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Int. J. Environ. Res. Public Health, Volume 17, Issue 13 (July-1 2020) – 296 articles

Cover Story (view full-size image): Over the last three decades, there has been a remarkable expansion in the clinical field of mindfulness-based interventions (MBIs). MBIs consist of short and structured intervention protocols focused on teaching patients the use of mindfulness for therapeutic purposes. However, despite the popularity of MBIs, evidence about their efficacy and safety in the treatment of schizophrenia is very scarce. Therefore, the authors conducted a systematic review and meta-analysis of randomised controlled trials published and indexed in various databases. Through careful analysis of the studies collected, including their methodological quality, conclusions were drawn regarding the efficacy of MBIs on different clinical parameters of schizophrenia, and on their safety in the treatment of this disorder. View this paper.
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Open AccessArticle
Crying Therapy Intervention for Breast Cancer Survivors: Development and Effects
Int. J. Environ. Res. Public Health 2020, 17(13), 4911; https://doi.org/10.3390/ijerph17134911 - 07 Jul 2020
Viewed by 1005
Abstract
Background: crying therapy is currently being applied in some countries to treat cancer patients, manage pain, and promote mental health. However, little nursing and medical research on the effects of crying therapy has been conducted in other parts of the world. This study [...] Read more.
Background: crying therapy is currently being applied in some countries to treat cancer patients, manage pain, and promote mental health. However, little nursing and medical research on the effects of crying therapy has been conducted in other parts of the world. This study aimed to develop a crying therapy program for breast cancer survivors and assess its effects. Interventions/method: data from 27 breast cancer survivors in South Korea were analyzed. The intervention, employing a single group, pre-post-test quasi-experimental design, was divided into three phases, and effects were verified for emotional (distress, fatigue, and mood conditions) and physiological (cortisol, immunoglobulin G, and blood pressure) variables. Results: there were significant changes in distress, mood changes, and immunoglobulin G and smaller changes in blood pressure postintervention. Fatigue and cortisol showed no significant changes. Conclusions: this study demonstrated the effectiveness of a short-term crying therapy program that can induce positive emotional changes and physiological effects in breast cancer survivors. This intervention can improve quality of life, indicating its value as a self-care program for cancer survivors. Full article
(This article belongs to the Section Women's Health)
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Open AccessArticle
Differences in Sense of Belonging, Pride, and Mental Health in the Daegu Metropolitan Region due to COVID-19: Comparison between the Presence and Absence of National Disaster Relief Fund
Int. J. Environ. Res. Public Health 2020, 17(13), 4910; https://doi.org/10.3390/ijerph17134910 - 07 Jul 2020
Cited by 3 | Viewed by 1264
Abstract
Korea’s Daegu Metropolitan City once had the second highest rate of COVID-19 infection after Wuhan in China. Following the outbreak, the government provided the first national disaster relief fund to citizens as financial aid. This study investigated whether the sense of regional belonging, [...] Read more.
Korea’s Daegu Metropolitan City once had the second highest rate of COVID-19 infection after Wuhan in China. Following the outbreak, the government provided the first national disaster relief fund to citizens as financial aid. This study investigated whether the sense of regional belonging, pride, and mental health among 550 citizens of Daegu differed between the times before and after COVID-19, based on the presence or absence of the disaster relief fund. Frequency analysis, descriptive statistical analysis, and t-tests were conducted using the SPSS 25.0 program. Results showed that the sense of belonging was higher after COVID-19 than before, while pride was lower. Individuals who received the disaster relief fund showed higher levels of regional belonging and pride with statistical significance. The prevalence of melancholy and depression increased after COVID-19, but the presence or absence of the fund did not lead to a significant difference. Thus, in case of a future national disaster level, provision of the disaster relief fund can raise the sense of regional belonging and pride, in order to elicit communication among local residents toward overcoming difficulties. Furthermore, during challenging disaster situations, central and local governments should provide diverse programs for the citizens’ mental health care. Full article
Open AccessArticle
Relationships between Controlling Interpersonal Coaching Style, Basic Psychological Need Thwarting, and Burnout, in Adolescent Soccer Players
Int. J. Environ. Res. Public Health 2020, 17(13), 4909; https://doi.org/10.3390/ijerph17134909 - 07 Jul 2020
Viewed by 1178
Abstract
The aim of this paper is to analyze the relationships between a controlling interpersonal style, psychological need thwarting and burnout in adolescent soccer players and to test a structural equation model to analyze whether (a) a controlling interpersonal style is a predictor of [...] Read more.
The aim of this paper is to analyze the relationships between a controlling interpersonal style, psychological need thwarting and burnout in adolescent soccer players and to test a structural equation model to analyze whether (a) a controlling interpersonal style is a predictor of psychological need thwarting and whether (b) psychological need thwarting is a predictor of burnout. A total of 103 male soccer players between the ages of 12 and 17 participated in the research (M = 14.91; SD = 5.56). The Controlling Coach Behaviors Scale, the Psychological Need Thwarting Scale, and the Athlete Burnout Questionnaire were used to evaluate the variables under study. The analyses revealed significant relationships between a controlling interpersonal style, psychological need thwarting and burnout. Furthermore, the proposed structural equations model, using the partial least squares (PLS) method, showed that a controlling style is a positive predictor of basic psychological need thwarting and that the latter is a predictor of burnout, as well as revealing an indirect relationship between a controlling style and burnout. This indirect effect of the controlling style variable on burnout can be enhanced (or attenuated) by the basic psychological need thwarting variable, which acts as a modulator. Full article
(This article belongs to the Special Issue New Trends in Psychosocial Dimensions of Physical Activity)
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Open AccessArticle
Post-Traumatic Stress Disorder in Homeless Migrant Mothers of the Paris Region Shelters
Int. J. Environ. Res. Public Health 2020, 17(13), 4908; https://doi.org/10.3390/ijerph17134908 - 07 Jul 2020
Viewed by 950
Abstract
Migrant women are disproportionately more likely to experience traumatic events in their country of origin, during migration and after arriving in the host country. Homeless women are more likely to be exposed to multiple victimizations in childhood (emotional or physical maltreatment) and in [...] Read more.
Migrant women are disproportionately more likely to experience traumatic events in their country of origin, during migration and after arriving in the host country. Homeless women are more likely to be exposed to multiple victimizations in childhood (emotional or physical maltreatment) and in adulthood (sexual abuse, street victimization). This study’s objective was to describe the factors associated with the likelihood of post-traumatic stress disorder (PTSD) among homeless migrant mothers in the Paris region. Face-to-face interviews were conducted by bilingual psychologists and interviewers in a representative sample of homeless families in the Paris region. PTSD was ascertained using the Mini International Neuropsychiatric Interview (MINI) (n = 691 mothers). We studied PTSD in mothers using weighted Poisson regression. Homeless migrant mothers had high levels of PTSD (18.9%) in the 12 months preceding the study. In multivariate analysis, PTSD was associated with departure from the country of origin because of violence (PR = 1.45 95% CI 1.03; 2.04), depression in the preceding 12 months (PR = 1.82 95% CI 1.20; 2.76), and residential instability (PR = 1.93 95% CI 1.27; 2.93). Homeless migrant mothers have high levels of traumatic events and PTSD. Improvements in screening for depression and PTSD and access to appropriate medical care are essential for this vulnerable group. Full article
(This article belongs to the Special Issue Health and Health Care Access of Vulnerable Populations)
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Open AccessArticle
The Relationship between Mercury Exposure Indices and Dietary Intake of Fish and Shellfish in Women of Childbearing Age
Int. J. Environ. Res. Public Health 2020, 17(13), 4907; https://doi.org/10.3390/ijerph17134907 - 07 Jul 2020
Viewed by 776
Abstract
Women of childbearing age who are susceptible to mercury exposure were studied to understand the relation between mercury intake through fish and shellfish consumption and mercury exposure indices from blood, hair, and urine samples. A total of 711 women of childbearing age from [...] Read more.
