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Int. J. Environ. Res. Public Health, Volume 16, Issue 24 (December-2 2019) – 288 articles

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Cover Story (view full-size image) The health of migrants is a widely studied topic. It has been argued that migrant health may [...] Read more.
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Open AccessArticle
Health-Related Quality of Life of Medical Students in a Chinese University: A Cross-Sectional Study
Int. J. Environ. Res. Public Health 2019, 16(24), 5165; https://doi.org/10.3390/ijerph16245165 - 17 Dec 2019
Viewed by 503
Abstract
Thus far, there have been no studies adapting the Mandarin 36-Item Short Form Health Survey (the SF-36) questionnaire for assessment of the health-related quality of life (HRQOL) of medical students in China. This study aimed to explore the feasibility of that form and [...] Read more.
Thus far, there have been no studies adapting the Mandarin 36-Item Short Form Health Survey (the SF-36) questionnaire for assessment of the health-related quality of life (HRQOL) of medical students in China. This study aimed to explore the feasibility of that form and analyse its impact factors. The study involved 498 randomly sampled medical students stratified by their academic majors, and general information was collected. The effective response rate was 83.53%. Split-half reliability coefficients and Cronbach’s α coefficients of seven dimensions were more than 0.7 with the exception of the social function (SF) dimension. Spearman’s correlation analysis results were basically in accord with the theoretical construction of the SF-36. The HRQOL of the students was scored from 43.83 (the RE dimension) to 93.34 (the PF dimension). The primary impact factors affecting the HRQOL of medical students included major, sleep quality, degree of physical exercise, post-exercise status, relationship with roommate, and satisfaction with family. These findings suggested that the Mandarin SF-36 was reliable for measuring the HRQOL, that the HRQOL of medical students in a Chinese university was relatively poor, and that its improvement requires concerted efforts. Full article
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Open AccessReview
Fathers’ Views and Experiences of Creating a Smoke-Free Home: A Scoping Review
Int. J. Environ. Res. Public Health 2019, 16(24), 5164; https://doi.org/10.3390/ijerph16245164 - 17 Dec 2019
Viewed by 461
Abstract
Enabling parents to create a smoke-free home is one of the key ways that children’s exposure to second-hand smoke (SHS) can be reduced. Smoke-free home interventions have largely targeted mothers who smoke, and there is little understanding of the barriers and facilitators that [...] Read more.
Enabling parents to create a smoke-free home is one of the key ways that children’s exposure to second-hand smoke (SHS) can be reduced. Smoke-free home interventions have largely targeted mothers who smoke, and there is little understanding of the barriers and facilitators that fathers experience in creating a smoke-free home. Systematic searches combining terms for fathers, homes, and SHS exposure were run in April 2019 in Web of Science’s Citation Indices, PsycINFO, and PubMed for English-language studies published since 2008. The searches identified 980 records for screening, plus 66 records from other sources. Twelve studies reported in 13 papers were included in this scoping review. Eight of the studies were conducted in Asian countries (five in China, one in India, one in Japan, and one in Iran), three were conducted in Canada, and one in Turkey. Findings were extracted in verbatim text for thematic analysis. The review identified that attitudes and knowledge, cultural and social norms, gender power relations, and shifting perceptions and responsibilities related to fatherhood can impact on fathers’ views of their role in relation to creating and maintaining a smoke-free home. There were too few published studies that had assessed smoke-free home interventions with fathers to draw conclusions regarding effective approaches. Research is clearly needed to inform our understanding of fathers’ roles, successes and challenges in creating and maintaining a smoke-free home, so that father-inclusive rather than mother-led interventions can be developed to benefit entire households and improve gender equity as well as health. Full article
(This article belongs to the Special Issue Sex, Gender and Substance Use)
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Open AccessArticle
Applying Intervention Mapping to Improve the Applicability of Precious Memories, an Intervention for Depressive Symptoms in Nursing Home Residents
Int. J. Environ. Res. Public Health 2019, 16(24), 5163; https://doi.org/10.3390/ijerph16245163 - 17 Dec 2019
Viewed by 488
Abstract
Precious memories (PM) is a life review intervention for depression in older adults with no to mild cognitive decline that has been implemented in multiple nursing homes (NHs) in the Netherlands. Previous research suggested its relevance but questioned its applicability. Therefore, this research [...] Read more.
Precious memories (PM) is a life review intervention for depression in older adults with no to mild cognitive decline that has been implemented in multiple nursing homes (NHs) in the Netherlands. Previous research suggested its relevance but questioned its applicability. Therefore, this research aimed to (1) investigate the applicability of PM, and (2) increase its applicability, if necessary. Intervention mapping (IM) was used to achieve these goals: process evaluation through semi-structured interviews with psychologists (n = 11) and clients (n = 2) to identify potential improvements for PM and to set an improvement goal (IM-step 1); three focus groups with stakeholders (n = 20) to specify behaviors necessary to reach the improvement goal (IM-step 2); and selection of behavior change techniques and applications to facilitate attainment of these behaviors (IM-step 3). Results showed that psychologists perceived a high drop-out rate, which was partly due to PM being provided to clients that did not belong to the target group. Although PM was generally considered relevant, psychologists articulated its longer-term effects should be improved. To improve PM’s applicability, concrete maintenance strategies were developed aiming to maintain clients’ well-being by stimulating positive contact with others. Future research must pilot, implement and evaluate these strategies. Full article
(This article belongs to the Special Issue Enhancing the Quality of Care in Long-Term Care Settings)
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Open AccessFeature PaperArticle
The Relative Associations of Body Image Dissatisfaction among Psychiatric Out-Patients in Singapore
Int. J. Environ. Res. Public Health 2019, 16(24), 5162; https://doi.org/10.3390/ijerph16245162 - 17 Dec 2019
Viewed by 430
Abstract
Background: Adults with body image dissatisfaction (BID) are more likely to be depressed, anxious, and suicidal when compared to those without intense dissatisfaction over their appearance. The current study aimed to estimate the prevalence and factors associated with BID among out-patients with [...] Read more.
Background: Adults with body image dissatisfaction (BID) are more likely to be depressed, anxious, and suicidal when compared to those without intense dissatisfaction over their appearance. The current study aimed to estimate the prevalence and factors associated with BID among out-patients with mental illness in Singapore. Methods: Data was collected from 310 psychiatric out-patients using a self-administered questionnaire. Measurements used were socio-demographic characteristics, Body Mass Index scores, Body Shape Questionnaire, Binge Eating Scale, Eating Attitudes Test, Beck’s Depression Inventory, Beck’s Anxiety Inventory and Alcohol Use Disorders Identification Test. Results: A prevalence of 30.9% of BID was established among psychiatric out-patients in Singapore. Being female, having higher BMI scores, binge eating behavior, eating disorders, and those diagnosed with depression were positively associated with BID. Conclusion: BID is prevalent among those with psychiatric illnesses which could lead to a higher degree of psychological distress and the emergence of eating disorders. Full article
(This article belongs to the Special Issue Current Trends in Mental Health Research in Asia Pacific Region)
Open AccessArticle
Patterns of Use and Knowledge about Contact Lens Wear amongst Teenagers in Rural Areas in Malaysia
Int. J. Environ. Res. Public Health 2019, 16(24), 5161; https://doi.org/10.3390/ijerph16245161 - 17 Dec 2019
Viewed by 388
Abstract
Background: Contact lenses (CLs) are more popular than spectacles for vision correction amongst the youth. Knowledge about the risks of wearing CLs is critical especially for those with poor access to public health education. This study investigates the patterns of use and level [...] Read more.
