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Int. J. Environ. Res. Public Health, Volume 17, Issue 10 (May-2 2020) – 404 articles

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Cover Story (view full-size image) Alzheimer’s disease (AD), the most common dementia, is characterized by mental and/or cognitive [...] Read more.
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Open AccessArticle
The Impact of COVID-19 on Tourist Satisfaction with B&B in Zhejiang, China: An Importance–Performance Analysis
Int. J. Environ. Res. Public Health 2020, 17(10), 3747; https://doi.org/10.3390/ijerph17103747 - 25 May 2020
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Abstract
After the outbreak of COVID-19 (especially in the stage of tourism recovery), the bed and breakfast (B&B) tourism industry faced big challenges in improving its health strategies. B&Bs are very important for the tourism industry in China and many other countries. However, few [...] Read more.
After the outbreak of COVID-19 (especially in the stage of tourism recovery), the bed and breakfast (B&B) tourism industry faced big challenges in improving its health strategies. B&Bs are very important for the tourism industry in China and many other countries. However, few studies have studied the impact of B&Bs, under COVID-19, on tourism in China. Our paper is among one of the first studies to investigate the impact of COVID-19 on tourist satisfaction with B&Bs in China. The work/travel restrictions started from 20 January 2020, and work/after travel resumed from 20 February 2020 in Zhejiang, China. Data were collected from 588 tourists (who experienced B&Bs in Zhejiang, China) from a WeChat online survey, from 1 March to 15 March 2020. The current study attempted to fill the gap by studying the changing tourist satisfaction levels with B&Bs before/after COVID-19. Moreover, some suggestions are given to the B&B industry for tourism resumption after COVID-19 by an importance–performance analysis (IPA). Full article
(This article belongs to the Special Issue Tourism and Health)
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Open AccessArticle
Transcriptomic Response of Breast Cancer Cells MDA-MB-231 to Docosahexaenoic Acid: Downregulation of Lipid and Cholesterol Metabolism Genes and Upregulation of Genes of the Pro-Apoptotic ER-Stress Pathway
Int. J. Environ. Res. Public Health 2020, 17(10), 3746; https://doi.org/10.3390/ijerph17103746 - 25 May 2020
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Abstract
Despite considerable efforts in prevention and therapy, breast cancer remains a major public health concern worldwide. Numerous studies using breast cancer cell lines have shown the antiproliferative and pro-apoptotic effects of docosahexaenoic acid (DHA). Some studies have also demonstrated the inhibitory effect of [...] Read more.
Despite considerable efforts in prevention and therapy, breast cancer remains a major public health concern worldwide. Numerous studies using breast cancer cell lines have shown the antiproliferative and pro-apoptotic effects of docosahexaenoic acid (DHA). Some studies have also demonstrated the inhibitory effect of DHA on the migration and invasion of breast cancer cells, making DHA a potential anti-metastatic agent. Thus, DHA has shown its potential as a chemotherapeutic adjuvant. However, the molecular mechanisms triggering DHA effects remain unclear, and the aim of this study was to provide a transcriptomic basis for further cellular and molecular investigations. Therefore, MDA-MB-231 cells were treated with 100 µM DHA for 12 h or 24 h before RNA-seq analysis. The results show the great impact of DHA-treatment on the transcriptome, especially after 24 h of treatment. The impact of DHA is particularly visible in genes involved in the cholesterol biosynthesis pathway that is strongly downregulated, and the endoplasmic reticulum (ER)-stress response that is, conversely, upregulated. This ER-stress and unfolded protein response could explain the pro-apoptotic effect of DHA. The expression of genes related to migration and invasion (especially SERPINE1, PLAT, and MMP11) is also impacted by DHA. In conclusion, this transcriptomic analysis supports the antiproliferative, pro-apoptotic and anti-invasive effects of DHA, and provides new avenues for understanding its molecular mechanisms. Full article
(This article belongs to the Special Issue Feature Papers in Women's Health)
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Open AccessArticle
Ethiopian Health Care Workers’ Insights into and Responses to Intimate Partner Violence in Pregnancy—A Qualitative Study
Int. J. Environ. Res. Public Health 2020, 17(10), 3745; https://doi.org/10.3390/ijerph17103745 - 25 May 2020
Viewed by 319
Abstract
Violence against women is a global pandemic, with the potential to spread through generations. Intimate partner violence has impacts on women’s sexual, reproductive, and psycho-social health. It can occur during pregnancy and adversely affect the health of both mother and child. Health care [...] Read more.
Violence against women is a global pandemic, with the potential to spread through generations. Intimate partner violence has impacts on women’s sexual, reproductive, and psycho-social health. It can occur during pregnancy and adversely affect the health of both mother and child. Health care workers involved in antenatal care can have a unique role in identifying intimate partner violence and in intervening, preventing, and mitigating its consequences. In this study, the objective was to explore Ethiopian health care workers’ insights of and responses to intimate partner violence in pregnancy. Using an exploratory design, this qualitative study includes ten semi-structured interviews of health care workers representing different antenatal care centers in Jimma, Ethiopia. The content analyses of translated interview notes were conducted with Atlas.ti7 software, (Atlas.ti Scientific Software Development Gmbh, Berlin). The health care workers shared their insights of the consequences of intimate partner violence during pregnancy in addition to their experience with and responses to the victims. There was a limited understanding of the extent of the adverse impacts of intimate partner violence on pregnancy outcomes, as well as the potential long-term health implications. The informants described how they only gave medical treatment for obstetric complications or visible trauma during pregnancy. There was no formal referral to or linkages with other resources. Women’s empowerment and systemic changes in the health care, including training and capacity building, clear guidelines addressing management of intimate partner violence in pregnancy, and inclusion of intimate partner violence screening tools in the Ethiopian antenatal care chart/card, were recommended by the informants. The adverse impacts of intimate partner violence on pregnancy outcomes were poorly understood by the Ethiopian health care workers in this study. They offered limited assistance to the victims and recommended changes in the routine antenatal care (ANC) and health care systems. They identified various policy initiatives focusing on women’s empowerment to reduce intimate partner violence and its complications especially during pregnancy. Full article
(This article belongs to the Special Issue Global Women's Health)
Open AccessArticle
Inadequate Knowledge, Attitude and Practices about Second-Hand Smoke among Non-Smoking Pregnant Women in Urban Vietnam: The Need for Health Literacy Reinforcement
Int. J. Environ. Res. Public Health 2020, 17(10), 3744; https://doi.org/10.3390/ijerph17103744 - 25 May 2020
Viewed by 343
Abstract
The rate of exposure to second-hand smoke (SHS) is relatively high in several countries, including Vietnam, and health issues related to SHS have worsened in recent years, especially for pregnant women and their infants. Enhancement of knowledge, attitude, and practice (KAP) scores of [...] Read more.