Women of childbearing age who are susceptible to mercury exposure were studied to understand the relation between mercury intake through fish and shellfish consumption and mercury exposure indices from blood, hair, and urine samples. A total of 711 women of childbearing age from coastal areas with a high concentration of mercury exposure in Korea were studied. Data were collected on demographic characteristics, dietary intake of fish and shellfish using the simple Food Frequency Questionnaire. Mercury concentration was estimated from the collected samples of blood, hair, and urine. The geometric mean of blood methyl mercury concentration of mercury exposure through seafood was 3.06 μg/L for the low tertile, 3.12 μg/L for the middle tertile, and 3.60 μg/L for the high tertile, indicating a clear tendency of blood methyl mercury to increase as the mercury exposure by fish and shellfish intake ascended. For total blood mercury and hair mercury, the middle and high tertiles had higher values than the low. Mercury exposure through fish and shellfish intake is a main factor for an increase of blood methyl mercury concentration in women of childbearing age. More attention needs to be paid to mercury exposure through seafood intake, considering the serious effect mercury concentration has on women of childbearing age. Full article
(This article belongs to the Section Environmental Health)
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Open AccessArticle
Violence as the Most Frequent Cause of Oral and Maxillofacial Injuries among the Patients from Low- and Middle-Income Countries—A Retrospective Study at a Level I Trauma University Emergency Department in Switzerland
Int. J. Environ. Res. Public Health 2020, 17(13), 4906; https://doi.org/10.3390/ijerph17134906 - 07 Jul 2020
Cited by 1 | Viewed by 780
Abstract
Preventive strategies can be developed by gathering more information about oral and maxillofacial injuries and oral pathologies in immigrants from low- to middle-income countries (LMIC). Additional information on the quality of care can also improve the allocation of clinical resources for the management [...] Read more.
Preventive strategies can be developed by gathering more information about oral and maxillofacial injuries and oral pathologies in immigrants from low- to middle-income countries (LMIC). Additional information on the quality of care can also improve the allocation of clinical resources for the management of these patients. We studied immigrants from LMIC who presented in the emergency department (ED) at Berne University Hospital with dental problems or oral or maxillofacial injuries. The patient data included age, gender, nationality, the etiology and type of trauma and infection in the oral-maxillofacial area, and overall costs. The greatest incidence of maxillofacial injuries was observed in the age group of 16–35 years (n = 128, 63.6%, p = 0.009), with males outnumbering females in all age groups. Trauma cases were most frequent in the late evening and were mostly associated with violence (n = 82, 55.4%, p = 0.001). The most common fracture was fracture of the nose (n = 31). The mean costs were approximately the same for men (mean = 2466.02 Swiss francs) and women (mean = 2117.95 Swiss francs) with maxillofacial injuries but were greater than for isolated dental problems. In conclusion, the etiology of dental and maxillofacial injuries in immigrants in Switzerland requires better support in the prevention of violence and continued promotion of oral health education. Full article
(This article belongs to the Special Issue Oral Health Inequalities in the World)
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Open AccessArticle
Energy System Contributions and Physical Activity in Specific Age Groups during Exergames
Int. J. Environ. Res. Public Health 2020, 17(13), 4905; https://doi.org/10.3390/ijerph17134905 - 07 Jul 2020
Cited by 1 | Viewed by 1422
Abstract
Exergames have been recommended as alternative ways to increase the health benefits of physical exercise. However, energy system contributions (phosphagen, glycolytic, and oxidative) of exergames in specific age groups remain unclear. The purpose of this study was to investigate the contributions of three [...] Read more.
Exergames have been recommended as alternative ways to increase the health benefits of physical exercise. However, energy system contributions (phosphagen, glycolytic, and oxidative) of exergames in specific age groups remain unclear. The purpose of this study was to investigate the contributions of three energy systems and metabolic profiles in specific age groups during exergames. Seventy-four healthy males and females participated in this study (older adults, n = 26: Age of 75.4 ± 4.4 years, body mass of 59.4 ± 8.7 kg, height of 157.2 ± 8.6 cm; adults, n = 24: Age of 27.8 ± 3.3 years, body mass of 73.4 ± 17.8 kg, height of 170.9 ± 11.9 cm; and adolescents, n = 24: Age of 14 ± 0.8 years, body mass of 71.3 ± 11.5 kg, height of 173.3 ± 5.2 cm). To evaluate the demands of different energy systems, all participants engaged in exergames named Action-Racing. Exergames protocol comprised whole-body exercises such as standing, sitting, stopping, jumping, and arm swinging. During exergames, mean heart rate (HRmean), peak heart rate (HRpeak), mean oxygen uptake (VO2mean), peak oxygen uptake (VO2peak), peak lactate (Peak La), difference in lactate (ΔLa), phosphagen (WPCr), glycolytic (WLa), oxidative (WAER), and total energy demands (WTotal) were analyzed. The contribution of the oxidative energy system was higher than that of the phosphagen or glycolytic energy system (65.9 ± 12% vs. 29.5 ± 11.1% or 4.6 ± 3.3%, both p < 0.001). The contributions of the total energy demands and oxidative system in older adults were significantly lower than those in adults and adolescents (72.1 ± 28 kJ, p = 0.028; 70.3 ± 24.1 kJ, p = 0.024, respectively). The oxidative energy system was predominantly used for exergames applied in the current study. In addition, total metabolic work in older adults was lower than that in adolescents and adults. This was due to a decrease in the oxidative energy system. For future studies, quantification of intensity and volume is needed to optimize exergames. Such an approach plays a crucial role in encouraging physical activity in limited spaces. Full article
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Open AccessArticle
Shock Index: A Simple and Effective Clinical Adjunct in Predicting 60-Day Mortality in Advanced Cancer Patients at the Emergency Department
Int. J. Environ. Res. Public Health 2020, 17(13), 4904; https://doi.org/10.3390/ijerph17134904 - 07 Jul 2020
Cited by 1 | Viewed by 938
Abstract
Deciding between palliative and overly aggressive therapies for advanced cancer patients who present to the emergency department (ED) with acute issues requires a prediction of their short-term survival. Various scoring systems have previously been studied in hospices or intensive care units, though they [...] Read more.