Background: Contact lenses (CLs) are more popular than spectacles for vision correction amongst the youth. Knowledge about the risks of wearing CLs is critical especially for those with poor access to public health education. This study investigates the patterns of use and level of knowledge about CL wear amongst teenagers living in rural areas in Selangor, Malaysia using a set of validated questionnaires. Methods: A total of 8500 self-administered questionnaires were distributed in eight selected secondary schools. The results were analysed using descriptive statistics. Results: A total of 2474 (29%) completed questionnaires were collected. The mean age of the respondents was 14.8 ± 1.5 years, and approximately 7.2% were CL wearers. The majority of the wearers were females (76.0%) and wore soft CLs (92.2%). Cosmetic purposes (58.1%) and comfort (24.6%) were the main reasons for wearing CLs. Many of the respondents purchased their lenses from optical shops (50.1%) and beauty accessory shops (15.6%), and approximately 10% did not disinfect their lenses properly. Regarding knowledge about CL care, approximately 56% of the respondents responded correctly. Conclusion: Half of the respondents do not have sufficient knowledge about the risks of wearing CLs. Thus, aggressive public health education aimed at teenagers is needed to prevent improper CL usage. Full article
Open AccessCase Report
Full Digital Workflow for the Treatment of an Edentulous Patient with Guided Surgery, Immediate Loading and 3D-Printed Hybrid Prosthesis: The BARI Technique 2.0. A Case Report
Int. J. Environ. Res. Public Health 2019, 16(24), 5160; https://doi.org/10.3390/ijerph16245160 - 17 Dec 2019
Viewed by 575
Abstract
Purpose: To describe a technique intended to transfer of the intermaxillary and occlusal relationships in a fully digital environment from a complete denture to an implant-supported 3D-printed hybrid prosthesis (an acrylic resin complete fixed dental prosthesis supported by implants). Methods: In edentulous cases, [...] Read more.
Purpose: To describe a technique intended to transfer of the intermaxillary and occlusal relationships in a fully digital environment from a complete denture to an implant-supported 3D-printed hybrid prosthesis (an acrylic resin complete fixed dental prosthesis supported by implants). Methods: In edentulous cases, the physiological mandibular position should be determined before the immediate loading procedures. In some cases, the use of interim removable prostheses for a few weeks could be useful to test the new occlusion in centric relation and to verify the prosthetic project. When the correct intermaxillary relationships are achieved, it is difficult to transfer them from the provisional to the final prostheses, as impressions or scans of edentulous arches do not have reference points for intermaxillary records. This paper presents a complex case and the technique used to transfer information from a complete denture to an implant-supported prosthesis with a digital workflow. A prosthetic stent has been used to scan the edentulous mandibular arch and to record the intermaxillary relation. Results: The delivery of the hybrid implant-supported prostheses was carried out with no problems and minimal occlusal adjustments. The patient was extremely satisfied with the treatment and the situation remained stable at the 1-year follow up. Conclusions: The approach described in the present article predictably maintains prosthetic information and allows the delivery of a final implant-supported restoration with the same occlusal relationship as the one tested with the provisional diagnostic dentures. Full article
(This article belongs to the Special Issue Digital Dentistry for Oral Health)
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Open AccessArticle
Leaching Characteristics of Heavy Metals and Plant Nutrients in the Sewage Sludge Immobilized by Composite Phosphorus-Bearing Materials
Int. J. Environ. Res. Public Health 2019, 16(24), 5159; https://doi.org/10.3390/ijerph16245159 - 17 Dec 2019
Viewed by 395
Abstract
In order to evaluate the environmental risk caused by land application of sewage sludge, leaching characteristics of heavy metals and plant nutrients in the sewage sludge immobilized by composite phosphorus-bearing materials were investigated. Their cumulative release characteristics were confirmed. Furthermore, the first-order kinetics [...] Read more.
In order to evaluate the environmental risk caused by land application of sewage sludge, leaching characteristics of heavy metals and plant nutrients in the sewage sludge immobilized by composite phosphorus-bearing materials were investigated. Their cumulative release characteristics were confirmed. Furthermore, the first-order kinetics equation, modified Elovich equation, double-constant equation, and parabolic equation were used to explore dynamic models of release. Results showed that sewage sludge addition significantly increased electricity conductivity (EC) in leachates, and the concentrations of heavy metals (Cu, Cr, Zn) and plant nutrients (N, P, K) were also obviously increased. The highest concentrations of Cu, Cr, and Zn in the leachates were all below the limit values of the fourth level in the Chinese national standard for groundwater quality (GB/T14848-2017). The immobilization of composite phosphorus-bearing materials reduced the release of Cu and Cr, while increased that of Zn. The fitting results of modified Elovich model and double-constant model were in good agreement with the leaching process of heavy metals and plant nutrients, indicating their release process in soil under simulated leaching conditions was not a simple first-order reaction, but a complex heterogeneous diffusion process controlled by multifactor. Full article
(This article belongs to the Section Environmental Science and Engineering)
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Open AccessArticle
Assessing the Acceptability of Vasectomy as a Family Planning Option: A Qualitative Study with Men in the Kingdom of Eswatini
Int. J. Environ. Res. Public Health 2019, 16(24), 5158; https://doi.org/10.3390/ijerph16245158 - 17 Dec 2019
Viewed by 366
Abstract
The uptake of vasectomy in many countries in sub-Saharan Africa is low. In Eswatini, a kingdom with strong patriarchal norms, the use of vasectomy is at 0.3%. This is despite great efforts to introduce vasectomy and involve men in reproductive health. This study [...] Read more.
