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Int. J. Environ. Res. Public Health, Volume 17, Issue 22 (November-2 2020) – 414 articles

Cover Story (view full-size image): Children with spina bifida often experience difficulties with activities of daily living. The HeyJoy Octopus child-friendly smartwatch could be used to promote purposeful activity. This research investigates the effectiveness of the Octopus watch for children with spina bifida (<8 years). A four-phase mixed-methods pilot study engaged parents and children. Results indicated three out of four participants showed mean activity increase. One participant showed clear improvement. Inhibition decreased and there was a mean change in performance and satisfaction scores using the Canadian Occupational Performance Measure. The Photovoice narrative supports findings evidenced, suggesting improved daily routines. The Octopus watch is an innovative early intervention that can promote purposeful activities of daily living. Further research is required. View this paper.
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Open AccessArticle
The Spatial Correlations of Health Resource Agglomeration Capacities and Their Influencing Factors: Evidence from China
Int. J. Environ. Res. Public Health 2020, 17(22), 8705; https://doi.org/10.3390/ijerph17228705 - 23 Nov 2020
Viewed by 461
Abstract
We measured the health resource agglomeration capacities of 31 Chinese provinces (or municipalities) in 2004–2018 based on the entropy weight method. Using a modified spatial gravity model, we constructed and analyzed the spatial correlation network of these health resource agglomeration capacities and their [...] Read more.
We measured the health resource agglomeration capacities of 31 Chinese provinces (or municipalities) in 2004–2018 based on the entropy weight method. Using a modified spatial gravity model, we constructed and analyzed the spatial correlation network of these health resource agglomeration capacities and their influencing factors through social network analysis. We found that: (i) China’s health resource agglomeration capacity had a gradual strengthening trend, with capacity weakening from east to west (strongest in the eastern region, second strongest in the central region, and weakest in the western region). (ii) The spatial network of such capacities became more densely connected, and the network density and level (efficiency) showed an upward (downward) trend. (iii) In terms of centrality, the high-ranking provinces (or municipalities) were Beijing, Shanghai, Jiangsu, Zhejiang, Guangdong, Shandong, Hunan, Hubei, Fujian, Anhui, Jiangxi, and Tianjin, while the low-ranking were Tibet, Qinghai, Gansu, Ningxia, Inner Mongolia, Heilongjiang, Yunnan, Guizhou, Xinjiang, Hainan, Shaanxi, and Shanxi. (iv) Block 1 (eight provinces or municipalities), including Beijing, Tianjin, and Hebei, had a “net spillover” effect in the spatial network of health resource agglomeration capacities; Block 2, (seven provinces or municipalities), including Shanghai, Jiangsu, and Zhejiang, had a “bidirectional spillover” effect in the spatial network; Block 3 (seven provinces or municipalities), including Anhui, Hubei, and Hunan, had a “mediator” effect in the network; and Block 4, (nine provinces or municipalities), including Sichuan, Guizhou, and Tibet, had a “net beneficial” effect in the network. (v) The economic development, urbanization wage, and financial health expenditure levels, and population size had significant positive correlations with the spatial network of health resource agglomeration capacities. Policy recommendations to enhance the radiating role of health resources in core provinces (or municipalities), rationally allocate health resources, and transform ideas to support public health resource services were provided. Full article
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Open AccessReview
New Psychoactive Substances: Evolution in the Exchange of Information and Innovative Legal Responses in the European Union
Int. J. Environ. Res. Public Health 2020, 17(22), 8704; https://doi.org/10.3390/ijerph17228704 - 23 Nov 2020
Viewed by 371
Abstract
At the end of 2019, the European Monitoring Centre for Drugs and Drug Addiction was monitoring around 790 new psychoactive substances, more than twice the total number of controlled substances under the United Nations Conventions. These substances, which are not subject to international [...] Read more.
At the end of 2019, the European Monitoring Centre for Drugs and Drug Addiction was monitoring around 790 new psychoactive substances, more than twice the total number of controlled substances under the United Nations Conventions. These substances, which are not subject to international drug controls, include a wide range of molecules, including the assortment of drugs such as synthetic cannabinoids, stimulants, opiates, and benzodiazepines. Most of them are sold as “legal” substitutes for illicit drugs, while others are intended for small groups willing to experiment with them in order to know their possible new effects. At the national level, various measures have been taken to control new substances and many European countries have responded with specific legislation in favor of consumer safety and by extending or adapting existing drug laws to incorporate the new psychoactive substances. Moreover, since 1997, an early warning system has been created in Europe for identifying and responding quickly to the risks of new psychoactive substances. In order to establish a quicker and more effective system to address the criminal activities associated with new dangerous psychoactive substances, the European legal framework has considerably changed over the years. Full article
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Open AccessArticle
Projection of the Number of Elderly in Different Health States in Thailand in the Next Ten Years, 2020–2030
Int. J. Environ. Res. Public Health 2020, 17(22), 8703; https://doi.org/10.3390/ijerph17228703 - 23 Nov 2020
Viewed by 366
Abstract
The objective of this study is to predict the volume of the elderly in different health status categories in Thailand in the next ten years (2020–2030). Multistate modelling was performed. We defined four states of elderly patients (aged ≥ 60 years) according to [...] Read more.
The objective of this study is to predict the volume of the elderly in different health status categories in Thailand in the next ten years (2020–2030). Multistate modelling was performed. We defined four states of elderly patients (aged ≥ 60 years) according to four different levels of Activities of Daily Living (ADL): social group; home group; bedridden group; and dead group. The volume of newcomers was projected by trend extrapolation methods with exponential growth. The transition probabilities from one state to another was obtained by literature review and model optimization. The mortality rate was obtained by literature review. Sensitivity analysis was conducted. By 2030, the number of social, home, and bedridden groups was 15,593,054, 321,511, and 152,749, respectively. The model prediction error was 1.75%. Sensitivity analysis with the change of transition probabilities by 20% caused the number of bedridden patients to vary from between 150,249 and 155,596. In conclusion, the number of bedridden elders will reach 153,000 in the next decade (3 times larger than the status quo). Policy makers may consider using this finding as an input for future resource planning and allocation. Further studies should be conducted to identify the parameters that better reflect the transition of people from one health state to another. Full article
(This article belongs to the Special Issue New Challenges and Crucial Topics for 2030 Public Health)
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Open AccessArticle
China’s Provincial Eco-Efficiency and Its Driving Factors—Based on Network DEA and PLS-SEM Method
Int. J. Environ. Res. Public Health 2020, 17(22), 8702; https://doi.org/10.3390/ijerph17228702 - 23 Nov 2020
Viewed by 347
Abstract
This study aims to estimate the eco-efficiencies of China at provincial levels. The eco-efficiencies of production and treatment stages are disentangled by the network data envelopment analysis (DEA) method. The key driving factors are identified by the integrative use of driving force-pressure-state-impact-response frame [...] Read more.
