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Int. J. Environ. Res. Public Health, Volume 17, Issue 16 (August-2 2020) – 382 articles

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Cover Story (view full-size image) Endocrine-disrupting chemicals (EDCs) are compounds that can be introduced into humans’ and [...] Read more.
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Open AccessArticle
Cost Effectiveness Analysis Using Disability-Adjusted Life Years for Cataract Surgery
Int. J. Environ. Res. Public Health 2020, 17(16), 6010; https://doi.org/10.3390/ijerph17166010 - 18 Aug 2020
Viewed by 494
Abstract
Cataracts are the second most prioritized eye disease in the world. Cataracts are an expensive treatment because surgery is the only method that can treat the disease. This study aims to analyze the cost effectiveness of each operating procedure. Specifically, phacoemulsification and Small [...] Read more.
Cataracts are the second most prioritized eye disease in the world. Cataracts are an expensive treatment because surgery is the only method that can treat the disease. This study aims to analyze the cost effectiveness of each operating procedure. Specifically, phacoemulsification and Small Incision Cataract Surgery (SICS) with Disability-Adjusted Life Years (DALYs) as the effectiveness indicator is used. This study is an observational analytic study with a prospective framework. The sample size is 130 patients who have undergone phacoemulsification and 25 patients who have undergone SICS. The DALY for phacoemulsification at Day-7 (D-7) is 0.3204, and at Day-21 (D-21), it is 0.3204, while the DALY for SICS at D-7 is 0.3060, and at D-21, it is 0.3158. The incremental cost effectiveness ratio (ICER) for cataract surgery at D-7 is USD $1872.49, and at D-21, it is USD $5861.71, whereas the Indonesian Gross Domestic Product (GDP) is USD $4174.90. In conclusion, the phacoemulsification technique is more cost effective than the SICS technique. The ICER value is very cost effective at D-7 post-surgery compared to at D-21 post-surgery because the ICER is less than 1 GDP per capita per DALY. Full article
(This article belongs to the Section Health Economics)
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Open AccessArticle
The Needs and Utilization of Long-Term Care Service Resources by Dementia Family Caregivers and the Affecting Factors
Int. J. Environ. Res. Public Health 2020, 17(16), 6009; https://doi.org/10.3390/ijerph17166009 - 18 Aug 2020
Viewed by 518
Abstract
This study was to evaluate the utilization of long-term care service resources by caregivers of patients with dementia (PWD) and to determine affecting factors. In this cross-sectional study, a total of 100 dyads were enrolled and caregivers responded to the questionnaires. We found [...] Read more.
This study was to evaluate the utilization of long-term care service resources by caregivers of patients with dementia (PWD) and to determine affecting factors. In this cross-sectional study, a total of 100 dyads were enrolled and caregivers responded to the questionnaires. We found 40% of caregivers not using any care resources. Between those caregivers using and not-using care resources, we found differences (p < 0.05) in their health status and living conditions; the difference (p < 0.05) was also found in patients’ behavior and psychological symptoms of dementia (BPSD). The frequency of BPSD (OR = 1.045, p = 0.016, 95% CI = 1.001–1.083) and the living conditions (OR = 3.519, p = 0.007, 95% CI = 1.414–8.759) were related to their use of care resources. Particular BPSDs, such as anxiety or restlessness, throwaway food, aggressive behavior, tearing of clothes, and sexual harassment of patients were related to the caregivers’ use of care resources (p < 0.01). Health professionals have to evaluate the patients’ BPSD and identify the caregivers’ essential needs. Individualized medical care and BPSD-related care resources should be provided for patients and caregivers for taking off their care burden and improving patient care. Full article
(This article belongs to the Special Issue Dementia Care in the 21st Century)
Open AccessArticle
Emotional Competence Mediates the Relationship between Communication Problems and Reactive Externalizing Problems in Children with and without Developmental Language Disorder: A Longitudinal Study
Int. J. Environ. Res. Public Health 2020, 17(16), 6008; https://doi.org/10.3390/ijerph17166008 - 18 Aug 2020
Viewed by 485
Abstract
Language problems are a risk factor for externalizing problems, but the developmental path remains unclear. Emotional competence may mediate the relationship, especially when externalizing problems are reactive in nature, such as in Oppositional Deviant Disorder (ODD) and reactive aggression. We examined the development [...] Read more.
Language problems are a risk factor for externalizing problems, but the developmental path remains unclear. Emotional competence may mediate the relationship, especially when externalizing problems are reactive in nature, such as in Oppositional Deviant Disorder (ODD) and reactive aggression. We examined the development of reactive and proactive externalizing problems in children with (n = 98) and without (n = 156) Developmental Language Disorder (DLD; age: 8–16 years) over 18 months. Relationships with communicative risk factors (structural, pragmatic and emotion communication) and the mediating role of emotional competence (emotion recognition and anger dysregulation) were examined. Multi-level analyses showed that increasing emotion recognition and decreasing anger dysregulation were longitudinally related to decreasing ODD symptoms in both groups, whereas anger dysregulation was related to more reactive aggression in children with DLD alone. Pragmatic and emotion communication problems were related to more reactive externalizing problems, but these relationships were mediated by emotional competence, suggesting that problems in emotional competence explain the communication problems of children with DLD. Therefore, in addition to interventions for communication skills, there is a need to address the emotional competence of children with DLD, as this decreases the risk for reactive externalizing problems. Full article
(This article belongs to the Special Issue Impact of Language Disorder on Child and Adolescent Outcomes)
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Open AccessArticle
Migration Status, Internet Use, and Social Participation among Middle-Aged and Older Adults in China: Consequences for Depression
Int. J. Environ. Res. Public Health 2020, 17(16), 6007; https://doi.org/10.3390/ijerph17166007 - 18 Aug 2020
Viewed by 453
Abstract
This study aimed to examine the underlying relationship between migration status and depressive symptoms among middle-aged and older adults in China. Data were derived from three waves of panel data (2011, 2013, and 2015) from the China Health and Retirement Longitudinal Study. Two-level [...] Read more.
This study aimed to examine the underlying relationship between migration status and depressive symptoms among middle-aged and older adults in China. Data were derived from three waves of panel data (2011, 2013, and 2015) from the China Health and Retirement Longitudinal Study. Two-level regression models and generalized structural equation modeling were run to fit the data. The results showed that migration status of the respondents could ameliorate their depression (β = −0.02, p < 0.01), so did internet use (β = −0.02, p < 0.001), and social participation (β = −0.06, p < 0.001). The indirect effects of migration status on depression through internet use and of internet use on depression through social participation existed. The effects of migration status, internet use, and social participation in decreasing depression were discussed. Provided the associations among migration status, internet use, social participation, and depression, attention should be paid on increasing protective aspects of migration among middle-aged and older adults, such as internet use and social participation, to enhance their mental health. Full article
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Open AccessArticle
CFD Modeling of Ventilation and Dust Flow Behavior in Polishing and the Design of an Innovative Wet Dust Removal System
Int. J. Environ. Res. Public Health 2020, 17(16), 6006; https://doi.org/10.3390/ijerph17166006 - 18 Aug 2020
Viewed by 411
Abstract
Fine aluminum dust pollution in the polishing process was detected during a field survey. To obtain a fundamental understanding of the airflow patterns and the fine dust dispersion characteristics during a polishing process, computational fluid dynamics simulations were first performed to analyze the [...] Read more.