The uptake of vasectomy in many countries in sub-Saharan Africa is low. In Eswatini, a kingdom with strong patriarchal norms, the use of vasectomy is at 0.3%. This is despite great efforts to introduce vasectomy and involve men in reproductive health. This study explored the views of men about the acceptability of vasectomy and their willingness to adopt vasectomy as a family planning option. Focus group discussions were conducted with adult men recruited from health facilities located in rural, semi urban, and urban areas in two of the regions of Eswatini. A thematic approach was used to analyze the data. The acceptability of and intention to use vasectomy as a family planning option was very low. Cultural beliefs, societal norms, lack of knowledge about the procedure for vasectomy, and misconceptions influenced the acceptability of vasectomy greatly. The participants could not grasp the concept of a family planning method that is as permanent as vasectomy. However, the decisions to accept or reject vasectomy were influenced by their misconceptions and fears about vasectomy and were not based on facts. To address the need to involve men in reproductive health and improve the acceptability and adoption of vasectomy, planning should be conducted with them and informed by their understanding of their needs. Full article
Open AccessArticle
A PISA-2015 Comparative Meta-Analysis between Singapore and Finland: Relations of Students’ Interest in Science, Perceived ICT Competence, and Environmental Awareness and Optimism
Int. J. Environ. Res. Public Health 2019, 16(24), 5157; https://doi.org/10.3390/ijerph16245157 - 17 Dec 2019
Viewed by 389
Abstract
The aim of the present study is twofold: (1) to identify a factor structure between variables-interest in broad science topics, perceived information and communications technology (ICT) competence, environmental awareness and optimism; and (2) to explore the relations between these variables at the country [...] Read more.
The aim of the present study is twofold: (1) to identify a factor structure between variables-interest in broad science topics, perceived information and communications technology (ICT) competence, environmental awareness and optimism; and (2) to explore the relations between these variables at the country level. The first part of the aim is addressed using exploratory factor analysis with data from the Program for International Student Assessment (PISA) for 15-year-old students from Singapore and Finland. The results show that a comparable structure with four factors was verified in both countries. Correlation analyses and linear regression were used to address the second part of the aim. The results show that adolescents’ interest in broad science topics can predict perceived ICT competence. Their interest in broad science topics and perceived ICT competence can predict environmental awareness in both countries. However, there is difference in predicting environmental optimism. Singaporean students’ interest in broad science topics and their perceived ICT competences are positive predictors, whereas environmental awareness is a negative predictor. Finnish students’ environmental awareness negatively predicted environmental optimism. Full article
Open AccessArticle
Rainfall Trends and Malaria Occurrences in Limpopo Province, South Africa
Int. J. Environ. Res. Public Health 2019, 16(24), 5156; https://doi.org/10.3390/ijerph16245156 - 17 Dec 2019
Viewed by 390
Abstract
This contribution aims to investigate the influence of monthly total rainfall variations on malaria transmission in the Limpopo Province. For this purpose, monthly total rainfall was interpolated from daily rainfall data from weather stations. Annual and seasonal trends, as well as cross-correlation analyses, [...] Read more.
This contribution aims to investigate the influence of monthly total rainfall variations on malaria transmission in the Limpopo Province. For this purpose, monthly total rainfall was interpolated from daily rainfall data from weather stations. Annual and seasonal trends, as well as cross-correlation analyses, were performed on time series of monthly total rainfall and monthly malaria cases in five districts of Limpopo Province for the period of 1998 to 2017. The time series analysis indicated that an average of 629.5 mm of rainfall was received over the period of study. The rainfall has an annual variation of about 0.46%. Rainfall amount varied within the five districts, with the northeastern part receiving more rainfall. Spearman’s correlation analysis indicated that the total monthly rainfall with one to two months lagged effect is significant in malaria transmission across all the districts. The strongest correlation was noticed in Vhembe (r = 0.54; p-value = <0.001), Mopani (r = 0.53; p-value = <0.001), Waterberg (r = 0.40; p-value =< 0.001), Capricorn (r = 0.37; p-value = <0.001) and lowest in Sekhukhune (r = 0.36; p-value = <0.001). Seasonally, the results indicated that about 68% variation in malaria cases in summer—December, January, and February (DJF)—can be explained by spring—September, October, and November (SON)—rainfall in Vhembe district. Both annual and seasonal analyses indicated that there is variation in the effect of rainfall on malaria across the districts and it is seasonally dependent. Understanding the dynamics of climatic variables annually and seasonally is essential in providing answers to malaria transmission among other factors, particularly with respect to the abrupt spikes of the disease in the province. Full article
(This article belongs to the Section Environmental Health)
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Open AccessArticle
Effects of an Educational Intervention on Angolan Adolescents’ Knowledge of Human Reproduction: A Quasi-Experimental Study
Int. J. Environ. Res. Public Health 2019, 16(24), 5155; https://doi.org/10.3390/ijerph16245155 - 17 Dec 2019
Viewed by 381
Abstract
Background and objectives: Sex education is a necessity and a right of young people in Angola. However, this education is deficient or even absent in various subsystems and, therefore, the impact of an educational intervention on human biology and sexuality was addressed. Materials [...] Read more.
Background and objectives: Sex education is a necessity and a right of young people in Angola. However, this education is deficient or even absent in various subsystems and, therefore, the impact of an educational intervention on human biology and sexuality was addressed. Materials and methods: This quasi-experimental study employed a non-equivalent control group, pre-test post-test design. It was conducted with students from three secondary schools (6th to 12th grade, two public and one private) in Huambo (Angola), between June and December 2017. First, a questionnaire was distributed to assess the students’ knowledge on aspects related to sexual maturation, psychological development, gynecological organs’ anatomy, human fertilization, contraception, and risks of unprotected sexuality. Then, an educational program was developed by the principal investigator along with the school’s moral and civic education and biology teachers selected for a group of students (experimental group, EG); the others constituted the control group (CG). Classes were held on non-working days, on Saturday mornings (8:00 to 10:00 a.m.), so as not to interfere with the school calendar. The initial questionnaire was redistributed two months later to assess the impact of the intervention. Results: Of the 589 individuals included (mean age of 16.8 ± 2.5 years), 56.7% were males. EG (n = 241) consisted of students from the public school and CG (n = 348) by students from public and private schools. The last part of the questionnaire consisted of 30 questions to assess students’ knowledge, and in 23 of these questions, both groups showed no differences at baseline. After the intervention, the EG showed significant improvements (p < 0.05), while the CG revealed only slight improvements. Conclusions: Students from Huambo province have a significant lack of knowledge on human biology and sexuality. Rigorous development and evaluation of interventions addressing multiple individual and environmental level factors is needed, notably for effective education in human biology and sexuality. Full article
(This article belongs to the Special Issue Health Promotion for Sexual Health and Prevention of HIV)
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Open AccessArticle
Effects of Backpacks on Ground Reaction Forces in Children of Different Ages When Walking, Running, and Jumping
Int. J. Environ. Res. Public Health 2019, 16(24), 5154; https://doi.org/10.3390/ijerph16245154 - 17 Dec 2019
Viewed by 360
Abstract
Backpacks for transporting school loads are heavily utilized by children, and their mechanical advantages have been allowing children to transport heavy loads. These heavy loads may increase ground reaction forces (GRFs), which can have a negative effect on joints and bone health. The [...] Read more.