This study aims to estimate the eco-efficiencies of China at provincial levels. The eco-efficiencies of production and treatment stages are disentangled by the network data envelopment analysis (DEA) method. The key driving factors are identified by the integrative use of driving force-pressure-state-impact-response frame model (DPSIR) model and partial least squares structural equation modeling (PLS-SEM) method. This study provides several important findings. In general, the eco-efficiencies of most regions in China are inefficient and show significant regional differences. All DPSIR factors have significant and strong impacts on the eco-efficiency of the treatment stage. The eco-efficiency of the production stage evidently outweighs the eco-efficiency in economically well-developed regions. The originality of this study lies in three aspects. First, using two-stage network DEA, this study dissects the overall eco-efficiency into production efficiency and treatment efficiency. Empirical results provide insights into the root cause of the low efficiency of each province (municipality). Second, on the basis of the DPSIR model, an expanded pool of driving factors is investigated. Third, using the PLS-SEM method to analyze eco-efficiency is more reliable and effective than applying other traditional regression models. Full article
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Open AccessArticle
Social Bots’ Sentiment Engagement in Health Emergencies: A Topic-Based Analysis of the COVID-19 Pandemic Discussions on Twitter
Int. J. Environ. Res. Public Health 2020, 17(22), 8701; https://doi.org/10.3390/ijerph17228701 - 23 Nov 2020
Viewed by 366
Abstract
During the COVID-19 pandemic, when individuals were confronted with social distancing, social media served as a significant platform for expressing feelings and seeking emotional support. However, a group of automated actors known as social bots have been found to coexist with human users [...] Read more.
During the COVID-19 pandemic, when individuals were confronted with social distancing, social media served as a significant platform for expressing feelings and seeking emotional support. However, a group of automated actors known as social bots have been found to coexist with human users in discussions regarding the coronavirus crisis, which may pose threats to public health. To figure out how these actors distorted public opinion and sentiment expressions in the outbreak, this study selected three critical timepoints in the development of the pandemic and conducted a topic-based sentiment analysis for bot-generated and human-generated tweets. The findings show that suspected social bots contributed to as much as 9.27% of COVID-19 discussions on Twitter. Social bots and humans shared a similar trend on sentiment polarity—positive or negative—for almost all topics. For the most negative topics, social bots were even more negative than humans. Their sentiment expressions were weaker than those of humans for most topics, except for COVID-19 in the US and the healthcare system. In most cases, social bots were more likely to actively amplify humans’ emotions, rather than to trigger humans’ amplification. In discussions of COVID-19 in the US, social bots managed to trigger bot-to-human anger transmission. Although these automated accounts expressed more sadness towards health risks, they failed to pass sadness to humans. Full article
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Open AccessArticle
Low Tongue Strength and the Number of Teeth Present Are Associated with Cognitive Decline in Older Japanese Dental Outpatients: A Cross-Sectional Study
Int. J. Environ. Res. Public Health 2020, 17(22), 8700; https://doi.org/10.3390/ijerph17228700 - 23 Nov 2020
Viewed by 350
Abstract
To mitigate the impact of dementia, initiating early intervention is important. This study aims to investigate the associations between deterioration in oral function and cognitive decline in older outpatients whose oral health was maintained in the dental clinic. This study included 50 outpatients [...] Read more.
To mitigate the impact of dementia, initiating early intervention is important. This study aims to investigate the associations between deterioration in oral function and cognitive decline in older outpatients whose oral health was maintained in the dental clinic. This study included 50 outpatients aged ≥65 years. We used the Japanese version of the Montreal Cognitive Assessment (MoCA-J) to assess cognitive decline. Oral function was evaluated by tongue pressure, masticatory performance, and swallowing ability. A full-mouth periodontal examination was conducted, and the occlusal support and number of teeth were recorded. Odds ratios (ORs) and 95% confidence intervals (CIs) for cognitive decline (MoCA-J score ≤25 points) were calculated using logistic regression models. The age, number of teeth, tongue pressure, and masticatory performance were significantly correlated with cognitive decline (p < 0.05). Logistic regression analyses revealed that cognitive decline was independently associated with age (OR: 1.25; 95% CI: 1.03–1.52; p = 0.024), number of teeth (OR = 0.83; 95% CI: 0.76–1.00; p = 0.047), and lower tongue pressure (OR: 0.87; 95% CI: 0.77–0.98; p = 0.022). Lower tongue pressure and a small number of remaining teeth may be associated with cognitive decline in Japanese outpatients. Full article
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Open AccessCommunication
Compliance to the Alcohol Law: Overserving to Obviously Intoxicated Visitors at Music Festivals
Int. J. Environ. Res. Public Health 2020, 17(22), 8699; https://doi.org/10.3390/ijerph17228699 - 23 Nov 2020
Viewed by 345
Abstract
Music festivals are often high-risk settings associated with large numbers of visitors and high alcohol intoxication levels, which contribute to a number of public health-related problems. According to the Swedish Alcohol Act, servers are responsible for not overserving alcohol to obviously intoxicated patrons. [...] Read more.
Music festivals are often high-risk settings associated with large numbers of visitors and high alcohol intoxication levels, which contribute to a number of public health-related problems. According to the Swedish Alcohol Act, servers are responsible for not overserving alcohol to obviously intoxicated patrons. The aim of the current study was to examine compliance to the Swedish Alcohol Act at music festivals by assessing the rate of alcohol overserving to festival-goers. We conducted a study at a large music festival in Sweden hosting approximately 50,000 visitors. Professional actors, i.e., pseudo-patrons, enacted a standardized scene in which a highly intoxicated festival-goer attempted to buy beer at licensed premises inside the festival. Observers monitored each attempt. A total of 52 purchase attempts were conducted. The rate of overserving was 26.9% and was not influenced by the server’s gender, the number of servers, or the level of crowdedness at the bar area. Overserving differed between server age groups, which was not statistically significant when controlling for other factors. Compliance to the Alcohol Act at the festival can be improved. Intoxication levels and related problems can be reduced by implementing a multicomponent intervention including staff training, policy work, and improved enforcement. Full article
(This article belongs to the Section Public Health Statistics and Risk Assessment)
Open AccessArticle
Muscle Activation and Kinematic Analysis during the Inclined Leg Press Exercise in Young Females
Int. J. Environ. Res. Public Health 2020, 17(22), 8698; https://doi.org/10.3390/ijerph17228698 - 23 Nov 2020
Viewed by 426
Abstract
Knee joint muscle activation imbalances, especially weakness in the vastus medialis oblique, are related to patellofemoral pain within the female population. The available literature presents the leg press as an exercise which potentially targets vastus medialis oblique activation, thus reducing imbalances in the [...] Read more.
