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Int. J. Environ. Res. Public Health, Volume 17, Issue 19 (October-1 2020) – 416 articles

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Cover Story (view full-size image) Mental healthcare is an emotionally taxing occupation that demands from professionals to [...] Read more.
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Open AccessArticle
The German Multi-Dimensional Perceived Autonomy Support Scale for Physical Education: Adaption and Validation in a Sample of Lower Track Secondary School Students
Int. J. Environ. Res. Public Health 2020, 17(19), 7353; https://doi.org/10.3390/ijerph17197353 - 08 Oct 2020
Viewed by 640
Abstract
Teachers’ autonomy support (AS) in physical education (PE) has positive effects on students’ affective and behavioral outcomes in PE. Even though the existence of three different dimensions of AS, namely cognitive, organizational and procedural AS has been suggested in educational settings, there is [...] Read more.
Teachers’ autonomy support (AS) in physical education (PE) has positive effects on students’ affective and behavioral outcomes in PE. Even though the existence of three different dimensions of AS, namely cognitive, organizational and procedural AS has been suggested in educational settings, there is a lack of multidimensional instruments for the assessment of autonomy-supportive teaching in PE. The aim of this study was to validate the German Multi-Dimensional Perceived Autonomy Support Scale for Physical Education (MD-PASS-PE). The sample comprised 1030 students of grades 6 through 10. Internal consistency was used to test the reliability of the assumed subscales. Factorial validity and measurement invariance across gender and age were examined by confirmatory factor analyses. Structural equation modeling was used to evaluate criterion validity. The subscales exhibited acceptable to good internal consistency. The assumed three-factor structure was confirmed within a bi-factor model including a general factor and three specific group factors. Results strongly supported measurement invariance across gender while tentatively suggesting measurement invariance across age. Criterion validity was supported as the MD-PASS-PE explained 15% and 14% of the variance in the constructs of self-efficacy and intrinsic value, respectively. The German MD-PASS-PE provides PE teachers with deeper insights into their autonomy-supportive teaching behavior, helping them to support their students’ autonomy in a holistic way. Full article
(This article belongs to the Special Issue New Advances in Self-Determination Theory in Physical Education)
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Open AccessArticle
Risk Information Seeking Behavior in Disaster Resettlement: A Case Study of Ankang City, China
Int. J. Environ. Res. Public Health 2020, 17(19), 7352; https://doi.org/10.3390/ijerph17197352 - 08 Oct 2020
Viewed by 500
Abstract
In 2011, the Chinese government launched a disaster mitigation and preparedness program called the Resettlement of South Shaanxi (RSS). Due to the wide geographical scope and complex interests, the possibility of conflicts was increased during and after resettlement. Efficient risk communication improves the [...] Read more.
In 2011, the Chinese government launched a disaster mitigation and preparedness program called the Resettlement of South Shaanxi (RSS). Due to the wide geographical scope and complex interests, the possibility of conflicts was increased during and after resettlement. Efficient risk communication improves the supply of information about risks and meets the risk-related information needs of individuals. Using the risk information seeking and processing (RISP) model, this research applied a structural equation model and survey with a structured questionnaire to study ways to improve risk communication in disaster resettlement. A total of 616 valid questionnaires were provided by study respondents in resettlement sites in Ziyang County, Ankang City, Shaanxi Province. The results indicated the following: (1) the public’s information seeking behavior relies more on village committees and village officials than other channels. Emerging information channels, such as Weibo and WeChat (social media applications in China), do not play leading roles in disseminating risk information. (2) There are differences between the information channels used by residents and the channels that residents believe the most. (3) Relevant channel beliefs, information sufficiency, perceived hazard characteristics, and self-efficacy directly influence risk information seeking behavior. However, the capacity to gather information has non-significant direct influences on information seeking behavior. (4) Perceived hazard characteristics and self-efficacy drive risk information seeking behavior in both direct and indirect ways through information sufficiency. Full article
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Open AccessArticle
Relationships between Prenatal Distress and Infant Body Mass Index in the First Year of Life in a Lower-Middle Income Country
Int. J. Environ. Res. Public Health 2020, 17(19), 7351; https://doi.org/10.3390/ijerph17197351 - 08 Oct 2020
Viewed by 494
Abstract
Prenatal stress affects body composition in childhood and later in life. However, few studies assess body composition in infancy. Furthermore, most are in high-income countries and do not consider interactive or curvilinear relationships. We assessed distress and diet during pregnancy via questionnaires among [...] Read more.
Prenatal stress affects body composition in childhood and later in life. However, few studies assess body composition in infancy. Furthermore, most are in high-income countries and do not consider interactive or curvilinear relationships. We assessed distress and diet during pregnancy via questionnaires among 310 women in Vanuatu, a lower-middle income country. We measured body mass index (BMI) among 54 infants at 4–12 months of age. We analyzed interactive relationships between prenatal distress and diet with BMI Z-scores, and curvilinear relationships between distress and BMI Z-scores. There were no direct linear or interactive relationships between prenatal distress or diet with BMI Z-scores. We observed curvilinear relationships between prenatal distress and BMI Z-scores (p = 0.008), explaining 13.3 percent of unique variance. Results highlight that relationships between prenatal stress and body composition are evident in infancy but might not be detected if only linear relationships are assessed. Analyses in more diverse samples might help to explain inconsistencies in past studies. Full article
(This article belongs to the Special Issue Prenatal Stress, Health Behaviors and Child Development)
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Open AccessArticle
Impact of Aurora Kinase A Polymorphism and Epithelial Growth Factor Receptor Mutations on the Clinicopathological Characteristics of Lung Adenocarcinoma
Int. J. Environ. Res. Public Health 2020, 17(19), 7350; https://doi.org/10.3390/ijerph17197350 - 08 Oct 2020
Viewed by 463
Abstract
Lung adenocarcinoma (LADC) is the most common subtype of lung cancer worldwide and the epidermal growth factor receptor (EGFR) has a great influence on its clinical course, mainly due to the influence of different phenotypes. The Aurora kinase A (AURKA) would influence the [...] Read more.