Backpacks for transporting school loads are heavily utilized by children, and their mechanical advantages have been allowing children to transport heavy loads. These heavy loads may increase ground reaction forces (GRFs), which can have a negative effect on joints and bone health. The aim of this study was to investigate the effect of backpacks on the GRFs generated by children during walking, running, and jumping. Twenty-one children from the fifth (G-5, n = 9) and ninth (G-9, n = 12) grades walked, ran, and jumped over a force plate. When walking, the G-5 had GRF increments in the first (17.3%; p < 0.001) and second (15.4%; p < 0.001) peak magnitude, and in the total integral of the vertical force (20%; p < 0.001), compared to the control condition (i.e., no backpack), and the G-9 had increments of 10.4%, 9%, and 9% (p < 0.001), respectively. The G-9 did not prolong their total stance time (p > 0.05), unlike the G-5 (p = 0.001). When running, total stance time increased 15% (p < 0.001) and 8.5% (p < 0.001) proportionally to the relative load carried, in the G-5 and G-9, respectively. Peak GRF did not increase in any group when running or landing from a jump over an obstacle. It was found that GRF was affected by the backpack load when walking and running. However, when landing from a jump with the backpack, schoolchildren smoothed the landing by prolonging the reception time and thus avoiding GRF peak magnitudes. Full article
(This article belongs to the Special Issue Health, Exercise and Sports Performance)
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Open AccessArticle
Depression and Anxiety Symptoms of British Adoptive Parents: A Prospective Four-Wave Longitudinal Study
Int. J. Environ. Res. Public Health 2019, 16(24), 5153; https://doi.org/10.3390/ijerph16245153 - 17 Dec 2019
Cited by 1 | Viewed by 353
Abstract
The mental health of birth parents has gained attention due to the serious negative consequences for personal, family, and child outcomes, but depression and anxiety in adoptive parents remains under-recognized. Using a prospective, longitudinal design, we investigated anxiety and depression symptoms in 96 [...] Read more.
The mental health of birth parents has gained attention due to the serious negative consequences for personal, family, and child outcomes, but depression and anxiety in adoptive parents remains under-recognized. Using a prospective, longitudinal design, we investigated anxiety and depression symptoms in 96 British adoptive parents over four time points in the first four years of an adoptive placement. Depression and anxiety symptom scores were relatively stable across time. Growth curve analysis showed that higher child internalizing scores and lower parental sense of competency at five months post-placement were associated with higher initial levels of parental depressive symptoms. Lower parental sense of competency was also associated with higher initial levels of parental anxiety symptoms. Parents of older children and those with higher levels of parental anxiety and sense of competency at five months post-placement had a steeper decrease in depressive symptoms over time. Support for adoptive families primarily focuses on child adjustment. Our findings suggest that professional awareness of parental mental health post-placement may be necessary, and interventions aimed at improving parents’ sense of competency may be beneficial. Full article
(This article belongs to the Special Issue Adult Psychiatry )
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Open AccessHypothesis
A Hypothesis and Evidence That Mercury May be an Etiological Factor in Alzheimer’s Disease
Int. J. Environ. Res. Public Health 2019, 16(24), 5152; https://doi.org/10.3390/ijerph16245152 - 17 Dec 2019
Viewed by 567
Abstract
Mercury is one of the most toxic elements and causes a multitude of health problems. It is ten times more toxic to neurons than lead. This study was created to determine if mercury could be causing Alzheimer’s disease (AD) by cross referencing the [...] Read more.
Mercury is one of the most toxic elements and causes a multitude of health problems. It is ten times more toxic to neurons than lead. This study was created to determine if mercury could be causing Alzheimer’s disease (AD) by cross referencing the effects of mercury with 70 factors associated with AD. The results found that all these factors could be attributed to mercury. The hallmark changes in AD include plaques, beta amyloid protein, neurofibrillary tangles, phosphorylated tau protein, and memory loss—all changes that can be caused by mercury. Neurotransmitters such as acetylcholine, serotonin, dopamine, glutamate, and norepinephrine are inhibited in patients with Alzheimer’s disease, with the same inhibition occurring in mercury toxicity. Enzyme dysfunction in patients with Alzheimer’s disease include BACE 1, gamma secretase, cyclooxygenase-2, cytochrome-c-oxidase, protein kinases, monoamine oxidase, nitric oxide synthetase, acetyl choline transferase, and caspases, all which can be explained by mercury toxicity. Immune and inflammatory responses seen in patients with Alzheimer’s disease also occur when cells are exposed to mercury, including complement activation, cytokine expression, production of glial fibrillary acid protein antibodies and interleukin-1, transforming growth factor, beta 2 microglobulins, and phosphodiesterase 4 stimulation. Genetic factors in patients with Alzheimer’s disease are also associated with mercury. Apolipoprotein E 4 allele increases the toxicity of mercury. Mercury can inhibit DNA synthesis in the hippocampus, and has been associated with genetic mutations of presenilin 1 and 2, found in AD. The abnormalities of minerals and vitamins, specifically aluminum, calcium, copper, iron, magnesium, selenium, zinc, and vitamins B1, B12, E, and C, that occur in patients with Alzheimer’s disease, also occur in mercury toxicity. Aluminum has been found to increase mercury’s toxicity. Likewise, similar biochemical factors in AD are affected by mercury, including changes in blood levels of homocysteine, arachidonic acid, DHEA sulfate, glutathione, hydrogen peroxide, glycosamine glycans, acetyl-L carnitine, melatonin, and HDL. Other factors seen in Alzheimer’s disease, such as increased platelet activation, poor odor identification, hypertension, depression, increased incidences of herpes virus and chlamydia infections, also occur in mercury exposure. In addition, patients diagnosed with Alzheimer’s disease exhibit higher levels of brain mercury, blood mercury, and tissue mercury in some studies. The greatest exogenous sources of brain mercury come from dental amalgams. Conclusion: This review of the literature strongly suggests that mercury can be a cause of Alzheimer’s Disease. Full article
Open AccessArticle
Application of the JA-CHRODIS Integrated Multimorbidity Care Model (IMCM) to a Case Study of Diabetes and Mental Health
Int. J. Environ. Res. Public Health 2019, 16(24), 5151; https://doi.org/10.3390/ijerph16245151 - 17 Dec 2019
Viewed by 508
Abstract
The Integrated Multimorbidity Care Model (IMCM), developed by the Joint Action on Chronic Diseases and Promoting Healthy Ageing across the Life Cycle (JA-CHRODIS), proposes a set of 16 multidimensional components (i.e., recommendations) to improve the care of persons with multimorbidity in Europe. This [...] Read more.