Fine aluminum dust pollution in the polishing process was detected during a field survey. To obtain a fundamental understanding of the airflow patterns and the fine dust dispersion characteristics during a polishing process, computational fluid dynamics simulations were first performed to analyze the data collected in field measurements. The inappropriate ventilation arrangement and lack of effective dust control measures were identified as the main reasons for the high dust exposure levels (in excess of 1000 μg/m3). Simulation results showed that inhalable dust particles (PM10) could be significantly diluted at the operator’s breathing level by adding a supply air inlet above the operating area. Moreover, dry dust collection systems create a risk of aluminum dust explosion accidents. An innovative design of wet dust removal system which could mitigate the occurrence of dust explosions was proposed and then implemented on site. An independent field dust assessment showed that a reduction of fine dust particles up to 95% in the worker’s breathing area and the fine dust in the vents was reduced to 80%. Therefore, the proposed strategies are implemented immediately to address the combustible dust in the polishing working environment and can provide guidance for operators. Full article
(This article belongs to the Special Issue Feature Papers in Environmental Science and Engineering)
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Open AccessArticle
Attitudes to Noise Inside Dwellings in Three Megacities: Seoul, London, and São Paulo
Int. J. Environ. Res. Public Health 2020, 17(16), 6005; https://doi.org/10.3390/ijerph17166005 - 18 Aug 2020
Viewed by 446
Abstract
This study investigated people’s attitudes towards noise inside their homes. Online questionnaire surveys were conducted in Seoul, London, and São Paulo. The questionnaire was designed to assess annoyance caused by noise from neighbours and environmental noise (transportation). Information was also collected on situational, [...] Read more.
This study investigated people’s attitudes towards noise inside their homes. Online questionnaire surveys were conducted in Seoul, London, and São Paulo. The questionnaire was designed to assess annoyance caused by noise from neighbours and environmental noise (transportation). Information was also collected on situational, personal, and socio-demographic variables. Respondents that were more annoyed by outdoor noise inside their dwelling reported higher neighbour noise annoyance. In Seoul, neighbour noise was found to be more annoying than outdoor noise, and those with higher noise sensitivity reported higher annoyance towards neighbour noise. However, neighbour noise and outdoor noise was found to be equally annoying in London and São Paulo. For neighbour noise, the average percentage of respondents hearing structure-borne sources compared to airborne sources differed in each city. Most neighbour noise sources in São Paulo gave rise to higher annoyance ratings than Seoul and London. Education and income levels had a limited effect on annoyance and coping strategy. Annoyance with indoor noise from neighbours was found to have stronger relationships with cognitive and behavioural coping strategies than outdoor noise annoyance. Full article
(This article belongs to the Special Issue Evaluations of Sound and Vibration in the Built Environments)
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Open AccessArticle
The Impact of Implementing a Namaste Care Intervention in UK Care Homes for People Living with Advanced Dementia, Staff and Families
Int. J. Environ. Res. Public Health 2020, 17(16), 6004; https://doi.org/10.3390/ijerph17166004 - 18 Aug 2020
Viewed by 646
Abstract
Care homes can struggle to provide optimal care for residents with advanced dementia. Namaste Care provides a structured daily programme of physical, sensory and emotional care delivered by regular care workers. A three-year, mixed method process study of implementation and impact created a [...] Read more.
Care homes can struggle to provide optimal care for residents with advanced dementia. Namaste Care provides a structured daily programme of physical, sensory and emotional care delivered by regular care workers. A three-year, mixed method process study of implementation and impact created a manualised Namaste Care Intervention for UK care homes (NCI-UK). This article reports on the impact of NCI-UK delivered consistently in five care homes for 12–24 weeks. Impact for residents was assessed using, pre-post data, showing significant positive effects for QUALID (t = 2.92, p = 0.01, n = 31) and CMAI (t = 3.31, p = 0.002, n = 32), alongside many qualitative examples of positive impacts on wellbeing, responsiveness and communication. Pre-post staff questionnaire data (n = 20) were not significant. Qualitative data indicated that NCI-UK is a positive staff experience, providing sense of purpose, improved wellbeing and relationships. The care homes reported benefiting from implementing NCI-UK in terms of reputation and quality improvement. Family interviews were also positive, relating to seeing the difference, improving relationships and being involved. NCI-UK can therefore be recommended as an impactful intervention for residents, staff and families. Full article
(This article belongs to the Special Issue Enhancing the Quality of Care in Long-Term Care Settings)
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Open AccessArticle
Leaching Behaviors of Chromium(III) and Ammonium-Nitrogen from a Tannery Sludge in North China: Comparison of Batch and Column Investigations
Int. J. Environ. Res. Public Health 2020, 17(16), 6003; https://doi.org/10.3390/ijerph17166003 - 18 Aug 2020
Viewed by 396
Abstract
Tannery sludge usually has high content of trivalent chromium (Cr(III)) and ammonium-nitrogen (NH4+-N). It is important to make a critical evaluation of the releasing behaviors of Cr(III) and NH4+-N from tannery sludge before its use on improving [...] Read more.
Tannery sludge usually has high content of trivalent chromium (Cr(III)) and ammonium-nitrogen (NH4+-N). It is important to make a critical evaluation of the releasing behaviors of Cr(III) and NH4+-N from tannery sludge before its use on improving soil fertility in agricultural applications. For this purpose, static batch and dynamic leaching experiments with different mathematical models were carried out to simulate the Cr(III) and NH4+-N releasing kinetics from tannery sludge sampled in a typical tannery disposal site in North China, and their influencing factors were also discussed. The results showed that a larger solid-liquid ratio, a higher temperature, and a lower pH value of the leaching solution were beneficial for the release of Cr(III) and NH4+-N from the tannery sludge. The release kinetics of Cr(III) and NH4+-N followed parabolic diffusion and simple Elovich models both in the static and dynamic leaching conditions, indicating that the release was a complex heterogeneous diffusion process. The NH4+-N was easy to be leached out and its released amount reached 3.14 mg/g under the dynamic leaching condition (pH 7), whereas the released amount of the Cr(III) was only 0.27 μg/g from the tannery sludge. There was a positive correlation coefficient between dissolved Fe and Cr(III) in the leachate under different leaching conditions, and the calculated average ratio of Fe/Cr(III) concentration was 3.56, indicating that the small amount of the released Cr(III) came from the dissolution of Cr0.25Fe0.75(OH)3 minerals in tannery sludge. Full article
(This article belongs to the Section Environmental Science and Engineering)
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Open AccessArticle
Spreading or Gathering? Can Traditional Knowledge Be a Resource to Tackle Reindeer Diseases Associated with Climate Change?