Lung adenocarcinoma (LADC) is the most common subtype of lung cancer worldwide and the epidermal growth factor receptor (EGFR) has a great influence on its clinical course, mainly due to the influence of different phenotypes. The Aurora kinase A (AURKA) would influence the progression of several solid malignancies. However, whether the interaction between EGFR phenotypes and AURKA would influence the clinical characteristics of LADC remains unknown. Herein, this study aimed to explore the effects of single-nucleotide polymorphisms (SNPs) of AURKA and EGFR phenotypes on the clinicopathological characteristics of LADC. Four loci of AURKA SNPs (rs1047972, rs2273535, rs6024836, and rs2064863) were genotyped using TaqMan allelic discrimination in 105 wild-type EGFR individuals and 167 LADC patients with EGFR mutations. After the statistical analysis, patients with LADC who had CT heterozygotes of AURKA rs1047972 had a lower risk of EGFR mutations than patients with wild-type homozygotes. Moreover, female and nonsmoking patients who carried the CT genotype of AURKA rs1047972 had a lower risk of EGFR mutation (p = 0.008 and p = 0.004, respectively). Moreover, in patients with EGFR mutations, AURKA SNP rs6024836 G allele (AG + GG) carriers had a lower risk of developing advanced-stage LADC (stage III or IV; odds ratio = 0.423, 95% confidence interval: 0.203–0.879, p = 0.019) than patients with AA homozygotes. Our results suggested that AURKA rs1047972 variants are significantly associated with EGFR mutations among patients with LADC, particularly in female and nonsmoking patients. AURKA variants may contribute to the pathological development of LADC. Full article
Open AccessArticle
Using the Machine Learning Method to Study the Environmental Footprints Embodied in Chinese Diet
Int. J. Environ. Res. Public Health 2020, 17(19), 7349; https://doi.org/10.3390/ijerph17197349 - 08 Oct 2020
Viewed by 449
Abstract
The food system profoundly affects the sustainable development of the environment and resources. Numerous studies have shown that the food consumption patterns of Chinese residents will bring certain pressure to the environment. Food consumption patterns have individual differences. Therefore, reducing the pressure of [...] Read more.
The food system profoundly affects the sustainable development of the environment and resources. Numerous studies have shown that the food consumption patterns of Chinese residents will bring certain pressure to the environment. Food consumption patterns have individual differences. Therefore, reducing the pressure of food consumption patterns on the environment requires the precise positioning of people with high consumption tendencies. Based on the related concepts of the machine learning method, this paper designs an identification method of the population with a high environmental footprint by using a decision tree as the core and realizes the automatic identification of a large number of users. By using the microdata provided by CHNS(the China Health and Nutrition Survey), we study the relationship between residents’ dietary intake and environmental resource consumption. First, we find that the impact of residents’ food system on the environment shows a certain logistic normal distribution trend. Then, through the decision tree algorithm, we find that four demographic characteristics of gender, income level, education level, and region have the greatest impact on residents’ environmental footprint, where the consumption trends of different characteristics are also significantly different. At the same time, we also use the decision tree to identify the population characteristics with high consumption tendency. This method can effectively improve the identification coverage and accuracy rate and promotes the improvement of residents’ food consumption patterns. Full article
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Open AccessArticle
Validation and Adaptation of the “Modified Transplant Symptom Occurrence and Symptom Distress Scale” for Kidney Transplant Recipients
Int. J. Environ. Res. Public Health 2020, 17(19), 7348; https://doi.org/10.3390/ijerph17197348 - 08 Oct 2020
Viewed by 545
Abstract
The aim was to adapt and validate the Modified Transplant Symptom Occurrence and Symptom Distress Scale (MTSOSD-59R) for kidney transplant recipients undergoing immunosuppressive therapy in Korea. The MTSOSD-59R has been used with solid organ transplant recipients globally to assess the adverse effects of [...] Read more.
The aim was to adapt and validate the Modified Transplant Symptom Occurrence and Symptom Distress Scale (MTSOSD-59R) for kidney transplant recipients undergoing immunosuppressive therapy in Korea. The MTSOSD-59R has been used with solid organ transplant recipients globally to assess the adverse effects of immunosuppressive medication. A descriptive cross-sectional design was used. MTSOSD-59R was first translated, and pilot tested. Next, content validity was established with nine organ transplant experts. Then, from October 2017 to October 2018, the Korean MTOSOSD-59R was administered to a convenience sample of 122 kidney transplant recipients recruited from a single center. Ridit analysis was used to measure symptom occurrence and distress. The known-group approach was used to test the construct validity using Mann–Whitney U tests for between-group comparisons. The content validity index for MTSOSD-59R was 0.98, and known-group validity was confirmed. The split-half Spearman–Brown corrected reliability coefficient was 0.902 for symptom occurrence and 0.893 for symptom distress. The four most frequent and distressing symptoms were fatigue, lack of energy, thinning hair, and erectile dysfunction (male). Results suggest this Korean MTSOSD-59R adaptation has adequate language, construct validity, and reliability to gather meaningful information from kidney transplant recipients in Korea. Full article
(This article belongs to the Section Health Behavior, Chronic Disease and Health Promotion)
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Open AccessArticle
A Comprehensive Investigation on the Fire Hazards and Environmental Risks in a Commercial Complex Based on Fault Tree Analysis and the Analytic Hierarchy Process
Int. J. Environ. Res. Public Health 2020, 17(19), 7347; https://doi.org/10.3390/ijerph17197347 - 08 Oct 2020
Viewed by 439
Abstract
This paper focuses on the fire risk assessment for commercial complex, as the variety of fire accidental triggers inside could be a big threat to the public fire safety, leading to catastrophic loss in human lives and properties. Both the qualitative and quantitative [...] Read more.
This paper focuses on the fire risk assessment for commercial complex, as the variety of fire accidental triggers inside could be a big threat to the public fire safety, leading to catastrophic loss in human lives and properties. Both the qualitative and quantitative analysis were imposed on a typical large commercial complex to recognize the potential fire-causative factors in this paper. Applying the fault tree analysis, the basic events leading to fire are acquired, and they are then further reclassified based on the analytic hierarchy process. Taking the damage of the accident as the target layer and the fire-causative factors, the equipment operation factors and firefighting factors as the criterion layer, the assessment index is well established. The risk of each factor is quantitatively evaluated, and the effect of each factor on the target layer is analyzed. The result of the fault tree analysis and analytic hierarchy process shows good consistency, in which human behavior is the main factor leading to the fire occurrence, followed by the combustible material, the rescue speed and the staff assignment factors. The results are beneficial for general decisions and measures in public fire safety management. Full article
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Open AccessArticle
“We Just Take Care of Each Other”: Navigating ‘Chosen Family’ in the Context of Health, Illness, and the Mutual Provision of Care amongst Queer and Transgender Young Adults
Int. J. Environ. Res. Public Health 2020, 17(19), 7346; https://doi.org/10.3390/ijerph17197346 - 08 Oct 2020
Viewed by 1018
Abstract
“Chosen family”—families formed outside of biological or legal (bio-legal) bonds—is a signature of the queer experience. Therefore, we address the stakes of “chosen family” for queer and transgender (Q/T) young adults in terms of health, illness and the mutual provision of care. “Chosen [...] Read more.