The Integrated Multimorbidity Care Model (IMCM), developed by the Joint Action on Chronic Diseases and Promoting Healthy Ageing across the Life Cycle (JA-CHRODIS), proposes a set of 16 multidimensional components (i.e., recommendations) to improve the care of persons with multimorbidity in Europe. This study aimed at analyzing the potential applicability of the IMCM. We followed a qualitative approach that comprised two phases: (1) The design of a case study based on empirical clinical data, which consisted of a hypothetical woman with multimorbidity, type 2 diabetes mellitus, mental health, and associated social problems, and (2) the creation of a consensus group to gather the opinions of a multidisciplinary group of experts and consider the potential applicability of the IMCM to our case study. Experts described how care should be delivered to this patient according to each model component, suggested the use of specific rating scales and tools to assess her needs in a comprehensive and regular way, and pointed our crucial health and social resources to improve her care process. Experts also highlighted patient-centered, integrated and tailored care as one of the keystones of quality healthcare. Our results suggest that the IMCM is applicable in complex patients with multimorbidity. Full article
(This article belongs to the Special Issue Implementation of Interventions in Public Health)
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Open AccessArticle
Psychosocial Stress, Sedentary Behavior, and Physical Activity during Pregnancy among Canadian Women: Relationships in a Diverse Cohort and a Nationwide Sample
Int. J. Environ. Res. Public Health 2019, 16(24), 5150; https://doi.org/10.3390/ijerph16245150 - 17 Dec 2019
Viewed by 398
Abstract
Background: Past research shows that psychosocial stress and distress predict sedentary behavior and physical activity, but few studies focus on pregnant women. Our objective was to analyze relationships between psychosocial stress and distress with sedentary behavior and physical activity among pregnant women in [...] Read more.
Background: Past research shows that psychosocial stress and distress predict sedentary behavior and physical activity, but few studies focus on pregnant women. Our objective was to analyze relationships between psychosocial stress and distress with sedentary behavior and physical activity among pregnant women in Canada. Methods: We analyzed objectively-measured sedentary behavior and physical activity at 16–18, 24–26, and 32–24 weeks pregnancy in a sociodemographically diverse cohort of 70 women in Montreal, Canada. Participants completed the Perceived Stress Questionnaire and wore an accelerometer for 3 days that quantified sitting time and steps per day. We used univariate general linear models to analyze relationships between perceived stress with sedentary behavior and physical activity at each evaluation. To assess generalizability, we analyzed relationships between psychological distress with self-reported leisure-time sedentary behavior and daily energy expenditure in transportation and leisure physical activities among a sample representative of 166,095 women in the Canadian Community Health Survey. Results: In the Montreal cohort, we observed a positive association between perceived stress and sitting time, with small to moderate effect sizes (partial η2 = 0.08–0.16). We observed negative relationships between perceived stress and steps per day at the first two evaluations only, with small to moderate effect sizes (partial η2 = 0.08–0.11). Relationships for sedentary behavior were similar in the nationwide sample, but with smaller effect sizes (partial η2 = 0.02). There were no relationships between distress and physical activity in the nationwide sample. Conclusion: Psychosocial stress represents one risk factor for sedentarity, with relationships evident throughout pregnancy and at the population level. Relationships with physical activity are less consistent, but stress might represent a risk factor for low physical activity in early to mid-pregnancy. Results might guide the development of more comprehensive interventions targeting stress, sedentarity, and physical activity. In particular, integrating psychosocial health into interventions to reduce sedentarity, and including concrete guidelines on sedentary behavior in psychosocial health interventions, might be prioritized. Full article
(This article belongs to the collection Sedentary Behaviour and Health)
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Open AccessFeature PaperArticle
Assessing the Impact of Road Traffic Externalities on Residential Price Values: A Case Study in Madrid, Spain
Int. J. Environ. Res. Public Health 2019, 16(24), 5149; https://doi.org/10.3390/ijerph16245149 - 17 Dec 2019
Viewed by 362
Abstract
This paper describes a study of the relationship between undesired road traffic externalities and residential price values in the Spanish city of Madrid. A large database was gathered, including the price and characteristics of 21,634 flats and road traffic intensity at 3904 different [...] Read more.
This paper describes a study of the relationship between undesired road traffic externalities and residential price values in the Spanish city of Madrid. A large database was gathered, including the price and characteristics of 21,634 flats and road traffic intensity at 3904 different points across the city. The results obtained by a hedonic model suggest that both distance from the traffic measurement point and average daily traffic are significantly related to the price of residential properties, even after controlling for structural and neighbourhood variables. Distance to traffic areas has a positive impact on dwelling prices, whilst these are negatively related to traffic intensity. Full article
(This article belongs to the Special Issue Trends in Environmental Valuation)
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Open AccessArticle
Diet, Secondhand Smoke, and Glycated Hemoglobin (HbA1c) Levels among Singapore Chinese Adults
Int. J. Environ. Res. Public Health 2019, 16(24), 5148; https://doi.org/10.3390/ijerph16245148 - 17 Dec 2019
Viewed by 475
Abstract
The combination of poor diet and exposure to secondhand smoke may increase hemoglobin A1c (HbA1c) levels, but few studies have explored this interaction. We explored an interaction among 574 never-smoking adults from the Singapore Chinese Health Study. At baseline (age 59 ± 8 [...] Read more.
The combination of poor diet and exposure to secondhand smoke may increase hemoglobin A1c (HbA1c) levels, but few studies have explored this interaction. We explored an interaction among 574 never-smoking adults from the Singapore Chinese Health Study. At baseline (age 59 ± 8 years), intakes of omega-3 polyunsaturated fatty acids, vitamin C, vitamin E and fiber were estimated using a modified food frequency questionnaire. At follow-up (age 64 ± 9 years), HbA1c and cotinine were measured. A product term between cotinine (above or below the median value) and each nutrient (high or low intake) was included in separate linear regression models with HbA1c as the outcome. HbA1c among those with high cotinine and low omega-3 polyunsaturated fatty acids intakes were higher than would be expected due to the individual effects alone (p-for-interaction = 0.05). Among those with lower intakes of omega-3 polyunsaturated fatty acids, high cotinine levels were associated with 0.54% higher HbA1c levels (95% confidence interval [CI]: 0.02, 1.06). Conversely, among those with higher intakes of omega-3 polyunsaturated fatty acids, HbA1c differ not differ by exposure (−0.09%; 95% CI: −0.45, 0.30). No evidence of interaction was observed for other nutrients. Diets high in omega-3 polyunsaturated fatty acids may ameliorate secondhand smoke-induced increases in HbA1c. Full article
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Open AccessArticle
From Egoism to Ecoism: Psychedelics Increase Nature Relatedness in a State-Mediated and Context-Dependent Manner
Int. J. Environ. Res. Public Health 2019, 16(24), 5147; https://doi.org/10.3390/ijerph16245147 - 16 Dec 2019
Viewed by 3714
Abstract
(1) Background: There appears to be a growing disconnection between humans and their natural environments which has been linked to poor mental health and ecological destruction. Previous research suggests that individual levels of nature relatedness can be increased through the use of classical [...] Read more.