The rate of exposure to second-hand smoke (SHS) is relatively high in several countries, including Vietnam, and health issues related to SHS have worsened in recent years, especially for pregnant women and their infants. Enhancement of knowledge, attitude, and practice (KAP) scores of pregnant women in Vietnam could raise practical interventions to protect their health and reduce complications of SHS. A cross-sectional study of 432 pregnant women who came to the Obstetrics Department of Bach Mai Hospital, Hanoi, Vietnam for antenatal care was conducted in 2016 to collect information about their KAP related to SHS. Composite mean scores from survey questions assessing their KAP were calculated on a 10-point scale, finding mean scores of 4.19, 7.45, and 4.30, respectively. Higher scores indicated better knowledge, attitude, and practice. Generalized linear models identified that age, occupation, living place, and sources of information were associated with SHS-related KAP. Findings from this study indicate that suitable programs related to SHS should be implemented to improve and reinforce health literacy to both mothers and smokers to reduce the harmfulness of smoking on women and their infants’ health. Full article
Open AccessArticle
Longitudinal Relationship Study of Depression and Self-Esteem in Postnatal Korean Women Using Autoregressive Cross-Lagged Modeling
Int. J. Environ. Res. Public Health 2020, 17(10), 3743; https://doi.org/10.3390/ijerph17103743 - 25 May 2020
Viewed by 293
Abstract
Individuals with low self-esteem are vulnerable to depression. Depressed individuals process information related to themselves in a distorted way, thereby negatively affecting their self-esteem. The purpose of this study was to examine the relationship between depression and self-esteem in postnatal Korean women using [...] Read more.
Individuals with low self-esteem are vulnerable to depression. Depressed individuals process information related to themselves in a distorted way, thereby negatively affecting their self-esteem. The purpose of this study was to examine the relationship between depression and self-esteem in postnatal Korean women using longitudinal data and an autoregressive cross-lagged analysis. This study was conducted in postpartum women who had consistently participated in the Panel Study on Korean Children (PSKC) from Wave 1 through to Wave 8. The study results showed that depression and self-esteem in postnatal women had a significant positive correlation over time. Moreover, the longitudinal relationship between depression and self-esteem in postnatal women was affected by weight gain during pregnancy. This study overcomes the limitations of cross-sectional studies by using longitudinal data on the correlations between depression and self-esteem in postnatal women; the study findings may be used in developing weight control programs for pregnant and postnatal women. Full article
(This article belongs to the Section Women's Health)
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Open AccessArticle
Initial Therapy, Regimen Change, and Persistence in a Spanish Cohort of Newly Treated Type 2 Diabetes Patients: A Retrospective, Observational Study Using Real-World Data
Int. J. Environ. Res. Public Health 2020, 17(10), 3742; https://doi.org/10.3390/ijerph17103742 - 25 May 2020
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Abstract
The World Health Organization considers the non-adherence to medication a significant issue with global impact, especially in chronic conditions such as type 2 diabetes. We aim to study antidiabetic treatment initiation, add-on, treatment switching, and medication persistence. We conducted an observational study on [...] Read more.
The World Health Organization considers the non-adherence to medication a significant issue with global impact, especially in chronic conditions such as type 2 diabetes. We aim to study antidiabetic treatment initiation, add-on, treatment switching, and medication persistence. We conducted an observational study on 4247 individuals initiating antidiabetic treatment between 2013 and 2014 in the EpiChron Cohort (Spain). We used Cox regression models to estimate the likelihood of non-persistence after a one-year follow-up, expressed as hazard ratios (HRs). Metformin was the most frequently used first-line antidiabetic (80% of cases); combination treatment was the second most common treatment in adults aged 40–79 years, while dipeptidyl peptidase-4 inhibitors were the second most common in individuals in their 80s and over, and in patients with renal disease. Individuals initiated on metformin were less likely to present addition and switching events compared with any other antidiabetic. Almost 70% of individuals initiated on monotherapy were persistent. Subjects aged 40 and over (HR 0.53–0.63), living in rural (HR 0.79) or more deprived areas (HR 0.77–0.82), or receiving polypharmacy (HR 0.84), were less likely to show discontinuation. Our findings could help identify the population at risk of discontinuation, and offer them closer monitoring for proper integrated management to improve prognosis and health outcomes. Full article
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Open AccessArticle
Shell Growth of Large Benthic Foraminifera under Heavy Metals Pollution: Implications for Geochemical Monitoring of Coastal Environments
Int. J. Environ. Res. Public Health 2020, 17(10), 3741; https://doi.org/10.3390/ijerph17103741 - 25 May 2020
Viewed by 310
Abstract
This study was promoted by the recent efforts using larger benthic foraminiferal (LBF) shells geochemistry for the monitoring of heavy metals (HMs) pollution in the marine environment. The shell itself acts as a recorder of the ambient water chemistry in low to extreme [...] Read more.
This study was promoted by the recent efforts using larger benthic foraminiferal (LBF) shells geochemistry for the monitoring of heavy metals (HMs) pollution in the marine environment. The shell itself acts as a recorder of the ambient water chemistry in low to extreme HMs-polluted environments, allowing the monitoring of recent-past pollution events. This concept, known as sclerochronology, requires the addition of new parts (i.e., new shell) even in extreme pollution events. We evaluated the physiological resilience of three LBF species with different shell types and symbionts to enriched concentrations of Cd, Cu, and Pb at levels several folds higher than the ecological criteria maximum concentration (CMC) (165–166, 33–43, 1001–1206 µg L−1, respectively), which is derived from aquatic organisms’ toxicity tests. The physiological response of the holobiont was expressed by growth rates quantified by the addition of new chambers (new shell parts), and by the chlorophyll a of the algal symbionts. The growth rate decrease varied between 0% and 30% compared to the unamended control for all HMs tested, whereas the algal symbionts exhibited a general non-fatal but significant response to Pb and Cu. Our results highlight that shell growth inhibition of LBF is predicted in extreme concentrations of 57 × CMC of Cu and 523 × CMC of Cd, providing a proof of concept for shell geochemistry monitoring, which is currently not used in the regulatory sectors. Full article
(This article belongs to the Special Issue Marine Coastal Environment Monitoring)
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Open AccessArticle
Depression and Anxiety in Hong Kong during COVID-19
Int. J. Environ. Res. Public Health 2020, 17(10), 3740; https://doi.org/10.3390/ijerph17103740 - 25 May 2020
Viewed by 331
Abstract
It has been three months since the first confirmed case of coronavirus disease 2019 (COVID-19) in Hong Kong, and people now have a more complete picture of the extent of the pandemic. Therefore, it is time to evaluate the impacts of COVID-19 on [...] Read more.
