Group’s Modified Delphi Method https://www.mdpi.com/1660-4601/17/18/6842 Leveraging the community of practice recently established through the U.S. National Institute of Environmental Health Sciences (NIEHS) Disaster Research Response (DR2) working group, we used a modified Delphi method to identify and prioritize environmental health sciences Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) and associated Coronavirus Disease 2019 (COVID-19) research questions. Twenty-six individuals with broad expertise across a variety of environmental health sciences subdisciplines were selected to participate among 45 self-nominees. In Round 1, panelists submitted research questions and brief justifications. In Round 2, panelists rated the priority of each question on a nine-point Likert scale. Responses were trichotomized into priority categories (low priority; medium priority; and high priority). A research question was determined to meet consensus if at least 69.2% of panelists rated it within the same priority category. Research needs that did not meet consensus in round 2 were redistributed for re-rating. Fourteen questions met consensus as high priority in round 2, and an additional 14 questions met consensus as high priority in round 3. We discuss the impact and limitations of using this approach to identify and prioritize research questions in the context of a disaster response. IJERPH, Vol. 17, Pages 6842: Developing an Environmental Health Sciences COVID-19 Research Agenda: Results from the NIEHS Disaster Research Response (DR2) Work Group’s Modified Delphi Method

International Journal of Environmental Research and Public Health doi: 10.3390/ijerph17186842

Authors: Nicole A. Errett Marilyn Howarth Kimberley Shoaf Megan Couture Steven Ramsey Richard Rosselli Sara Webb April Bennett Aubrey Miller

Leveraging the community of practice recently established through the U.S. National Institute of Environmental Health Sciences (NIEHS) Disaster Research Response (DR2) working group, we used a modified Delphi method to identify and prioritize environmental health sciences Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) and associated Coronavirus Disease 2019 (COVID-19) research questions. Twenty-six individuals with broad expertise across a variety of environmental health sciences subdisciplines were selected to participate among 45 self-nominees. In Round 1, panelists submitted research questions and brief justifications. In Round 2, panelists rated the priority of each question on a nine-point Likert scale. Responses were trichotomized into priority categories (low priority; medium priority; and high priority). A research question was determined to meet consensus if at least 69.2% of panelists rated it within the same priority category. Research needs that did not meet consensus in round 2 were redistributed for re-rating. Fourteen questions met consensus as high priority in round 2, and an additional 14 questions met consensus as high priority in round 3. We discuss the impact and limitations of using this approach to identify and prioritize research questions in the context of a disaster response.

]]>
Developing an Environmental Health Sciences COVID-19 Research Agenda: Results from the NIEHS Disaster Research Response (DR2) Work Group’s Modified Delphi Method Nicole A. Errett Marilyn Howarth Kimberley Shoaf Megan Couture Steven Ramsey Richard Rosselli Sara Webb April Bennett Aubrey Miller doi: 10.3390/ijerph17186842 International Journal of Environmental Research and Public Health 2020-09-19 International Journal of Environmental Research and Public Health 2020-09-19 17 18 Article 6842 10.3390/ijerph17186842 https://www.mdpi.com/1660-4601/17/18/6842
IJERPH, Vol. 17, Pages 6841: Fenton Reaction-Induced Oxidative Damage to Membrane Lipids and Protective Effects of 17β-Estradiol in Porcine Ovary and Thyroid Homogenates https://www.mdpi.com/1660-4601/17/18/6841 The Fenton reaction (Fe2++H2O2→Fe3++•OH+OH-) results in strong oxidative damage to macromolecules when iron (Fe) or hydrogen peroxide (H2O2) are in excess. This study aims at comparing Fe2++H2O2-induced oxidative damage to membrane lipids (lipid peroxidation, LPO) and protective effects of 17β-estradiol (a potential antioxidant) in porcine ovary and thyroid homogenates. Iron, as one of the Fenton reaction substrates, was used in the highest achievable concentrations. Thyroid or ovary homogenates were incubated in the presence of: (1st) FeSO4+H2O2 with/without 17β-estradiol (1 mM; 100, 10.0, 1.0 µM; 100, 10.0, 1.0 nM; 100, 10.0, 1.0 pM); five experiments were performed with different FeSO4 concentrations (2400, 1200, 600, 300, 150 µM); (2nd) FeSO4 (2400, 1200, 600, 300, 150 µM)+H2O2 with/without 17β-estradiol; three experiments were performed with three highest 17β-estradiol concentrations; (3rd) FeSO4 (2400, 1200, 1100, 1000, 900, 800, 700, 600, 300, 150, 75 µM)+H2O2 (5 mM). LPO level [MDA+4-HDA/mg protein] was measured spectrophotometrically. The basal LPO level is lower in ovary than in thyroid homogenates. However, experimentally-induced LPO was higher in the former tissue, which was confirmed for the three highest Fe2+ concentrations (2400, 1200, 1100 µM). Exogenous 17β-estradiol (1 mM, 100, and 10 µM) reduced experimentally-induced LPO independently of iron concentration and that protective effect did not differ between tissues. The ovary, compared to the thyroid, reveals higher sensitivity to prooxidative effects of iron, however, it showed similar responsivity to protective 17β-estradiol activity. The therapeutic effect of 17β-estradiol against iron overload consequences should be considered with relation to both tissues. IJERPH, Vol. 17, Pages 6841: Fenton Reaction-Induced Oxidative Damage to Membrane Lipids and Protective Effects of 17β-Estradiol in Porcine Ovary and Thyroid Homogenates

