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Int. J. Environ. Res. Public Health, Volume 18, Issue 13 (July-1 2021) – 533 articles

Cover Story (view full-size image): Inferences from conventional statistical models of health outcomes observed across census tracts, counties, and other areal units are premised on the possession of accurate data, but small area covariate data are typically survey-based. This study examines systematic spatial and social patterns in the reliability of American Community Survey data, summarizes the threats such patterns pose to inferences, and introduces a workflow and modeling strategy for population health research with small area data. To demonstrate the feasibility and import of this approach, the study measures socio-spatial inequality in all-cause county mortality rates using the Index of Concentration at the Extremes. Ignoring data quality can bias inferences, and the widespread adoption of workflows and modeling strategies to address this challenge is warranted. View this paper.
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12 pages, 341 KiB  
Review
Pharmacological Treatment of Patients with Mild to Moderate COVID-19: A Comprehensive Review
by Reinaldo B. Bestetti, Rosemary Furlan-Daniel and Vinicius M. R. Silva
Int. J. Environ. Res. Public Health 2021, 18(13), 7212; https://doi.org/10.3390/ijerph18137212 - 05 Jul 2021
Cited by 10 | Viewed by 4805
Abstract
Mild to moderate COVID-19 can be found in about 80% of patients. Although mortality is low, mild to moderate COVID-19 may progress to severe or even critical stages in about one week. This poses a substantial burden on the health care system, and [...] Read more.
Mild to moderate COVID-19 can be found in about 80% of patients. Although mortality is low, mild to moderate COVID-19 may progress to severe or even critical stages in about one week. This poses a substantial burden on the health care system, and ultimately culminates in death or incapacitation and hospitalization. Therefore, pharmacological treatment is paramount for patients with this condition, especially those with recognized risk factors to disease progression. We conducted a comprehensive review in the medical literature searching for randomized studies carried out in patients with mild to moderate COVID-19. A total of 14 randomized studies were identified, enrolling a total of 6848 patients. Nine studies (64%) were randomized, placebo-controlled trials, whereas five were open-label randomized trials (35%). We observed that Bamlanivimab and nitazoxanide reduced viral load, whereas ivermectin may have shortened time to viral clearance; Interferon Beta-1 reduced time to viral clearance and vitamin D reduced viral load; Favirapir, peginterferon, and levamisole improved clinical symptoms, whereas fluvoxamine halted disease progression; inhaled budesonide reduced the number of hospitalizations and visits to emergency departments; colchicine reduced the number of deaths and hospitalizations. Collectively, therefore, these findings show that treatment of early COVID-19 may be associated with reduced viral load, thus potentially decreasing disease spread in the community. Moreover, treatment of patients with mild to moderate COVID-19 may also be associated with improved clinical symptoms, hospitalization, and disease progression. We suggest that colchicine, inhaled budesonide, and nitazoxanide, along with nonpharmacological measures, based on efficacy and costs, may be used to mitigate the effects of the COVID-19 pandemic in middle-income countries. Full article
10 pages, 534 KiB  
Article
Preterm Labor Using Tocolysis as a Possible Risk Factor for Postpartum Depression: A 14-Year Population-Based Study in Taiwan
by Jui-Ming Liu, Chien-Yu Liu, Ren-Jun Hsu and Fung-Wei Chang
Int. J. Environ. Res. Public Health 2021, 18(13), 7211; https://doi.org/10.3390/ijerph18137211 - 05 Jul 2021
Cited by 2 | Viewed by 2569
Abstract
Postpartum depression (PPD) is associated with negative physical and mental health outcomes for the mother and infant. Women often experience elevated symptoms of PPD, and the incidence of PPD has increased in recent years. There were lack of studies to investigate the effects [...] Read more.