It has been three months since the first confirmed case of coronavirus disease 2019 (COVID-19) in Hong Kong, and people now have a more complete picture of the extent of the pandemic. Therefore, it is time to evaluate the impacts of COVID-19 on mental health. The current population-based study aimed to evaluate the depression and anxiety of people in Hong Kong during the COVID-19 pandemic. Respondents were randomly recruited and asked to complete a structured questionnaire, including the patient health questionnaire-9 (PHQ-9), the generalized anxiety disorder-7 (GAD-7), the global rating of change scale and items related to COVID-19. Of the 500 respondents included in the study, 19% had depression (PHQ-9 score ≥ 10) and 14% had anxiety (GAD score ≥ 10). In addition, 25.4% reported that their mental health had deteriorated since the pandemic. Multiple logistic regression analysis found that not experiencing the SARS outbreak in 2003, being worried about being infected by COVID-19, being bothered by having not enough surgical masks and being bothered by not being able to work from home were associated with a poorer mental health status. Psychological support, such as brief, home-based psychological interventions, should be provided to citizens during the pandemic. Full article
(This article belongs to the Special Issue Mental Health in the Time of COVID-19)
Open AccessArticle
The Prevalence of Burnout and Its Associations with Psychosocial Work Environment among Kaunas Region (Lithuania) Hospitals’ Physicians
Int. J. Environ. Res. Public Health 2020, 17(10), 3739; https://doi.org/10.3390/ijerph17103739 - 25 May 2020
Viewed by 286
Abstract
The primary prevention of occupational burnout should be considered as a public health priority worldwide. The aim of this study was to evaluate the prevalence of burnout and its associations with the work environment among hospital physicians in the Kaunas region, Lithuania. The [...] Read more.
The primary prevention of occupational burnout should be considered as a public health priority worldwide. The aim of this study was to evaluate the prevalence of burnout and its associations with the work environment among hospital physicians in the Kaunas region, Lithuania. The cross-sectional study was carried out in 2018. The Job Content Questionnaire (JCQ) and the Copenhagen Burnout Inventory (CBI) were administered to examine occupational stress and personal, work-related, and client-related burnout among 647 physicians. Logistic regression analysis was applied to determine the association between dependent variable burnout and psychosocial environment among physicians, adjusting for potential confounders of age and gender. The prevalence rate of client-related, work-related, and personal burnout was 35.1%, 46.7%, and 44.8%, respectively. High job control, lack of supervisor, coworker support, job demands, and job insecurity were significantly associated with all three sub-dimensions of burnout. High job demands increased the probability of all three burnout dimensions, high job control reduced the probability of work-related, and client-related burnout and high job insecurity increased the probability of client-related burnout. The confirmed associations suggest that optimization of job demands and job control and the improvement of job security would be effective preventive measures in reducing occupational burnout among physicians. Full article
(This article belongs to the Special Issue Prevention of Occupational Risks)
Open AccessReview
Depression and Objectively Measured Physical Activity: A Systematic Review and Meta-Analysis
Int. J. Environ. Res. Public Health 2020, 17(10), 3738; https://doi.org/10.3390/ijerph17103738 - 25 May 2020
Viewed by 383
Abstract
Depression is a major contributor to the overall global burden of disease, with high prevalence and relapse rate. Several factors have been considered in order to reduce the depression burden. Among them, physical activity (PA) showed a potential protective role. However, evidence is [...] Read more.
Depression is a major contributor to the overall global burden of disease, with high prevalence and relapse rate. Several factors have been considered in order to reduce the depression burden. Among them, physical activity (PA) showed a potential protective role. However, evidence is contrasting probably because of the differences in PA measurement. The aim of this systematic review with meta-analysis is to assess the association between objectively measured PA and incident and prevalent depression. The systematic review was conducted according to methods recommended by the Cochrane Collaboration and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Relevant papers published through 31 August 2019 were identified searching through the electronic databases PubMed/MEDLINE, Excerpta Medica dataBASE (Embase), PsycINFO, Scopus, Web of Science (WoS), and the Cochrane Library. All analyses were conducted using ProMeta3. Finally, 42 studies met inclusion criteria. The overall Effect size (ES) of depression for the highest vs. the lowest level of PA was −1.16 [(95% CI = −1.41; −0.91), p-value < 0.001] based on 37,408 participants. The results of the meta-analysis showed a potential protective effect of PA on prevalent and incident depression. Full article
(This article belongs to the Special Issue Lifestyle and Risk of Depression)
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Open AccessArticle
Risk for Irritable Bowel Syndrome in Patients with Helicobacter Pylori Infection: A Nationwide Population-Based Study Cohort Study in Taiwan
Int. J. Environ. Res. Public Health 2020, 17(10), 3737; https://doi.org/10.3390/ijerph17103737 - 25 May 2020
Viewed by 299
Abstract
Background: The association between Helicobacter pylori (H. pylori) infection and the risk of developing irritable bowel syndrome (IBS) has yet to be investigated; thus, we conducted this nationwide cohort study to examine the association in patients from Taiwan. Methods: A total [...] Read more.
Background: The association between Helicobacter pylori (H. pylori) infection and the risk of developing irritable bowel syndrome (IBS) has yet to be investigated; thus, we conducted this nationwide cohort study to examine the association in patients from Taiwan. Methods: A total of approximately 2669 individuals with newly diagnosed H. pylori infection and 10,676 age- and sex-matched patients without a diagnosis of H. pylori infection from 2000 to 2013 were identified from Taiwan’s National Health Insurance Research Database. The Kaplan–Meier method was used to determine the cumulative incidence of H. pylori infection in each cohort. Whether the patient underwent H. pylori eradication therapy was also determined. Results: The cumulative incidence of IBS was higher in the H. pylori-infected cohort than in the comparison cohort (log-rank test, p < 0.001). After adjustment for potential confounders, H. pylori infection was associated with a significantly increased risk of IBS (adjusted hazard ratio (aHR) 3.108, p < 0.001). In addition, the H. pylori-infected cohort who did not receive eradication therapy had a higher risk of IBS than the non-H. pylori-infected cohort (adjusted HR 4.16, p < 0.001). The H. pylori-infected cohort who received eradication therapy had a lower risk of IBS than the comparison cohort (adjusted HR 0.464, p = 0.037). Conclusions: Based on a retrospective follow-up, nationwide study in Taiwan, H. pylori infection was associated with an increased risk of IBS; however, aggressive H. pylori infection eradication therapy can also reduce the risk of IBS. Further underlying biological mechanistic research is needed. Full article
(This article belongs to the Special Issue Global Infectious Diseases and Surveillance and Control Systems)
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Open AccessArticle
Perceived Benefits for Mental and Physical Health and Barriers to Horseback Riding Participation. The Analysis among Professional and Amateur Athletes
Int. J. Environ. Res. Public Health 2020, 17(10), 3736; https://doi.org/10.3390/ijerph17103736 - 25 May 2020
Viewed by 290
Abstract
The aim of this study was to investigate perceived benefits for mental and physical health and barriers to horseback riding participation among professional and amateur athletes by gender. The empirical study of 2651 professional and amateur horseback riders was conducted during the last [...] Read more.
