Objective: Healthcare workers in general are at a high risk of potential infections with COVID-19, especially those who work with aerosol generating procedures. Dentists fall in this category, as not only do they operate with aerosol generating procedures but also operate within a face-to-face contact area. Methods: A structured self-administered questionnaire was developed at Najran University and provided to the participants for data collection. The data collected included information on risk perception and incorporation of measures for protection against COVID-19 to gauge the attitude of dentists during this period. Also, clinical implementation of various protective measures was reviewed. Results: Of the n = 322 dentists that answered the questions, 50% were general dentists and 28.9% were dentists working at specialist clinics, while the remaining 21.1% of dentists were employed in academic institutions. Among the newer additions to the clinic, 36.3% of dentists answered that they had added atomizers to their practices, followed by 26.4% of dentists that had incorporated the use of UV lamps for sterilization. We found that 18.9% dentists were using HEPA filters in their clinics, while 9.9% of dentists were making use of fumigation devices to control the risk of infection. One-way ANOVA was also carried out to demonstrate that there was a statistically significant difference (p = 0.049) between groups of dentists utilizing HEPA filters, UV lamps, atomizers, and fumigation devices to prevent the spread of SARS-CoV2 across their workplaces. Conclusion: Dentists are aware of recently updated knowledge about the modes of transmission of COVID-19 and the recommended infection control measures in dental settings. A better understanding of the situation and methods to prevent it will ensure that the dental community is able to provide healthcare services to patients during the pandemic. Full article

In the last decade, readily available electronic devices have created unprecedented opportunities for teens to access a wide variety of information and media–both positive and negative–on the internet. Despite the increasing number of initiatives taking place worldwide intended to assess and mitigate the online risks encountered by children and adolescents, there is still a need for a better understanding of how adolescents use the internet and their susceptibility to exposure to risks in the online space. We conducted a cross-sectional online survey of a convenience sample of 733 8th and 9th grade students in Utah. The survey contained eight questions regarding students’ exposure to three types of online risk scenarios: content risk, contact risk, and criminal risk. Independent variables included students’ online behaviors, use of social media and private messaging apps, and adult supervision of online activities. Logistic and negative binomial regression models indicated that gender, social media use, and chatting with strangers were associated with exposure to multiple risky online scenarios. Our results provide critical information to educators involved in the development of initiatives focusing on the reduction of youth online risk by identifying correlates of risky online events, allowing them to tailor their initiatives to meet the needs of potentially vulnerable populations. Full article

Currently, little attention has been paid to reducing carbon dioxide (CO₂) emissions of Gansu, and the two-dimensional decoupling model has been rarely used to study the relationship between the economic development and CO₂ emissions, especially in western China (e.g., Gansu). Thus, here, we first used the Logarithmic Mean Divisia Index (LMDI) to decompose the driving factors of Gansu’s CO₂ emissions between 2000–2017 and then analyzed the decoupling relationship by using the two-dimensional model. Results showed: (1) Gansu’s CO₂ emissions increased from 7805.70 × 10⁴ t in 2000 to 19,896.05 × 10⁴ t in 2017. The secondary industry accounted for the largest proportion in Gansu’s CO₂ emissions, followed by the tertiary industry and the primary industry. (2) The economic output showed the dominant driving effect on Gansu’s CO₂ emissions growth with the cumulative contribution rate of 201.94%, followed by the effects of industrial structure, population size, and energy structure, and their cumulative contribution rates were 9.68%, 7.81%, and 3.05%, respectively. In contrast, the energy intensity effect presented the most obvious mitigating effect with the cumulative contribution rate of −122.49%. (3) The Environmental Kuznets Curve (EKC) between CO₂ emissions and economic growth was demonstrated the inverted U-shape in Gansu. The two-dimensional decoupling status was the low level-weak decoupling (WD-LE) during 2000–2017. Thus, dropping the proportion of the secondary industry, reducing the use of carbon-intensive fuel like coal, introducing advanced technologies, and increasing the investment of new energy might effectively restrain the growth of Gansu’s CO₂ emissions. Full article