“Chosen family”—families formed outside of biological or legal (bio-legal) bonds—is a signature of the queer experience. Therefore, we address the stakes of “chosen family” for queer and transgender (Q/T) young adults in terms of health, illness and the mutual provision of care. “Chosen family” is a refuge specifically generated by and for the queer experience, so we draw upon anthropological theory to explore questions of queer kinship in terms of care. We employ a phenomenological approach to semi-structured interviews (n = 11), open coding, and thematic analysis of transcriptions to meet our aims: (1) Develop an understanding of the beliefs and values that form the definition of “chosen family” for Q/T young adults; and (2) Understand the ways in which “chosen family” functions in terms of care for health and illness. Several themes emerged, allowing us to better understand the experiences of this population in navigating the concept of “chosen family” within and beyond health care settings. Emergent themes include: (1) navigating medical systems; (2) leaning on each other; and (3) mutual aid. These findings are explored, as are the implications of findings for how health care professionals can better engage Q/T individuals and their support networks. Full article
(This article belongs to the Special Issue Health Inequalities and Social Support among LGBT + Populations)
Open AccessCommentary
Immediate Antiretroviral Therapy: The Need for a Health Equity Approach
Int. J. Environ. Res. Public Health 2020, 17(19), 7345; https://doi.org/10.3390/ijerph17197345 - 08 Oct 2020
Viewed by 352
Abstract
Immediate antiretroviral therapy (iART), defined as same-day initiation of ART or as soon as possible after diagnosis, has recently been recommended by global and national clinical care guidelines for patients newly diagnosed with human immunodeficiency virus (HIV). Based on San Francisco’s Rapid ART [...] Read more.
Immediate antiretroviral therapy (iART), defined as same-day initiation of ART or as soon as possible after diagnosis, has recently been recommended by global and national clinical care guidelines for patients newly diagnosed with human immunodeficiency virus (HIV). Based on San Francisco’s Rapid ART Program Initiative for HIV Diagnoses (RAPID) model, most iART programs in the US condense ART initiation, insurance acquisition, housing assessment, and mental health and substance use evaluation into an initial visit. However, the RAPID model does not explicitly address structural racism and homophobia, HIV-related stigma, medical mistrust, and other important factors at the time of diagnosis experienced more poignantly by African American, Latinx, men who have sex with men (MSM), and transgender patient populations. These factors negatively impact initial and subsequent HIV care engagement and exacerbate significant health disparities along the HIV care continuum. While iART has improved time to viral suppression and linkage to care rates, its association with retention in care and viral suppression, particularly in vulnerable populations, remains controversial. Considering that in the US the HIV epidemic is sharply defined by healthcare disparities, we argue that incorporating an explicit health equity approach into the RAPID model is vital to ensure those who disproportionately bear the burden of HIV are not left behind. Full article
(This article belongs to the Special Issue The Social Epidemiology of Sexual Health)
Open AccessArticle
The Role of the Teacher in the Implementation of a School-Based Intervention on the Physical Activity Practice of Children
Int. J. Environ. Res. Public Health 2020, 17(19), 7344; https://doi.org/10.3390/ijerph17197344 - 08 Oct 2020
Viewed by 434
Abstract
Medium- or long-term intervention strategies for physical activity practice (PAP) need to be more effective in terms of their implementation by practitioners. The aim of this study was to evaluate the role of a teacher to implement the Team Pentathlon (TP) in order [...] Read more.
Medium- or long-term intervention strategies for physical activity practice (PAP) need to be more effective in terms of their implementation by practitioners. The aim of this study was to evaluate the role of a teacher to implement the Team Pentathlon (TP) in order to improve the PAP in primary children. TP is a health education program made to improve PAP of children through individual and collective achievements. In this study, 203 children (age: 10–13 years) in grades 5 and 6 (intervention group (IG) N = 104, control group (CG) N = 99) were guided to increase their PAP during an eight-week period by five elementary school teachers (physical education or classroom) who had received four training sessions. Levels of PAP (self-reported) were compared between groups (IG/CG), sex, socioeconomic status of the schools and between teachers: baseline and during TP. Several teachers noted significant increases in PAP in the IG for both boys and girls (p ≤ 0.05 or p < 0.01), whereas others found only small improvements in PAP. One teacher even observed higher PAP in the CG. Training session records revealed that the teacher himself, how the TP is implemented, and proper resources were the three elements that explained the successful implementation of the TP program. The implementation of the TP significantly increased the PAP in primary children. Training sessions helped teachers to implement the TP program but personal engagement, motivation, respecting protocol, and an adequate environment are also necessary in improving the PAP of children. Full article
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Open AccessArticle
Legionnaires’ Disease on the Rise in Switzerland: A Denominator-Based Analysis of National Diagnostic Data, 2007–2016
Int. J. Environ. Res. Public Health 2020, 17(19), 7343; https://doi.org/10.3390/ijerph17197343 - 08 Oct 2020
Viewed by 436
Abstract
The risk of falling ill with Legionnaires’ disease (LD) is suggested to increase, but the global burden of disease is unknown due to a lack of appropriate diagnosis and surveillance systems. In Switzerland, the number of LD cases, captured by the National Notification [...] Read more.
The risk of falling ill with Legionnaires’ disease (LD) is suggested to increase, but the global burden of disease is unknown due to a lack of appropriate diagnosis and surveillance systems. In Switzerland, the number of LD cases, captured by the National Notification System for Infectious Diseases, has more than doubled since 2008. This study aims to investigate this increase, contextualizing disease surveillance data with denominator data, which is not routinely available, i.e., the number of tests performed for Legionella spp. We collected the testing data for Legionella spp. of 14 Swiss diagnostic laboratories and calculated the positivity, defined as the proportion of the number of positive tests to the number of tests performed. The number of positive tests increased proportionally to the number of tests performed; hence, the positivity remained stable. However, the cause of the increase in test volume is unclear and has a large impact on the interpretation of the positivity curve. Further, the test outcome was found to be dependent on regional determinants, and the diagnostic method applied. The lack of understanding if and at which stage LD is considered in current case management of pneumonia patients limits the interpretation of observed heterogeneities in incidence or underestimation of LD in Switzerland. The absence of (or non-adherence to) existing guidelines and the heterogeneity in diagnostic testing hampers the comparison of data in the Swiss public health context. Therefore, diagnostic procedures should be harmonised across Switzerland and adherence to national LD management guidelines supported. Full article
(This article belongs to the Section Infectious Disease Epidemiology)
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Open AccessReview
Individual Stress Prevention through Qigong
Int. J. Environ. Res. Public Health 2020, 17(19), 7342; https://doi.org/10.3390/ijerph17197342 - 08 Oct 2020
Viewed by 324
Abstract
Owing to work intensification and an accelerated pace of life in general, individuals in many Western countries are often overactivated and find it difficult to switch off. However, recovery from physiological and mental activation is critical to prevent stress symptoms and maintain one’s [...] Read more.