The aim of this study was to investigate perceived benefits for mental and physical health and barriers to horseback riding participation among professional and amateur athletes by gender. The empirical study of 2651 professional and amateur horseback riders was conducted during the last edition of Cavaliada competitions (held in Poznan in December 2019)—one of the biggest and most important horseback riding events in Europe. A diagnostic survey method was used in the study. In the questionnaire a division of benefits and barriers according to the EBBS (Exercise Benefits/Barriers Scale) was used. The results are presented by means of frequency distributions for individual items. The verification of hypotheses about the differences between the analyzed groups was conducted using the U-Mann Whitney test with a correction of tied ranks. For the compared groups the mean rank values were calculated. Research results showed that respondents rated the positive impact of equestrianism on mental health higher than on physical health. Among the barriers, the most frequently mentioned aspects were not related to the internal motivation of the respondents, but to external factors—money, time and distance of sports facilities. Men rated the social and psychological benefits higher, while women rated the positive impact of equestrianism on physicality. Professionals rated more highly a number of aspects related to positive effects on the body, while amateurs claimed that were more often not supported by loved ones. This is important research from the point of view of horseback riding promotion. Understanding the horseback riding benefits and barriers are needed, as such knowledge can be used to encourage horseback riding. Perceived benefits and barriers to horseback riding have so far been rarely studied by researchers. Full article
(This article belongs to the Special Issue Management and Promotion of Healthy Habits and Active Life)
Open AccessArticle
Gender Differences in Factors Influencing Self-Efficacy Toward Pregnancy Planning among College Students in Korea
Int. J. Environ. Res. Public Health 2020, 17(10), 3735; https://doi.org/10.3390/ijerph17103735 - 25 May 2020
Viewed by 309
Abstract
The purpose of this study was to examine factors influencing college students’ self-efficacy toward pregnancy planning by gender using the health belief model (HBM). Utilizing a comparative descriptive design, a total of 819 college students were recruited. A survey was administered to gather [...] Read more.
The purpose of this study was to examine factors influencing college students’ self-efficacy toward pregnancy planning by gender using the health belief model (HBM). Utilizing a comparative descriptive design, a total of 819 college students were recruited. A survey was administered to gather information on health beliefs related to pregnancy planning, self-efficacy toward pregnancy planning, fertility knowledge, and general characteristics. The main variables were compared by gender. The factors influencing self-efficacy toward pregnancy planning were identified using hierarchical regression analysis. Female students (476) had lower self-efficacy toward pregnancy planning than male students (343). The significant factors influencing self-efficacy toward pregnancy planning in female students were: depression (β = −0.09, p = 0.030), fertility knowledge (β = 0.08, p = 0.025), barriers (β = −0.57, p < 0.001), and cues to action (β = 0.16, p < 0.001), whereas the corresponding factors in male students were benefits (β = 0.12, p = 0.020), barriers (β = −0.44, p < 0.001), and cues to action (β = 0.16, p = 0.001). The present study confirmed the suitability of the HBM as a conceptual framework for identifying factors influencing self-efficacy toward pregnancy planning. Based on the findings of this study, gender-based similarities and differences in factors influencing self-efficacy should be considered when taking steps to promote self-efficacy toward pregnancy planning among college students. Full article
(This article belongs to the Section Women's Health)
Open AccessArticle
Surveillance of a Pest Through a Public Health Information System: The Case of the Blackfly (Simulium erythrocephalum) in Zaragoza (Spain) during 2009–2015
Int. J. Environ. Res. Public Health 2020, 17(10), 3734; https://doi.org/10.3390/ijerph17103734 - 25 May 2020
Viewed by 336
Abstract
Background: Animals and people in many Spanish regions are increasingly being affected by blackfly bites in the last decade. Because of blackflies, the city of Zaragoza has become in recent years a paradigm of discomfort in Europe, with thousands of citizens affected. [...] Read more.
Background: Animals and people in many Spanish regions are increasingly being affected by blackfly bites in the last decade. Because of blackflies, the city of Zaragoza has become in recent years a paradigm of discomfort in Europe, with thousands of citizens affected. The OMI-AP system (Stacks, Barcelona, Spain) implemented by the Government of Aragón, a software that manages the electronic medical history of all patients, has been evaluated in order to document the increase of insect bite recorded by the primary care consultations in Zaragoza after the first outbreak of blackflies occurred in 2011. Methods: An observational, ecological and longitudinal study of insect bites recorded at the primary care consultations was carried out in primary care during the period 2009–2015. Results: The incidence of medical consultations by insect bites in Basic Health Areas (BHA) near to rivers is higher than the furthest BHA. Rural BHA are more affected by insect bites than the urban ones. The increase of medical assistance due to insect bites in Zaragoza since 2011 is correlated with the blackflies bites. Conclusions: This tool was very useful to describe the initial stage of this public health problem. It could be used for guiding public health responses in terms of surveillance and management of this pest. Full article
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Open AccessArticle
Nitrogen-Dioxide Remains a Valid Air Quality Indicator
Int. J. Environ. Res. Public Health 2020, 17(10), 3733; https://doi.org/10.3390/ijerph17103733 - 25 May 2020
Viewed by 187
Abstract
In epidemiological studies, both spatial and temporal variations in nitrogen dioxide (NO2) are a robust predictor of health risks. Compared to particulate matter, the experimental evidence for harmful effects at typical ambient concentrations is less extensive and not as clear for [...] Read more.
In epidemiological studies, both spatial and temporal variations in nitrogen dioxide (NO2) are a robust predictor of health risks. Compared to particulate matter, the experimental evidence for harmful effects at typical ambient concentrations is less extensive and not as clear for NO2. In the wake of the “Diesel emission scandal—Dieselgate”, the scientific basis of current limit values for ambient NO2 concentrations was attacked by industry lobbyists. It was argued that associations between NO2 levels and medical endpoints were not causal, as NO2 in older studies served as a proxy for aggressive particulate matter from incineration processes. With the introduction of particle filters in diesel cars, NO2 would have lost its meaning as a health indicator. Austria has a high percentage of diesel-powered cars (56%). If, indeed, associations between NO2 concentrations and health risks in previous studies were only due to older engines without a particle filter, we should expect a reduction in effect estimates over time as an increasing number of diesel cars on the roads were outfitted with particle filters. In previous time series studies from Vienna over shorter time intervals, we have demonstrated distributed lag effects over days up to two weeks and previous day effects of NO2 on total mortality. In a simplified model, we now assess the effect estimates for moving 5-year periods from the beginning of NO2 monitoring in Vienna (1987) until the year 2018 of same and previous day NO2 on total daily mortality. Contrary to industry claims of a spurious, no longer valid indicator function of NO2, effect estimates remained fairly stable, indicating an increase in total mortality of previous day NO2 by 0.52% (95% CI: 0.35–0.7%) per 10 µg/m3 change in NO2 concentration. Full article
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Open AccessArticle
Self and Nature: Parental Socialization, Self-Esteem, and Environmental Values in Spanish Adolescents
Int. J. Environ. Res. Public Health 2020, 17(10), 3732; https://doi.org/10.3390/ijerph17103732 - 25 May 2020
Viewed by 319
Abstract
Emergent research seriously questions the use of parental strictness as the best parenting strategy in all cultural contexts. Moreover, previous research on environmental socialization offers inconsistent findings about which specific parenting practices would be the most appropriate for environmental socialization. The present paper [...] Read more.