Deciding between palliative and overly aggressive therapies for advanced cancer patients who present to the emergency department (ED) with acute issues requires a prediction of their short-term survival. Various scoring systems have previously been studied in hospices or intensive care units, though they are unsuitable for use in the ED. We aim to examine the use of a shock index (SI) in predicting the 60-day survival of advanced cancer patients presenting to the ED. Identified high-risk patients and their families can then be counseled accordingly. Three hundred and five advanced cancer patients who presented to the EDs of three tertiary hospitals were recruited, and their data retrospectively analyzed. Relevant data regarding medical history and clinical presentation were extracted, and respective shock indices calculated. Multivariate logistic regression analyses were performed. Receiver operating characteristic (ROC) curves were plotted to evaluate the predictive performance of the SI. Nonsurvivors within 60 days had significantly lower body temperatures and blood pressure, as well as higher pulse rates, respiratory rates, and SI. Each 0.1 SI increment had an odds ratio of 1.39 with respect to 60-day mortality. The area under the ROC curve was 0.7511. At the optimal cut-off point of 0.94, the SI had 81.38% sensitivity and 73.11% accuracy. This makes the SI an ideal evaluation tool for rapidly predicting the 60-day mortality risk of advanced cancer patients presenting to the ED. Identified patients can be counseled accordingly, and they can be assisted in making informed decisions on the appropriate treatment goals reflective of their prognoses. Full article
(This article belongs to the Special Issue Palliative and End-of-Life Care)
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Open AccessArticle
Health Literacy of Osteoporosis Risks among Caregivers Serving in Disability Care Facilities
Int. J. Environ. Res. Public Health 2020, 17(13), 4903; https://doi.org/10.3390/ijerph17134903 - 07 Jul 2020
Viewed by 751
Abstract
Osteoporosis is a global public health issue and its consequent effects are a growing concern worldwide. Caregivers generally experience occupational physical ailments and they have less of a tendency to engage in preventive health behaviors, leading them to be in a higher risk [...] Read more.
Osteoporosis is a global public health issue and its consequent effects are a growing concern worldwide. Caregivers generally experience occupational physical ailments and they have less of a tendency to engage in preventive health behaviors, leading them to be in a higher risk group for osteoporosis. This study aims to present a general profile of health literacy related to osteoporosis risks and identify its associated factors among disability institutional caregivers. A cross-sectional study with a structured questionnaire was used to collect information on 465 caregivers from seven disability care institutions regarding their awareness of the health literacy related to osteoporosis risks. The results indicate that the average literacy score related to osteoporosis risks among the respondents was 60 points (full score is 80 points), with 50–59 being the most common range (51.9%), followed by 60–69 points (43.5%), and 4.4% of cases had more than 70 points. A multivariate logistic regression model revealed that respondents’ age (40–49 vs. 18–29; odds ratio (OR) = 2.53, 95% confidence interval (CI) = 1.31–4.87), education level (senior high vs. primary and junior high, OR = 2.00, 95% CI = 1.03–3.89; college and above vs. primary and junior high, OR = 3.66, 95% CI = 1.84–7.31), experience in undergoing a bone density test (OR = 1.94, 95% CI = 1.28–2.93), and poor physical fitness status (OR = 0.64, 95% CI = 0.43–0.95) were the significant predictors of the osteoporosis health literacy level. The osteoporosis health literacy of institutional caregivers is moderate, and there are many items that are worthy of attention in future health promotion programs. This study highlights risk factors related to a lower level of osteoporosis healthy literacy such as older age, less education, no experience of bone density test, and poor physical fitness that highlight the need to raise further awareness in order to improve caregivers’ bone health. Full article
Open AccessArticle
Effects of Neuromuscular Electrical Stimulation Synchronized with Chewing Exercises on Bite Force and Masseter Muscle Thickness in Community-Dwelling Older Adults in South Korea: A Randomized Controlled Trial
Int. J. Environ. Res. Public Health 2020, 17(13), 4902; https://doi.org/10.3390/ijerph17134902 - 07 Jul 2020
Viewed by 807
Abstract
This study is aimed at investigating the effects of synchronized neuromuscular electrical stimulation (NMES) and chewing exercises on bite force and the masseter muscle thickness in community-dwelling older adults. Material and methods: Forty older adults were enrolled in South Korea and randomly assigned [...] Read more.
This study is aimed at investigating the effects of synchronized neuromuscular electrical stimulation (NMES) and chewing exercises on bite force and the masseter muscle thickness in community-dwelling older adults. Material and methods: Forty older adults were enrolled in South Korea and randomly assigned to either an experimental or control group. The experimental group performed chewing exercises using the No-Sick Exerciser equipment synchronized with NMES applied to the bilateral masseter muscles, while the control group performed only chewing exercises. Both groups received interventions for 20 min/day, 5 days/week, for 6 weeks. Bite force was measured using the OCCLUZER device, and masseter muscle thickness was measured using a portable ultrasound. Results: Both groups showed a significant increase in bite force and masseter muscle thickness compared to baseline measurements (p < 0.05). The experimental group showed a significantly higher increase in bite force and masseter muscle thickness than the control group after combined intervention (p < 0.05). Conclusion: This study demonstrates that NMES synchronized with chewing exercises is more efficient in increasing bite force and masseter muscle thickness than chewing exercises alone in community-dwelling older adults. Full article
(This article belongs to the Section Oral Health)
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Open AccessArticle
Effects of Academic Motivation on Clinical Practice-Related Post-Traumatic Growth among Nursing Students in South Korea: Mediating Effect of Resilience
Int. J. Environ. Res. Public Health 2020, 17(13), 4901; https://doi.org/10.3390/ijerph17134901 - 07 Jul 2020
Viewed by 819
Abstract
Post-traumatic growth (PTG) refers to personal growth that occurs after experiencing challenges. For many nursing students, PTG could occur during their clinical practice. Academic motivation and resilience could help students to overcome these traumatic clinical experiences and possibly achieve PTG. This study examined [...] Read more.
Post-traumatic growth (PTG) refers to personal growth that occurs after experiencing challenges. For many nursing students, PTG could occur during their clinical practice. Academic motivation and resilience could help students to overcome these traumatic clinical experiences and possibly achieve PTG. This study examined the relationships between nursing students’ academic motivation and resilience leading to post-traumatic growth. A total of 291 nursing students from three South Korean nursing colleges participated in this cross-sectional study. Self-report questionnaire data were analyzed using t-tests, ANOVA, correlations, and hierarchical multiple linear regressions. Intrinsically motivated students’ PTG scores were significantly higher compared to extrinsically motivated students (t = 4.62, p < 0.001). Resilience scores showed similar results (t = 3.81, p < 0.001). Significant total, direct, and indirect effects of academic motivation on resilience and PTG were found. In addition, resilience mediated 40.9% of the relationship between academic motivation and PTG. Nursing students with intrinsic academic motivation were more likely to achieve high PTG scores, and resilience mediated the relationship between academic motivation and PTG. It is suggested that the importance of academic motivation must be considered in the early stages of university-level nursing education to increase retention rates of nursing students. Full article
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Open AccessArticle
Myostatin A55T Genotype is Associated with Strength Recovery Following Exercise-Induced Muscle Damage
Int. J. Environ. Res. Public Health 2020, 17(13), 4900; https://doi.org/10.3390/ijerph17134900 - 07 Jul 2020
Cited by 1 | Viewed by 722
Abstract
Myostatin A55T genotype is one of the candidates showing inter-individual variation in skeletal muscle phenotypes. The aim of this study was to investigate the effect of the myostatin A55T genotype on markers of muscle damage after eccentric exercise. Forty-eight young, healthy male college [...] Read more.