Int. J. Environ. Res. Public Health 2020, 17(16), 6002; https://doi.org/10.3390/ijerph17166002 - 18 Aug 2020
Viewed by 506
Abstract
This paper inquires whether reindeer herders’ traditional knowledge (TK) provides a reservoir of precaution and adaptation possibilities that may be relevant to counteract climate change. As our core example, we used the milking of reindeer—which, in some areas, was practiced up until the [...] Read more.
This paper inquires whether reindeer herders’ traditional knowledge (TK) provides a reservoir of precaution and adaptation possibilities that may be relevant to counteract climate change. As our core example, we used the milking of reindeer—which, in some areas, was practiced up until the 1950s–1960s—and the risk of getting foot rot disease (digital necrobacillosis; slubbo in North Sámi), caused by the bacterium Fusobacterium necrophorum. Via wounds or scratches, the bacterium creates an infection that makes the infected limb swell and, eventually, necrotize. The disease is often mortal in its final stage. Historically, female reindeer were gathered on unfenced milking meadows near herder tents or in small corrals, from early summer onward. When the soil was wet and muddy, the risk of developing digital necrobacillosis was considerable. Our sources included classical Sámi author/herder narratives, ethnographic and veterinary literature, and herder interviews. For this study, we conducted a qualitative review of the literature and carried out individual in-depth interviews with local knowledge holders. Our findings seem consistent: a documented prevention strategy was, in early summer, to move the reindeer to unused grazing land and to avoid staying too long in trampled and dirty grazing land. Contemporary climate change and winter uncertainty due to freeze–thaw cycles and ice-locked pastures challenge this type of strategy. Due to a lack of pasture resources, typical actions today include the increased use of supplementary feeding, which involves more gathering and handling of reindeer, higher animal density, challenging hygienic conditions, and stress, which all contribute to increased risks of contracting and transmitting diseases. Full article
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Open AccessArticle
Associations of Self-Efficacy, Optimism, and Empathy with Psychological Health in Healthcare Volunteers
Int. J. Environ. Res. Public Health 2020, 17(16), 6001; https://doi.org/10.3390/ijerph17166001 - 18 Aug 2020
Viewed by 530
Abstract
Optimism and self-efficacy have been associated with psychological health. Empathy has also been found to have a unique role in community health volunteering and promote positive functioning. This study investigated whether self-efficacy and optimism were associated with psychological health in terms of psychological [...] Read more.
Optimism and self-efficacy have been associated with psychological health. Empathy has also been found to have a unique role in community health volunteering and promote positive functioning. This study investigated whether self-efficacy and optimism were associated with psychological health in terms of psychological and subjective well-being in healthcare volunteers. It also investigated whether empathy added to the explanation of psychological health, over and above that accounted for by self-efficacy and optimism. A convenience sample of 160 Italian clown doctors volunteering in various hospitals completed self-report measures of self-efficacy, optimism, empathy, psychological well-being, and subjective well-being. Results of hierarchical multiple regression analysis indicated that self-efficacy and optimism were associated with both outcomes and that aspects of empathy, such as others’ perspective taking and personal distress for others’ difficulties, added to the explanation of psychological health with opposite effects. The present study adds to previous research on the role of self-efficacy, optimism, and empathy for community health volunteers’ psychological health. It also offers suggestions regarding the training for this type of volunteer. Full article
(This article belongs to the Special Issue Survey about Psychological Health)
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Open AccessArticle
Quality of Life in Cohabitants of Patients with Hidradenitis Suppurativa: A Cross-sectional Study
Int. J. Environ. Res. Public Health 2020, 17(16), 6000; https://doi.org/10.3390/ijerph17166000 - 18 Aug 2020
Viewed by 441
Abstract
Hidradenitis suppurativa (HS) is a chronic inflammatory disease that impairs patients’ physical and mental health. However, few studies have considered the consequences of HS on cohabitants. The aims of this study were to explore the impact of HS on the quality of life [...] Read more.
Hidradenitis suppurativa (HS) is a chronic inflammatory disease that impairs patients’ physical and mental health. However, few studies have considered the consequences of HS on cohabitants. The aims of this study were to explore the impact of HS on the quality of life (QOL) of cohabitants and to assess potentially associated factors. A cross-sectional study was conducted and patients with HS and their cohabitants were invited to participate. Validated questionnaires were used to measure QOL, anxiety and depression, type D personality and sexual dysfunction. The clinical variables of patients and the demographic characteristics of cohabitants were also collected. Twenty-seven patients and 27 cohabitants were included for analysis. Patients and cohabitants presented significant QOL impairment. A direct association was found between the Dermatology Life Quality Index (DLQI) and the Familiar Dermatology Life Quality Index (FDLQI). DLQI scores were associated with the presence of negative affectivity, a trait typical of type D personality, as well as with cohabitants’ anxiety. FDLQI scores were associated with cohabitant anxiety and patient depression. Hidradenitis suppurativa damages quality of life in patients and cohabitants. Identifying potential psychological factors could help us to recognize at-risk patients and apply personalized treatments for them and their environment. Full article
(This article belongs to the Special Issue Inflammatory Diseases and Its Impact on Quality of Life)
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Open AccessPerspective
A Nationwide Network to Provide Supervised Exercise Therapy and Lifestyle Counseling for All Patients with Non-Communicable Diseases: Chronic CareNet
Int. J. Environ. Res. Public Health 2020, 17(16), 5999; https://doi.org/10.3390/ijerph17165999 - 18 Aug 2020
Viewed by 407
Abstract
Non-communicable diseases (NCDs) are a major cause of disability and mortality worldwide. Physical inactivity is an important contributor to the development of NCDs. Increasing physical activity through supervised exercise therapy (SET) is proven to be effective, and is a key component in both [...] Read more.