Knee joint muscle activation imbalances, especially weakness in the vastus medialis oblique, are related to patellofemoral pain within the female population. The available literature presents the leg press as an exercise which potentially targets vastus medialis oblique activation, thus reducing imbalances in the quadriceps muscles. The main aim of the present study was to compare thigh muscle activation and kinematic parameters under different conditions during the inclined leg press exercise in a young female population. A cross-sectional study was conducted on 10 young, trained females. Muscle activation of the vastus medialis oblique, vastus lateralis, rectus femoris and gluteus medialis was analyzed under five different inclined leg press conditions, modifying the feet rotation (0–45° external rotation) and the stance width (100–150% hip width) on the footplate. All the conditions were performed at two different movement velocities: controlled velocity (2″ eccentric–2″ concentric) and maximal intended velocity. Mean propulsive velocity, maximum velocity and maximum power were also assessed. The results show that both controlled velocity conditions and maximal intended velocity conditions elicited a similar muscle activation pattern with greater activation during the concentric phase (p < 0.001, ηp2 = 0.96). The maximal intended velocity conditions showed greater overall muscle activation (p < 0.001, ηp2 = 0.91). The vastus medialis oblique presented the greatest muscle activation, followed by the rectus femoris, vastus lateralis and, the gluteus medialis. Furthermore, the inclined leg press condition with 0º feet rotation, 100% hip width distance and the maximal intended velocity generated the greatest kinematic parameter outputs. In conclusion, the inclined leg press exercise might be an optimal exercise to target vastus medialis activation regardless of the feet rotation and stance width conditions. Full article
(This article belongs to the Section Exercise and Health)
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Open AccessArticle
Status and Factors Associated with Healthcare Choices among Older Adults and Children in an Urbanized County: A Cross-Sectional Study in Kunshan, China
Int. J. Environ. Res. Public Health 2020, 17(22), 8697; https://doi.org/10.3390/ijerph17228697 - 23 Nov 2020
Viewed by 380
Abstract
As important unit for regional health planning, urbanized counties are facing challenges because of internal migrants and aging. This study took urbanized counties in China as cases and two key populations as objects to understand different populations’ intentions of choosing corresponding health service [...] Read more.
As important unit for regional health planning, urbanized counties are facing challenges because of internal migrants and aging. This study took urbanized counties in China as cases and two key populations as objects to understand different populations’ intentions of choosing corresponding health service resources and to provide support for resource allocation. A cross-sectional study was conducted in Kunshan, a highly urbanized county in China, in 2016, among older adults aged 60 or over and children aged 0–6. Multinomial logistics models were used to identify the factors associated with healthcare choices. In this study, we found that income, distance of the tertiary provider, and migrant status were not associated with choices of tertiary healthcare outside county for children, while parents’ education level was. The responsiveness of the tertiary provider inside the county was lower than primary and secondary providers inside the county, while respondents were dissatisfied with the medical technology and medical facility for the tertiary inside the county compared to those of the tertiary provider outside the county. Significant differences existed in terms of the perception of different categories of institutions. To conclude, local governments should particularly seek to strengthen pediatric primary health services and improve the responsiveness of healthcare facilities to treat geriatric and pediatric diseases, which also bring significance to the developing countries in the process of urbanization. Full article
Open AccessArticle
Characteristics of Psychosocial Factors in Liver Transplantation Candidates with Alcoholic Liver Disease before Transplantation: A Retrospective Study in a Single Center in Taiwan
Int. J. Environ. Res. Public Health 2020, 17(22), 8696; https://doi.org/10.3390/ijerph17228696 - 23 Nov 2020
Viewed by 300
Abstract
Liver transplantation (LT) is an essential treatment for end-stage alcoholic liver disease (ALD). The patients’ psychosocial condition plays a vital role in post-transplantation prognosis. A survey of the candidates’ psychosocial wellbeing is necessary before LT. This study aims to investigate the psychosocial characteristics, [...] Read more.
Liver transplantation (LT) is an essential treatment for end-stage alcoholic liver disease (ALD). The patients’ psychosocial condition plays a vital role in post-transplantation prognosis. A survey of the candidates’ psychosocial wellbeing is necessary before LT. This study aims to investigate the psychosocial characteristics, including the depression degree, family function, alcohol use duration, and alcohol abstinence period, of LT candidates with ALD. In addition, 451 candidates for LT due to ALD were enrolled. They received psychosocial evaluations, including depression scale (Hamilton depression rating scale) and family functioning assessment (adaptability, partnership, growth, affection, resolve (APGAR) index). The test scores were analyzed according to age, alcohol use duration, and alcohol abstinence period. The Hamilton depression rating scale (HAM-D) score and the family APGAR index score differentiated significantly according to the age, alcohol use duration, and abstinence period of the LT candidates. The patients with shorter alcohol use duration tended to have more severe depressive symptoms and poorer family support. The younger patients showed a significantly shorter abstinence period, more severe depression, and poorer family functioning than older patients. The younger ALD patients and patients with shorter alcohol use duration showed an increased severity of depression before transplantation. They need more mental health care over time. Full article
Open AccessArticle
Whites’ County-Level Racial Bias, COVID-19 Rates, and Racial Inequities in the United States
Int. J. Environ. Res. Public Health 2020, 17(22), 8695; https://doi.org/10.3390/ijerph17228695 - 23 Nov 2020
Viewed by 503
Abstract
Mounting evidence reveals considerable racial inequities in coronavirus disease 2019 (COVID-19) outcomes in the United States (US). Area-level racial bias has been associated with multiple adverse health outcomes, but its association with COVID-19 is yet unexplored. Combining county-level data from Project Implicit on [...] Read more.
Mounting evidence reveals considerable racial inequities in coronavirus disease 2019 (COVID-19) outcomes in the United States (US). Area-level racial bias has been associated with multiple adverse health outcomes, but its association with COVID-19 is yet unexplored. Combining county-level data from Project Implicit on implicit and explicit anti-Black bias among non-Hispanic Whites, Johns Hopkins Coronavirus Resource Center, and The New York Times, we used adjusted linear regressions to estimate overall COVID-19 incidence and mortality rates through 01 July 2020, Black and White incidence rates through 28 May 2020, and Black–White incidence rate gaps on average area-level implicit and explicit racial bias. Across 2994 counties, the average COVID-19 mortality rate (standard deviation) was 1.7/10,000 people (3.3) and average cumulative COVID-19 incidence rate was 52.1/10,000 (77.2). Higher racial bias was associated with higher overall mortality rates (per 1 standard deviation higher implicit bias b = 0.65/10,000 (95% confidence interval: 0.39, 0.91); explicit bias b = 0.49/10,000 (0.27, 0.70)) and higher overall incidence (implicit bias b = 8.42/10,000 (4.64, 12.20); explicit bias b = 8.83/10,000 (5.32, 12.35)). In 957 counties with race-specific data, higher racial bias predicted higher White and Black incidence rates, and larger Black–White incidence rate gaps. Anti-Black bias among Whites predicts worse COVID-19 outcomes and greater inequities. Area-level interventions may ameliorate health inequities. Full article
Open AccessReview
Shaping the Future of Rare Diseases after a Global Health Emergency: Organisational Points to Consider
Int. J. Environ. Res. Public Health 2020, 17(22), 8694; https://doi.org/10.3390/ijerph17228694 - 23 Nov 2020
Viewed by 436
Abstract
The unexpected outbreak of the COVID-19 disease had significant and enormous repercussions on the healthcare systems, such as the need to reorganise healthcare organisations in order to concentrate resources needed to the care of COVID-19 patients and to respond in general to this [...] Read more.