Dichlorvos (O,O-dimethyl O-(2,2-dichlorovinyl)phosphate, DDVP) is a widely acknowledged broad-spectrum organophosphorus insecticide and acaracide. This pesticide has been used for more than four decades and is still in strong demand in many developing countries. Extensive application of DDVP in agriculture has caused severe hazardous impacts on living systems. The International Agency for Research on Cancer of the World Health Organization considered DDVP among the list of 2B carcinogens, which means a certain extent of cancer risk. Hence, removing DDVP from the environment has attracted worldwide attention. Many studies have tested the removal of DDVP using different kinds of physicochemical methods including gas phase surface discharge plasma, physical adsorption, hydrodynamic cavitation, and nanoparticles. Compared to physicochemical methods, microbial degradation is regarded as an environmentally friendly approach to solve several environmental issues caused by pesticides. Till now, several DDVP-degrading microbes have been isolated and reported, including but not limited to Cunninghamella, Fusarium, Talaromyces, Aspergillus, Penicillium, Ochrobium, Pseudomonas, Bacillus, and Trichoderma. Moreover, the possible degradation pathways of DDVP and the transformation of several metabolites have been fully explored. In addition, there are a few studies on DDVP-degrading enzymes and the corresponding genes in microorganisms. However, further research relevant to molecular biology and genetics are still needed to explore the bioremediation of DDVP. This review summarizes the latest development in DDVP degradation and provides reasonable and scientific advice for pesticide removal in contaminated environments. Full article

The aim of this study was to describe and update current knowledge of manual therapy accuracy in treating cervical and lumbar radiculopathy, to identify the limitations in current studies, and to suggest areas for future research. The study was conducted according to PRISMA guidelines for systematic reviews. A comprehensive literature review was conducted using PubMed and Web of Science databases up to April 2020. The following inclusion criteria were used: (1) presence of radiculopathy; (2) treatment defined as manual therapy (i.e., traction, manipulation, mobilization); and (3) publication defined as a Randomized Controlled Trial. The electronic literature search resulted in 473 potentially relevant articles. Finally, 27 articles were accepted: 21 on cervical (CR) and 6 in lumbar radiculopathy (LR). The mean PEDro score for CR was 6.6 (SD 1.3), and for LR 6.7 (SD 1.6). Traction-oriented techniques are the most frequently chosen treatment form for CR and are efficient in reducing pain and improving functional outcomes. In LR, each of the included publications used a different form of manual therapy, which makes it challenging to summarize knowledge in this group. Of included publications, 93% were either of moderate or low quality, which indicates that quality improvement is necessary for this type of research. Full article

While studies on the health benefits of Tai Chi have sprung up over the past four decades, few have engaged in collecting global data, estimating the developing trends, and conducting reviews from the perspective of visualization and bibliometric analysis. This study aimed to provide a summary of the global scientific outputs on Tai Chi research from 1980 to 2020, explore the frontiers, identify cooperation networks, track research trends and highlight emerging hotspots. Relevant publications were downloaded from the Web of Science Core Collection (WoSCC) database between 1980 and 2020. Bibliometric visualization and comparative analysis of authors, cited authors, journals, co-cited journals, institutions, countries, references, and keywords were systematically conducted using CiteSpace software. A total of 1078 publications satisfied the search criteria, and the trend of annual related publications was generally in an upward trend, although with some fluctuations. China (503) and Harvard University (74) were the most prolific country and institution, respectively. Most of the related researches were published in the journals with a focus on sport sciences, alternative medicine, geriatrics gerontology, and rehabilitation. Our results indicated that the current concerns and difficulties of Tai Chi research are “Intervention method”, “Targeted therapy”, “Applicable population”, “Risk factors”, and “Research quality”. The frontiers and promising domains of Tai Chi exercise in the health science field are preventions and rehabilitations of “Fall risk”, “Cardiorespiratory related disease”, “Stroke”, “Parkinson’s disease”, and “Depression”, which should receive more attention in the future. Full article