Non-communicable diseases (NCDs) are a major cause of disability and mortality worldwide. Physical inactivity is an important contributor to the development of NCDs. Increasing physical activity through supervised exercise therapy (SET) is proven to be effective, and is a key component in both the prevention and treatment of most NCDs. However, only a minority of patients with NCDs receive this treatment, mainly due to an insufficient number and poor accessibility of specialized physical therapists. The aim of this article is to describe a solution that, if indicated, enables all patients with NCDs in the Netherlands to receive SET by a specialized physical therapist: Chronic CareNet. Chronic CareNet is a nationwide network of specialized physical therapists, providing high quality SET and lifestyle counselling to patients with NCDs, initially focusing on peripheral arterial disease, chronic obstructive pulmonary disease and coronary heart disease. The network evolved from ClaudicatioNet. In order to monitor quality of care, therapists enroll in a continuous educational program, and process and outcome indicators are collected by all therapists, which can be compared with a nationwide benchmark (quality system). A robust infrastructure of information and communication technology provides an online care finder and referral system to locate and refer to nearby therapists. All elements of Chronic CareNet are essential, to ensure that all patients in the Netherlands have access to a nearby specialized therapist. Full article
(This article belongs to the Special Issue Physical Activity and Elder Health)
Open AccessConference Report
Medication-Related Osteonecrosis of Jaws (MRONJ) Prevention and Diagnosis: Italian Consensus Update 2020
Int. J. Environ. Res. Public Health 2020, 17(16), 5998; https://doi.org/10.3390/ijerph17165998 - 18 Aug 2020
Viewed by 927
Abstract
The Medication-Related Osteonecrosis of Jaws (MRONJ) diagnosis process and its prevention play a role of great and rising importance, not only on the Quality of Life (QoL) of patients, but also on the decision-making process by the majority of dentists and oral surgeons [...] Read more.
The Medication-Related Osteonecrosis of Jaws (MRONJ) diagnosis process and its prevention play a role of great and rising importance, not only on the Quality of Life (QoL) of patients, but also on the decision-making process by the majority of dentists and oral surgeons involved in MRONJ prevention (primary and secondary). The present paper reports the update of the conclusions from the Consensus Conference—held at the Symposium of the Italian Society of Oral Pathology and Medicine (SIPMO) (20 October 2018, Ancona, Italy)—after the newest recommendations (2020) on MRONJ were published by two scientific societies (Italian Societies of Maxillofacial Surgery and Oral Pathology and Medicine, SICMF and SIPMO), written on the inputs of the experts of the Italian Allied Committee on ONJ (IAC-ONJ). The conference focused on the topic of MRONJ, and in particular on the common practices at risk of inappropriateness in MRONJ diagnosis and therapy, as well as on MRONJ prevention and the dental management of patients at risk of MRONJ. It is a matter of cancer and osteometabolic patients that are at risk since being exposed to several drugs with antiresorptive (i.e., bisphosphonates and denosumab) or, more recently, antiangiogenic activities. At the same time, the Conference traced for dentists and oral surgeons some easy applicable indications and procedures to reduce MRONJ onset risk and to diagnose it early. Continuous updating on these issues, so important for the patient community, is recommended. Full article
(This article belongs to the Special Issue Dental Public Health: Issues, Challenges and Opportunities)
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Open AccessArticle
Profiles of Active Transportation among Children and Adolescents in the Global Matrix 3.0 Initiative: A 49-Country Comparison
Int. J. Environ. Res. Public Health 2020, 17(16), 5997; https://doi.org/10.3390/ijerph17165997 - 18 Aug 2020
Viewed by 786
Abstract
This article aims to compare the prevalence of active transportation among children and adolescents from 49 countries at different levels of development. The data was extracted from the Report Cards on Physical Activity for Children and Youth from the 49 countries that participated [...] Read more.
This article aims to compare the prevalence of active transportation among children and adolescents from 49 countries at different levels of development. The data was extracted from the Report Cards on Physical Activity for Children and Youth from the 49 countries that participated in the Global Matrix 3.0 initiative. Descriptive statistics and a latent profile analysis with active transportation, Human Development Index and Gini index as latent variables were conducted. The global average grade was a “C”, indicating that countries are succeeding with about half of children and youth (47–53%). There is wide variability in the prevalence and in the definition of active transportation globally. Three different profiles of countries were identified based on active transportation grades, Human Development Index (HDI) and income inequalities. The first profile grouped very high HDI countries with low prevalence of active transport and low inequalities. The second profile grouped low and middle HDI countries with high prevalence of active transportation and higher inequalities. And the third profile was characterized by the relatively high prevalence of active transportation and more variability in the socioeconomic variables. Promising policies from countries under each profile were identified. A unified definition of active transportation and contextualized methods for its assessment are needed to advance in surveillance and practice. Full article
(This article belongs to the Special Issue Active Commuting and Active Transportation)
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Open AccessArticle
Leadership among Women Working to Eradicate Female Genital Mutilation: The Impact of Environmental Change in Transcultural Moments
Int. J. Environ. Res. Public Health 2020, 17(16), 5996; https://doi.org/10.3390/ijerph17165996 - 18 Aug 2020
Viewed by 371
Abstract
The study of cultural moments can identify the level of acceptance of female genital mutilation and the visibility of the involved health problems in a globalized world. Aims: To describe the transcultural process through which immigrant women who have experienced female genital mutilation [...] Read more.
The study of cultural moments can identify the level of acceptance of female genital mutilation and the visibility of the involved health problems in a globalized world. Aims: To describe the transcultural process through which immigrant women who have experienced female genital mutilation become leaders against this practice. Method: Descriptive research with cross-cultural principles and a qualitative approach. A semi-structured interview was the chosen technique for data collection. A total of 18 women participated in the preliminary observation and analysis unit, and only 8 women (38.8%) were ideologically against female genital mutilation (FGM). Inclusion criteria: The selected women had undergone FGM and were fully prepared to discuss it. Results: Staying in a different country and the associated social relations reduce cultural pressure and promote critical thinking. Cultural moments reflect the different situations that affect the perception and practice of female genital mutilation. Health problems associated with female genital mutilation (sexual, reproductive, and psychological) become visible at transcultural moments. Conclusions: Environmental country change affects the cultural pressure that sustains this practice in individual minds, institutions, structures, and bodies. These changes produce transcultural moments. The practice of female genital mutilation constitutes a significant segment of gender-based violence. Full article
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Open AccessArticle
Investigating the Relationship between Work-To-Family Conflict, Job Burnout, Job Outcomes, and Affective Commitment in the Construction Industry
Int. J. Environ. Res. Public Health 2020, 17(16), 5995; https://doi.org/10.3390/ijerph17165995 - 18 Aug 2020
Viewed by 456
Abstract
This study explored the effects of work-to-family conflict on job burnout and job outcomes in the construction industry, focusing on the moderating effects of affective commitment. Based on the conservation of resources theory, a theoretical model introducing affective commitment as a moderating variable [...] Read more.