Myostatin A55T genotype is one of the candidates showing inter-individual variation in skeletal muscle phenotypes. The aim of this study was to investigate the effect of the myostatin A55T genotype on markers of muscle damage after eccentric exercise. Forty-eight young, healthy male college students (age = 24.8 ± 2.2 years, height = 176.7 ± 5.3 cm, weight = 73.7 ± 8.3 kg) were enrolled in this study, and muscle damage was induced through 50 reps of maximal eccentric muscle contraction. As markers of muscle damage, maximal isometric strength (MIS), muscle soreness, creatine kinase (CK), and aspartate transaminase (AST) were measured. Myostatin A55T genotypes were classified into homozygous myostatin A55T allele (AA, n = 34, 72%), heterozygous myostatin A55T allele (AT, n = 13, 26%), and homozygous mutant carriers (TT, n = 1, 2%). After eccentric exercise, the subjects with heterozygous for AT showed markedly quicker MIS recovery compared to the AA group (p = 0.042). However, there were no significant variations in muscle soreness (p = 0.379), CK (p = 0.955), and AST (p = 0.706) among the groups. These results suggest that AT in myostatin A55T genotype may be associated with quicker strength recovery following exercise-induced muscle damage. Full article
Open AccessArticle
Disease Perception and Coping with Emotional Distress During COVID-19 Pandemic: A Survey Among Medical Staff
Int. J. Environ. Res. Public Health 2020, 17(13), 4899; https://doi.org/10.3390/ijerph17134899 - 07 Jul 2020
Cited by 11 | Viewed by 4018
Abstract
The novel coronavirus disease, COVID-19, is a highly contagious infectious disease declared by the World Health Organization to be a pandemic and a global public health emergency. During outbreaks, health care workers are submitted to an enormous emotional burden as they must balance [...] Read more.
The novel coronavirus disease, COVID-19, is a highly contagious infectious disease declared by the World Health Organization to be a pandemic and a global public health emergency. During outbreaks, health care workers are submitted to an enormous emotional burden as they must balance the fundamental “duty to treat” with their parallel duties to family and loved ones. The aims of our study were to evaluate disease perceptions, levels of stress, emotional distress, and coping strategies among medical staff (COVID-19 versus non-COVID-19 departments) in a tertiary pulmonology teaching hospital in the first month after the outbreak of COVID-19. One hundred and fifteen health care workers completed four validated questionnaires (the brief illness perception questionnaire, perceived stress scale, the profile of emotional distress emotional, and the cognitive coping evaluation questionnaire) that were afterwards interpreted by one psychologist. There was a high level of stress and psychological distress among health care workers in the first month after the pandemic outbreak. Interestingly, there were no differences between persons that worked in COVID-19 departments versus those working in non-COVID-19 departments. Disease perceptions and coping mechanisms were similar in the two groups. As coping mechanisms, refocusing on planning and positive reappraisal were used more than in the general population. There is no difference in disease perceptions, levels of stress, emotional distress, and coping strategies in medical staff handling COVID-19 patients versus those staff who were not handling COVID-19 patients in the first month after the pandemic outbreak. Full article
Open AccessArticle
Comparison of Patients’ Perceived Quality of Primary Care Between Urban and Rural Community Health Centers in Guangdong, China
Int. J. Environ. Res. Public Health 2020, 17(13), 4898; https://doi.org/10.3390/ijerph17134898 - 07 Jul 2020
Viewed by 732
Abstract
Background: A series of reforms were implemented to improve the quality of primary care services in China. This study aims to assess patients’ perceived quality of primary healthcare between rural and urban community health centers in Guangdong. Methods: A cross-sectional survey was conducted [...] Read more.
Background: A series of reforms were implemented to improve the quality of primary care services in China. This study aims to assess patients’ perceived quality of primary healthcare between rural and urban community health centers in Guangdong. Methods: A cross-sectional survey was conducted from July to December 2015 in Guangdong. We surveyed 1010 respondents who visited either community health centers/stations (CHCs/CHSs) in urban areas or township health centers/rural health stations (THCs/RHSs) in rural areas. A validated Chinese version of the Primary Care Assessment Tool-Adult Short Version (PCAT-AS), representing ten primary care domains, was used to collect information on patients’ primary care experiences. A t-test was used for comparison on domain scores and total scores between patients from CHCs/CHSs and THCs/RHSs. An analysis of covariance was employed to compare the adjusted PCAT domain scores and total scores. Multilevel models were used to explore factors associated with PCAT total scores. Results: Overall, patients reported a lower level of experience of community orientation and family centeredness compared to other primary care domains. Patients from THCs/RHSs settings in the rural area reported better primary care experience in four domains, including first contact, accessibility, ongoing care, and community orientation. Higher education background and those with a chronic disease were associated with better primary care experience, after controlling for confounding factors. Patients who preferred primary care institutions when getting sick or used health services more frequently reported better primary care experiences. Conclusion: Continued efforts are needed to strengthen primary care performances, particularly in a community orientation and family centeredness. Primary care delivery in CHCs/CHSs settings should be improved in four domains, including first contact, accessibility, ongoing care, and community orientation. Full article
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Open AccessCommunication
Food Safety Conditions in Home-Kitchens: A Cross-Sectional Study in the Federal District/Brazil
Int. J. Environ. Res. Public Health 2020, 17(13), 4897; https://doi.org/10.3390/ijerph17134897 - 07 Jul 2020
Cited by 1 | Viewed by 774
Abstract
This study aimed to analyze the food safety conditions in home kitchens from the Brazilian Federal District. A previously validated instrument composed of 77 items (in four blocks) was used to evaluate the safety conditions in home kitchens. A survey was carried out [...] Read more.
This study aimed to analyze the food safety conditions in home kitchens from the Brazilian Federal District. A previously validated instrument composed of 77 items (in four blocks) was used to evaluate the safety conditions in home kitchens. A survey was carried out with on-site application with 226 home kitchens’ food handlers in the Federal District, Brazil to evaluate Brazilian home kitchens’ good practices. Of the home kitchen food handlers, most of them were female (64.6%), had completed undergraduate education (29.2%), and were 45–59 years old (23.5%). The visited households had an average of 3.38 ± 1.48 residents that ate some of their meals at home, and 40% declared the monthly family income to be between 5 and 15 Brazilian minimum wages (MW). Regarding the reliability of the instrument, from the KR-20 test, it was verified that the instrument presents good internal consistency (α = 0.758). According to the instrument classification, the home kitchens’ sample was considered as at a medium risk of food contamination (46.5% of them presented from 51 to 75% of conformities to the instrument). There was a statistical difference between house-kitchens with a family income from zero to one minimum wage (MW) and those receiving from 5 to 15 MW (p = 0.017), as well as between those from zero to one MW and who earn above 15 MW (p = 0.009). The result of the on-site evaluation shows that the instrument was able to measure food safety conditions in Brazilian Federal District domestic kitchens. Such findings can contribute positively to the development of actions in health education that help in the adoption of good practices of food manipulation and, consequently, in the reduction in foodborne disease outbreaks in residences. Full article
(This article belongs to the Special Issue Environmental and Food Hygiene)
Open AccessArticle
Communication Skills, Problem-Solving Ability, Understanding of Patients’ Conditions, and Nurse’s Perception of Professionalism among Clinical Nurses: A Structural Equation Model Analysis
Int. J. Environ. Res. Public Health 2020, 17(13), 4896; https://doi.org/10.3390/ijerph17134896 - 07 Jul 2020
Cited by 2 | Viewed by 1516
Abstract
This study was intended to confirm the structural relationship between clinical nurse communication skills, problem-solving ability, understanding of patients’ conditions, and nurse’s perception of professionalism. Due to changes in the healthcare environment, it is becoming difficult to meet the needs of patients, and [...] Read more.