Background: Families are the backbone of caregiving for older adults living in communities. This is a tradition common to Thailand and many low- and middle-income countries where formal long-term care services are not so available or accessible. Therefore, population aging demands more and more young people engaging as family caregivers. Informal caregiving can become an unexpected duty for anyone anytime. However, studies measuring the burden of informal caregivers are limited. We aimed to determine the caregiver burden, both from the perspective of the caregivers as well as that of their care recipients. Method: We used the baseline survey data from a cluster randomized controlled trial providing a community integrated intermediary care (CIIC) service for seniors in Chiang Mai, Thailand, TCTR20190412004. Study participants were 867 pairs of older adults and their primary family caregivers. Descriptive analysis explored the characteristics of the caregivers and binary logistic regression identified factors influencing the caregivers’ burden. Results: The mean age of family caregivers was 55.27 ± 13.7 years and 5.5% indicated the need for respite care with Caregiver Burden Inventory (CBI) scores ≥24. The highest burden was noted in the time-dependence burden domain (25.7%). The significant associated factors affecting CBI ≥24 were as follows: caregivers older than 60 years, being female, current smokers, having diabetes, and caring for seniors with probable depression and moderate to severe dependency. Conclusions: A quarter of caregivers can have their careers disturbed because of the time consumed with caregiving. Policies to assist families and interventions, such as respite service, care capacity building, official leave for caregiving, etc., may reduce the burden of families struggling with informal care chores. Furthermore, caregiver burden measurements can be applied as a screening tool to assess long-term care needs, complementing the dependency assessment. Finally, implementation research is required to determine the effectiveness of respite care services for older people in Thailand. Full article

Health literacy is an indicator of a society’s ability to make better health judgements for themselves and the people around them. This study investigated the prevalence of health literacy among Malaysian adults and provided an overall picture of the society’s current health literacy status, which has not been previously assessed. The study also highlighted socio-demographic markers of communities with limited health literacy that may warrant future intervention. A population-based self-administered survey using the Health Literacy Survey Malaysian Questionnaire18 (HLS-M-Q18) instrument was conducted as part of the National Health Morbidity Survey 2019 in Malaysia. The nationwide survey utilized a two-staged stratified random sampling method. A sample of 9478 individuals aged 18 and above, drawn from the living quarter list, participated in the study. The health literacy score was divided into three levels; limited, sufficient, and excellent. Findings showed a majority of the Malaysian population had a sufficient health literacy level in all three domains—healthcare, diseases prevention and health promotion (49.1%, 44.2%, and 47.5%, respectively)—albeit leaning towards the lower end of the category with an average score of 35.5. The limited health literacy groups were prevalent among respondents with older age (68%), lower education level (64.8%), and lower household income (49.5%). The overall health literacy status for Malaysia was categorized at a lower sufficiency level. Future health literacy improvements should focus on communities with a limited health literacy level to improve the overall score. Full article

The study objective was to determine prevalence of food insecurity and its associations with socioecological model (SEM) characteristics for undergraduate and graduate students. An online questionnaire was distributed to a convenience sample of students aged 18–34 at a Midwestern university. Of the 938 responses, 675 were complete for analysis. Outcome measures included demographics, food security level, housing, food access barriers, coping strategies, and food assistance program usage. Results found that predictors associated with undergraduate food insecurity included non-White race, receipt of financial aid, lower self-reported health status, living off-campus, employment, and food cost (p < 0.001). Graduate student food insecurity was associated with Asian self-identification, employment, food cost, no time to prepare foods, and lack of foods for dietary needs (p < 0.001). Students with food insecurity were more likely to buy cheap food (p < 0.001). Almost 50% of food-insecure undergraduates asked friends or family to help buy food. Food-insecure students were more likely to want information on meal preparation and budgeting. More graduate students were likely to know of and use food pantries. Overall, food insecurity was higher among undergraduate than graduate students. Universities should consider institutional and policy changes tailored to the separate populations to mitigate the prevalence of campus food insecurity. Full article