This study explored the effects of work-to-family conflict on job burnout and job outcomes in the construction industry, focusing on the moderating effects of affective commitment. Based on the conservation of resources theory, a theoretical model introducing affective commitment as a moderating variable was established. A structured questionnaire survey was then implemented among construction professionals in China. A total of 376 valid responses were obtained. Structural equation modeling was used to analyze the valid data. The results revealed the following: (i) work-to-family conflict has a significant positive impact on job burnout, but a significant negative impact on job satisfaction and job performance; (ii) job burnout negatively affects job satisfaction and job performance; (iii) affective commitment negatively moderates the effects of work-to-family conflict on job burnout. This study provides a reference for construction companies to manage work-to-family conflict and job burnout of employees, while also improving their affective commitment and job outcomes. Full article
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Open AccessArticle
High-Flow Oxygen through Nasal Cannula vs. Non-Invasive Ventilation in Hypercapnic Respiratory Failure: A Randomized Clinical Trial
Int. J. Environ. Res. Public Health 2020, 17(16), 5994; https://doi.org/10.3390/ijerph17165994 - 18 Aug 2020
Viewed by 421
Abstract
High-flow oxygen through nasal cannula (HFNC) provides adequate oxygenation and can be an alternative to noninvasive ventilation (NIV) for patients with hypoxemic respiratory failure. The aim of the present study was to assess the efficacy of HFNC versus NIV in hypercapnic respiratory failure. [...] Read more.
High-flow oxygen through nasal cannula (HFNC) provides adequate oxygenation and can be an alternative to noninvasive ventilation (NIV) for patients with hypoxemic respiratory failure. The aim of the present study was to assess the efficacy of HFNC versus NIV in hypercapnic respiratory failure. Patients (n = 40) who were admitted to the Emergency Department of Alexandra Hospital due to hypercapnic respiratory failure (PaCO2 ≥ 45 mmHg) were randomized assigned into two groups, i.e., an intervention group (use of HFNC, n = 20) and a control group (use of NIV, n = 20). During their hospitalization in the Intensive Care Unit, vital signs (respiratory and heart rate, arterial blood pressure) and arterial blood gases (ABG) were closely monitored on admission, after 24 h and at discharge. No difference between the two groups regarding the duration of hospitalization and the use of HFNC or NIV was observed (p > 0.05). On admission, the two groups did not differ in terms of gender, age, body mass index, APACHE score, predicted death rate, heart rate, arterial blood pressure and arterial blood gases (p > 0.05). Respiratory rate in the HFNC group was lower than in the NIV group (p = 0.023). At discharge, partial carbon dioxide arterial pressure (PaCO2) in the HFNC group was lower than in the NIV group (50.8 ± 9.4 mmHg versus 59.6 ± 13.9 mmHg, p = 0.024). The lowerPaCO2 in the HFNC group than in the NIV group indicated that HFNC was superior to NIV in the management of hypercapnic respiratory failure. Full article
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Open AccessArticle
Using Deep Learning with Convolutional Neural Network Approach to Identify the Invasion Depth of Endometrial Cancer in Myometrium Using MR Images: A Pilot Study
Int. J. Environ. Res. Public Health 2020, 17(16), 5993; https://doi.org/10.3390/ijerph17165993 - 18 Aug 2020
Viewed by 568
Abstract
Myometrial invasion affects the prognosis of endometrial cancer. However, discrepancies exist between pre-operative magnetic resonance imaging staging and post-operative pathological staging. This study aims to validate the accuracy of artificial intelligence (AI) for detecting the depth of myometrial invasion using a deep learning [...] Read more.
Myometrial invasion affects the prognosis of endometrial cancer. However, discrepancies exist between pre-operative magnetic resonance imaging staging and post-operative pathological staging. This study aims to validate the accuracy of artificial intelligence (AI) for detecting the depth of myometrial invasion using a deep learning technique on magnetic resonance images. We obtained 4896 contrast-enhanced T1-weighted images (T1w) and T2-weighted images (T2w) from 72 patients who were diagnosed with surgico-pathological stage I endometrial carcinoma. We used the images from 24 patients (33.3%) to train the AI. The images from the remaining 48 patients (66.7%) were used to evaluate the accuracy of the model. The AI then interpreted each of the cases and sorted them into stage IA or IB. Compared with the accuracy rate of radiologists’ diagnoses (77.8%), the accuracy rate of AI interpretation in contrast-enhanced T1w was higher (79.2%), whereas that in T2w was lower (70.8%). The diagnostic accuracy was not significantly different between radiologists and AI for both T1w and T2w. However, AI was more likely to provide incorrect interpretations in patients with coexisting benign leiomyomas or polypoid tumors. Currently, the ability of this AI technology to make an accurate diagnosis has limitations. However, in hospitals with limited resources, AI may be able to assist in reading magnetic resonance images. We believe that AI has the potential to assist radiologists or serve as a reasonable alternative for pre-operative evaluation of the myometrial invasion depth of stage I endometrial cancers. Full article
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Open AccessArticle
The Phenotype of Elderly Patients with Type 2 Diabetes Mellitus and Poor Sleep Quality
Int. J. Environ. Res. Public Health 2020, 17(16), 5992; https://doi.org/10.3390/ijerph17165992 - 18 Aug 2020
Viewed by 380
Abstract
Background: Sleep disturbances are a common problem among patients with Type 2 diabetes mellitus (T2DM). The aim of the study was to identify the phenotype of T2DM patients with poor sleep quality. Methods: An observational, cross-sectional study was conducted between May 2013 and [...] Read more.
Background: Sleep disturbances are a common problem among patients with Type 2 diabetes mellitus (T2DM). The aim of the study was to identify the phenotype of T2DM patients with poor sleep quality. Methods: An observational, cross-sectional study was conducted between May 2013 and August 2015. One hundred and sixty consecutive patients with T2DM: 74 women and 86 men, with a median age of 69.50 years (59.00; 79.50 years) were enrolled in the study. Sleep quality was evaluated using the Pittsburgh Sleep Quality Index (PSQI) questionnaire. Results: Poor sleep quality was noted in 85 (53%) patients. Sleep disorders were associated with older age, as well as female gender, longer duration of diabetes, lower level of fasting plasma glucose, glycated hemoglobin A1c, estimated glomerular filtration rate, triglycerides, waist-to-hip ratio, and the presence of nephropathy. A multivariate logistic regression revealed that sleep disorders were associated with older age (Odd Ratio (OR) = 1.11, 95% Confidence Interval (CI) 1.07–1.15). Fifty-one patients (31.87%) were treated with sleeping pills. We found that older age, female gender, longer duration of diabetes, lower level of fasting plasma glucose, glycated hemoglobin A1c, estimated glomerular filtration rate, triglycerides, and the presence of nephropathy were linked with more frequent usage of hypnotics. A multivariate logistic regression demonstrated that older age (OR = 1.09, 95% CI 1.05–1.14) and nephropathy (OR = 2.79, 95% CI 1.24–6.28) were associated with a more frequent receiving the hypnotics, whereas male gender (OR = 0.30, 95% CI 0.13–0.71) has less frequent hypnotics usage. Conclusion: Although, we assessed a wide range of patients’ characteristics, age had the most negative impact on the quality of sleep in patients with T2DM. We detected more frequent use of hypnotics in older females, with coexisting nephropathy. Full article
(This article belongs to the Section Health Behavior, Chronic Disease and Health Promotion)
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Open AccessArticle
Effectiveness of a Community-Based Intervention to Increase Supermarket Vendors’ Compliance with Age Restrictions for Alcohol Sales in Spain: A Pilot Study
Int. J. Environ. Res. Public Health 2020, 17(16), 5991; https://doi.org/10.3390/ijerph17165991 - 18 Aug 2020
Viewed by 452
Abstract
In Spain the legal age to buy alcohol is 18 years. However, official surveys show that minors perceive alcohol availability to be easy. This paper describes the impacts of a community-based intervention to increase vendors’ compliance with age limits regarding alcohol sales in [...] Read more.