This study was intended to confirm the structural relationship between clinical nurse communication skills, problem-solving ability, understanding of patients’ conditions, and nurse’s perception of professionalism. Due to changes in the healthcare environment, it is becoming difficult to meet the needs of patients, and it is becoming very important to improve the ability to perform professional nursing jobs to meet expectations. In this study method, structural model analysis was applied to identify factors influencing the perception of professionalism in nurses. The subjects of this study were 171 nurses working at general hospitals in city of Se, Ga, and Geu. Data analysis included frequency analysis, identification factor analysis, reliability analysis, measurement model analysis, model fit, and intervention effects. In the results of the study, nurse’s perception of professionalism was influenced by factors of communication skills and understanding of the patient’s condition, but not by their ability to solve problems. Understanding of patient’s condition had a mediating effect on communication skills and nursing awareness. Communication skills and understanding of the patient’s condition greatly influenced the nurse’s perception of professionalism. To improve the professionalism of clinical nurses, nursing managers need to emphasize communication skills and understanding of the patient’s condition. The purpose of this study was to provide a rationale for developing a program to improve job skills by strengthening the awareness of professional positions of clinical nurses to develop nursing quality of community. Full article
(This article belongs to the Special Issue Advances in Communication and Public Health)
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Open AccessArticle
Quality of Life and Health in Patients with Chronic Periodontitis: A Qualitative Study
Int. J. Environ. Res. Public Health 2020, 17(13), 4895; https://doi.org/10.3390/ijerph17134895 - 07 Jul 2020
Cited by 2 | Viewed by 810
Abstract
Purpose: Periodontal disease causes tooth loss if not treated early, and advanced periodontitis can cause a decline in various oral functions. These results diminish the health-related quality of life (QOL) for various populations. Thus, early detection and management of the disease, as well [...] Read more.
Purpose: Periodontal disease causes tooth loss if not treated early, and advanced periodontitis can cause a decline in various oral functions. These results diminish the health-related quality of life (QOL) for various populations. Thus, early detection and management of the disease, as well as a systematic strategy for the prevention of periodontal disease, are necessary. Methods: Adults, 19 years of age or older and diagnosed with chronic gingivitis or chronic periodontitis under the ICD-10 codes, were selected to participate in the study. A total of 20 participants were informed of the purpose of the study and gave consent to participate in in-depth interviews. Results: The treatment of periodontal disease improved health-related QOL and enabled the participants to have positive dental care health behaviors. Furthermore, the participants recognized the severity of periodontal disease and the importance of dental examinations. It enabled them to be aware of the societal need for dental care awareness. Conclusions: This study was an in-depth examination of the health-related QOL of periodontal patients through a qualitative research methodology. We expect that this study will expand research on health-related QOL due to periodontal disease and revitalize the dental health system and practices. Full article
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Open AccessArticle
Impact of Residential Green Space on Sleep Quality and Sufficiency in Children and Adolescents Residing in Australia and Germany
Int. J. Environ. Res. Public Health 2020, 17(13), 4894; https://doi.org/10.3390/ijerph17134894 - 07 Jul 2020
Cited by 4 | Viewed by 1010
Abstract
Increasing evidence suggests adults living in greener areas tend to have more favourable sleep-related outcomes, but children and adolescents are under-researched. We hypothesised that children and adolescents living in greener areas would have better quality and more sufficient levels of sleep on average, [...] Read more.
Increasing evidence suggests adults living in greener areas tend to have more favourable sleep-related outcomes, but children and adolescents are under-researched. We hypothesised that children and adolescents living in greener areas would have better quality and more sufficient levels of sleep on average, especially within the context of high traffic noise exposure. These hypotheses were tested using multilevel logistic regressions fitted on samples from the nationally representative Longitudinal Study of Australian Children (10–11 years old, n = 3469, and 14–15 years old, n = 2814) and the GINIplus and LISA cohorts (10 years old, n = 1461, and 15 years old, n = 4172) from the Munich, Wesel, and Leipzig areas of Germany. Questionnaire-based binary indicators of sleep sufficiency and sleep quality in each cohort were assessed with respect to objectively measured green space exposures adjusting for age, sex, and maternal education. Models were augmented with proxy measures of traffic noise and two-way interaction terms to test for effect modification. Cross-tabulations illustrated little convincing evidence of association between green space and insufficient sleep or poor sleep quality in either sample, except for insufficient sleep among 10 year old participants in Germany. These null findings were replicated in adjusted models. The proxy for traffic noise was associated with poor quality sleep in 15 year old participants in Germany, but no convincing evidence of modified association with green space was observed. Full article
(This article belongs to the Special Issue Natural and Built Outdoor Environments and Children’s Health)
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Open AccessArticle
The Effect of Different Cadence on Paddling Gross Efficiency and Economy in Stand-Up Paddle Boarding
Int. J. Environ. Res. Public Health 2020, 17(13), 4893; https://doi.org/10.3390/ijerph17134893 - 07 Jul 2020
Viewed by 891
Abstract
Background: Due to the importance of energy efficiency and economy in endurance performance, it is important to know the influence of different paddling cadences on these variables in the stand-up paddleboarding (SUP). The purpose of this study was to determine the effect of [...] Read more.