International Journal of Environmental Research and Public Health doi: 10.3390/ijerph17186841

Authors: Aleksandra Rynkowska Jan Stępniak Małgorzata Karbownik-Lewińska

The Fenton reaction (Fe2++H2O2→Fe3++•OH+OH-) results in strong oxidative damage to macromolecules when iron (Fe) or hydrogen peroxide (H2O2) are in excess. This study aims at comparing Fe2++H2O2-induced oxidative damage to membrane lipids (lipid peroxidation, LPO) and protective effects of 17β-estradiol (a potential antioxidant) in porcine ovary and thyroid homogenates. Iron, as one of the Fenton reaction substrates, was used in the highest achievable concentrations. Thyroid or ovary homogenates were incubated in the presence of: (1st) FeSO4+H2O2 with/without 17β-estradiol (1 mM; 100, 10.0, 1.0 µM; 100, 10.0, 1.0 nM; 100, 10.0, 1.0 pM); five experiments were performed with different FeSO4 concentrations (2400, 1200, 600, 300, 150 µM); (2nd) FeSO4 (2400, 1200, 600, 300, 150 µM)+H2O2 with/without 17β-estradiol; three experiments were performed with three highest 17β-estradiol concentrations; (3rd) FeSO4 (2400, 1200, 1100, 1000, 900, 800, 700, 600, 300, 150, 75 µM)+H2O2 (5 mM). LPO level [MDA+4-HDA/mg protein] was measured spectrophotometrically. The basal LPO level is lower in ovary than in thyroid homogenates. However, experimentally-induced LPO was higher in the former tissue, which was confirmed for the three highest Fe2+ concentrations (2400, 1200, 1100 µM). Exogenous 17β-estradiol (1 mM, 100, and 10 µM) reduced experimentally-induced LPO independently of iron concentration and that protective effect did not differ between tissues. The ovary, compared to the thyroid, reveals higher sensitivity to prooxidative effects of iron, however, it showed similar responsivity to protective 17β-estradiol activity. The therapeutic effect of 17β-estradiol against iron overload consequences should be considered with relation to both tissues.

]]>
Fenton Reaction-Induced Oxidative Damage to Membrane Lipids and Protective Effects of 17β-Estradiol in Porcine Ovary and Thyroid Homogenates Aleksandra Rynkowska Jan Stępniak Małgorzata Karbownik-Lewińska doi: 10.3390/ijerph17186841 International Journal of Environmental Research and Public Health 2020-09-18 International Journal of Environmental Research and Public Health 2020-09-18 17 18 Communication 6841 10.3390/ijerph17186841 https://www.mdpi.com/1660-4601/17/18/6841
IJERPH, Vol. 17, Pages 6840: Public Voice via Social Media: Role in Cooperative Governance during Public Health Emergency https://www.mdpi.com/1660-4601/17/18/6840 With the development of the Internet, social networking sites have empowered the public to directly express their views about social issues and hence contribute to social change. As a new type of voice behavior, public voice on social media has aroused wide concern among scholars. However, why public voice is expressed and how it influences social development and betterment in times of public health emergencies remains unstudied. A key point is whether governments can take effective countermeasures when faced with public health emergencies. In such situation, public voice is of great significance in the formulation and implementation of coping policies. This qualitive study uses China’s Health Code policy under COVID-19 to explore why the public performs voice behavior on social media and how this influences policy evolution and product innovation through cooperative governance. A stimulus-cognition-emotion-behavior model is established to explain public voice, indicating that it is influenced by cognitive processes and public emotions under policy stimulus. What is more, as a form of public participation in cooperative governance, public voice plays a significant role in promoting policy evolution and product innovation, and represents a useful form of cooperation with governments and enterprises to jointly maintain social stability under public health emergencies IJERPH, Vol. 17, Pages 6840: Public Voice via Social Media: Role in Cooperative Governance during Public Health Emergency