Emergent research seriously questions the use of parental strictness as the best parenting strategy in all cultural contexts. Moreover, previous research on environmental socialization offers inconsistent findings about which specific parenting practices would be the most appropriate for environmental socialization. The present paper aims to examine parents’ contribution (i.e., authoritative, indulgent, authoritarian, and neglectful) to adolescents’ self-esteem and internalization of environmental values. Participants were 308 Spanish adolescents with 171 females (55.5%), between 12 and 17 years old. The four parenting styles were defined using measures of parental warmth and strictness. Self-esteem was captured with global and multidimensional measures. Internalization of environmental values was evaluated by measuring the priority given to biospheric values. Results revealed a consistent pattern between parenting styles and adolescent self-esteem and internalization of environmental values. Overall, adolescents from homes characterized by parental warmth (i.e., indulgent and authoritative) have higher self-esteem and greater internalization of environmental values than their counterparts. These findings clearly contrast with those obtained in other cultural contexts where parental strictness is essential in achieving well-adjusted children with optimal psychosocial development. Full article
(This article belongs to the Special Issue Social and Family Determinants of Adolescent Adjustment)
Open AccessArticle
Association between Different Modes of Travelling and Adiposity in Chilean Population: Findings from the Chilean National Health Survey 2016–2017
Int. J. Environ. Res. Public Health 2020, 17(10), 3731; https://doi.org/10.3390/ijerph17103731 - 25 May 2020
Viewed by 332
Abstract
Background: Active travel has been suggested as a feasible way of increasing physical activity levels. Although international studies have demonstrated its effect over different health outcomes and adiposity, there is still limited evidence on this topic in developing countries, such as Chile. Aim: [...] Read more.
Background: Active travel has been suggested as a feasible way of increasing physical activity levels. Although international studies have demonstrated its effect over different health outcomes and adiposity, there is still limited evidence on this topic in developing countries, such as Chile. Aim: To investigate the associations between different types of travelling and markers of obesity in the Chilean adult population. Methods: 5411 participants from the Chilean National Health Survey 2016–2017 (CNHS) were included in this study. Active travel was assessed using a questionnaire. Car commuters, public transport (PT), walking and cycling were the four forms of travelling assessed. Bodyweight, body mass index and waist circumference were used as markers of adiposity. Results: Compared to car travellers, body weight, WC and BMI levels were lower for PT walking and cycling travellers. The odds for obesity (Odds ratio (OR): 0.41 (95% CI: 0.28; 0.61 p ≤ 0.001) were lower for walking and the odds (OR: 0.56 (95%CI: 0.35; 0.89 p = 0.014) for central obesity were significantly lower for cyclist in comparison to car travellers. Additionally, participation in any form of active travel (walking or cycling) was low, with only 20.9% of the population reporting being active travellers. Conclusion: Active travel, such as walking and cycling, was associated with lower adiposity levels in the Chilean adult population. Promoting active travel could be a feasible strategy to tackle the high prevalence of obesity and physical inactivity in the Chilean population. Full article
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Open AccessArticle
Prioritizing and Analyzing the Role of Climate and Urban Parameters in the Confirmed Cases of COVID-19 Based on Artificial Intelligence Applications
Int. J. Environ. Res. Public Health 2020, 17(10), 3730; https://doi.org/10.3390/ijerph17103730 - 25 May 2020
Viewed by 354
Abstract
Nowadays, an infectious disease outbreak is considered one of the most destructive effects in the sustainable development process. The outbreak of new coronavirus (COVID-19) as an infectious disease showed that it has undesirable social, environmental, and economic impacts, and leads to serious challenges [...] Read more.
Nowadays, an infectious disease outbreak is considered one of the most destructive effects in the sustainable development process. The outbreak of new coronavirus (COVID-19) as an infectious disease showed that it has undesirable social, environmental, and economic impacts, and leads to serious challenges and threats. Additionally, investigating the prioritization parameters is of vital importance to reducing the negative impacts of this global crisis. Hence, the main aim of this study is to prioritize and analyze the role of certain environmental parameters. For this purpose, four cities in Italy were selected as a case study and some notable climate parameters—such as daily average temperature, relative humidity, wind speed—and an urban parameter, population density, were considered as input data set, with confirmed cases of COVID-19 being the output dataset. In this paper, two artificial intelligence techniques, including an artificial neural network (ANN) based on particle swarm optimization (PSO) algorithm and differential evolution (DE) algorithm, were used for prioritizing climate and urban parameters. The analysis is based on the feature selection process and then the obtained results from the proposed models compared to select the best one. Finally, the difference in cost function was about 0.0001 between the performances of the two models, hence, the two methods were not different in cost function, however, ANN-PSO was found to be better, because it reached to the desired precision level in lesser iterations than ANN-DE. In addition, the priority of two variables, urban parameter, and relative humidity, were the highest to predict the confirmed cases of COVID-19. Full article
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Open AccessArticle
Effect of Different Running Exercise Modalities on Post-Exercise Oxidative Stress Markers in Trained Athletes
Int. J. Environ. Res. Public Health 2020, 17(10), 3729; https://doi.org/10.3390/ijerph17103729 - 25 May 2020
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Abstract
The aim of this study was to examine the effect of running exercise modality on oxidative stress. Thirteen endurance athletes (age: 21.46 ± 0.66 years) performed three different running exercise modalities (Continuous running exercise (CR): continuous running exercise at 75% of VO2max [...] Read more.
The aim of this study was to examine the effect of running exercise modality on oxidative stress. Thirteen endurance athletes (age: 21.46 ± 0.66 years) performed three different running exercise modalities (Continuous running exercise (CR): continuous running exercise at 75% of VO2max for 25 min; intermittent running exercise #1 (15/15): intermittent running protocol, 15 s running at 75% of VO2max, 15 s passive recovery, performed for 50 min; intermittent running exercise #2 (30/30): intermittent running protocol, 30 s running at 75% of VO2max, 30 s passive recovery, performed for 50 min) in a randomized order. Blood samples were drawn at rest and immediately after each running exercise and assessed for malondialdehyde (MDA), advanced oxidation protein products (AOPP), superoxide dismutase(SOD), and glutathione peroxidase (GPX) activities. MDA increased by 55% following 30/30 exercise (p < 0.01), while it remained unchanged with CR and15/15 exercise. SOD increased after CR (+13.9%, p < 0.05), and also remained unchanged after 15/15 (p > 0.05) and decreased after 30/30 (−19.7% p < 0.05). GPX and AOPP did not change after exercise in all experimental sessions (p > 0.05). In conclusion, 30/30 intermittent running induced higher lipid damages than the 15/15 and CR exercise. 15/15 intermittent exercise promoted a better balance between free radicals production and antioxidant defense compared to continuous exercise and intermittent 30/30 exercise. Full article
(This article belongs to the Special Issue Sports and Health)
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Open AccessArticle
The Effect of Physical Activity and High Body Mass Index on Health-Related Quality of Life in Individuals with Metabolic Syndrome
Int. J. Environ. Res. Public Health 2020, 17(10), 3728; https://doi.org/10.3390/ijerph17103728 - 25 May 2020
Viewed by 403
Abstract
The main objective of this study was to examine the relationship between the level of physical activity (PA) and the degree of obesity with health-related quality of life (HRQoL) in individuals with metabolic syndrome (MetS) who participated in the Predimed-Plus study. A total [...] Read more.