Owing to work intensification and an accelerated pace of life in general, individuals in many Western countries are often overactivated and find it difficult to switch off. However, recovery from physiological and mental activation is critical to prevent stress symptoms and maintain one’s physiological and mental well-being. Extensive research evidence indicates that Qigong, a traditional Chinese movement practice for promoting health, provides an effective means to recover from work and off-work demands. The main objective of this paper is to offer a comprehensive, narrative review of the effects of Qigong and its core components. Attention is first paid to the outcomes of work and off-work demands and stress, and the role of recovery for individuals’ well-being. Then, Qigong and its components are explained, followed by the results of scientific research. Finally, limitations and implications for research and practiced are discussed. Full article
(This article belongs to the Special Issue Prevention Better than Cure for Long Term Conditions?)
Open AccessArticle
Prevalence and Associated Factors of Compliance Behaviors among Middle-Aged and Older Hypertensive Patients in China: Results from the China Health and Retirement Longitudinal Study
Int. J. Environ. Res. Public Health 2020, 17(19), 7341; https://doi.org/10.3390/ijerph17197341 - 08 Oct 2020
Viewed by 454
Abstract
Partial or total non-adherence has been recognized as major issues in the long-term management of hypertension. This study aims to investigate the prevalence and associated factors of compliance behaviors among Chinese middle-aged and older hypertensive patients. A sample of 6308 hypertensive patients aged [...] Read more.
Partial or total non-adherence has been recognized as major issues in the long-term management of hypertension. This study aims to investigate the prevalence and associated factors of compliance behaviors among Chinese middle-aged and older hypertensive patients. A sample of 6308 hypertensive patients aged ≥45 years was obtained from the 2015 China Health and Retirement Longitudinal Study (CHARLS) data. Two compliance behaviors were involved including medication and blood pressure monitoring. Stratified binary logistic regression analysis was employed to examine the associated factors. 77.2% of the participants reported medication compliance, and 40.7% complied with blood pressure monitoring. Better medication compliance associated with older age, overweight or obesity, one or ≥3 complications, no drinking, living in urban areas, and health education. Better blood pressure monitoring compliance associated with older age, overweight or obesity, ≥3 complications, normal activities of daily living (ADL), no smoking, sleep duration of 6–8 h, better cognitive function, living in urban areas, education level of middle school or above, and health education. Chinese middle-aged and older hypertensive patients experienced unoptimistic compliance behaviors, especially for blood pressure monitoring. Special attention and targeted interventions are urgent for the high-risk population of poor compliance behaviors, such as rural individuals, low educational population, and younger hypertensive patients. Full article
Open AccessArticle
Doctors’ Mental Health in the Midst of COVID-19 Pandemic: The Roles of Work Demands and Recovery Experiences
Int. J. Environ. Res. Public Health 2020, 17(19), 7340; https://doi.org/10.3390/ijerph17197340 - 08 Oct 2020
Cited by 1 | Viewed by 616
Abstract
The COVID-19 pandemic potentially increases doctors’ work demands and limits their recovery opportunity; this consequently puts them at a high risk of adverse mental health impacts. This study aims to estimate the level of doctors’ fatigue, recovery, depression, anxiety, and stress, and exploring [...] Read more.
The COVID-19 pandemic potentially increases doctors’ work demands and limits their recovery opportunity; this consequently puts them at a high risk of adverse mental health impacts. This study aims to estimate the level of doctors’ fatigue, recovery, depression, anxiety, and stress, and exploring their association with work demands and recovery experiences. This was a cross-sectional study among all medical doctors working at all government health facilities in Selangor, Malaysia. Data were collected in May 2020 immediately following the COVID-19 contagion peak in Malaysia by using self-reported questionnaires through an online medium. The total participants were 1050 doctors. The majority of participants were non-resident non-specialist medical officers (55.7%) and work in the hospital setting (76.3%). The highest magnitude of work demands was mental demand (M = 7.54, SD = 1.998) while the lowest magnitude of recovery experiences was detachment (M = 9.22, SD = 5.043). Participants reported a higher acute fatigue level (M = 63.33, SD = 19.025) than chronic fatigue (M = 49.37, SD = 24.473) and intershift recovery (M = 49.97, SD = 19.480). The majority of them had no depression (69.0%), no anxiety (70.3%), and no stress (76.5%). Higher work demands and lower recovery experiences were generally associated with adverse mental health. For instance, emotional demands were positively associated with acute fatigue (adj. b = 2.73), chronic fatigue (adj. b = 3.64), depression (adj. b = 0.57), anxiety (adj. b = 0.47), and stress (adj. b = 0.64), while relaxation experiences were negatively associated with acute fatigue (adj. b = −0.53), chronic fatigue (adj. b = −0.53), depression (adj. b = −0.14), anxiety (adj. b = −0.11), and stress (adj. b = −0.15). However, higher detachment experience was associated with multiple mental health parameters in the opposite of the expected direction such as higher level of chronic fatigue (adj. b = 0.74), depression (adj. b = 0.15), anxiety (adj. b = 0.11), and stress (adj. b = 0.11), and lower level of intershift recovery (adj. b = −0.21). In conclusion, work demands generally worsen, while recovery experiences protect mental health during the COVID-19 pandemic with the caveat of the role of detachment experiences. Full article
(This article belongs to the Special Issue Mental Health in the Time of COVID-19)
Open AccessArticle
Effect of Five Bench Inclinations on the Electromyographic Activity of the Pectoralis Major, Anterior Deltoid, and Triceps Brachii during the Bench Press Exercise
Int. J. Environ. Res. Public Health 2020, 17(19), 7339; https://doi.org/10.3390/ijerph17197339 - 08 Oct 2020
Viewed by 665
Abstract
The bench press exercise is one of the most used for training and for evaluating upper-body strength. The aim of the current study was to evaluate the electromyographic (EMG) activity levels of the pectoralis major (PM) in its three portions (upper portion, PMUP, [...] Read more.
The bench press exercise is one of the most used for training and for evaluating upper-body strength. The aim of the current study was to evaluate the electromyographic (EMG) activity levels of the pectoralis major (PM) in its three portions (upper portion, PMUP, middle portion, PMMP, and lower portion, PMLP), the anterior deltoid (AD), and the triceps brachii (TB) medial head during the bench press exercise at five bench angles (0°, 15°, 30°, 45°, and 60°). Thirty trained adults participated in the study. The EMG activity of the muscles was recorded at the aforementioned inclinations at 60% of one-repetition maximum (1RM). The results showed that the maximal EMG activity for PMUP occurred at a bench inclination of 30°. PMMP and PMLP showed higher EMG activity at a 0° bench inclination. AD had the highest EMG activity at 60°. TB showed similar EMG activities at all bench inclinations. In conclusion, the horizontal bench press produces similar electromyographic activities for the pectoralis major and the anterior deltoid. An inclination of 30° produces greater activation of the upper portion of the pectoralis major. Inclinations greater than 45° produce significantly higher activation of the anterior deltoid and decrease the muscular performance of the pectoralis major. Full article
(This article belongs to the Special Issue Monitoring and Evaluation of Training in Sport and Exercise)
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Open AccessArticle
Predicting Caregiver Burden in Informal Caregivers for the Elderly in Ecuador
Int. J. Environ. Res. Public Health 2020, 17(19), 7338; https://doi.org/10.3390/ijerph17197338 - 08 Oct 2020
Viewed by 436
Abstract
Informal caregivers are the main providers of care for the elderly. The aim of this study is to examine the predictive value of different variables regarding caregivers and their elderly patients with respect to the caregiver’s burden. A convenience sample of 688 informal [...] Read more.