(1) Background: There appears to be a growing disconnection between humans and their natural environments which has been linked to poor mental health and ecological destruction. Previous research suggests that individual levels of nature relatedness can be increased through the use of classical psychedelic compounds, although a causal link between psychedelic use and nature relatedness has not yet been established. (2) Methods: Using correlations and generalized linear mixed regression modelling, we investigated the association between psychedelic use and nature relatedness in a prospective online study. Individuals planning to use a psychedelic received questionnaires 1 week before (N = 654), plus one day, 2 weeks, 4 weeks, and 2 years after a psychedelic experience. (3) Results: The frequency of lifetime psychedelic use was positively correlated with nature relatedness at baseline. Nature relatedness was significantly increased 2 weeks, 4 weeks and 2 years after the psychedelic experience. This increase was positively correlated with concomitant increases in psychological well-being and was dependent on the extent of ego-dissolution and the perceived influence of natural surroundings during the acute psychedelic state. (4) Conclusions: The here presented evidence for a context- and state-dependent causal effect of psychedelic use on nature relatedness bears relevance for psychedelic treatment models in mental health and, in the face of the current ecological crisis, planetary health. Full article
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Open AccessArticle
Comparability of ActivPAL-Based Estimates of Meeting Physical Activity Guidelines for Preschool Children
Int. J. Environ. Res. Public Health 2019, 16(24), 5146; https://doi.org/10.3390/ijerph16245146 - 16 Dec 2019
Viewed by 400
Abstract
The activPAL (PAL Technologies, Glasgow, UK) has been increasingly used on children to assess sedentary time and physical activity (PA). However, there is no consensus on how it can estimate PA at different intensities. This study compared three commonly used, activPAL-based classifications of [...] Read more.
The activPAL (PAL Technologies, Glasgow, UK) has been increasingly used on children to assess sedentary time and physical activity (PA). However, there is no consensus on how it can estimate PA at different intensities. This study compared three commonly used, activPAL-based classifications of moderate-to-vigorous physical activity (MVPA) (daily steps, acceleration counts, and step rate) in determining compliance with the World Health Organization (WHO)’s PA guidelines for preschool children on a daily basis. One hundred and fourteen preschool children aged 3–6 years wore an activPALTM for 24 h over 7 consecutive days and provided valid data for a total of 548 days. MVPA was calculated based on published cut-points of counts (MVPA-counts) and step rate (MVPA-step rate). Compliance with standard PA guidelines (≥180 min/day of PA including ≥60 min/day of MVPA) was determined based on three criteria: ≥11,500 steps/day, a threshold of 1418 acceleration counts/15 s, and 25 steps/15 s for MVPA. Applying cut-points of daily steps and acceleration counts provided the same estimates of compliance with the WHO PA guidelines (20%), while the estimated compliance based on the step rate was lower (7.7%). There was a moderate agreement between the daily steps- (or counts-) derived and step rate-derived compliances (κ = 0.41; 95% confidence interval (CI): 0.31, 0.51). The amount of MVPA derived from counts (1.95 ± 0.72 h/day) was significantly higher than that from step rates (0.47 ± 0.31 h/day). The activPAL may be useful for surveillance studies to estimate total PA in preschool children. Further development of the activPAL algorithms based on either counts or step rate is warranted before it can be used to accurately estimate MVPA in this age group. Full article
(This article belongs to the Section Children's Health)
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Open AccessArticle
The Unmet Needs of Parents of Highly Dependent Children with Cerebral Palsy
Int. J. Environ. Res. Public Health 2019, 16(24), 5145; https://doi.org/10.3390/ijerph16245145 - 16 Dec 2019
Viewed by 438
Abstract
The overall care for children with cerebral palsy (CP) is challenging to the family which causes significant impacts to their livelihood. There is limited qualitative research that reports the unmet needs of parents with physically disabled children, especially highly dependent CP. The aim [...] Read more.
The overall care for children with cerebral palsy (CP) is challenging to the family which causes significant impacts to their livelihood. There is limited qualitative research that reports the unmet needs of parents with physically disabled children, especially highly dependent CP. The aim of this study was to explore the unmet needs of parents of highly dependent children with CP. A qualitative study using semi-structured face to face interviews was carried out among nine parents of children with CP with gross motor classification function score (GMFCS) levels III, IV, and V. The interviews were tape-recorded and transcribed verbatim. Transcribed data was analysed using thematic analysis method. Several unmet needs were highlighted by the parents; namely the needs in receiving information regarding CP conditions, getting psychological and financial support and explaining the child’s condition to strangers. In addition, parents expressed the need for better support from the social welfare department, as well as in effectively organising family functioning. The findings of this study indicate that there is a need for the healthcare professionals to develop suitable strategies to assist the parents of highly dependent children with CP in fulfilling their specific needs. The role of relevant agencies should be optimised in addressing this area of concern. Full article
Open AccessArticle
Virtual Reality Games as an Adjunct in Improving Upper Limb Function and General Health among Stroke Survivors
Int. J. Environ. Res. Public Health 2019, 16(24), 5144; https://doi.org/10.3390/ijerph16245144 - 16 Dec 2019
Viewed by 440
Abstract
Virtual reality (VR) games has the potential to improve patient outcomes in stroke rehabilitation. However, there is limited information on VR games as an adjunct to standard physiotherapy in improving upper limb function. This study involved 36 participants in both experimental (n = [...] Read more.
Virtual reality (VR) games has the potential to improve patient outcomes in stroke rehabilitation. However, there is limited information on VR games as an adjunct to standard physiotherapy in improving upper limb function. This study involved 36 participants in both experimental (n = 18) and control (n = 18) groups with a mean age (SD) of 57 (8.20) and 63 (10.54) years, respectively. Outcome measures were the Fugl-Meyer assessment for upper extremities (FMA-UE), Wolf motor function test (WMFT), intrinsic motivation inventory (IMI), Lawton of instrumental activities of daily living (IADL), and stroke impact scale (SIS) assessed at pre-post intervention. The experimental group had 0.5 h of upper limb (UL) VR games with 1.5 h of standard physiotherapy, and the control group received 2 h of standard physiotherapy. The intervention for both groups was performed once a week for eight consecutive weeks. The results showed a significant time–group interaction effect for IMI (p = 0.001), Lawton IADL (p = 0.01) and SIS domain of communication (p = 0.03). A significant time effect was found in FMA-UE (p = 0.001), WMFT (p = 0.001), Lawton IADL (p = 0.01), and SIS domains; strength, ADL and stroke recovery (p < 0.05). These results indicated an improvement in UL motor ability, sensory function, instrumental ADL, and quality of life in both groups after eight weeks of intervention. However, no significant (p > 0.05) group effect on all the outcome measures was demonstrated. Thus, replacing a portion of standard physiotherapy time with VR games was equally effective in improving UL function and general health compared to receiving only standard physiotherapy among stroke survivors. Full article
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Open AccessArticle
Numerical Simulation of Flow and Temperature Fields in a Deep Stratified Reservoir Using Water-Separating Curtain
Int. J. Environ. Res. Public Health 2019, 16(24), 5143; https://doi.org/10.3390/ijerph16245143 - 16 Dec 2019
Viewed by 380
Abstract
In this work, the flow and temperature fields of a thermally stratified reservoir under different settings of a water-separating curtain are simulated by using the standard k-ε turbulence model. In the simulation, two different equations of state including Boussinesq approximation and the density-temperature [...] Read more.