Occupational exposure to respirable crystalline silica (SiO₂) is one of the most common and serious risks because of the health consequences for the workers involved. Silicosis is a progressive, irreversible, and incurable fibrotic lung disease caused by the inhalation of respirable crystalline silica dust. A cross-sectional epidemiological study was carried out to assess the occupational risk factors that may contribute to the onset of silicosis in workers carrying out work activities with the inhalation of silica compact dust. The study population consisted of 311 artificial stone workers from the province of Almeria (southeast of Spain). Among them, 64 were previously diagnosed with silicosis and the rest of the participants (n = 247 workers) were not diagnosed with such a disease. The workers showing a greater risk of developing silicosis were those who installed kitchen worktops at consumers’ homes, as they did not use face-masks or were not provided with personal protective equipment (PPE) by their business. The results of this study provide support for the evidence indicating that silicosis is a major emerging health concern for workers in the artificial stone sector. Exposure to crystalline silica dust thus can influence the development of silicosis in those cases where individual and collective protection measures are not used or adequately applied. Full article

Changes in working styles and physical activities, and an increase in psychological stress during the coronavirus disease 2019 (COVID-19) pandemic, may have affected pain conditions among workers with pain; however, these associations are still poorly understood. Therefore, we conducted a web-based, cross-sectional study to investigate these changes among Japanese workers suffering from pain. A total of 1941 workers who were aged 20–64 years and suffered from body pain within 4 weeks prior to the study were included. Information was collected using a self-reported questionnaire between July and August 2020. Among the respondents, 15% reported that their pain worsened during the COVID-19 pandemic. Approximately half of the workers claimed to have decreased physical activity (47%) and increased psychological stress (47%) during the pandemic. Multivariable logistic regression analyses found that telework (odds ratio 2.27, 95% confidence interval 1.68–3.06), decreased physical activity (3.18, 2.38–4.27), and increased psychological stress (2.16, 1.64–2.84) were associated significantly with pain augmentation. The group of workers who participated in telework and had decreased physical activity comprised the highest proportion of those with augmented pain. Our findings suggest that measures, which consider physical activities, psychological aspects, and working styles, to alleviate pain may be required for the working population in the future. Full article

For recruits, basic military training (BMT) can be experienced as a stressful episode in which relevant protective factors such as resilience might be essential for successful completion of the training. The present study examined whether resilience would act as a protective factor during BMT in the Swiss Armed Forces. To this end, we conducted a cross-sectional and longitudinal study of resilience and psychological burden. At the beginning of the BMT and at week 11, 525 male recruits (mean age: 20.3 years) completed a series of questionnaires covering demographic information and assessing resilience, perceived stress and mental distress. In parallel, their superiors rated recruits’ military performance in week 13. Dropout rates were also registered. Cross-sectionally and longitudinally, higher resilience scores predicted lower scores for perceived stress, mental distress, and better military performance. Higher self-rated resilience was moderately associated with military performance, as rated by recruits’ superiors. Resilience scores, perceived stress and mental distress did not differ between those recruits continuing their BMT and dropouts. In support of our assumptions, resilience acted as a protective factor during Swiss Armed Forces BMT. Full article