Informal caregivers are the main providers of care for the elderly. The aim of this study is to examine the predictive value of different variables regarding caregivers and their elderly patients with respect to the caregiver’s burden. A convenience sample of 688 informal caregivers and 688 elderly people from Ecuador was surveyed. Only households with one caregiver and one elderly person were considered for the study. For informal caregivers, the following standardized measures were obtained: burden (Zarit Burden Interview), neuroticism (Eysenck Personality Questionnaire Revised-Abbreviated, EPQR-A), caregiver’s general health (GHQ-12), and social support (modified Duke-UNC Functional Social Support Questionnaire, FSSQ11). For the elderly, we employed standardized measures of cognitive function (short portable mental status questionnaire, SPMSQ), Pfeiffer’s test, and functional dependency (Barthel scale/Index, BI). Females were over-represented in caregiving and reported significantly higher burden levels than those of males. In both male and female caregivers, the burden was best predicted by the time of caring, neuroticism, and elderly cognitive impairment. However, some predictors of burden were weighted differently in males and females. The functional independence of the elderly was a significant predictor of burden for male caregivers but not females, while caregiver competence was a significant predictor for females but not males. These variables accounted for more than 88% of the variability in informal caregivers. Full article
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Open AccessArticle
Association between Perceived Oral Symptoms and Presence of Clinically Diagnosed Oral Diseases in a Sample of Pregnant Women in Malaysia
Int. J. Environ. Res. Public Health 2020, 17(19), 7337; https://doi.org/10.3390/ijerph17197337 - 08 Oct 2020
Viewed by 425
Abstract
The integration of oral health into primary health care denotes the important role of medical counterparts as the front liners in antenatal care to help screen mothers for oral symptoms and refer them to dentists accordingly. However, the validity of self-perceived oral health [...] Read more.
The integration of oral health into primary health care denotes the important role of medical counterparts as the front liners in antenatal care to help screen mothers for oral symptoms and refer them to dentists accordingly. However, the validity of self-perceived oral health status is inconclusive. This study determined the association between self-perceived oral symptoms and the presence of clinically diagnosed oral diseases in a sample of pregnant women. A total of 192 pregnant women participated in this cross-sectional study. Clinical oral examinations were performed to record dental caries experience, gingival health and periodontal health. The women were also asked about their oral symptoms. Most women had at least one oral symptom (84.9%): cavitated tooth (62.0%), bad breath (38.5%), bleeding gums (28.6%), and toothache (22.9%). About half of the women had untreated dental caries (58.9%), and the odds were significantly higher in women who complained of having cavitated tooth. About half of the women had moderate to severe gingivitis (53.7%), and the odds were significantly higher in women who complained of bleeding gums. About half had periodontal pockets (46.3%), and the odds were higher in women who complained of bleeding gums and bad breath although lower in women who complained of swollen gums. In conclusion, the prevalence of dental caries and periodontal disease among pregnant women in this study were relatively high. The presence of untreated dental caries, moderate and severe gingivitis, and periodontal pockets were significantly associated with their corresponding oral symptoms. Full article
(This article belongs to the Section Oral Health)
Open AccessArticle
A Comprehensive Approach Limiting Extractions under General Anesthesia Could Improve Oral Health
Int. J. Environ. Res. Public Health 2020, 17(19), 7336; https://doi.org/10.3390/ijerph17197336 - 08 Oct 2020
Viewed by 412
Abstract
Access to dental treatment could be difficult for some patients due to dental phobia or anxiety, cognitive or sensorial disabilities, systemic disorders, or social difficulties. General anesthesia (GA) was often indicated for dental surgery, and there is almost no available data on adapted [...] Read more.
Access to dental treatment could be difficult for some patients due to dental phobia or anxiety, cognitive or sensorial disabilities, systemic disorders, or social difficulties. General anesthesia (GA) was often indicated for dental surgery, and there is almost no available data on adapted procedures and materials that can be applied during GA for maintaining functional teeth on the arches and limiting oral dysfunctions. This study evaluates changes in oral health-related quality of life and mastication in a cohort of uncooperative patients treated under GA according to a comprehensive and conservative dental treatment approach. Dental status, oral health-related quality of life, chewed bolus granulometry, kinematic parameters of mastication, and food refusals were evaluated one month preoperatively (T0), and then one month (T1) and six months post-operatively (T2). One hundred and two adult patients (mean age ± SD: 32.2 ± 9.9 years; range: 18–57.7) participated in the preoperative evaluation, 87 were treated under GA of which 36 participated in the evaluation at T1 and 15 were evaluated at T2. Preoperative and postoperative data comparisons demonstrated that oral rehabilitation under GA helped increase chewing activity and oral health-related quality of life. The conditions for providing dental treatment under GA could be arranged to limit dental extractions in uncooperative patients. Full article
(This article belongs to the Section Oral Health)
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Open AccessReview
The Prospects of Secondary Moderate Mitral Regurgitation after Aortic Valve Replacement —Meta-Analysis
Int. J. Environ. Res. Public Health 2020, 17(19), 7335; https://doi.org/10.3390/ijerph17197335 - 08 Oct 2020
Viewed by 443
Abstract
Aortic valve replacement for aortic stenosis represents one of the most frequent surgical procedures on heart valves. These patients often have concomitant mitral regurgitation. To reveal whether the moderate mitral regurgitation will improve after aortic valve replacement alone, we performed a systematic review [...] Read more.