In Spain the legal age to buy alcohol is 18 years. However, official surveys show that minors perceive alcohol availability to be easy. This paper describes the impacts of a community-based intervention to increase vendors’ compliance with age limits regarding alcohol sales in supermarkets. The aim of this study was to explore the association between implementation of a multicomponent intervention to reduce adolescents’ alcohol use and sale of alcohol to minors in the city of Palma (Spain). Twenty trained adolescents (14–17 years old) conducted 138 alcohol test purchases in nine supermarket chains in August 2018 (baseline; n = 73) prior to the intervention, and again in January 2020 (follow-up; n = 65). Analysis was conducted according to three levels of intervention implemented across the supermarkets: (i) personnel from the supermarkets’ Human Resources or Corporate Social Responsibility teams received alcohol service training as trainers (i.e., community mobilization); (ii) managers and vendors training by the capacitated trainers; and (iii) no training of managers or vendors (i.e., control group). In the supermarkets that completed the Training of Trainers and the vendors’ training program, average sales decreased significantly from 76.9% in 2018 to 45.5% in 2020, asking for the age of the shopper significantly increased from 3.8% to 45.4%, and asking for proof of age significantly increased from 15.4% to 72.7%. Additionally, a statistically significant increase was observed in the visibility of prohibition to sell alcohol to minors’ signs, from 61.5% to 100%. No statistically significant differences were found for the Training of Trainers intervention alone nor in the control group. In conclusion, community mobilization combined with staff training is associated with significant increases in supermarket vendors’ compliance with alcohol legislation in Spain. Full article
(This article belongs to the Special Issue Risk Behaviors and Substance Abuse among Adolescents)
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Open AccessArticle
Living Conditions of Adolescents Who Have Attempted Suicide in Mexico
Int. J. Environ. Res. Public Health 2020, 17(16), 5990; https://doi.org/10.3390/ijerph17165990 - 18 Aug 2020
Viewed by 295
Abstract
Suicidal behavior represents a complex public health problem, with a rising number of suicide attempts registered among Mexican adolescents. We undertook a qualitative study in order to understand the living conditions of adolescents who had attempted to take their lives in five Mexican [...] Read more.
Suicidal behavior represents a complex public health problem, with a rising number of suicide attempts registered among Mexican adolescents. We undertook a qualitative study in order to understand the living conditions of adolescents who had attempted to take their lives in five Mexican states. We interviewed 37 adolescents who had engaged in suicide attempts in the year prior to our study. To code and analyze the information, we defined the following three categories of living conditions as social determinants of health for adolescents: poverty and vulnerability, education, and health care. To this end, we followed the methodology proposed by Taylor and Bogdan, and used Atlas.ti 7.5.18 software for analyses. Among our findings, we noted that poverty, manifested primarily as material deprivation, rendered the daily lives of our interviewees precarious, compromising even their basic needs. All the young people analyzed had either received medical, psychological, and/or psychiatric care as outpatients or had been hospitalized. School played a positive role in referring adolescents with suicidal behavior to health services; however, it also represented a high-risk environment. Our findings highlight the urgent need to implement a national intersectoral strategy as part of comprehensive public policy aimed at improving the health of adolescents in Mexico. Full article
(This article belongs to the Special Issue Social Determinants of Mental Health)
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Open AccessArticle
A Guide to Nature Immersion: Psychological and Physiological Benefits
Int. J. Environ. Res. Public Health 2020, 17(16), 5989; https://doi.org/10.3390/ijerph17165989 - 18 Aug 2020
Viewed by 524
Abstract
Nature exposure has been renowned for its positive physiological and psychological benefits. Recent years have seen a rise in nature immersion programs that make use of Guided Forest Therapy walks in a standard sequence of sensory awareness activities to expose participants to natural [...] Read more.
Nature exposure has been renowned for its positive physiological and psychological benefits. Recent years have seen a rise in nature immersion programs that make use of Guided Forest Therapy walks in a standard sequence of sensory awareness activities to expose participants to natural environments in a safe but effective manner. The study aimed to compare the efficacy of guided versus unguided nature immersion, upon three dependent variables of mood, nature connectedness and heartrate. 51 participants were assigned to either guided or unguided nature immersion. Nature connectedness (Connectedness to Nature Scale, CNS), Environmental Identity Scale, EID short form) and mood (Positive and Negative Affect Scale, PANAS) were assessed before and after nature immersion, while heart rate was tracked continuously by a wristwatch heart rate tracker throughout the 2-h experience. Demographics and general health practice (GHP) information were also collected. A mixed model ANOVA revealed that nature connectedness and mood (but not heart rate) improved post-immersion for all participants. Comparing the guided/unguided conditions, there were no significant differences in the change in nature connectedness, mood or heart rate. Comparing within the five segments within the standard sequence in the guided condition, the third and fifth segments revealed a significantly lower heart rate compared to the baseline heart rate. Full article
(This article belongs to the Section Health Behavior, Chronic Disease and Health Promotion)
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Open AccessArticle
Positive Psychological Capital Mediates the Association between Burnout and Nursing Performance Outcomes among Hospital Nurses
Int. J. Environ. Res. Public Health 2020, 17(16), 5988; https://doi.org/10.3390/ijerph17165988 - 18 Aug 2020
Viewed by 405
Abstract
Nursing burnout is associated with reduced nursing performance outcomes. Positive psychological capital is known to play an important role in improving workers’ job performance. However, the association among the three variables has rarely been addressed. The purpose of this cross-sectional descriptive study was [...] Read more.