International Journal of Environmental Research and Public Health doi: 10.3390/ijerph17186840

Authors: Yang Yang Yingying Su

With the development of the Internet, social networking sites have empowered the public to directly express their views about social issues and hence contribute to social change. As a new type of voice behavior, public voice on social media has aroused wide concern among scholars. However, why public voice is expressed and how it influences social development and betterment in times of public health emergencies remains unstudied. A key point is whether governments can take effective countermeasures when faced with public health emergencies. In such situation, public voice is of great significance in the formulation and implementation of coping policies. This qualitive study uses China’s Health Code policy under COVID-19 to explore why the public performs voice behavior on social media and how this influences policy evolution and product innovation through cooperative governance. A stimulus-cognition-emotion-behavior model is established to explain public voice, indicating that it is influenced by cognitive processes and public emotions under policy stimulus. What is more, as a form of public participation in cooperative governance, public voice plays a significant role in promoting policy evolution and product innovation, and represents a useful form of cooperation with governments and enterprises to jointly maintain social stability under public health emergencies

]]>
Public Voice via Social Media: Role in Cooperative Governance during Public Health Emergency Yang Yang Yingying Su doi: 10.3390/ijerph17186840 International Journal of Environmental Research and Public Health 2020-09-18 International Journal of Environmental Research and Public Health 2020-09-18 17 18 Article 6840 10.3390/ijerph17186840 https://www.mdpi.com/1660-4601/17/18/6840
IJERPH, Vol. 17, Pages 6839: The Promotion of Physical Activity from Digital Services: Influence of E-Lifestyles on Intention to Use Fitness Apps https://www.mdpi.com/1660-4601/17/18/6839 E-Lifestyles are individual forms of behavior in the digital environment that reflect the values, activities, interests, and opinions of consumers. Likewise, fitness Apps are considered technological tools for promoting physical activity online. Although there are studies related to sports lifestyles, it has not been analyzed yet how e-lifestyles are related to the use of fitness Apps. Based on this, this study represents a step to clarify how e-lifestyles influence different relationships with perceived ease of use, perceived usefulness, attitude, and intentions to use Fitness Apps. Therefore, the objective of the study was to analyze the relationship between the e-lifestyles of consumers of Boutique fitness centers and their relationship with the perceived ease of use, the perceived usefulness, the attitude, and the intention to use Fitness Apps. The sample was 591 customers (378 women and 213 men) of 25 Boutique fitness centers. An online questionnaire was used for data collection. Data was analyzed with confirmatory factor analysis and structural equation model. Findings provide an insight into the importance of e-lifestyles in the intention of using fitness Apps and therefore in promoting physical activity through online fitness services. The results showed positive relationships between e-lifestyles, perceived ease of use, perceived usefulness and attitude toward fitness Apps. Finally, the attitude toward fitness Apps offered a very high predictive value on use intention. This study provides a better understanding of consumer´s intention to use fitness Apps. The conclusions and recommendations for sports managers of fitness centers highlight the importance of e-lifestyles as a predecessor for the use of fitness Apps. IJERPH, Vol. 17, Pages 6839: The Promotion of Physical Activity from Digital Services: Influence of E-Lifestyles on Intention to Use Fitness Apps

International Journal of Environmental Research and Public Health doi: 10.3390/ijerph17186839

Authors: Jerónimo García-Fernández Pablo Gálvez-Ruiz Moisés Grimaldi-Puyana Salvador Angosto Jesús Fernández-Gavira M. Rocío Bohórquez