The main objective of this study was to examine the relationship between the level of physical activity (PA) and the degree of obesity with health-related quality of life (HRQoL) in individuals with metabolic syndrome (MetS) who participated in the Predimed-Plus study. A total of 6875 subjects between 55 and 75 years of age with MetS were selected and randomized in 23 Spanish centers. Subjects were classified according to categories of body mass index (BMI). PA was measured with the validated Registre Gironí del Cor (REGICOR) questionnaire and subjects were classified according to their PA level (light, moderate, vigorous) and the HRQoL was measured with the validated short-form 36 (SF-36) questionnaire. By using the ANOVA model, we found a positive and statistically significant association between the level of PA and the HRQoL (aggregated physical and mental dimensions p < 0.001), but a negative association with higher BMI in aggregated physical dimensions p < 0.001. Furthermore, women obtained lower scores compared with men, more five points in all fields of SF-36. Therefore, it is essential to promote PA and body weight control from primary care consultations to improve HRQoL, paying special attention to the differences that sex incurs. Full article
(This article belongs to the Special Issue Assessment of Health-Related Quality of Life (HRQoL) in Public Health)
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Open AccessArticle
A National Communication Campaign in Indonesia Is Associated with Improved WASH-Related Knowledge and Behaviors in Indonesian Mothers
Int. J. Environ. Res. Public Health 2020, 17(10), 3727; https://doi.org/10.3390/ijerph17103727 - 25 May 2020
Viewed by 275
Abstract
Background: Water, sanitation, and hygiene (WASH) behaviors play a significant role in stunting. Knowledge and behaviors regarding WASH among caregivers are critical to providing children with chances to survive and thrive. The purpose of this study is to determine if exposure to a [...] Read more.
Background: Water, sanitation, and hygiene (WASH) behaviors play a significant role in stunting. Knowledge and behaviors regarding WASH among caregivers are critical to providing children with chances to survive and thrive. The purpose of this study is to determine if exposure to a national communication campaign using media and interpersonal communication (IPC) is associated with WASH-related knowledge and behaviors among Indonesian mothers with children under the age of two. Methods: Data came from a cross-sectional survey of 1734 mothers with children under the age of two. The measures included exposure to two different interventions: media messages (media) and interpersonal communication strategies (IPC) and WASH-related knowledge and behavior. Multiple logistic regression was used to examine the association between intervention exposure and study variables. Results: Exposure to both media and IPC interventions was associated with participants having a higher knowledge of appropriate defecation practices (p < 0.001), higher knowledge of proper handwashing practices (p < 0.001), and higher self-reported handwashing at critical times (p < 0.001) but was not associated with reported practicing of appropriate defecation (OR = 0.780, 95% CI: 0.566–1.101). Mothers exposed to only media interventions were more likely to have knowledge of appropriate defecation practices (p < 0.001) and to have reported practicing appropriate defecation behaviors (OR = 1.539, 95% CI: 1.173–2.019). Mothers exposed to only IPC interventions were more likely to have reported handwashing at critical times (p = 0.009). Conclusions: Exposure to both media and IPC interventions was associated with increased knowledge and optimal behaviors related to WASH. These findings demonstrate the value of communications campaigns that use mass media coupled with IPC to improve WASH knowledge and behavior. Full article
(This article belongs to the Section Health Behavior, Chronic Disease and Health Promotion)
Open AccessArticle
Blood Mercury Levels in Children with Kawasaki Disease and Disease Outcome
Int. J. Environ. Res. Public Health 2020, 17(10), 3726; https://doi.org/10.3390/ijerph17103726 - 25 May 2020
Viewed by 346
Abstract
The risk of ethnic Kawasaki disease (KD) has been proposed to be associated with blood mercury levels in American children. We investigated the blood levels of mercury in children with KD and their association with disease outcome. The mercury levels demonstrated a significantly [...] Read more.
The risk of ethnic Kawasaki disease (KD) has been proposed to be associated with blood mercury levels in American children. We investigated the blood levels of mercury in children with KD and their association with disease outcome. The mercury levels demonstrated a significantly negative correlation with sodium levels (p = 0.007). However, data failed to reach a significant difference after excluding the child with blood mercury exceeding the toxic value. The findings indicate that KD patients with lower sodium concentrations had a remarkably higher proportion of intravenous immunoglobulin (IVIG) resistance (p = 0.022). Our patients who had lower mercury levels (<0.5 μg/L) had more changes in bacille Calmette-Guerin. Mercury levels in 14/14 patients with coronary artery lesions and 4/4 patients with IVIG resistance were all measured to have values greater than 1 μg/L (while average values showed 0.92 μg/L in Asian American children). Mercury levels had no correlations with IVIG resistance or coronary artery lesion (CAL) formation (p > 0.05). CAL development was more common in the incomplete group than in the complete KD group (p = 0.019). In this first report about mercury levels in KD patients, we observed that the juvenile Taiwanese had higher mercury concentration in blood compared to other populations. Full article
(This article belongs to the Special Issue Children's Environmental Health)
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Open AccessArticle
Osteoporosis in Polish Older Women: Risk Factors and Osteoporotic Fractures: A Cross–Sectional Study
Int. J. Environ. Res. Public Health 2020, 17(10), 3725; https://doi.org/10.3390/ijerph17103725 - 25 May 2020
Viewed by 276
Abstract
Background: Osteoporosis is a skeletal disease. It is still not known which of the risk factors have the greatest impact on osteoporosis development. The study aimed to determine how the selected osteoporosis risk factors contribute to the development of the disease and to [...] Read more.