Background: Due to the importance of energy efficiency and economy in endurance performance, it is important to know the influence of different paddling cadences on these variables in the stand-up paddleboarding (SUP). The purpose of this study was to determine the effect of paddling at different cadences on the energy efficiency, economy, and physiological variables of international SUP race competitors. Methods: Ten male paddlers (age 28.8 ± 11.0 years; height 175.4 ± 5.1 m; body mass 74.2 ± 9.4 kg) participating in international tests carried out two test sessions. In the first one, an incremental exercise test was conducted to assess maximal oxygen uptake and peak power output (PPO). On the second day, they underwent 3 trials of 8 min each at 75% of PPO reached in the first test session. Three cadences were carried out in different trials randomly assigned between 45–55 and 65 strokes-min−1 (spm). Heart rate (HR), blood lactate, perceived sense of exertion (RPE), gross efficiency, economy, and oxygen uptake (VO2) were measured in the middle (4-min) and the end (8-min) of each trial. Results: Economy (45.3 ± 5.7 KJ·l−1 at 45 spm vs. 38.1 ± 5.3 KJ·l−1 at 65 spm; p = 0.010) and gross efficiency (13.4 ± 2.3% at 45 spm vs. 11.0 ± 1.6% at 65 spm; p = 0.012) was higher during de 45 spm condition than 65 spm in the 8-min. Respiratory exchange ratio (RER) presented a lower value at 4-min than at 8-min in 55 spm (4-min, 0.950 ± 0.065 vs. 8-min, 0.964 ± 0.053) and 65 spm cadences (4-min, 0.951 ± 0.030 vs. 8-min, 0.992 ± 0.047; p < 0.05). VO2, HR, lactate, and RPE were lower (p < 0.05) at 45 spm (VO2, 34.4 ± 6.0 mL·kg−1·min−1; HR, 161.2 ± 16.4 beats·min−1; lactate, 3.5 ± 1.0 mmol·l−1; RPE, 6.0 ± 2.1) than at 55 spm (VO2, 38.6 ± 5.2 mL·kg−1·min−1; HR, 168.1 ± 15.1 beats·min−1; lactate, 4.2 ± 1.2 mmol·l−1; RPE, 6.9 ± 1.4) and 65 spm (VO2, 38.7 ± 5.9 mL·kg−1·min−1; HR, 170.7 ± 13.0 beats·min−1; 5.3 ± 1.8 mmol·l−1; RPE, 7.6 ± 1.4) at 8-min. Moreover, lactate and RPE at 65 spm was greater than 55 spm (p < 0.05) at 8-min. Conclusion: International male SUP paddlers were most efficient and economical when paddling at 45 spm vs. 55 or 65 spm, confirmed by lower RPE values, which may likely translate to faster paddling speed and greater endurance. Full article
(This article belongs to the Special Issue Exercise and Performance Physiology)
Open AccessArticle
Characterizing Lifetime and Daily Experiences of Weight Stigma among Sexual Minority Women with Overweight and Obesity: A Descriptive Study
Int. J. Environ. Res. Public Health 2020, 17(13), 4892; https://doi.org/10.3390/ijerph17134892 - 07 Jul 2020
Cited by 1 | Viewed by 963
Abstract
Sexual minority women are disproportionately impacted by obesity yet are underrepresented in weight stigma research. This Ecological Momentary Assessment (EMA) study is a secondary analysis that aimed to elucidate the frequency and contextual characteristics of perceived experiences of lifetime and momentary weight stigma [...] Read more.
Sexual minority women are disproportionately impacted by obesity yet are underrepresented in weight stigma research. This Ecological Momentary Assessment (EMA) study is a secondary analysis that aimed to elucidate the frequency and contextual characteristics of perceived experiences of lifetime and momentary weight stigma among sexual minority women with overweight/obesity. Participants were 55 sexual minority women ages 18–60 with a body mass index ≥25 kg/m2. Perceived lifetime weight stigma events were assessed at baseline. For the subsequent five days, participants used a smartphone to complete five daily, random EMA prompts assessing the frequency/characteristics of perceived weight stigma events in daily life. All participants reported at least one lifetime weight stigma event. During the EMA period, participants reported 44 momentary weight stigma events (M = 0.80), with 24% of participants reporting at least one event. During most instances of weight stigma, women perceived the stigma’s cause to be their weight and another minority identity (e.g., sexual orientation). Findings showing high rates of perceived lifetime weight stigma in this sample and frequent co-occurrence of perceived weight stigma with stigma due to other marginalized identities in daily life underscore the need for future, larger studies investigating weight stigma through an intersectional lens in sexual minority women with overweight/obesity. Full article
(This article belongs to the Special Issue Stigma, Health and Wellbeing)
Open AccessArticle
Analysis of Motor Intervention Program on the Development of Gross Motor Skills in Preschoolers
Int. J. Environ. Res. Public Health 2020, 17(13), 4891; https://doi.org/10.3390/ijerph17134891 - 07 Jul 2020
Cited by 1 | Viewed by 1090
Abstract
This study aimed to investigate the influence of a structured movement activity program on the motor development of children aged three to five years attending preschool. Participants were 136 preschool students with normative development at three to four years old who lived in [...] Read more.
This study aimed to investigate the influence of a structured movement activity program on the motor development of children aged three to five years attending preschool. Participants were 136 preschool students with normative development at three to four years old who lived in the Region of Murcia (Spain). The McCarthy Children’s Psychomotricity and Aptitude Scales (MSCA) battery of psychomotor tests was used to evaluate the motor development profiles of preschoolers before and after the intervention. The sample was divided into two groups: an intervention group (28 students) and a comparison group (108 students). A structured 24 week physical education program was used in the intervention group. An experiential program based on free play was used in the comparison group during the same period. Preschoolers in both groups got a significant improvement in the contrast of pre-intervention with post-intervention in limb coordination. Statistically significant differences in the post-intervention measurements between the comparison group and the intervention group on arm and leg coordination were observed, whereby the intervention group presented higher arm coordination values (F1,134 = 14,389, p = 0.000, η2 = 0.097) and higher leg coordination values (F1,134 = 19,281, p = 0.000, η2 = 0.126) than the comparison group. It was pointed out that structured physical activity education is better educational methodology than free play to achieve adequate motor development in preschool children. Full article
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Open AccessArticle
A Proposal for Multidisciplinary Tele-Rehabilitation in the Assessment and Rehabilitation of COVID-19 Survivors
Int. J. Environ. Res. Public Health 2020, 17(13), 4890; https://doi.org/10.3390/ijerph17134890 - 07 Jul 2020
Cited by 12 | Viewed by 4439
Abstract
A global pandemic of a new highly contagious disease called COVID-19 resulting from coronavirus (severe acute respiratory syndrome (SARS)-Cov-2) infection was declared in February 2020. Though primarily transmitted through the respiratory system, other organ systems in the body can be affected. Twenty percent [...] Read more.
A global pandemic of a new highly contagious disease called COVID-19 resulting from coronavirus (severe acute respiratory syndrome (SARS)-Cov-2) infection was declared in February 2020. Though primarily transmitted through the respiratory system, other organ systems in the body can be affected. Twenty percent of those affected require hospitalization with mechanical ventilation in severe cases. About half of the disease survivors have residual functional deficits that require multidisciplinary specialist rehabilitation. The workforce to deliver the required rehabilitation input is beyond the capacity of existing community services. Strict medical follow-up guidelines to monitor these patients mandate scheduled reviews within 12 weeks post discharge. Due to the restricted timeframe for these events to occur, existing care pathway are unlikely to be able to meet the demand. An innovative integrated post-discharge care pathway to facilitate follow up by acute medical teams (respiratory and intensive care) and a specialist multidisciplinary rehabilitation team is hereby proposed. Such a pathway will enable the monitoring and provision of comprehensive medical assessments and multidisciplinary rehabilitation. This paper proposes that a model of tele-rehabilitation is integrated within the pathway by using digital communication technology to offer quick remote assessment and efficient therapy delivery to these patients. Tele-rehabilitation offers a quick and effective option to respond to the specialist rehabilitation needs of COVID-19 survivors following hospital discharge. Full article
(This article belongs to the Special Issue COVID-19: Prognosis, Outcomes and Long-Term Sequelae)
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Open AccessArticle
A Snapshot of Knowledge about Oral Cancer in Italy: A 505 Person Survey
Int. J. Environ. Res. Public Health 2020, 17(13), 4889; https://doi.org/10.3390/ijerph17134889 - 07 Jul 2020
Cited by 1 | Viewed by 562
Abstract
Objectives: Patients’ knowledge about oral squamous cell carcinoma (OSCC) plays an important role in primary prevention, early diagnosis, and prognosis and survival rate. The aim of this study was to assess OSCC awareness attitudes among general population in order to provide information [...] Read more.