E-Lifestyles are individual forms of behavior in the digital environment that reflect the values, activities, interests, and opinions of consumers. Likewise, fitness Apps are considered technological tools for promoting physical activity online. Although there are studies related to sports lifestyles, it has not been analyzed yet how e-lifestyles are related to the use of fitness Apps. Based on this, this study represents a step to clarify how e-lifestyles influence different relationships with perceived ease of use, perceived usefulness, attitude, and intentions to use Fitness Apps. Therefore, the objective of the study was to analyze the relationship between the e-lifestyles of consumers of Boutique fitness centers and their relationship with the perceived ease of use, the perceived usefulness, the attitude, and the intention to use Fitness Apps. The sample was 591 customers (378 women and 213 men) of 25 Boutique fitness centers. An online questionnaire was used for data collection. Data was analyzed with confirmatory factor analysis and structural equation model. Findings provide an insight into the importance of e-lifestyles in the intention of using fitness Apps and therefore in promoting physical activity through online fitness services. The results showed positive relationships between e-lifestyles, perceived ease of use, perceived usefulness and attitude toward fitness Apps. Finally, the attitude toward fitness Apps offered a very high predictive value on use intention. This study provides a better understanding of consumer´s intention to use fitness Apps. The conclusions and recommendations for sports managers of fitness centers highlight the importance of e-lifestyles as a predecessor for the use of fitness Apps.

]]>
The Promotion of Physical Activity from Digital Services: Influence of E-Lifestyles on Intention to Use Fitness Apps Jerónimo García-Fernández Pablo Gálvez-Ruiz Moisés Grimaldi-Puyana Salvador Angosto Jesús Fernández-Gavira M. Rocío Bohórquez doi: 10.3390/ijerph17186839 International Journal of Environmental Research and Public Health 2020-09-18 International Journal of Environmental Research and Public Health 2020-09-18 17 18 Article 6839 10.3390/ijerph17186839 https://www.mdpi.com/1660-4601/17/18/6839
IJERPH, Vol. 17, Pages 6838: Heterogeneous Influences of Social Support on Physical and Mental Health: Evidence from China https://www.mdpi.com/1660-4601/17/18/6838 Employing a national representative survey (the China Labor-force Dynamics Survey 2016, CLDS2016) data (N = 14246), this paper examines the heterogeneous influences of social support on individual physical and mental health in China. Social support is characterized by four dimensions: emotional support, tangible or instrumental support, interaction or exchange support, and community support. Physical health is measured by self-rated health and body mass index (BMI), while mental health is measured by depression, hopelessness, failure, fear, loneliness, and meaninglessness. The results indicate that different dimensions of social support have heterogeneous effects on individual physical and mental health. Specifically, the correlation between emotional support and individual physical health is not significant, but emotional support is significantly related to some mental health variables. Tangible or instrumental support is significantly related to individual self-rated physical health but not to BMI or mental health. Interaction or exchange support is significantly correlated with individual self-rated health and some mental health variables. In general, there are significant correlations between community support, and individual physical and mental health. The results also suggest that the influences of social support on physical and mental health of individuals at different ages (<60 years and ≥60 years) are heterogeneous. The results of this study provide direction for the dimension selection of social support to promote individual health. IJERPH, Vol. 17, Pages 6838: Heterogeneous Influences of Social Support on Physical and Mental Health: Evidence from China

International Journal of Environmental Research and Public Health doi: 10.3390/ijerph17186838

Authors: Fan Yang Yao Jiang

Employing a national representative survey (the China Labor-force Dynamics Survey 2016, CLDS2016) data (N = 14246), this paper examines the heterogeneous influences of social support on individual physical and mental health in China. Social support is characterized by four dimensions: emotional support, tangible or instrumental support, interaction or exchange support, and community support. Physical health is measured by self-rated health and body mass index (BMI), while mental health is measured by depression, hopelessness, failure, fear, loneliness, and meaninglessness. The results indicate that different dimensions of social support have heterogeneous effects on individual physical and mental health. Specifically, the correlation between emotional support and individual physical health is not significant, but emotional support is significantly related to some mental health variables. Tangible or instrumental support is significantly related to individual self-rated physical health but not to BMI or mental health. Interaction or exchange support is significantly correlated with individual self-rated health and some mental health variables. In general, there are significant correlations between community support, and individual physical and mental health. The results also suggest that the influences of social support on physical and mental health of individuals at different ages (<60 years and ≥60 years) are heterogeneous. The results of this study provide direction for the dimension selection of social support to promote individual health.

]]>
Heterogeneous Influences of Social Support on Physical and Mental Health: Evidence from China Fan Yang Yao Jiang doi: 10.3390/ijerph17186838 International Journal of Environmental Research and Public Health 2020-09-18 International Journal of Environmental Research and Public Health 2020-09-18 17 18 Article 6838 10.3390/ijerph17186838 https://www.mdpi.com/1660-4601/17/18/6838