Background: Osteoporosis is a skeletal disease. It is still not known which of the risk factors have the greatest impact on osteoporosis development. The study aimed to determine how the selected osteoporosis risk factors contribute to the development of the disease and to assess the risk of osteoporotic fractures in older women. Methods: A cohort of 99 older females was divided into two groups (with and without osteoporosis). The risk of osteoporosis was determined using assessment forms and bone densitometry data subjected to logistic regression. The risk of osteoporotic fractures was assessed by the FRAX tool (FRAX, Center for Metabolic Bone Diseases, University of Sheffield, UK). Results: The logistic regression analysis showed that the highest risk of developing osteoporosis associated with lifestyle, mainly cigarette smoking (odds ratio: OR = 2.12), past gynecological operations (OR = 1.46), corticosteroid therapies (OR = 1.38). More than half of participants were at a medium risk of femoral neck fractures (over 90% in the osteoporotic group). Conclusion: Most of the Polish women living in care facilities are at medium risk of low-energy fractures. Smoking appeared to have the strongest effect on osteoporosis among analyzed risk factors. The results may contribute to the creation of more appropriate prevention strategies. Full article
(This article belongs to the Section Women's Health)
Open AccessArticle
Gender Differences in Cognitive Impairment among Rural Elderly in China
Int. J. Environ. Res. Public Health 2020, 17(10), 3724; https://doi.org/10.3390/ijerph17103724 - 25 May 2020
Viewed by 182
Abstract
Elders in rural areas of developing countries are particularly vulnerable to cognitive impairment and gender disparities are notable. Yet, evidence related to gender differences in cognitive impairment in these settings is scarce. This study examined gender differences in cognitive impairment among elderly people [...] Read more.
Elders in rural areas of developing countries are particularly vulnerable to cognitive impairment and gender disparities are notable. Yet, evidence related to gender differences in cognitive impairment in these settings is scarce. This study examined gender differences in cognitive impairment among elderly people aged 65 and above in rural China. A multi-site cross-sectional survey was conducted. In total, 550 males and 700 females were recruited. The Chinese version of the Mini-Mental Status Examination was applied for cognitive impairment screening. Demographic information, lifestyle factors, psychosocial factors, and health-related information were assessed. The prevalence of cognitive impairment was 40.0%in males and 45.1% in females, respectively. Females showed significant higher prevalence after age 75 (62.7% vs. 45.4%, p < 0.005). Older age, hearing impairment, and activities of daily living dependence were common factors associated with cognitive impairment in both females and males. For males, living in a neighborhood with poor social interactions and diabetes were risk factors, while tea consumption was a protective factor. For females, vision impairment and illiteracy were additional risk factors. Individualized interventions and standardized measurements of cognitive function should be developed to suit older populations living in rural and less-developed areas, through collective efforts involving all stakeholders and multidisciplinary teamwork. Full article
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Open AccessArticle
The Mental Health Burden of the COVID-19 Pandemic on Physical Therapists
Int. J. Environ. Res. Public Health 2020, 17(10), 3723; https://doi.org/10.3390/ijerph17103723 - 25 May 2020
Viewed by 301
Abstract
We evaluated the mental health burden of coronavirus disease (COVID-19) on physical therapists, including their stress and anxiety levels, who were at risk of developing psychological distress and other mental health symptoms. A questionnaire survey was conducted with physical therapists of three university [...] Read more.
We evaluated the mental health burden of coronavirus disease (COVID-19) on physical therapists, including their stress and anxiety levels, who were at risk of developing psychological distress and other mental health symptoms. A questionnaire survey was conducted with physical therapists of three university hospitals in South Korea on 10 April 2020. The questionnaires evaluated the presence of anxiety and depression in the respondents. Among the 65 physical therapists who completed our survey, 21 (32.3%) and 12 (18.5%) physical therapists reported having symptoms of anxiety and depression, respectively. If a physical therapist was living with a ≤6-year-old infant or child, the possibility of the presence of anxiety was significantly higher. The risk of depression among those who were in their 30 s and 50 s was significantly higher than among those in their 20 s. Thus, physical therapists living with a ≤6-year-old infant or child and those in their 30 s and 50 s need special attention. Full article
Open AccessArticle
Mental Health Problems during the COVID-19 Pandemics and the Mitigation Effects of Exercise: A Longitudinal Study of College Students in China
Int. J. Environ. Res. Public Health 2020, 17(10), 3722; https://doi.org/10.3390/ijerph17103722 - 25 May 2020
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Abstract
(1) Background: The novel coronavirus disease 2019 (COVID-19) is a global public health emergency that has caused worldwide concern. Vast resources have been allocated to control the pandemic and treat patients. However, little attention has been paid to the adverse impact on mental [...] Read more.
(1) Background: The novel coronavirus disease 2019 (COVID-19) is a global public health emergency that has caused worldwide concern. Vast resources have been allocated to control the pandemic and treat patients. However, little attention has been paid to the adverse impact on mental health or effective mitigation strategies to improve mental health. (2) Purpose: The aim of this study was to assess the adverse impact of the COVID-19 outbreak on Chinese college students’ mental health, understand the underlying mechanisms, and explore feasible mitigation strategies. (3) Methods: During the peak time of the COVID-19 outbreak in China, we conducted longitudinal surveys of sixty-six college students. Structured questionnaires collected information on demographics, physical activity, negative emotions, sleep quality, and aggressiveness level. A mixed-effect model was used to evaluate associations between variables, and the mediating effect of sleep quality was further explored. A generalized additive model was used to determine the dose-response relationships between the COVID-19 death count, physical activity, and negative emotions. (4) Results: The COVID-19 death count showed a direct negative impact on general sleep quality (β = 1.37, 95% confidence interval [95% CI]: 0.55, 2.19) and reduced aggressiveness (β = −6.57, 95% CI: −12.78, −0.36). In contrast, the COVID-19 death count imposed not a direct but an indirect impact on general negative emotions (indirect effect (IE) = 0.81, p = 0.012), stress (IE = 0.40, p < 0.001), and anxiety (IE = 0.27, p = 0.004) with sleep quality as a mediator. Moreover, physical activity directly alleviated general negative emotions (β = −0.12, 95% CI: −0.22, −0.01), and the maximal mitigation effect occurred when weekly physical activity was about 2500 METs. (5) Conclusions: (a) The severity of the COVID-19 outbreak has an indirect effect on negative emotions by affecting sleep quality. (b) A possible mitigation strategy for improving mental health includes taking suitable amounts of daily physical activity and sleeping well. (c) The COVID-19 outbreak has reduced people’s aggressiveness, probably by making people realize the fragility and preciousness of life. Full article
(This article belongs to the Section Mental Health)
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Open AccessArticle
The Quality of Life of Seniors Hospitalized Due to Cardiovascular Diseases in Poland
Int. J. Environ. Res. Public Health 2020, 17(10), 3721; https://doi.org/10.3390/ijerph17103721 - 25 May 2020
Viewed by 266
Abstract
Introduction: In the light of the increased ageing of the world population, social policy needs to be focused on actions aimed at improving the quality of life of older people. Objective: The main objective of this study was to assess the quality of [...] Read more.