The unexpected outbreak of the COVID-19 disease had significant and enormous repercussions on the healthcare systems, such as the need to reorganise healthcare organisations in order to concentrate resources needed to the care of COVID-19 patients and to respond in general to this health emergency. Due to these challenges, the care of several chronic conditions was in many cases discontinued and patients and healthcare professionals treating these conditions had to cope with this new scenario. This was the case of the world rare diseases (RDs) that had to face this global emergency despite the vulnerability of people with RDs and the well-known need for high expertise required to treat and manage them. The numerous lessons learned so far regarding health emergencies and RDs should represent the basis for the establishment of new healthcare policies and plans aimed at ensuring the preparedness of our health systems in providing appropriate care to people living with RDs in the case of eventual new emergencies. This paper aims at providing pragmatic considerations that might be useful in designing future actions to create or optimise existing organisational models for the care of RDs in case of future emergencies or any other situation that might threaten the provision of routine care. These policies and plans should benefit from the multi-stakeholder RDs networks (such as the European Reference Networks), that should join forces at European, national, and local levels to minimise the economic, organisational, and health-related impact and the negative effects of potential emergencies on the RDs community. In order to design and develop these policies and plans, a decalogue of points to consider were developed to ensure appropriate care for people living with RDs in the case of eventual future health emergencies. Full article
Open AccessReview
Abdominal Cutaneous Thermography and Perfusion Mapping after Caesarean Section: A Scoping Review
Int. J. Environ. Res. Public Health 2020, 17(22), 8693; https://doi.org/10.3390/ijerph17228693 - 23 Nov 2020
Viewed by 316
Abstract
Introduction: Caesarean section (CS) is the most prevalent surgical procedure in women. The incidence of surgical site infection (SSI) after CS remains high but recent observations of CS wounds using infrared thermography has shown promise for the technique in SSI prognosis. Although thermography [...] Read more.
Introduction: Caesarean section (CS) is the most prevalent surgical procedure in women. The incidence of surgical site infection (SSI) after CS remains high but recent observations of CS wounds using infrared thermography has shown promise for the technique in SSI prognosis. Although thermography is recognised as a ‘surrogate’ of skin perfusion, little is known of the relationship between skin temperature and skin perfusion in the context of wound healing. Aim: To assess the extent of literature regarding the application of infrared thermography and mapping of abdominal cutaneous perfusion after CS. Methods: Wide eligibility criteria were used to capture all relevant studies of any design, published in English, and addressing thermal imaging or skin perfusion mapping of the abdominal wall. The CINAHL and MEDLINE databases were searched, with two independent reviewers screening the title and abstracts of all identified citations, followed by full-text screening of relevant studies. Data extraction from included studies was undertaken using a pre-specified data extraction chart. Data were tabulated and synthesised in narrative format. Results: From 83 citations identified, 18 studies were considered relevant. With three additional studies identified from the reference lists, 21 studies were screened via full text. None of the studies reported thermal imaging and cutaneous perfusion patterns of the anterior abdominal wall. However, two observational studies partially met the inclusion criteria. The first explored analysis methodologies to ‘interrogate’ the abdominal thermal map. A specific thermal signature (‘cold spots’) was identified as an early ‘flag’ for SSI risk. A second study, by the same authors, focusing on obesity (a known risk factor for SSI after CS) showed that a 1 °C lower abdominal skin temperature led to a 3-fold odds of SSI. Conclusion: There is a significant gap in knowledge on how to forewarn of wound complications after CS. By utilising the known association between skin temperature and blood flow, thermographic assessment of the wound and adjacent thermal territories has potential as a non-invasive, independent, imaging option with which to identify tissue ‘at risk’. By identifying skin ‘hot’ or ‘cold’ spots, commensurate with high or low blood flow regions, there is potential to shed light on the underlying mechanisms leading to infective and non-infective wound complications. Full article
(This article belongs to the Section Women's Health)
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Open AccessReview
Comparing Mindful and Non-Mindful Exercises on Alleviating Anxiety Symptoms: A Systematic Review and Meta-Analysis
Int. J. Environ. Res. Public Health 2020, 17(22), 8692; https://doi.org/10.3390/ijerph17228692 - 23 Nov 2020
Viewed by 379
Abstract
Background: In recent years, studies and reviews have reported the therapeutic benefits of both mindful and non-mindful exercises in reducing anxiety. However, there have not been any systematic reviews to compare their relative effectiveness for therapeutic application, especially among the non-clinical population. Thus, [...] Read more.
Background: In recent years, studies and reviews have reported the therapeutic benefits of both mindful and non-mindful exercises in reducing anxiety. However, there have not been any systematic reviews to compare their relative effectiveness for therapeutic application, especially among the non-clinical population. Thus, the aim of this review is to compare the effectiveness between mindful and non-mindful exercise on treating anxiety among non-clinical samples. Methods: Potential articles were retrieved from PubMed, Embase, Academic Search Premier, and PsycInfo. Randomized controlled trials, which involved both mindful and non-mindful exercises as intervention, and the use of anxiety outcome measures were included. Results: Twenty-four studies fulfilled the inclusion criteria and were included in our systematic review. In addition, 14 studies provided sufficient data to be included in the meta-analysis. For studies that reported significant group differences at post-assessment, results showed that mindful exercise was more beneficial in reducing anxiety than non-mindful exercise. The meta-analysis reported that yoga was more effective in reducing anxiety than non-mindful exercise. Conclusions: Compared to non-mindful exercise, yoga is shown to be more effective in alleviating anxiety symptoms. It is recommended that yoga could be used as a primary healthcare intervention to help the public reduce anxiety. Full article
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Open AccessArticle
Investigating a Potential Map of PM2.5 Air Pollution and Risk for Tourist Attractions in Hsinchu County, Taiwan
Int. J. Environ. Res. Public Health 2020, 17(22), 8691; https://doi.org/10.3390/ijerph17228691 - 23 Nov 2020
Viewed by 331
Abstract
In the past few years, human health risks caused by fine particulate matters (PM2.5) and other air pollutants have gradually received attention. According to the Disaster Prevention and Protection Act of Taiwan’s Government enforced in 2017, “suspended particulate matter” has officially [...] Read more.