Background: College students are among the heaviest users of smartphones and the Internet, and there is growing concern regarding problematic Internet (PIU) and smartphone use (PSU). A subset of adverse childhood experiences, household dysfunction [(HHD) e.g.; parental substance use, mental illness, incarceration, suicide, intimate partner violence, separation/divorce, homelessness], are robust predictors of behavioral disorders; however, few studies have investigated the link between HHD and PIU and PSU and potential protective factors, such as social support, among students. Methods: Data are from a diverse California student sample (N = 1027). The Smartphone Addiction Scale—Short Version and Internet Addiction Test assessed dimensions of addiction. Regression models tested associations between students’ level of HHD (No HHD, 1–3 HHD, ≥4 HHD) and PSU and PIU, and the role of extrafamilial social support in these relationships, adjusting for age, gender, ethnicity, SES, employment loss due to COVID-19, and depression. Results: Compared to students reporting no HHD, students with ≥4 HHD had twice the odds (AOR: 2.03, 95% CI: 1.21–3.40) of meeting criteria for PSU, while students with 1–3 HHD and ≥4 HHD had three and six times the odds of moderate to severe PIU (AORs: 2.03–2.46, CI:1.21–3.96) after adjusting for covariates. Extrafamilial social support was inversely associated with PIU and moderated the HHD–PSU association for students with 1–3 HHD. Conclusion: Students exposed to HHD may be especially vulnerable to developing behavioral addictions such as PSU and PIU. Extrafamilial social support offset the negative effects of HHD for PSU among the moderate risk group; implications for prevention efforts are discussed. Full article

This study was conducted to estimate the prevalence of non-suicidal self-injury (NSSI)—the most severe mental health problem among South Korean adolescents in 2019. The participants were students from 12 middle and seven high schools in a single city in the metropolitan area in South Korea. A cluster-random sampling method was used—one class per school year at each middle and high schools. Every student in the selected classes was investigated. The final number of selected classes and students were as follows: 36 classes, 1074 students at middle schools; 35 classes, 873 students at high school. Data were obtained using a self-administered online questionnaire. The 12-month prevalence of NSSI was 8.8% among Korean adolescents, 2.85 times higher for female than male students (13.4% vs. 4.7%). For the school grade, the multivariable-adjusted odds ratio [mOR] was 3.89 times (95% confidence interval [CI] 1.35–11.26) higher for the group with the highest school records compared with the middle group for male students, while such pattern was not observed among female students (mOR 1.11, 95% CI 0.54–2.26). The risks for NSSI were higher among female students with lower economic status, compared with those with higher economic status (mOR 4.16, 95% CI 1.43–12.05). In contrast, economic status did not indicate higher risk among male students (mOR 1.43, 95% CI 0.42–4.84). This study suggests that the risk for NSSI among adolescent students may be different according to gender and comprehensive interventions from schools against NSSI may need a gender-sensitive approach in South Korea. Full article

While the COVID-19 has dramatically altered our lifestyle and sleep practices, the links between sleep, individual characteristics, personal experiences and mental health during the pandemic require further examination. This cross-sectional, multi-methods study examined differences in language used to describe personal experiences, and mental health, based on sleep quality during the early stages of the pandemic. N = 1745 participants (mean age 42.97 ± 14.46 years) from 63 countries responded to the survey. Sleep quality was assessed using the Pittsburgh Sleep Quality Index and mental health was examined using the Patient Health Questionnaire-9, the State Trait Anxiety Inventory, the Perceived Stress Scale and the UCLA-Loneliness Scale. Quantitative analysis of qualitative, language content of personal experiences was conducted using free-text responses and comments to a question on the survey. Almost 50% of the participants reported poor sleep quality, which was linked to a more negative emotional tone and greater mentions of money or finance related words. Good sleepers reported more positive emotional tone in their experiences. Greater reports of clinical state anxiety, moderate depression and moderate stress were observed in poor sleepers, even after accounting for demographics and pandemic-related factors such as loneliness, financial concerns and risk of contracting COVID-19 disease. Results from this study highlight an urgent need for sleep-related public health interventions. Practitioner education, sleep screening for those with mental health conditions, and encouraging people to adopt digital tools may help to reduce the burden of poor sleep on mental health. While the pandemic itself is a stressful and uncertain time, improving sleep can support positive emotion regulation, improving mood and consequential action. Full article