Aortic valve replacement for aortic stenosis represents one of the most frequent surgical procedures on heart valves. These patients often have concomitant mitral regurgitation. To reveal whether the moderate mitral regurgitation will improve after aortic valve replacement alone, we performed a systematic review and meta-analysis. We identified 27 studies with 4452 patients that underwent aortic valve replacement for aortic stenosis and had co-existent mitral regurgitation. Primary end point was the impact of aortic valve replacement on the concomitant mitral regurgitation. Secondary end points were the analysis of the left ventricle reverse remodeling and long-term survival. Our results showed that there was significant improvement in mitral regurgitation postoperatively (RR, 1.65; 95% CI 1.36–2.00; p < 0.00001) with the average decrease of 0.46 (WMD; 95% CI 0.35–0.57; p < 0.00001). The effect is more pronounced in the elderly population. Perioperative mortality was higher (p < 0.0001) and long-term survival significantly worse (p < 0.00001) in patients that had moderate/severe mitral regurgitation preoperatively. We conclude that after aortic valve replacement alone there are fair chances but for only slight improvement in concomitant mitral regurgitation. The secondary moderate mitral regurgitation should be addressed at the time of aortic valve replacement. A more conservative approach should be followed for elderly and high-risk patients. Full article
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Open AccessArticle
Indoor Thermal Environment Long-Term Data Analytics Using IoT Devices in Korean Apartments: A Case Study
Int. J. Environ. Res. Public Health 2020, 17(19), 7334; https://doi.org/10.3390/ijerph17197334 - 08 Oct 2020
Viewed by 450
Abstract
IoT-based monitoring devices can transmit real-time and long-term thermal environment data, enabling innovative conversion for the evaluation and management of the indoor thermal environment. However, long-term indoor thermal measurements using IoT-based devices to investigate health effects have rarely been conducted. Using apartments in [...] Read more.
IoT-based monitoring devices can transmit real-time and long-term thermal environment data, enabling innovative conversion for the evaluation and management of the indoor thermal environment. However, long-term indoor thermal measurements using IoT-based devices to investigate health effects have rarely been conducted. Using apartments in Seoul as a case study, we conducted long-term monitoring of thermal environmental using IoT-based real-time wireless sensors. We measured the temperature, relative humidity (RH), and CO2 in the kitchen, living room, and bedrooms of each household over one year. In addition, in one of the houses, velocity and globe temperatures were measured for multiple summer and autumn seasons. Results of our present study indicated that outdoor temperature is an important influencing factor of indoor thermal environment and indoor RH is a good indicator of residents’ lifestyle. Our findings highlighted the need for temperature management in summer, RH management in winter, and kitchen thermal environment management during summer and tropical nights. This study suggested that IoT devices are a potential approach for evaluating personal exposure to indoor thermal environmental risks. In addition, long-term monitoring and analysis is an efficient approach for analyzing complex indoor thermal environments and is a viable method for application in healthcare. Full article
(This article belongs to the Special Issue Climate Change and Health: Big Data Based Approach)
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Open AccessArticle
Effect of an Ergonomics Educational Program on Musculoskeletal Disorders in Nursing Staff Working in the Operating Room: A Quasi-Randomized Controlled Clinical Trial
Int. J. Environ. Res. Public Health 2020, 17(19), 7333; https://doi.org/10.3390/ijerph17197333 - 08 Oct 2020
Viewed by 477
Abstract
Background: Nursing staff working in the operating room are exposed to risk factors that can cause musculoskeletal disorders (MSDs) and work-related disabilities. The use of ergonomics principles can help with the prevention of MSDs. This study aimed to examine the effect of an [...] Read more.
Background: Nursing staff working in the operating room are exposed to risk factors that can cause musculoskeletal disorders (MSDs) and work-related disabilities. The use of ergonomics principles can help with the prevention of MSDs. This study aimed to examine the effect of an ergonomics educational program on MSDs among nursing staff working in the operating room. Methods: In this pragmatic parallel group quasi-randomized controlled clinical trial, 74 nursing staff working in the operating rooms of two teaching hospitals participated. The hospitals were randomly assigned to either the intervention or the control group and all nursing staff working in the operating room of each hospital were invited to take part in this research. They were initially assessed for the prevalence and risk of MSDs by using the Nordic questionnaire and the rapid entire body assessment (REBA) checklist. The intervention group received the ergonomics educational program and were assessed in two-week intervals over a period of three months. At the end of the study, the risk and prevalence of MSDs were compared between the intervention and control groups. Results: Statistically significant differences were reported between the groups in terms of the prevalence and risk of MSDs. The overall risk of MSDs decreased in the intervention group after the educational program (p = 0.03). The reduction in the prevalence of MSDs in the different parts of the body in the intervention group was as follows: ankle (p = 0.005), hand/wrist (p = 0.041), low back (p = 0.000), the neck (p = 0.003), hip (p = 0.001) and shoulder (p = 0.043). Conclusion: The education of nursing staff about ergonomics can influence the prevalence and risk of MSDs. Therefore, it should be incorporated into the degree education and on-the-job training initiatives for nurses working in the operating theatre in order to reduce workplace injuries and associated absences, and increase the quality of care delivered by them. This clinical trial has been registered in the Iranian Registry of Clinical Trials: IRCT2015081823677N1. Full article
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Open AccessArticle
Maladaptive Rumination Mediates the Relationship between Self-Esteem, Perfectionism, and Work Addiction: A Largescale Survey Study
Int. J. Environ. Res. Public Health 2020, 17(19), 7332; https://doi.org/10.3390/ijerph17197332 - 08 Oct 2020
Viewed by 648
Abstract
Background: Empirical evidence suggests that low self-esteem and high perfectionism are significant personality correlates of work addiction, but the mechanisms underlying these relationships are still unclear. Consequently, exploring cognitive mechanisms will help to better understand work addiction. For instance, rumination is one [...] Read more.
Background: Empirical evidence suggests that low self-esteem and high perfectionism are significant personality correlates of work addiction, but the mechanisms underlying these relationships are still unclear. Consequently, exploring cognitive mechanisms will help to better understand work addiction. For instance, rumination is one of the under-researched topics in work addiction, although it may explain specific thinking processes of work-addicted individuals. The purpose of the study was to test the mediating role of maladaptive rumination (i.e., brooding) in the relationship between personality and addiction. Methods: In a largescale cross-sectional, unrepresentative, online study, 4340 adults with a current job participated. The following psychometric instruments were used: Work Addiction Risk Test Revised, Rosenberg Self-Esteem Scale, Multidimensional Perfectionism Scale, and Ruminative Response Scale. Results: It was found that self-oriented perfectionism, socially prescribed perfectionism, and self-esteem had both direct and indirect relationships with work addiction via the mediating effect of maladaptive rumination. The two paths involving brooding explained 44% of the direct relationship. Conclusions: The study demonstrated that brooding type of rumination as a putatively maladaptive strategy explains why individuals characterized by low self-esteem and high perfectionism may have a higher risk of work addiction. The results suggest that cognitive-affective mechanisms in work addiction are similar to those found in other addictive disorders. Full article
(This article belongs to the Special Issue Advancing Workaholism Research)
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Open AccessArticle
Incarceration Exposure and Barriers to Prenatal Care in the United States: Findings from the Pregnancy Risk Assessment Monitoring System
Int. J. Environ. Res. Public Health 2020, 17(19), 7331; https://doi.org/10.3390/ijerph17197331 - 08 Oct 2020
Viewed by 473
Abstract
Previous research demonstrates that exposure to incarceration during pregnancy – either personally or vicariously through a partner – worsens parental care. However, little is known about the specific barriers to parental care that are associated with incarceration exposure. Using data from the Pregnancy [...] Read more.