In the past few years, human health risks caused by fine particulate matters (PM2.5) and other air pollutants have gradually received attention. According to the Disaster Prevention and Protection Act of Taiwan’s Government enforced in 2017, “suspended particulate matter” has officially been acknowledged as a disaster-causing hazard. The long-term exposure to high concentrations of air pollutants negatively affects the health of citizens. Therefore, the precise determination of the spatial long-term distribution of hazardous high-level air pollutants can help protect the health and safety of residents. The analysis of spatial information of disaster potentials is an important measure for assessing the risks of possible hazards. However, the spatial disaster-potential characteristics of air pollution have not been comprehensively studied. In addition, the development of air pollution potential maps of various regions would provide valuable information. In this study, Hsinchu County was chosen as an example. In the spatial data analysis, historical PM2.5 concentration data from the Taiwan Environmental Protection Administration (TWEPA) were used to analyze and estimate spatially the air pollution risk potential of PM2.5 in Hsinchu based on a geographic information system (GIS)-based radial basis function (RBF) spatial interpolation method. The probability that PM2.5 concentrations exceed a standard value was analyzed with the exceedance probability method; in addition, the air pollution risk levels of tourist attractions in Hsinchu County were determined. The results show that the air pollution risk levels of the different seasons are quite different. The most severe air pollution levels usually occur in spring and winter, whereas summer exhibits the best air quality. Xinfeng and Hukou Townships have the highest potential for air pollution episodes in Hsinchu County (approximately 18%). Hukou Old Street, which is one of the most important tourist attractions, has a relatively high air pollution risk. The analysis results of this study can be directly applied to other countries worldwide to provide references for tourists, tourism resource management, and air quality management; in addition, the results provide important information on the long-term health risks for local residents in the study area. Full article
(This article belongs to the Special Issue Spatial Modeling of Air Pollutant Variability)
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Open AccessArticle
Quality of Life and Concerns in Parent Caregivers of Adult Children Diagnosed with Intellectual Disability: A Qualitative Study
Int. J. Environ. Res. Public Health 2020, 17(22), 8690; https://doi.org/10.3390/ijerph17228690 - 23 Nov 2020
Viewed by 339
Abstract
Background: Previous studies have confirmed that parenting a child diagnosed with an intellectual disability (ID) can negatively affect the parents’ quality of life in several dimensions. However, fewer have assessed its impact years after the initial diagnosis. The objective of this work was [...] Read more.
Background: Previous studies have confirmed that parenting a child diagnosed with an intellectual disability (ID) can negatively affect the parents’ quality of life in several dimensions. However, fewer have assessed its impact years after the initial diagnosis. The objective of this work was to carry out an in-depth analysis of the current quality of life and concerns of both mothers and fathers of adults diagnosed with ID, having as a reference the moment of the diagnosis. Methods: 16 parents of adult children with ID were evaluated using a semi-structured interview format. A thematic qualitative analysis was carried out by employing ATLAS.ti software. Results: The results suggested that both the emotional and physical well-being of parents, as well as their interpersonal relationships, had declined. In addition, the multiple life changes that had occurred over the time considered in this study, as well as day-to-day worries, had prevented improvements in their quality of life. Conclusions: Several dimensions of the parents’ quality of life were affected years after a child is diagnosed with ID. These included poor physical and psychological health, economic difficulties, lack of social and family support, and lack of time for self-care. Full article
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Open AccessArticle
Follow-Up of Elevated Blood Lead Levels and Sources in a Cohort of Children in Benin
Int. J. Environ. Res. Public Health 2020, 17(22), 8689; https://doi.org/10.3390/ijerph17228689 - 23 Nov 2020
Viewed by 402
Abstract
Lead exposure is associated with poor cognitive development in children. Very few studies in sub-Saharan Africa (SSA) have studied blood lead levels (BLLs) and non-gasoline sources of exposure in children. Data from a birth cohort in Benin (2011–2013) suggested that 58% of 1-year-old [...] Read more.
Lead exposure is associated with poor cognitive development in children. Very few studies in sub-Saharan Africa (SSA) have studied blood lead levels (BLLs) and non-gasoline sources of exposure in children. Data from a birth cohort in Benin (2011–2013) suggested that 58% of 1-year-old children had BLLs > 50 ug/L. We aimed to investigate the prevalence of elevated BLLs (>50 µg/L and >100 µg /L) among 425 of these children at 6 years of age in 2016–2018 and to compare BLLs between age 1 and 6 years, and study sources of lead at age 6 years. BLLs were analysed by inductively coupled plasma mass spectrometry. Multiple linear regression and quantile regressions were used to study potential sources of lead. The prevalence of BLLs > 50 µg/L in children was 59.5% (Geometric Mean (GM) 56.4 µg/L, 95% CI: 54.1–58.7) at 6 years of age compared to 54.8% (GM 56.5 µg/L, 95% CI: 53.4–59.6) at 1 year of age. The prevalence of children with BLLs > 100 µg/L decreased from 14.4% at 1 year of age to 8.2% at 6 years of age. After adjustment for all other covariates, consumption of peanuts more than once per month was significantly associated with a 22.0% (95% CI: 4.6, 42.5) increment in BLLs at age 6 years compared with no consumption. Consumption of bushmeat killed by lead bullets at age 6 years was associated with an increase in the higher percentiles of BLLs (P75) compared with the absence of this source. Other potential sources of lead associated with BLLs with marginal significance were consumption of rice, paternal occupational exposure, and the presence of activity with the potential use of lead. This prospective cohort confirms the persistently high prevalence of elevated BLLs in children residing in a rural region in the south of Benin, as well as the presence of multiple and continuous sources of lead. These results highlight the need for prevention programs to reduce and eliminate lead exposure in children. Full article
(This article belongs to the Section Environmental Health)
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Open AccessReview
Multimorbidity, Loneliness, and Social Isolation. A Systematic Review
Int. J. Environ. Res. Public Health 2020, 17(22), 8688; https://doi.org/10.3390/ijerph17228688 - 23 Nov 2020
Viewed by 266
Abstract
No systematic review has appeared so far synthesizing the evidence regarding multimorbidity and loneliness, social isolation, or social frailty. Consequently, our aim was to fill this gap. Three electronic databases (PubMed, PsycINFO, and CINAHL) were searched in our study. Observational studies examining the [...] Read more.