Nursing burnout is associated with reduced nursing performance outcomes. Positive psychological capital is known to play an important role in improving workers’ job performance. However, the association among the three variables has rarely been addressed. The purpose of this cross-sectional descriptive study was to explore the association between burnout and nursing performance outcomes among Korean nurses working at a tertiary hospital and the mediating role of psychological capital in this relationship. Recruited through convenience sampling, a total of 285 nurses provided data on their demographic characteristics and completed a structured questionnaire consisting of items from the Professional Quality of Life Scale (burnout), Nursing Performance Scale, and Psychology Capital Questionnaire. Descriptive statistics, student’s t-tests, one-way analysis of variance, Pearson’s correlation coefficients, and multiple linear regression analyses were used to analyze data. The significance of the mediation effect was obtained using a bootstrap approach with the PROCESS macro. The mean age of participants was 30.51 years, and most participants were females (94.0%) and unmarried (71.6%); more than half (57.5%) experienced a severe workload. The average (±standard deviation) scores of burnout, nursing performance outcomes, and positive psychological capital were 28.77 ± 4.93, 2.98 ± 0.32, and 3.19 ± 0.45, respectively. Burnout was associated with nursing performance among clinical nurses (β = −0.20, p < 0.001). Positive psychological capital mediated the association between burnout and nursing performance outcomes (β = 0.41, p < 0.001). These findings contribute to the understanding that burnout among nurses could be reduced by increased positive psychological capital, which results in improved performance outcomes. The findings also indicate that interventions to improve positive psychological capital should be developed and implemented for nurses’ burnout management and improvement in nursing performance outcomes. Full article
(This article belongs to the Special Issue Burnout as a Public Health Problem and Its Approach from Prevention)
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Open AccessArticle
The Impact of a Multi-Pronged Intervention on Students’ Perceptions of School Lunch Quality and Convenience and Self-Reported Fruit and Vegetable Consumption
Int. J. Environ. Res. Public Health 2020, 17(16), 5987; https://doi.org/10.3390/ijerph17165987 - 18 Aug 2020
Viewed by 421
Abstract
School lunch programs provide an opportunity to improve students’ diets. We sought to determine the impact of a multifaceted intervention (cafeteria redesigns, increased points-of-sale and teacher education) on secondary students’ perceptions of school-lunch quality and convenience and fruit and vegetable intake. Surveys ( [...] Read more.
School lunch programs provide an opportunity to improve students’ diets. We sought to determine the impact of a multifaceted intervention (cafeteria redesigns, increased points-of-sale and teacher education) on secondary students’ perceptions of school-lunch quality and convenience and fruit and vegetable intake. Surveys (n = 12,827) from middle and high school students in 12 intervention and 11 control schools were analyzed. We investigated change in school-lunch perceptions and lunchtime and daily fruit and vegetable consumption from 2016 to 2018. Among 8th graders, perceptions that school lunch tastes good and that school lunch was enough to make students feel full increased 0.2 points (on a 5-point scale; p < 0.01) in intervention schools relative to control schools. Among 10th graders, lunchtime fruit and vegetable consumption increased 6% in intervention relative to control schools (p < 0.05 and p < 0.01 respectively). Daily fruit intake increased 0.1 cups/day in intervention relative to control schools among 9th graders (p < 0.01). This study provides important evidence on the limited effect of design approaches in the absence of meal changes. We observed only modest changes in school lunch perceptions and fruit and vegetable consumption that were not consistent across grades, suggesting that additional efforts are needed to improve school-lunch uptake. Full article
(This article belongs to the Special Issue Interventions to Enhance Physical Activity and Nutrition in Children)
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Open AccessReview
Career Adaptability Research: A Literature Review with Scientific Knowledge Mapping in Web of Science
Int. J. Environ. Res. Public Health 2020, 17(16), 5986; https://doi.org/10.3390/ijerph17165986 - 18 Aug 2020
Viewed by 429
Abstract
With the rapid development of society and technology, personal adaptability is becoming more and more important. Learning how to adapt to a changing world is becoming one of the necessary conditions for success. Career adaptability can help individuals to smoothly adapt to changes [...] Read more.
With the rapid development of society and technology, personal adaptability is becoming more and more important. Learning how to adapt to a changing world is becoming one of the necessary conditions for success. Career adaptability can help individuals to smoothly adapt to changes when coping with their career roles, and maintain their ability to balance their career roles, which will affect their important psychological resources for career development and achieve more meaning in life. In recent years, career adaptability has gradually attracted the attention of researchers. Therefore, in order to explore the main factors, such as research focus, the main researchers, its evolution, and the important results of career adaptability in the last ten years, this study used the scientific knowledge mapping software CiteSpace as a research tool, and select related articles from the Web of Science between 2010 to 2020 under the theme of “career adaptability” for data analysis, which can help future researchers to understand current and future career adaptability research and control the research direction of career adaptability. The results of this research indicate that there are direct or indirect connections between different themes, such as the career adaptability scale, career construction, positive personalities, and so on, but few articles integrate multiple research topics. At the same time, the main researchers, research frontiers and network relationships were also obtained. Based on the above findings, the correlative main concept, theoretical structure, evolution, and research progress of career adaptability in the past ten years are discussed. Full article
(This article belongs to the Section Mental Health)
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Open AccessArticle
Cycle of Perpetual Vulnerability for Women Facing Homelessness near an Urban Library in a Major U.S. Metropolitan Area
Int. J. Environ. Res. Public Health 2020, 17(16), 5985; https://doi.org/10.3390/ijerph17165985 - 18 Aug 2020
Viewed by 370
Abstract
Background: Homelessness among women and the multiple vulnerabilities they endure (sexual exploitation/human trafficking, violence, and mental health issues) is a perpetually unresolved issue in the U.S. and globally. Methods: This study is based on qualitative in-depth interviews accompanied by brief socio-demographic surveys conducted [...] Read more.
Background: Homelessness among women and the multiple vulnerabilities they endure (sexual exploitation/human trafficking, violence, and mental health issues) is a perpetually unresolved issue in the U.S. and globally. Methods: This study is based on qualitative in-depth interviews accompanied by brief socio-demographic surveys conducted among 32 total participants, consisting of cisgender females (n = 17) and cisgender males (n = 15) experiencing homelessness at a large public library. Results: Of the women, 35% were White, 35% Latina, 18% African American/Black, and 18% LGBT. Half of all participants said in qualitative interviews that they witnessed violence against women, and/or experienced unwanted harassment/sexual exploitation; one in three described suspected human trafficking. Of the women interviewed, half struggled with mental health symptoms, feelings of hopelessness, and nearly all reported isolation; approximately one-third had substance use issues. Many described an inadequate number of emergency and long-term shelters Available for women facing homelessness; many had to wait or saw other women waiting to get into shelters and faced abuse on the streets in the meantime. Conclusion: The emergent themes showed that women face a “cycle of perpetual vulnerability” with three relational pathways: iterated trauma from chronic abuse/violence inflicted on them, a state of paralysis due to inadequate availability of supportive services, shelters, and mental health resources to cover all women living on the streets, leaving women susceptible to being a target phenotype for predators. Full article
(This article belongs to the Special Issue Women, Patriarchy and Health Inequalities: An Unresolved Issue)
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Open AccessArticle
Short and Long-Term Trainability in Older Adults: Training and Detraining Following Two Years of Multicomponent Cognitive—Physical Exercise Training
Int. J. Environ. Res. Public Health 2020, 17(16), 5984; https://doi.org/10.3390/ijerph17165984 - 18 Aug 2020
Cited by 1 | Viewed by 400
Abstract
Despite the benefits of multicomponent physical–cognitive training programs (MCCogTPs), lower training intensities in the concurrent approach, and bigger heterogeneity with aging, suggest the need for long-term analyses, with special attention to training and detraining in older adults. The present study aims [...] Read more.