In this work, the flow and temperature fields of a thermally stratified reservoir under different settings of a water-separating curtain are simulated by using the standard k-ε turbulence model. In the simulation, two different equations of state including Boussinesq approximation and the density-temperature function have been used and compared. This study shows that Boussinesq approximation is more time-saving, and the density-temperature function has higher computational accuracy. Thus, the standard k-ε turbulence model with two equations of state is applied to study the effect of adding a water-separating curtain in the stratified reservoir on the Discharged Water Temperature (DWT). It is found that adding the Water-Separating Curtain (WSC) can effectively increase the discharged water temperature. Moreover, the different arrangements of WSC have obvious effects on the discharged water temperature. For example, the increased temperature by adding a WSC with full sealing is 1 °C higher than that by using the WSC with a bottom opening height of 2 m. However, the maximum pressure difference acting on the WSC for the former WSC is 100 Pa higher than that for the latter WSC. In addition, this study shows that the different equations of state have little effect on the simulation results. Considering the calculation efficiency, equations of state using the Boussinesq approximation can be recommended to save the calculation time. Full article
(This article belongs to the Section Environmental Science and Engineering)
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Open AccessArticle
The Influence of Emotional Environmental Pictures on Behavior Intentions: The Evidence of Neuroscience Technology
Int. J. Environ. Res. Public Health 2019, 16(24), 5142; https://doi.org/10.3390/ijerph16245142 - 16 Dec 2019
Viewed by 383
Abstract
Background: In recent years, researchers have been paying increasing attention to the issues of how emotions affect people’s perceptions of the environment, and how they influence people’s behavior or intentions to act. The purpose of this study is to explore the influences of [...] Read more.
Background: In recent years, researchers have been paying increasing attention to the issues of how emotions affect people’s perceptions of the environment, and how they influence people’s behavior or intentions to act. The purpose of this study is to explore the influences of emotions on environmental intention to act by using the neuroscience technology electroencephalography (EEG). Methods: A total of 70 university students participated in this study. They looked at positive and negative emotional environmental pictures and decided if they wanted to protect the environment after looking at the pictures. The participants wore an EEG cap throughout the process in order to collect their brain wave (EEG) data. Results: The analysis of variance (ANOVA) results showed that the power value of meditation was significantly higher when the participants looked at the positive than at the negative emotional environmental pictures (p < 0.001). The power value of pressure was significantly higher when the participants looked at the negative than at the positive emotional environmental pictures (p < 0.001). The power value of attention was significantly higher when the participants looked at the negative than at the emotional environmental pictures (p < 0.001). Conclusions and recommendations: The findings showed that positive emotional environmental pictures might promote positive emotions, but will decrease the intention to act to protect the environment. In contrast, negative emotional environmental pictures will increase negative emotions, and will also increase attention and intention to act to protect the environment. Implications of the findings are discussed. Full article
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Open AccessCommunication
Characteristics of a Nationwide Voluntary Antibiotic Resistance Awareness Campaign in India; Future Paths and Pointers for Resource Limited Settings/Low and Middle Income Countries
Int. J. Environ. Res. Public Health 2019, 16(24), 5141; https://doi.org/10.3390/ijerph16245141 - 16 Dec 2019
Viewed by 498
Abstract
Antibiotic resistance has reached alarming proportions globally, prompting the World Health Organization to advise nations to take up antibiotic awareness campaigns. Several campaigns have been taken up worldwide, mostly by governments. The government of India asked manufacturers to append a ‘redline’ to packages [...] Read more.
Antibiotic resistance has reached alarming proportions globally, prompting the World Health Organization to advise nations to take up antibiotic awareness campaigns. Several campaigns have been taken up worldwide, mostly by governments. The government of India asked manufacturers to append a ‘redline’ to packages of antibiotics as identification marks and conducted a campaign to inform the general public about it and appropriate antibiotic use. We investigated whether an antibiotic resistance awareness campaign could be organized voluntarily in India and determined the characteristics of the voluntarily organized campaign by administering a questionnaire to the coordinators, who participated in organizing the voluntary campaign India. The campaign characteristics were: multiple electro–physical pedagogical and participatory techniques were used, 49 physical events were organized in various parts of India that included lectures, posters, booklet/pamphlet distribution, audio and video messages, competitions, and mass contact rallies along with broadcast of messages in 11 local languages using community radio stations (CRS) spread all over India. The median values for campaign events were: expenditure—3000 Indian Rupees/day (US$~47), time for planning—1 day, program spread—4 days, program time—4 h, direct and indirect reach of the message—respectively 250 and 500 persons/event. A 2 min play entitled ‘Take antibiotics as prescribed by the doctor’ was broadcast 10 times/day for 5 days on CRS with listener reach of ~5 million persons. More than 85%ofcoordinators thought that the campaign created adequate awareness about appropriate antibiotic use and antibiotic resistance. The voluntary campaign has implications for resource limited settings/low and middle income countries. Full article
(This article belongs to the Special Issue Toxicology and Public Health)
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Open AccessReview
Class Time Physical Activity Programs for Primary School Aged Children at Specialist Schools: A Systematic Mapping Review
Int. J. Environ. Res. Public Health 2019, 16(24), 5140; https://doi.org/10.3390/ijerph16245140 - 16 Dec 2019
Viewed by 407
Abstract
Children with disabilities tend to be less active than typically developing peers and may therefore miss important developmental benefits. Class time physical activity (PA) programs can provide additional PA to children and have shown to contribute to numerous benefits in mainstream classrooms. However, [...] Read more.
Children with disabilities tend to be less active than typically developing peers and may therefore miss important developmental benefits. Class time physical activity (PA) programs can provide additional PA to children and have shown to contribute to numerous benefits in mainstream classrooms. However, it is unclear whether class time PA opportunities are provided in specialist education settings. This review aimed to identify and map class time PA programs that have been implemented in specialist schools and classes. Nine electronic databases were searched. Grey literature searches were also conducted. Programs were included if they were implemented in a primary/elementary specialist school or class, involved a PA component, were conducted during class time and involved more than one child from the class participating. Included programs were mapped and narratively synthesised according to activity type. Of the 2068 records screened, 34 programs were included. Programs involving dance/drama activities (k = 11) were most common and programs involving stretching activities (k = 2) were least frequently implemented. Twenty-three programs had been evaluated, of which only two were randomised controlled trials. More class time PA opportunities are warranted in specialist education settings. Further research is required to build the evidence base for these programs. Full article
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Open AccessArticle
Reliability of a Virtual Prosthodontic Project Realized through a 2D and 3D Photographic Acquisition: An Experimental Study on the Accuracy of Different Digital Systems
Int. J. Environ. Res. Public Health 2019, 16(24), 5139; https://doi.org/10.3390/ijerph16245139 - 16 Dec 2019
Viewed by 393
Abstract
Aims: The study aims to assess the accuracy of digital planning in dentistry, evaluating the characteristics of different intraoral 3D scanners and comparing it with traditional imaging 2D recording methods. Specifically, using computer aided design (CAD) software and measuring inside CAD software, authors [...] Read more.