Objectives: Patients’ knowledge about oral squamous cell carcinoma (OSCC) plays an important role in primary prevention, early diagnosis, and prognosis and survival rate. The aim of this study was to assess OSCC awareness attitudes among general population in order to provide information for educational interventions. Methods: A survey delivered as a web-based questionnaire was submitted to 505 subjects (aged from 18 to 76 years) in Italy, and the answers collected were statistically analyzed. Information was collected about existence, incidence, features of lesions, risk factors of oral cancer, and self-inspection habits, together with details about professional reference figures and preventive behaviors. Results: Chi-square tests of independence with adjusted standardized residuals highlighted correlations between population features (age, gender, educational attainment, provenance, medical relationship, or previous diagnoses of oral cancer in family) and knowledge about oral cancer. Conclusions: Knowledge about OSCC among the Italian population is limited, and it might be advisable to implement nudging and sensitive customized campaigns in order to promote awareness and therefore improve the prognosis of this disease. Full article
(This article belongs to the Special Issue Oral Diseases and Public Health)
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Open AccessArticle
Air Pollution Exposure Monitoring among Pregnant Women with and without Asthma
Int. J. Environ. Res. Public Health 2020, 17(13), 4888; https://doi.org/10.3390/ijerph17134888 - 07 Jul 2020
Viewed by 913
Abstract
Background: We monitored exposure to fine particulates (PM2.5), ozone, nitrogen dioxide (NO2), and ambient temperature for pregnant women with and without asthma. Methods: Women (n = 40) from the Breathe—Well-Being, Environment, Lifestyle, and Lung Function Study [...] Read more.
Background: We monitored exposure to fine particulates (PM2.5), ozone, nitrogen dioxide (NO2), and ambient temperature for pregnant women with and without asthma. Methods: Women (n = 40) from the Breathe—Well-Being, Environment, Lifestyle, and Lung Function Study (2015–2018) were enrolled during pregnancy and monitored for 2–4 days. Daily pollutants were measured using personal air monitors, indoor air monitors, and nearest Environmental Protection Agency’s stationary monitors based on GPS tracking and home address. Results: Personal-monitor measurements of PM2.5, ozone, and NO2 did not vary by asthma status but exposure profiles significantly differed by assessment methods. EPA stationary monitor-based methods appeared to underestimate PM2.5 and temperature exposure and overestimate ozone and NO2 exposure. Higher indoor-monitored PM2.5 exposures were associated with smoking and the use of gas appliances. The proportion of waking-time during which personal monitors were worn was ~56%. Lower compliance was associated with exercise, smoking, being around a smoker, and the use of a prescription drug. Conclusions: Exposure did not vary by asthma status but was influenced by daily activities and assessment methods. Personal monitors may better capture exposures but non-compliance merits attention. Meanwhile, larger monitoring studies are warranted to further understand exposure profiles and the health effects of air pollution during pregnancy. Full article
(This article belongs to the Special Issue The Ambient Environment and Reproductive Health)
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Open AccessArticle
Investigating Rural Domestic Waste Sorting Intentions Based on an Integrative Framework of Planned Behavior Theory and Normative Activation Models: Evidence from Guanzhong Basin, China
Int. J. Environ. Res. Public Health 2020, 17(13), 4887; https://doi.org/10.3390/ijerph17134887 - 07 Jul 2020
Cited by 3 | Viewed by 729
Abstract
The sorting of domestic waste is the most effective way to alleviate the problem of mass garbage accumulation around the villages of rural China. Farmers are the creators of rural domestic waste as well as the direct beneficiaries of effective waste management. However, [...] Read more.
The sorting of domestic waste is the most effective way to alleviate the problem of mass garbage accumulation around the villages of rural China. Farmers are the creators of rural domestic waste as well as the direct beneficiaries of effective waste management. However, few studies have been conducted on the psychological determinants of farmers’ intentions to sort domestic waste. This paper applies planned behavior theory (TPB) and normative activation theory (NAM), to analyze the domestic waste sorting intentions of rural residents in Guanzhong, China. Based on the micro-data of 327 rural households in Guanzhong, structural equation models of the factors influencing farmers’ domestic waste sorting intentions were estimated. The results demonstrate the following. (1) Farmers’ attitudes, perceived behavioral control, and personal norms have significant positive direct impacts on their domestic waste sorting intentions, with personal norms having the greatest direct impact. (2) Subjective norms have no direct impact on farmers’ domestic waste sorting intentions but do have an indirect impact on them through personal norms, behavioral attitudes, and perceived behavior control. This article increases scholarly understanding of the psychosocial determinants of the environmentally friendly behavioral intention to sort domestic waste. The study also provides academic and theoretical support to policy makers in implementing relevant policy recommendations. Full article
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Open AccessArticle
Assessment of the Levels of Oxidative Stress, Muscle Damage, and Psychomotor Abilities of Special Force Soldiers during Military Survival Training
Int. J. Environ. Res. Public Health 2020, 17(13), 4886; https://doi.org/10.3390/ijerph17134886 - 07 Jul 2020
Viewed by 715
Abstract
The aim of this study was to analyze the changes in biochemical markers of oxidative stress and muscle damage, as well as psychomotor abilities during a military survival training. The study included 15 soldiers of special unit (SU), that completed 48 h military [...] Read more.
The aim of this study was to analyze the changes in biochemical markers of oxidative stress and muscle damage, as well as psychomotor abilities during a military survival training. The study included 15 soldiers of special unit (SU), that completed 48 h military survival training combined with sleep deprivation. Before the training (P1), after 24 h (P2), and after 48 h of training (P3), blood samples were taken to measure biochemical markers. At the same time points, the measurements of divided attention and handgrip strength were conducted. Glutathione peroxidase activity decreased significantly at P3, in comparison with P1 and P2 (p < 0.0001), however, no changes were observed in other biochemical markers (i.e., lipid hydroperoxides, creatine kinase and superoxide dismutase activity) throughout the survival training (p > 0.05). The divided attention index was improved significantly at P2 and P3, as compared to P1 (p < 0.05). A tendency to change in maximum strength was found during the training period (main time effect; p = 0.08). Moreover, the strength differentiation (i.e., 50% maximum strength; 50%max) was higher at P3 than at P1 and P2 (p < 0.05). In conclusion, the 48 h survival training in the SU soldiers does not cause oxidative stress or muscle tissue damage, as well as any deterioration, and even improvement in psychomotor abilities. However, the change in strength differentiation (i.e., the production above 60%max instead of target 50%max) after the training may point to deterioration in motor control. Although it should be confirmed in further study with a more numerous group of soldiers, our findings indicate that the special unit soldiers will be able to perform, in a correct manner, specialized tasks related to their long-term activities, especially those which require divided attention. However, participation in long-term survival training, even with low workload, combined with sleep deprivation, results in a deterioration in motor control which may indicate the relevance of monitoring coordination motor abilities/skills in the training process of special unit soldiers. Full article
Open AccessArticle
Park Proximity and Use for Physical Activity among Urban Residents: Associations with Mental Health
Int. J. Environ. Res. Public Health 2020, 17(13), 4885; https://doi.org/10.3390/ijerph17134885 - 07 Jul 2020
Cited by 1 | Viewed by 1876
Abstract
Increasing global urbanization limits interaction between people and natural environments, which may negatively impact population health and wellbeing. Urban residents who live near parks report better mental health. Physical activity (PA) reduces depression and improves quality of life. Despite PA’s protective effects on [...] Read more.