Despite the benefits of multicomponent physical–cognitive training programs (MCCogTPs), lower training intensities in the concurrent approach, and bigger heterogeneity with aging, suggest the need for long-term analyses, with special attention to training and detraining in older adults. The present study aims to examine these training/detraining effects in a two year MCCogTP, looking for specific dynamics in the trainability of their physical and cognitive capacities. The intervention was divided into four periods: T1, T2 (8 months of training each), and D1, D2 (3.5 months of detraining plus 0.5 of testing each). Twenty-five healthy seniors (70.82 ± 5.18 years) comprised the final sample and were assessed for cardiovascular fitness (6-minutes walking test), lower-limbs strength (30-seconds chair-stand test) and agility (8-feet timed up-and-go test). Inhibition (Stroop test) was considered for executive function. Physical and cognitive status improved significantly (p < 0.05) throughout the two years, with larger enhancements for physical function (mainly strength and agility). Strength and cardiovascular fitness were more sensitive to detraining, whilst agility proved to have larger training retentions. Inhibition followed an initial similar trend, but it was the only variable to improve along D2 (d = 0.52), and changes were not significant within periods. Notwithstanding aging, and the exercise cessation in D2, physical and cognitive status remained enhanced two years later compared to baseline, except for lower-limb strength. According to these results, basic physical capacities are very sensitive to training/detraining, deserving continuous attention (especially strength). Both reducing detraining periods and complementary resistance training should be considered. Additionally, physical enhancements following MCcogTPs may help cognition maintenance during detraining. Full article
(This article belongs to the Special Issue Interaction of Exercise and Cognitive Function)
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Open AccessArticle
How Does Part-Time Farming Affect Farmers’ Adoption of Conservation Agriculture in Jianghan Plain, China?
Int. J. Environ. Res. Public Health 2020, 17(16), 5983; https://doi.org/10.3390/ijerph17165983 - 18 Aug 2020
Viewed by 358
Abstract
Part-time farming has been suggested by scholars to play an important part in farmers’ decision making, but seldom empirical evidence has been done on the field of conservation agriculture (CA) technology adoption worldwide. Based on the field survey data of 433 farmers in [...] Read more.
Part-time farming has been suggested by scholars to play an important part in farmers’ decision making, but seldom empirical evidence has been done on the field of conservation agriculture (CA) technology adoption worldwide. Based on the field survey data of 433 farmers in Jianghan Plain, China, this paper estimate the impact of part-time farming on farmers’ adoption of CA technology by applying the multivariate logistic model. The results show that 91.92% of the farmers adopted CA technology. Part-time farming had a highly significant positive influence on the likelihood of adoption. Moreover, the impact degree increased along with the deepening of part-time farming. In addition, farmers’ adoption behaviors were affected by gender, contracted land area, economic welfare cognition and social welfare cognition. Our results help to understand farmers’ complex decision-making on farmland and to promote the sustainable development of agriculture in Jianghan Plain. A somewhat targeted approach to design policies to support technological, policy and institutional interventions to encourage farmers to engage in part-time farming are recommended, especially in areas that share similar edaphic and climatic characteristics with Jianghan Plain. Full article
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Open AccessArticle
Perception of Gingival Bleeding by People and Healthcare Professionals: A Multicentre Study in an Adult French Population
Int. J. Environ. Res. Public Health 2020, 17(16), 5982; https://doi.org/10.3390/ijerph17165982 - 18 Aug 2020
Viewed by 573
Abstract
Gingival bleeding (GB) is a common sign of gingival inflammation, which indicates the presence of periodontal diseases. This study aimed to describe the perception of French adults about their self-reported GB and answers of healthcare professionals regarding the GB reported by these interviewees. [...] Read more.
Gingival bleeding (GB) is a common sign of gingival inflammation, which indicates the presence of periodontal diseases. This study aimed to describe the perception of French adults about their self-reported GB and answers of healthcare professionals regarding the GB reported by these interviewees. A questionnaire administered by one investigator in each of three public settings of four cities in France from September 2016 to November 2017. Among 794 adults interviewed, 502 (63.2%) reported a GB. Among them, 414 (82.5%) believed that GB is benign, and 309 (61.6%) declared one or more responses. The three main responses were to use mouthwash (29.3%), to change to a soft-bristle toothbrush (20.1%) and to modify the brushing technique (19.3%). Almost half (49.0%) questioned at least one healthcare professional concerning their GB: a dentist (43.0%), a physician (14.1%), and a pharmacist (8.0%). The main response of each healthcare professional was: for dentists: a “prescription of mouthwash”, for physicians to say “gingival bleeding is not serious”; and for pharmacists: “to sell a mouthwash”. Most of the participants considered their GB as benign and had inappropriate responses, which indicates their lack of knowledge regarding periodontal health. The same conclusions can be drawn for healthcare professionals, as reported by interviewees. Full article
(This article belongs to the Special Issue Oral Microbiota and Oral Health)
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Open AccessReview
Narrative Review on Health-EDRM Primary Prevention Measures for Vector-Borne Diseases
Int. J. Environ. Res. Public Health 2020, 17(16), 5981; https://doi.org/10.3390/ijerph17165981 - 18 Aug 2020
Viewed by 751
Abstract
Climate change is expanding the global at-risk population for vector-borne diseases (VBDs). The World Health Organization (WHO) health emergency and disaster risk management (health-EDRM) framework emphasises the importance of primary prevention of biological hazards and its value in protecting against VBDs. The framework [...] Read more.
Climate change is expanding the global at-risk population for vector-borne diseases (VBDs). The World Health Organization (WHO) health emergency and disaster risk management (health-EDRM) framework emphasises the importance of primary prevention of biological hazards and its value in protecting against VBDs. The framework encourages stakeholder coordination and information sharing, though there is still a need to reinforce prevention and recovery within disaster management. This keyword-search based narrative literature review searched databases PubMed, Google Scholar, Embase and Medline between January 2000 and May 2020, and identified 134 publications. In total, 10 health-EDRM primary prevention measures are summarised at three levels (personal, environmental and household). Enabling factor, limiting factors, co-benefits and strength of evidence were identified. Current studies on primary prevention measures for VBDs focus on health risk-reduction, with minimal evaluation of actual disease reduction. Although prevention against mosquito-borne diseases, notably malaria, has been well-studied, research on other vectors and VBDs remains limited. Other gaps included the limited evidence pertaining to prevention in resource-poor settings and the efficacy of alternatives, discrepancies amongst agencies’ recommendations, and limited studies on the impact of technological advancements and habitat change on VBD prevalence. Health-EDRM primary prevention measures for VBDs require high-priority research to facilitate multifaceted, multi-sectoral, coordinated responses that will enable effective risk mitigation. Full article
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