No systematic review has appeared so far synthesizing the evidence regarding multimorbidity and loneliness, social isolation, or social frailty. Consequently, our aim was to fill this gap. Three electronic databases (PubMed, PsycINFO, and CINAHL) were searched in our study. Observational studies examining the link between multimorbidity and loneliness, social isolation, and social frailty were included, whereas disease-specific samples were excluded. Data extraction included methods, characteristics of the sample, and the main results. A quality assessment was conducted. Two reviewers performed the study selection, data extraction, and quality assessment. In sum, eight studies were included in the final synthesis. Some cross-sectional and longitudinal studies point to an association between multimorbidity and increased levels of loneliness. However, the associations between multimorbidity and social isolation as well as social frailty remain largely underexplored. The quality of the studies included was rather high. In conclusion, most of the included studies showed a link between multimorbidity and increased loneliness. However, there is a lack of studies examining the association between multimorbidity and social isolation as well as social frailty. Future studies are required to shed light on these important associations. This is particularly important in times of the COVID-19 pandemic. Full article
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Open AccessArticle
Metabolic Syndrome and Colorectal Cancer Risk: Results of Propensity Score-Based Analyses in a Community-Based Cohort Study
Int. J. Environ. Res. Public Health 2020, 17(22), 8687; https://doi.org/10.3390/ijerph17228687 - 23 Nov 2020
Viewed by 353
Abstract
Background: This study aimed to determine the effects of metabolic syndrome (MetS) on colorectal cancer (CRC) using propensity score (PS) methods. Methods: The study subjects were 2417 men and 4568 women from the Korean National Cancer Center (KNCC) Community Cohort enrolled between 2003 [...] Read more.
Background: This study aimed to determine the effects of metabolic syndrome (MetS) on colorectal cancer (CRC) using propensity score (PS) methods. Methods: The study subjects were 2417 men and 4568 women from the Korean National Cancer Center (KNCC) Community Cohort enrolled between 2003 and 2010. Odds risks (ORs) and 95% confidence intervals (CIs) using PS matching analysis, regression models adjusted by the PS or stratified into five strata according to PS, and PS weighting methods were calculated. Results: In women, MetS and abnormally high triglyceride (TG) levels were associated with CRC risk using the PS matching analysis (ORs, for MetS, 2.19 (95% CI, 1.10–4.33); for abnormal TG levels, 2.08 (95% CI, 1.07–4.02)). However, there were no significant associations between MetS and TG levels and CRC risk in men. Conclusions: Our study might provide additional evidence that deteriorated metabolic profiles increase the risk of CRC in women rather than men. Thus, this may have an important role in effective population-level interventions for deteriorated metabolic profiles at an early stage. Full article
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Open AccessArticle
Chinese Women’s Acceptance and Uptake of Referral after Screening for Perinatal Depression
Int. J. Environ. Res. Public Health 2020, 17(22), 8686; https://doi.org/10.3390/ijerph17228686 - 23 Nov 2020
Viewed by 356
Abstract
China recently issued a national plan on perinatal depression (PND) screening. Previous studies elsewhere suggested that uptake of referral after screening for PND is suboptimal, but little is known in China. In this cohort study including 1126 women in Hunan, we identified women [...] Read more.
China recently issued a national plan on perinatal depression (PND) screening. Previous studies elsewhere suggested that uptake of referral after screening for PND is suboptimal, but little is known in China. In this cohort study including 1126 women in Hunan, we identified women at a high risk of PND using the Edinburgh Postpartum Depression Scale (EPDS) over multiple time points. We texted them and offered free consultations with a psychiatrist/psychologist. Among 248 screen-positive women, only three expressed interest and one attended the appointment. We surveyed the women about their reasons for declining referrals and preferred means of care. Of the 161 respondents, 128 (79.5%) indicated that they could cope with the condition without professional assistance and 142 (88.2%) chose their families as the preferred source of help. Only 15 (9.3%) chose professionals as their first option. Implementing a referral policy for screen-positive women would mean approximately one-third of women who gave birth in China would be eligible. Our result argues against referring all screen-positive women for professional services at this time. Interventions should instead build upon the tradition of family support in a more engaged response. These considerations are relevant for the implementation of national screening for PND in China. Full article
(This article belongs to the Special Issue Maternal Perinatal Mental Health)
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Open AccessReview
Review of the Mechanical Behavior of Different Implant–Abutment Connections
Int. J. Environ. Res. Public Health 2020, 17(22), 8685; https://doi.org/10.3390/ijerph17228685 - 23 Nov 2020
Viewed by 304
Abstract
Introduction: Different implant–abutment connections have been developed to reduce mechanical and biological failure. The most frequent complications are loss of preload, screw loosening, abutment or implant fracture, deformations at the different interfaces, and bacterial microleakage. Aim: To review the evidence indicating whether the [...] Read more.
Introduction: Different implant–abutment connections have been developed to reduce mechanical and biological failure. The most frequent complications are loss of preload, screw loosening, abutment or implant fracture, deformations at the different interfaces, and bacterial microleakage. Aim: To review the evidence indicating whether the implant–abutment connection type is significant regarding the following issues: (1) maintenance of the preload in static and dynamic in vitro studies; (2) assessment of possible deformations at the implant–abutment interfaces, after repeated application of the tightening torque; (3) evaluation of the sealing capability of different implant connections against microleakage. Materials and Methods: In June 2020, an electronic literature search was performed in Medline, EBSCO host, and PubMed databases. The search was focused on the ability of different implant connections to maintain preload, resist deformation after tightening and retightening, and prevent microleakage. The related titles and abstracts available in English were screened, and the articles that fulfilled the inclusion criteria were selected for full-text reading. Results: The literature search conducted for this review initially resulted in 68 articles, among which 19 articles and 1 systematic review fulfilled the criteria for inclusion. The studies were divided according to the three proposed objectives, with some studies falling into more than one category (maintenance of preload, surface abutment–implant deformation, and resistance to microleakage). Conclusions: Conical abutment appears to result in fewer mechanical complications, such as screw loosening or fractures, and higher torque preservation. After SEM evaluation, damage was observed in the threads of the abutment screws, before and after loading in internal and external connections. Internal hexagon implants and predominantly internal conical (Morse taper) implants showed less microleakage in dynamic loading conditions. We suggest further studies to guarantee excellence in methodological quality. Full article
(This article belongs to the Special Issue Impact of Dental Implants on Oral Health)
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Open AccessArticle
Comparative Study on the Cooling Effects of Green Space Patterns in Waterfront Build-Up Blocks: An Experience from Shanghai
Int. J. Environ. Res. Public Health 2020, 17(22), 8684; https://doi.org/10.3390/ijerph17228684 - 23 Nov 2020
Viewed by 384
Abstract
Different structural patterns of waterfront green space networks in built-up areas have different synergistic cooling characteristics in cities. This study’s aim is to determine what kinds of spatial structures and morphologies of waterfront green spaces offer a good cooling effect, combined with three [...] Read more.