Aims: The study aims to assess the accuracy of digital planning in dentistry, evaluating the characteristics of different intraoral 3D scanners and comparing it with traditional imaging 2D recording methods. Specifically, using computer aided design (CAD) software and measuring inside CAD software, authors want to verify the reliability of different models obtained with different techniques and machines. Methods: 12 patients that needed aesthetic restorative treatment were enrolled in the study. All the patients underwent recording data of the height and width dental elements 1.1, 1.2, and 1.3 size using different technologies and comparing 2D with 3D methods. A T test was then applied in order to verify whether there was a statistically significant difference between the measurements obtained, comparing the different tools data (Emerald, TRIOS, Photogrammetry and DSS (Digital Smile System)) with the reference values. Results: No significant differences emerged in the measurements made with the different scanners (Trios 3Shape ®, Planmeca Emerald ®) and photogrammetry. Therefore, what should be underlined regarding the 2D measurements is the speed and simplicity compared to all 3D techniques, so this work can help to better define the field of application and the limits connected to 2D techniques, giving a good window of the technique. Conclusions: The low number of patients is not sufficient to provide statistically significant results, but the digital planning future prospects seem to be promising. This study results highlighted how a photogrammetric scanner for dental arches would only have a much smaller shooting field size and greater accuracy. Despite these considerations, the photogrammetric facial scanner provided excellent results for the measurement of individual teeth, showing a great versatility of use. Full article
(This article belongs to the Special Issue Digital Dentistry for Oral Health)
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Open AccessArticle
Nanomaterials in the Environment: Research Hotspots and Trends
Int. J. Environ. Res. Public Health 2019, 16(24), 5138; https://doi.org/10.3390/ijerph16245138 - 16 Dec 2019
Viewed by 366
Abstract
Research on the field of nanomaterials in environment has continued to be a major area of interest in recent years. To present the up-to-date progress in this field, a bibliometric study is conducted to analyze 7087 related publications in the Science Citation Index [...] Read more.
Research on the field of nanomaterials in environment has continued to be a major area of interest in recent years. To present the up-to-date progress in this field, a bibliometric study is conducted to analyze 7087 related publications in the Science Citation Index (SCI) core collection of Web of Science based on the expanded SCI. These publications are identified through using representative keywords in the research directions environment of the Web of Science. This study finds that China and the United States dominate the field; one difference between them is that China issued more independent publications and the United States issued more cooperative publications. In addition, the number of the related publications in Asian countries has exceeded that of European and American ones. A Chinese institution, the Chinese Academy of Sciences, has an absolute dominance in this field. Traditional high-impact environmental journals have ruled this field. The number of publications in the Energy and Environmental Science field has gradually decreased. In addition, a co-citation analysis shows that previous studies in this field can be divided into four major branches, and that graphene oxide and nano-inorganic particles are increasingly becoming research hotspots. Full article
(This article belongs to the Section Environmental Science and Engineering)
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Open AccessArticle
Analysis of Factors Influencing Hospitals’ Implementation of a Green E-Procurement System Using a Cloud Model
Int. J. Environ. Res. Public Health 2019, 16(24), 5137; https://doi.org/10.3390/ijerph16245137 - 16 Dec 2019
Viewed by 435
Abstract
Currently, the green procurement activities of private hospitals in Taiwan follow the self-built green electronic-procurement (e-procurement) system. This requires professional personnel to take the time to regularly update the green specification and software and hardware of the e-procurement system, and the information system [...] Read more.
Currently, the green procurement activities of private hospitals in Taiwan follow the self-built green electronic-procurement (e-procurement) system. This requires professional personnel to take the time to regularly update the green specification and software and hardware of the e-procurement system, and the information system maintenance cost is high. In the case of a green e-procurement system crash, the efficiency of green procurement activities for hospitals is affected. If the green e-procurement can be moved to a convenient and trusty cloud computing model, this will enhance the efficiency of procurement activities and reduce the information maintenance cost for private hospitals. However, implementing a cloud model is an issue of technology innovation application and the technology-organization-environment (TOE) framework has been widely applied as the theoretical framework in technology innovation application. In addition, finding the weight of factors is a multi-criteria decision-making (MCDM) issue. Therefore, the present study first collected factors influencing implementation of the cloud mode together with the TOE as the theoretical framework, by reviewing the literature. Therefore, an expert questionnaire was designed and distributed to top managers of 20 private hospitals in southern Taiwan. The fuzzy analysis hierarchical process (FAHP), which is a MCDM tool, finds the weights of the factors influencing private hospitals in southern Taiwan when they implement a cloud green e-procurement system. The research results can enable private hospitals to successfully implement a green e-procurement system through a cloud model by optimizing resource allocation according to the weight of each factor. In addition, the results of this research can help cloud service providers of green e-procurement understand users’ needs and develop relevant cloud solutions and marketing strategies. Full article
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Open AccessArticle
Device-Measured Sedentary Behavior, Physical Activity and Aerobic Fitness Are Independent Correlates of Cognitive Performance in Healthy Middle-Aged Adults—Results from the SCAPIS Pilot Study
Int. J. Environ. Res. Public Health 2019, 16(24), 5136; https://doi.org/10.3390/ijerph16245136 - 16 Dec 2019
Viewed by 454
Abstract
High aerobic fitness, more moderate to vigorous physical activity (MVPA) and less sedentary behavior (SED) have all been suggested to promote cognitive functions, but it is unclear whether they are independent predictors of specific cognitive domains. This study aimed to investigate to what [...] Read more.
High aerobic fitness, more moderate to vigorous physical activity (MVPA) and less sedentary behavior (SED) have all been suggested to promote cognitive functions, but it is unclear whether they are independent predictors of specific cognitive domains. This study aimed to investigate to what extent aerobic fitness MVPA and SED are independently associated with cognitive performance among middle-aged Swedish adults. We acquired device-based measures of aerobic fitness, cognitive performance and percent daily time spent in MVPA and SED in Swedish adults (n = 216; 54–66 years old). Aerobic fitness was associated with better performance at one out of two tests of speed/attention and one out of four tests of executive attention, and with worse performance at one of seven tests of memory. Increasing %MVPA was associated with better performance at one out of seven tests of memory and two out of three tests of verbal ability, whereas increasing %SED was associated with better performance at all four tests of executive attention and four out of seven tests of memory. These findings suggest that aerobic fitness, %MVPA and %SED are partly independent correlates of cognitive performance. To fully understand the association between SED and performance at several tests of cognitive function, future investigations might attempt to investigate intellectually engaging SED (such as reading books) separately from mentally undemanding SED (such as watching TV). Full article
(This article belongs to the Section Health Behavior, Chronic Disease and Health Promotion)
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