Previous research demonstrates that exposure to incarceration during pregnancy – either personally or vicariously through a partner – worsens parental care. However, little is known about the specific barriers to parental care that are associated with incarceration exposure. Using data from the Pregnancy Risk Assessment Monitoring System (years 2009–2016), the current study examines the relationship between exposure to incarceration during pregnancy and barriers to prenatal care in the United States. Negative binomial and logistic regression models were used to assess the association between the recent incarceration of a woman or her partner (i.e., incarceration that occurred in the 12 months prior to the focal birth) and several barriers to prenatal care. Findings indicate that exposure to incarceration, either personally or vicariously through a partner, increases the overall number of barriers to prenatal care and this association operates through several specific barriers including a lack of transportation to doctor’s appointments, having difficulty finding someone to take care of her children, being too busy, keeping pregnancy a secret, and a woman not knowing she was pregnant. Policies designed to help incarceration exposed women overcome these barriers can potentially yield benefits for enhancing access to parental care. Full article
(This article belongs to the Special Issue Effects of Parental Incarceration on the Family)
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Open AccessArticle
Post-9/11 Mental Health Comorbidity Predicts Self-Reported Confusion or Memory Loss in World Trade Center Health Registry Enrollees
Int. J. Environ. Res. Public Health 2020, 17(19), 7330; https://doi.org/10.3390/ijerph17197330 - 08 Oct 2020
Viewed by 506
Abstract
Numerous studies report elevated levels of chronic mental health conditions in those exposed to the World Trade Center attacks of 11 September 2001 (9/11), but few studies have examined the incidence of confusion or memory loss (CML) or its association with mental health [...] Read more.
Numerous studies report elevated levels of chronic mental health conditions in those exposed to the World Trade Center attacks of 11 September 2001 (9/11), but few studies have examined the incidence of confusion or memory loss (CML) or its association with mental health in 9/11 attack survivors. We investigated the incidence of CML and its association with the number of post-9/11 mental health conditions (PTSD, depression, and anxiety) in 10,766 World Trade Center Health Registry (Registry) enrollees aged 35–64 at the time of the wave 4 survey (2015–2016) that completed all four-wave surveys and met the study inclusion criteria. We employed log-binomial regression to evaluate the associations between CML and the number of mental health conditions. A total of 20.2% of enrollees in the sample reported CML, and there was a dose-response relationship between CML and the number of mental health conditions (one condition: RR = 1.85, 95% CI (1.65, 2.09); two conditions: RR = 2.13, 95% CI (1.85, 2.45); three conditions: RR = 2.51, 95% CI (2.17, 2.91)). Survivors may be experiencing confusion or memory loss partly due to the mental health consequences of the 9/11 attacks. Clinicians treating patients with mental health conditions should be aware of potential cognitive impairment. Full article
(This article belongs to the Special Issue 9/11 Health Update)
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Open AccessArticle
The Association between Esports Participation, Health and Physical Activity Behaviour
Int. J. Environ. Res. Public Health 2020, 17(19), 7329; https://doi.org/10.3390/ijerph17197329 - 08 Oct 2020
Viewed by 740
Abstract
We investigated the association between obesity, self-reported physical activity, cigarette smoking, alcohol consumption, and perceived health in esports players, and the influence of player in-game rank. Data was collected with an online survey with an international participant sample of esports players representing five [...] Read more.
We investigated the association between obesity, self-reported physical activity, cigarette smoking, alcohol consumption, and perceived health in esports players, and the influence of player in-game rank. Data was collected with an online survey with an international participant sample of esports players representing five esports and all skill levels (n = 1772). Esports players were more likely to be categorized as normal weight, or obesity class 2 and 3 and as non-smokers (92%) and non-drinkers (65.1%) compared to international reference data. Esports players met international physical activity guidelines less than global general population. Esports players ranked in the top 10% were more physically active compared to the remaining esports players. As esports player in-game rank increased, so did the amount of time spent playing esports. Although esports players appear generally healthy, a small group was significantly obese and most esports players did not meet physical activity guidelines, indicating potential future health risks. Full article
Open AccessReview
Risk Management in the New Frontier of Professional Liability for Nosocomial Infection: Review of the Literature on Mycobacterium Chimaera
Int. J. Environ. Res. Public Health 2020, 17(19), 7328; https://doi.org/10.3390/ijerph17197328 - 07 Oct 2020
Viewed by 545
Abstract
Background: Mycobacterium chimaera (MC) is of recent origin and belongs to the large family of non-tuberculous mycobacteria. In recent years, it has shown a high infectious capacity via the aerosol produced by operating room equipment, such as heater–cooler units (HCU). The infection [...] Read more.
Background: Mycobacterium chimaera (MC) is of recent origin and belongs to the large family of non-tuberculous mycobacteria. In recent years, it has shown a high infectious capacity via the aerosol produced by operating room equipment, such as heater–cooler units (HCU). The infection has a long latent period and high mortality rate. Genetic and epidemiological studies have shown that there is a clear link between the infection and a specific HCU model manufactured by LivaNova/Sorin. There is, therefore, a strong possibility that contamination occurs during device construction. The objective of this article is to describe the characteristics of this particular infection in view of the medico–legal implications on professional liability, specifically focusing on current evidence regarding contamination prevention. Methods: we have analyzed the clinical characteristics and data from the autopsic investigations performed on a patient who died as a result of MC infection, in addition to analyzing all pertinent recommendation documents available internationally. We searched for all articles in the literature available on MEDLINE between 1995 and 30 July 2020, using the search words “Mycobacterium chimaera”. We then analyzed those articles and reported only those that provide useful information regarding prevention techniques for containing dissemination and contamination. Results: the literature review produced 169 results that highlight the need to develop systems to mitigate and eliminate the risk of MC infection in operating rooms such as physical containment measures, e.g. device replacement, use of safe water, providing patients with information, and training healthcare professionals. Conclusions: from a medico–legal viewpoint, this particular situation represents a new frontier of professional liability, which includes manufacturers of electromedical equipment. In order to comprehend the true extent of this silent global epidemic, the development of an organic, preventative monitoring system is essential. Full article
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Open AccessArticle
Life Conditions during COVID-19 Lockdown and Mental Health in Spanish Adolescents
Int. J. Environ. Res. Public Health 2020, 17(19), 7327; https://doi.org/10.3390/ijerph17197327 - 07 Oct 2020
Viewed by 671
Abstract
Spanish children were locked down for 72 days due to COVID-19, causing severe disruption to their normal life. The threat posed by COVID-19 continues and clinicians, administrators, and families need to know the life conditions associated with more psychological problems to modify them [...] Read more.