Increasing global urbanization limits interaction between people and natural environments, which may negatively impact population health and wellbeing. Urban residents who live near parks report better mental health. Physical activity (PA) reduces depression and improves quality of life. Despite PA’s protective effects on mental health, the added benefit of urban park use for PA is unclear. Thus, we examined whether park-based PA mediated associations between park proximity and mental distress among 3652 New York City residents (61.4% 45 + years, 58.9% female, 56.3% non-white) who completed the 2010–2011 Physical Activity and Transit (PAT) random-digit-dial survey. Measures included number of poor mental health days in the previous month (outcome), self-reported time to walk to the nearest park from home (exposure), and frequency of park use for sports, exercise or PA (mediator). We used multiple regression with bootstrap-generated 95% bias-corrected confidence intervals (BC CIs) to test for mediation by park-based PA and moderation by gender, dog ownership, PA with others, and perceived park crime. Park proximity was indirectly associated with fewer days of poor mental health via park-based PA, but only among those not concerned about park crime (index of moderated mediation = 0.04; SE = 0.02; 95% BC CI = 0.01, 0.10). Investment in park safety and park-based PA promotion in urban neighborhoods may help to maximize the mental health benefits of nearby parks. Full article
(This article belongs to the Section Mental Health)
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Open AccessArticle
Does Breast Cancer Increasingly Affect Younger Women?
Int. J. Environ. Res. Public Health 2020, 17(13), 4884; https://doi.org/10.3390/ijerph17134884 - 07 Jul 2020
Cited by 2 | Viewed by 768
Abstract
Breast cancer is the most frequently diagnosed malignant neoplasm among females. The proportion of women diagnosed in the premenopausal period is relatively small. Nevertheless, this is the most commonly diagnosed cancer among young women. The aim of the study was to analyze the [...] Read more.
Breast cancer is the most frequently diagnosed malignant neoplasm among females. The proportion of women diagnosed in the premenopausal period is relatively small. Nevertheless, this is the most commonly diagnosed cancer among young women. The aim of the study was to analyze the incidence rate of breast cancer in a group of young women based on data obtained in the Lower Silesian Voivodeship between 1984 and 2016. A total of 34,251 women with a diagnosis of invasive breast cancer were analyzed. The median age of diagnosis exhibited an upward trend from 57 to 63. The youngest age of breast cancer diagnosis did not decrease. Women up to the age of 24 were sporadically diagnosed. Given the total number of cases, the proportion of women under the age of 39 was approximately 5%, and it did not increase throughout the entire examination period. The major increase in the growth trend during the analyzed period was observed in a group of women aged of 50–69 (regression coefficient: +24.9) and above 70 (regression coefficient +21.2). In a group of women under 40 the regression coefficient was only +4. It seems that breast cancer does not increasingly affect younger women since the risk in this age group remains low. However, an increasing incidence rate of breast cancer is more commonly observed in premenopausal women. Full article
(This article belongs to the Special Issue Cancer as a Public Health Problem--Prevention of Cancer)
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Open AccessArticle
Effect of a Game-Based Physical Education Program on Physical Fitness and Mental Health in Elementary School Children
Int. J. Environ. Res. Public Health 2020, 17(13), 4883; https://doi.org/10.3390/ijerph17134883 - 07 Jul 2020
Viewed by 1230
Abstract
Promotion of healthy active behaviors should start from early ages, as behaviors learned in youth are more likely to endure. A fundamental body of research in this field focuses on the implementation of programs within physical education (PE), thanks to its favorable characteristics. [...] Read more.
Promotion of healthy active behaviors should start from early ages, as behaviors learned in youth are more likely to endure. A fundamental body of research in this field focuses on the implementation of programs within physical education (PE), thanks to its favorable characteristics. However, traditional PE based on exercise training and controlling styles seems to have weaker association with students’ health benefits. For this reason, the aim of this study was to assess the effects of a game-based PE program on physical fitness and psychological health in schoolchildren aged 10 to 12 years old. A total of 252 students were distributed in experimental (EG, games-centered activities) and control (CG, traditional exercise training activities) groups. The program lasted 6 months. Health-related physical fitness components, psychological wellbeing, self-esteem, stress, and anxiety were assessed before and after the treatment. Both groups increased physical fitness at post-test; however, cardiorespiratory fitness did not improve. No differences were found between the groups at post-test. Our results show that games may be as effective as traditional training methods; yet, they suggest that PE alone may be insufficient for obtaining substantive benefits in cardiorespiratory fitness, regardless of the type of task presented. Full article
Open AccessArticle
Randomized Clinical Trial: The Effect of Exercise of the Intrinsic Muscle on Foot Pronation
Int. J. Environ. Res. Public Health 2020, 17(13), 4882; https://doi.org/10.3390/ijerph17134882 - 07 Jul 2020
Cited by 2 | Viewed by 1540
Abstract
Background: There is little scientific evidence regarding the effectiveness of strengthening exercises on the foot’s intrinsic musculature in improving the lower limb on the statics and dynamics in healthy individuals. Method: To evaluate the effect on foot posture with regard to the reinforcement [...] Read more.
Background: There is little scientific evidence regarding the effectiveness of strengthening exercises on the foot’s intrinsic musculature in improving the lower limb on the statics and dynamics in healthy individuals. Method: To evaluate the effect on foot posture with regard to the reinforcement of the short foot exercise (SFE) compared to another without a recognized biomechanical action, which we called the “non-biomechanical function” (NBF) exercise. A randomized clinical trial was carried out with 85 asymptomatic participants with a bilateral Foot Posture Index (FPI) greater than 6 points. An experimental group (n = 42) did SFE training and a control group (n = 43) carried out NBF exercises. The foot posture was evaluated twice via the navicular drop (ND) test, and the FPI was assessed on the day of inclusion in the study (pre-intervention) and after four weeks of training (post-intervention). Results: Statistically significant values were not found in foot posture between the experimental and the control groups when comparing before and after the training. However, the foot posture was modified in both groups with respect to its initial state, and the ND value decreased. Conclusions: SFE could be considered a useful tool to deal with pathologies whose etiology includes excessive pronation of the foot. Full article
(This article belongs to the Special Issue Advances in Foot Posture Assessment and Health Implications)
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