Different structural patterns of waterfront green space networks in built-up areas have different synergistic cooling characteristics in cities. This study’s aim is to determine what kinds of spatial structures and morphologies of waterfront green spaces offer a good cooling effect, combined with three different typical patterns in Shanghai. A multidimensional spatial influence variable system based on the cooling effect was constructed to describe the spatial structural and morphological factors of the green space network. The ENVI-met 4.3 software, developed by Michael Bruse at Bochum, German, was used to simulate the microclimate distribution data, combined with the boosted regression tree (BRT) model and the correlation analysis method. The results showed that at the network level, the distance from the water body and the connectivity of green space had a stronger cooling correlation. The orientation of green corridors consistent with a summer monsoon had larger cooling effect ranges. In terms of spatial morphology, the vegetation sky view factor (SVF) and Vegetation Surface Albedo (VSAlbedo) had an important correlation with air temperature (T), and the green corridor with a 20–25 m width had the largest marginal effect on cooling. These results will provide useful guidance for urban climate adaptive planning and design. Full article
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Open AccessArticle
Illness Experiences and Attitudes towards Medication in Online Communities for People with Fibromyalgia
Int. J. Environ. Res. Public Health 2020, 17(22), 8683; https://doi.org/10.3390/ijerph17228683 - 23 Nov 2020
Viewed by 333
Abstract
Fibromyalgia is a chronic disabling syndrome, and the legitimacy of its diagnosis is still debated. Internet and online communities may become a relevant resource for affected people. This present study aims to understand the role of online communities relating to fibromyalgia syndrome (FMS) [...] Read more.
Fibromyalgia is a chronic disabling syndrome, and the legitimacy of its diagnosis is still debated. Internet and online communities may become a relevant resource for affected people. This present study aims to understand the role of online communities relating to fibromyalgia syndrome (FMS) patients’ illness experiences and their attitudes towards medication. A qualitative content analysis based on the grounded theory approach was conducted on 19 conversations from an online forum, and 14 online interviews. Illness experience, lack of reference points, online communities, personal role and attitude towards medication were the five categories identified, with the search for recognition as the core category. The study highlighted that online communities represent a resource that allows users to express and share their needs, especially in terms of legitimacy and recognition. Full article
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Open AccessArticle
Subjective Generic Health Literacy and Its Associated Factors among Adolescents: Results of a Population-Based Online Survey in Germany
Int. J. Environ. Res. Public Health 2020, 17(22), 8682; https://doi.org/10.3390/ijerph17228682 - 23 Nov 2020
Viewed by 671
Abstract
Profound data on adolescent health literacy are needed as a requirement for the development of health literacy promoting interventions. This paper aims to study the level of generic health literacy among adolescents and to explore associations between health literacy and socio-demographic (age, sex, [...] Read more.
Profound data on adolescent health literacy are needed as a requirement for the development of health literacy promoting interventions. This paper aims to study the level of generic health literacy among adolescents and to explore associations between health literacy and socio-demographic (age, sex, family affluence, migration background), social (social support by family and friends) and personal (self-efficacy) factors. We conducted a representative cross-sectional online survey. Four health literacy dimensions were captured among 14–17 years old adolescents living in Germany (n = 1235) with the “Measurement of Health Literacy Among Adolescents-Questionnaire” (MOHLAA-Q). Descriptive, bivariate and multiple logistic regression analyses were used to analyse the data (n = 1202). We found poor health literacy levels—to varying degrees—in all examined health literacy dimensions: dealing with health-related information (8.41% with many difficulties), health-related communication skills (28.13% with low skills), attitudes toward one’s own health and health information (8.81% with passive attitudes) and health-related knowledge (22.73% with low levels). We identified significant associations between poor health literacy levels and all factors studied except for age. Our results indicate a need for the implementation of evidence-based health literacy-related promoting interventions, preferentially in education and training institutions. Full article
(This article belongs to the collection Global Health Literacy)
Open AccessArticle
Development and Validation of a Sexual-Outlook Questionnaire (SOQ) for Adult Populations in the Republic of Korea
Int. J. Environ. Res. Public Health 2020, 17(22), 8681; https://doi.org/10.3390/ijerph17228681 - 23 Nov 2020
Viewed by 368
Abstract
A Sexual Outlook Questionnaire (SOQ) that can apply to a wide range of Korean populations, including disabled people, was necessary for comprehensive research on improving clinical practice of sexual education and developing sex-related intervention programs. We developed the SOQ and tested its validity [...] Read more.
A Sexual Outlook Questionnaire (SOQ) that can apply to a wide range of Korean populations, including disabled people, was necessary for comprehensive research on improving clinical practice of sexual education and developing sex-related intervention programs. We developed the SOQ and tested its validity with exploratory and confirmatory factor analysis and multi-trait/-item matrix analyses. Internal consistency was assessed using Cronbach’s α coefficient for item total correlations. We studied a total of 334 married or previously married adults with no cognitive impairment in the community settings. The eleven survey items were included in the final SOQ. Three factors were found: The first, “personal benefit”, was devoted to the impact of one’s sexual life and included four questions about the health-promoting effects and their recognition of healthiness, youth, and vitality as benefits of their sexual life. The second, “relational value”, included four questions about sex as an expression of love and means of communication, and its effect on the improvement of their relationship with their spouse (partner). The third, “sexual endeavor”, included three questions about the handling of sex-related problems, consulting with an expert, and sexual education. The questionnaire can briefly measure the sexual outlook of any married or previously married adult, regardless of disability. Full article
(This article belongs to the Special Issue Advances in Sexual Health and Sexual Rights)
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Open AccessArticle
Clinical Characteristics in Early Childhood Associated with a Nevus-Prone Phenotype in Adults from Tropical Australia: Two Decades of Follow-Up of the Townsville Preschool Cohort Study
Int. J. Environ. Res. Public Health 2020, 17(22), 8680; https://doi.org/10.3390/ijerph17228680 - 23 Nov 2020
Viewed by 331
Abstract
Having numerous melanocytic nevi increases melanoma risk. Few studies have enumerated nevi in children and re-examined them as adults. We aimed to determine if childhood nevus-counts predict nevus-prone adults, and further explore the relevance of host-factors and sun-exposure. Fifty-one Caucasian residents of Townsville [...] Read more.
Having numerous melanocytic nevi increases melanoma risk. Few studies have enumerated nevi in children and re-examined them as adults. We aimed to determine if childhood nevus-counts predict nevus-prone adults, and further explore the relevance of host-factors and sun-exposure. Fifty-one Caucasian residents of Townsville (19.16° S, Queensland, Australia) had full-body nevus-counts aged 1–6 and 21–31 years-old. Sun-exposure was determined from questionnaires. Children in the upper-quartile of nevus-counts acquired nevi more rapidly than those in the bottom-quartile (13.3 versus 4.7 nevi/year; p < 0.0005). Children sunburnt before 7 years-old acquired more incident nevi by adulthood (238 versus 126, p = 0.003) particularly if sunburn was severe (321 versus 157.5, p = 0.003) or erythema occurred annually (380 versus 132, p = 0.008). Fair-skinned, freckled children with some nevi ≥ 3 mm, solar lentigines, or a family history of melanoma acquired more incident nevi than children without these attributes. Nevus-prone adults exhibit distinguishing features earlier in life (<7 years-old in Queensland) than has been shown previously. In addition to intervening with sun-protection counselling early enough to reduce risk, being able to reliably triage children into high- and low melanoma-risk groups may inform more efficacious and cost-effective targeted-screening in melanoma-prone populations. Further longitudinal research is needed to confirm that these attributes can reliably separate risk-groups. Full article
Open AccessArticle
Parenting Behavior at 18 Months Predicts Internalizing and Externalizing Problems at 6 Years in Moderately Preterm and Full Term Children
Int. J. Environ. Res. Public Health 2020, 17(22), 8679; https://doi.org/10.3390/ijerph17228679 - 23 Nov 2020
Viewed by 368
Abstract
Moderately preterm born children (MPT) are at increased risk for behavior problems compared to full term born (FT) children. MPT children may receive less optimal parenting, and in response, may develop behavior problems. Our aims were to examine whether parenting behavior and mother–child [...] Read more.