Introduction: In the light of the increased ageing of the world population, social policy needs to be focused on actions aimed at improving the quality of life of older people. Objective: The main objective of this study was to assess the quality of life in a population of seniors hospitalized due to cardiovascular disease. Materials and methods: The study included 408 elderly patients hospitalized for cardiovascular diseases in the Poddębickie Centrum Zdrowia Hospital in Poddębice, Łódzkie voivodship, Poland. The study used two survey questionnaires: the author’s survey questionnaire and the standardized SF36v2 Questionnaire. Statistical analysis of the obtained test results was carried out in the R program, version 3.5.1. Results: Having analyzed the health status of the study group, it was found that the largest group of subjects (84.07%) were treated due to hypertension. Among the ailments that hindered daily functioning, the respondents indicated primarily poor eyesight (53.68%). Patients assessed their own health as ‘mediocre’ (average) (58.58%). The analysis of the study results from the SF36v2 Questionnaire showed that the highest quality of life was in the limited activity due to emotional problems (RE) dimension, social functioning (SF), and physical functioning (PF); the weakest scores were observed in vitality (VT), general health perception (GH), and health transition (HT) dimensions. Conclusions: The significant demographic, social and socio-medical factors that determined respondents’ quality of life were: age, gender, marital status, education and health situation. The analysis of quality of life according to the SF36v2 Questionnaire showed that the study group functioned better in the mental dimension (MCS—mental component summary, overall mental health) than in the physical one (PCS—physical component summary, total physical health). Full article
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Open AccessArticle
Effect of Polyols and Selected Dental Materials on the Ability to Create a Cariogenic Biofilm–On Children Caries-Associated Streptococcus Mutans Isolates
Int. J. Environ. Res. Public Health 2020, 17(10), 3720; https://doi.org/10.3390/ijerph17103720 - 25 May 2020
Viewed by 266
Abstract
Secondary caries is a disease associated with the formation of biofilm on the border of the tooth and dental filling. Its development is strongly influenced by the dietary sweet foods and the type of dental material. The aim of the study was to [...] Read more.
Secondary caries is a disease associated with the formation of biofilm on the border of the tooth and dental filling. Its development is strongly influenced by the dietary sweet foods and the type of dental material. The aim of the study was to assess the effect of sweeteners on the ability of clinical Streptococcus mutans strains to form biofilm on dental materials. Strains were isolated from plaque samples from 40 pediatric patients from the 3–6 ICADS II group. The ability to form biofilm was tested on composite and glass ionomer dental materials used for milk teeth filling in the presence of sucrose, xylitol, sorbitol, and erythritol. The bacterial film mass after 12, 24, 48, and 72 h and the number of bacterial colonies significantly decreased (p < 0.01) compared to the initial value for 5% erythritol and sorbitol on examined materials. A greater inhibitory effect was noted for glass ionomers compared to composites. Sucrose and xylitol supported biofilm formation, while erythritol had the best inhibitory effect. The use of fluoride-releasing glass ionomers exerted an effect synergistic to erythritol, i.e., inhibited plaque formation and the amount of cariogenic S. mutans. Selection of proper type of dental material together with replacing sucrose with polyols can significantly decrease risk of secondary caries development. Erithritol in combination with glass ionomer seems to be the most effective in secondary caries prevention. Full article
(This article belongs to the Special Issue Dental Caries Risk Assessment and Management)
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Open AccessArticle
The Effects of Multifaceted Ergonomic Interventions on Musculoskeletal Complaints in Intensive Care Units
Int. J. Environ. Res. Public Health 2020, 17(10), 3719; https://doi.org/10.3390/ijerph17103719 - 25 May 2020
Viewed by 291
Abstract
Working at intensive care units (ICUs) is considered a risk factor for developing musculoskeletal complaints (MSC). This study was conducted between January 2017 and June 2019 in two ICUs of a university hospital. It was designed as a pre- and post-assessment of the [...] Read more.
Working at intensive care units (ICUs) is considered a risk factor for developing musculoskeletal complaints (MSC). This study was conducted between January 2017 and June 2019 in two ICUs of a university hospital. It was designed as a pre- and post-assessment of the intervention group (IG) (N = 27) compared with a control group (CG) (N = 23) to determine the effects of a multifaceted ergonomics intervention program in reducing MSC. The IG (N: 35) received a multifaceted ergonomic intervention program, which was implemented by an ERGO team over an 18 month period. Four ergonomic interventions were planned as follows: individual level interventions such as training; stretching exercises and motivation meetings; administrative intervention such as a daily 10 min stretching exercises break; engineering interventions such as lifting and usage of auxiliary devices. The CG (N:29) did not receive any intervention. Cornell Musculoskeletal Discomfort Questionnaire (CMDQ) was used to assess MSC in both groups. At the start of the intervention, both groups were similar concerning the number of visits to doctors due to MSC, the number of sick leave days, and total CMDQ scores (p > 0.05 for all). Two factor repeated ANOVA measures were performed for between-groups and within-group analyses. The mean of the initial CMSDQ total scores in both groups increased significantly in the 18th month (p < 0.001). However, the interaction effect of group and time (between and within factors) was not significant (p = 0.992). Work-related MSC is a common occupational health problem among nurses. This study showed that individual-level interventions are not likely to succeed in eliminating manual patient lifting by nurses. Our results suggested that interventions without administrative measures might have limited success Full article
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Open AccessArticle
Respiratory Diseases, Malaria and Leishmaniasis: Temporal and Spatial Association with Fire Occurrences from Knowledge Discovery and Data Mining
Int. J. Environ. Res. Public Health 2020, 17(10), 3718; https://doi.org/10.3390/ijerph17103718 - 25 May 2020
Viewed by 307
Abstract
The relationship between the fires occurrences and diseases is an essential issue for making public health policy and environment protecting strategy. Thanks to the Internet, today, we have a huge amount of health data and fire occurrence reports at our disposal. The challenge, [...] Read more.
The relationship between the fires occurrences and diseases is an essential issue for making public health policy and environment protecting strategy. Thanks to the Internet, today, we have a huge amount of health data and fire occurrence reports at our disposal. The challenge, therefore, is how to deal with 4 Vs (volume, variety, velocity and veracity) associated with these data. To overcome this problem, in this paper, we propose a method that combines techniques based on Data Mining and Knowledge Discovery from Databases (KDD) to discover spatial and temporal association between diseases and the fire occurrences. Here, the case study was addressed to Malaria, Leishmaniasis and respiratory diseases in Brazil. Instead of losing a lot of time verifying the consistency of the database, the proposed method uses Decision Tree, a machine learning-based supervised classification, to perform a fast management and extract only relevant and strategic information, with the knowledge of how reliable the database is. Namely, States, Biomes and period of the year (months) with the highest rate of fires could be identified with great success rates and in few seconds. Then, the K-means, an unsupervised learning algorithms that solves the well-known clustering problem, is employed to identify the groups of cities where the fire occurrences is more expressive. Finally, the steps associated with KDD is perfomed to extract useful information from mined data. In that case, Spearman’s rank correlation coefficient, a nonparametric measure of rank correlation, is computed to infer the statistical dependence between fire occurrences and those diseases. Moreover, maps are also generated to represent the distribution of the mined data. From the results, it was possible to identify that each region showed a susceptible behaviour to some disease as well as some degree of correlation with fire outbreak, mainly in the drought period. Full article
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