Spanish children were locked down for 72 days due to COVID-19, causing severe disruption to their normal life. The threat posed by COVID-19 continues and clinicians, administrators, and families need to know the life conditions associated with more psychological problems to modify them and minimize their effect on mental health. The goal was to study the life conditions of adolescents during lockdown and their association with psychological problems. A total of 226 parents of 117 girls and 109 boys (mean age: 13.9; Standard deviation: 0.28) from the community that were participants in a longitudinal study answered an online questionnaire about life conditions during lockdown and the Strengths and Difficulties Questionnaire (SDQ). Stepwise regression analyses controlling by previous reports of SDQ were performed. Conduct, peer, prosocial, and total problems scores increased after lockdown. After adjusting for previous measures of psychopathology, worse adolescents’ mental health during COVID-19 lockdown was associated with unhealthy activities, worsening of the relationships with others, and dysfunctional parenting style. It seems important to mitigate psychological stress in a situation of isolation due to a state of emergency by keeping the adolescent active and maintaining their daily habits and routines in a non-conflictive atmosphere and give support to parents. Full article
(This article belongs to the Section Adolescents)
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Open AccessArticle
The Mortality Risk and Socioeconomic Vulnerability Associated with High and Low Temperature in Hong Kong
Int. J. Environ. Res. Public Health 2020, 17(19), 7326; https://doi.org/10.3390/ijerph17197326 - 07 Oct 2020
Viewed by 511
Abstract
(1) Background: The adverse health effect associated with extreme temperature has been extensively reported in the current literature. Some also found that temperature effect may vary among the population with different socioeconomic status (SES), but found inconsistent results. Previous studies on the socioeconomic [...] Read more.
(1) Background: The adverse health effect associated with extreme temperature has been extensively reported in the current literature. Some also found that temperature effect may vary among the population with different socioeconomic status (SES), but found inconsistent results. Previous studies on the socioeconomic vulnerability of temperature effect were mainly achieved by multi-city or country analysis, but the large heterogeneity between cities may introduce additional bias to the estimation. The linkage between death registry and census in Hong Kong allows us to perform a city-wide analysis in which the study population shares virtually the same cultural, lifestyle and policy environment. This study aims to examine and compare the high and low temperature on morality in Hong Kong, a city with a subtropical climate and address a key research question of whether the extreme high and low temperature disproportionally affects population with lower SES. (2) Methods: Poisson-generalized additive models and distributed-lagged nonlinear models were used to examine the association between daily mortality and daily mean temperature between 2007–2015 with other meteorological and confounding factors controlled. Death registry was linked with small area census and area-level median household income was used as the proxy for socioeconomic status. (3) Results: 362,957 deaths during the study period were included in the analysis. The minimum mortality temperature was found to be 28.9 °C (82nd percentile). With a subtropical climate, the low temperature has a stronger effect than the high temperature on non-accidental, cardiovascular, respiratory and cancer deaths in Hong Kong. The hot effect was more pronounced in the first few days, while cold effect tended to last up to three weeks. Significant heat effect was only observed in the lower SES groups, whilst the extreme low temperature was associated with significantly higher mortality risk across all SES groups. The older population were susceptible to extreme temperature, especially for cold. (4) Conclusions: This study raised the concern of cold-related health impact in the subtropical region. Compared with high temperature, low temperature may be considered a universal hazard to the entire population in Hong Kong rather than only disproportionally affecting people with lower SES. Future public health policy should reconsider the strategy at both individual and community levels to reduce temperature-related mortality. Full article
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Open AccessArticle
Attitudes of Mainstream and Special-Education Teachers toward Intellectual Disability in Italy: The Relevance of Being Teachers
Int. J. Environ. Res. Public Health 2020, 17(19), 7325; https://doi.org/10.3390/ijerph17197325 - 07 Oct 2020
Viewed by 1053
Abstract
The attitudes of teachers toward intellectual disability (ID) contribute to an effective school inclusion of students with ID, thereby enhancing their quality of life. The present study was aimed at investigating the attitude differences toward ID of mainstream and special-education teachers in Italy [...] Read more.
The attitudes of teachers toward intellectual disability (ID) contribute to an effective school inclusion of students with ID, thereby enhancing their quality of life. The present study was aimed at investigating the attitude differences toward ID of mainstream and special-education teachers in Italy and the general and specific teachers’ characteristics most related to these attitudes. An online version of the Attitudes toward Intellectual Disability (ATTID) questionnaire was filled by 307 mainstream teachers and 237 special-education teachers. The findings show that special-education teachers held more positive attitudes. Specific ATTID dimensions were positively affected for both types of teachers by previous training in special education/ID, perceived support, and promotion of positive attitudes toward ID, in addition to the quality of relationships with individuals with ID, while they were positively affected for special-education teachers by perceived efficacy of ID knowledge. No or very limited effects were observed for previous experience in teaching students with typical development or ID (even with severe/profound ID). Fostering resources to provide teachers with high-quality training, support, and resources and strategies to promote positive attitudes toward ID seems a relevant approach leading to favorable attitudes, thereby improving the quality of life of students with ID. Full article
Open AccessArticle
The Relationships between Screen Use and Health Indicators among Infants, Toddlers, and Preschoolers: A Meta-Analysis and Systematic Review
Int. J. Environ. Res. Public Health 2020, 17(19), 7324; https://doi.org/10.3390/ijerph17197324 - 07 Oct 2020
Viewed by 460
Abstract
Evidence suggests that excessive screen time in early childhood is related to children’s physical and mental health. This study aimed to review the relationships between screen media use and several health indicators in infants, toddlers, and preschoolers. A systematic search was conducted by [...] Read more.
Evidence suggests that excessive screen time in early childhood is related to children’s physical and mental health. This study aimed to review the relationships between screen media use and several health indicators in infants, toddlers, and preschoolers. A systematic search was conducted by two independent reviewers on PubMed, Web of Science, Embase, and Cochrane Library to identify the eligible studies, with an end date of 13 August 2019. Included studies (published in English) were peer-reviewed and met the determinate population (children aged 0–7 years with screen media exposure and related health outcomes). The AHRQ, NOS, and the Cochrane Handbook were used to evaluate the cross-sectional study, cohort study, and RCT, respectively. A meta-analysis and narrative syntheses were employed separately. Eighty studies (23 studies for meta-analysis) met the inclusion criteria for the systematic review. Strong evidence of the meta-analysis suggested that excessive screen time was associated with overweight/obesity and shorter sleep duration among toddlers and preschoolers. Excessive screen use was associated with various health indicators in physical, behavioral, and psychosocial aspects. Better-quality research on newer media devices, on various kinds of contents in young children, and on dose–response relationships between excessive screen use and health indicators are needed to update recommendations of screen use. Full article
(This article belongs to the Section Digital Health)
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