Moderately preterm born children (MPT) are at increased risk for behavior problems compared to full term born (FT) children. MPT children may receive less optimal parenting, and in response, may develop behavior problems. Our aims were to examine whether parenting behavior and mother–child interaction quality mediate the association between birth status and child behavior problems. Participants were 120 MPT children and 100 FT children. At 18 months of age, mothers reported on their parenting behavior (support and structure), and mother–child interaction (sensitivity and limit-setting) was observed. At 6 years of age, mothers reported on children’s behavior problems. Using structural equation modeling, birth status was found to predict attention problems, but not internalizing and externalizing problems. Mothers of MPT children set less appropriate limits than mothers of FT children at 18 months of age. More maternal structure at 18 months predicted fewer internalizing and externalizing problems, but not attention problems, at 6 years. These associations between parenting behavior, mother–child interaction quality, and child behavior problems were similar for MPT and FT children. Our findings indicate that maternal structure in toddlerhood is an important predictor of later internalizing and externalizing problems for both MPT and FT children. Full article
(This article belongs to the Special Issue Preterm Birth: Research, Intervention and Developmental Outcomes)
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Open AccessStudy Protocol
Impact of Aquatic-Based Physical Exercise Programs on Risk Markers of Cardiometabolic Diseases in Older People: A Study Protocol for Randomized-Controlled Trials
Int. J. Environ. Res. Public Health 2020, 17(22), 8678; https://doi.org/10.3390/ijerph17228678 - 23 Nov 2020
Viewed by 389
Abstract
Cardiometabolic diseases are one of the primary causes of mortality and morbidity worldwide and sedentary lifestyles are contributing factors to these pathologies. Physical exercise has been recognized as an important tool in the prevention and treatment of these diseases. However, there are still [...] Read more.
Cardiometabolic diseases are one of the primary causes of mortality and morbidity worldwide and sedentary lifestyles are contributing factors to these pathologies. Physical exercise has been recognized as an important tool in the prevention and treatment of these diseases. However, there are still some doubts about the efficacy of certain type of physical exercise programs for older participants. The main goal of this study is to assess the impact of different aquatic-based physical exercise programs on risk markers of cardiometabolic diseases in older people. The study group will consist of non-institutionalized individuals, within the age group of 65 or older. The sample will be randomly divided into four groups, three experimental groups (EG) and one control group (CG). Participants from the EGs will be exposed to three physical aquatic-based exercise programs for a period of 28 weeks (continuous aerobic, interval aerobic and combined). The evaluated parameters include anthropometry, physical functions, mental health, cognitive function, carotid arteries intima-media thickness, heart rate variability and biochemical markers. The results will allow an interpretation of the impact of different aquatic-based physical exercise programs on cardiometabolic diseases markers and can also be used as a tool for professionals to prescribe adequate and more efficient physical exercise programs. Full article
(This article belongs to the Special Issue Sport and Exercise for Health and Performance)
Open AccessBrief Report
Proximity to Facilities and Its Association with the Health-Related Habits of Functionally Independent Older Adults
Int. J. Environ. Res. Public Health 2020, 17(22), 8677; https://doi.org/10.3390/ijerph17228677 - 23 Nov 2020
Viewed by 427
Abstract
The aim was to examine how proximity to facilities, as a component of community determinants, is associated with the health-related habits of functionally independent community-dwelling older adults. This was a cross-sectional study. Data were collected by face-to-face interviews. Participants were >65 years old, [...] Read more.
The aim was to examine how proximity to facilities, as a component of community determinants, is associated with the health-related habits of functionally independent community-dwelling older adults. This was a cross-sectional study. Data were collected by face-to-face interviews. Participants were >65 years old, living in 15 municipalities of Gipuzkoa (Basque Country, Spain). Proximity to park-green spaces, cultural-sport centers, market-food stores, retirement associations, religious centers, primary care centers and hospitals was explored. Sociodemographic variables and health-related habits (diet, physical activity and self-perceived social life) were collected. Logistic regression models were performed. The sample comprised of 634 individuals (55% women; mean age: 74.8, SD 6.7 years). Older age (odds ratio-OR: 0.94, 95% CI: 0.91–0.97) was associated with lower physical activity, while being male (OR: 1.71, 95% CI: 1.08–2.68) and proximity to park-green spaces (OR: 1.64, 95% CI: 1.03–2.61) were related to more physical activity. Individuals with good self-perceived health (OR: 3.50, 95% CI: 1.82–6.74) and religious centers within walking distance (OR: 2.66, 95% CI: 1.40–5.04) had higher odds of a satisfactory social life. Encouraging the creation of park-green spaces and leisure centers near residential areas can assist in promoting physical activity and improving the social life of older adults. Full article
(This article belongs to the Special Issue Active/Healthy Ageing and Quality of Life)
Open AccessArticle
Preventing Work-Related Musculoskeletal Disorders in Manufacturing by Digital Human Modeling
Int. J. Environ. Res. Public Health 2020, 17(22), 8676; https://doi.org/10.3390/ijerph17228676 - 22 Nov 2020
Viewed by 437
Abstract
This research concerns the workplace design methodology, involving digital human models, that prevents work-related musculoskeletal disorders (WMSDs). We propose an approach that, in conjunction with one of the classic WMSD risk assessment methods, allows one to simplify simulations in a three-dimensional digital environment. [...] Read more.
This research concerns the workplace design methodology, involving digital human models, that prevents work-related musculoskeletal disorders (WMSDs). We propose an approach that, in conjunction with one of the classic WMSD risk assessment methods, allows one to simplify simulations in a three-dimensional digital environment. Two real-life workstations from a manufacturing industry were modelled in a 3D Studio Max environment by means of an Anthropos ErgoMax system. A number of simulations show that, for the examined cases, classic boundary mannequins’ approaches can be replaced by using 50th percentile of a population individual, with a minimal impact on the WMSD risk. Although, the finding might not be suitable in all situations, it should be considered, especially where compromise solutions are being sought due to other criteria. Full article
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