Postpartum depression (PPD) is associated with negative physical and mental health outcomes for the mother and infant. Women often experience elevated symptoms of PPD, and the incidence of PPD has increased in recent years. There were lack of studies to investigate the effects of medications during pregnancy. Herein, we focused on the most common obstetric medical therapies used in labor and determined whether the medical therapies cause mental stress in pregnant women. This 14-year retrospective population-based nationwide study was based on the National Health Insurance Research Database. Univariate and multivariate logistic regression analyses were used to evaluate unadjusted and adjusted odds ratios and 95% confidence intervals for each tocolytic and uterotonic treatments during pregnancy and common medical illnesses. In comparing the effects of tocolytic and uterotonic medications on maternal PPD, tocolysis with the injection form of ritodrine resulted in a significantly higher risk of PPD based on multivariate analysis. This study supports existing research demonstrating an association between tocolysis with ritodrine and PPD. Ritodrine treatment for preterm labor was a significant risk factor for PPD, especially the injection form. This information provides obstetricians and health policy providers to pay attention to maternal mental health outcomes among high-risk pregnant women. Full article
(This article belongs to the Special Issue Obstetrics and Gynecology in Public Health)
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18 pages, 369 KiB  
Article
Fear of COVID-19 and COVID-19 Stress and Association with Sociodemographic and Psychological Process Factors in Cases under Surveillance in a Frontline Worker Population in Borneo
by Nicholas Tze Ping Pang, Gracyvinea Nold Imon, Elisa Johoniki, Mohd Amiruddin Mohd Kassim, Azizan Omar, Syed Sharizman Syed Abdul Rahim, Firdaus Hayati, Mohammad Saffree Jeffree and Jun Rong Ng
Int. J. Environ. Res. Public Health 2021, 18(13), 7210; https://doi.org/10.3390/ijerph18137210 - 05 Jul 2021
Cited by 17 | Viewed by 3323
Abstract
COVID-19 stress and fear of COVID-19 is an increasingly researched construct in the general population. However, its prevalence and association with sociodemographic factors and psychological process variables has not been explored in frontline workers under surveillance in a Bornean population. This study was [...] Read more.
COVID-19 stress and fear of COVID-19 is an increasingly researched construct in the general population. However, its prevalence and association with sociodemographic factors and psychological process variables has not been explored in frontline workers under surveillance in a Bornean population. This study was a cross-sectional study using a sociodemographic questionnaire incorporating two specific epidemiological risk variables, namely specific questions about COVID-19 surveillance status (persons under investigation (PUI), persons under surveillance (PUS), and positive cases) and the nature of frontline worker status. Furthermore, five other instruments were used, with three measuring psychopathology (namely depression, anxiety and stress, fear of COVID-19, and stress due to COVID-19) and two psychological process variables (namely psychological flexibility and mindfulness). Kruskal–Wallis and Mann–Whitney tests were performed to assess if there were significant differences in psychopathology and psychological process variables between sociodemographic and epidemiological risk variables. Hierarchical multiple regression was further performed, with depression, anxiety, and stress as dependent variables. There were significant differences in the fear of COVID-19 between positive cases, PUI, and PUS. The fear of COVID-19 scores were higher in positive cases compared to in PUS and PUI groups. Upon hierarchical multiple regression, mindfulness and psychological flexibility were significant predictors of depression, anxiety, and stress after controlling for sociodemographic and epidemiological risk factors. This study demonstrates that exposure to COVID-19 as persons under investigation or surveillance significantly increases the fear of COVID-19, and brief psychological interventions that can positively influence mindfulness and psychological flexibility should be prioritized for these at-risk groups to prevent undue psychological morbidity in the long run. Full article
(This article belongs to the Special Issue Mental Health in the Time of COVID-19)
6 pages, 292 KiB  
Brief Report
Influence of Menstrual Cycle Estradiol-β-17 Fluctuations on Energy Substrate Utilization-Oxidation during Aerobic, Endurance Exercise
by Hannah N. Willett, Kristen J. Koltun and Anthony C. Hackney
Int. J. Environ. Res. Public Health 2021, 18(13), 7209; https://doi.org/10.3390/ijerph18137209 - 05 Jul 2021
Cited by 9 | Viewed by 3025
Abstract
This study examined the effect of estradiol-β-17 across the menstrual cycle (MC) during aerobic exercise on energy substrate utilization and oxidation. Thirty-two eumenorrheic (age = 22.4 ± 3.8 y (mean ± SD)), physically active women participated in two steady-state running sessions at 65% [...] Read more.
This study examined the effect of estradiol-β-17 across the menstrual cycle (MC) during aerobic exercise on energy substrate utilization and oxidation. Thirty-two eumenorrheic (age = 22.4 ± 3.8 y (mean ± SD)), physically active women participated in two steady-state running sessions at 65% of VO2max, one during the early follicular and one during the luteal phase of the MC. Blood samples were collected at rest before each exercise session and analyzed for Estradiol-β-17 to confirm the MC phase. Carbohydrate (CHO) utilization and oxidation values were significantly lower (p < 0.05) in the luteal (utilization: 51.6 ± 16.7%; oxidation: 1.22 ± 0.56 g/min; effect size (ES) = 0.45, 0.27) than follicular phase (utilization: 58.2 ± 15.1%; oxidation: 1.38 ± 0.60 g/min) exercise sessions. Conversely, fat utilization and oxidation values were significantly (p < 0.05) higher in the luteal (utilization: 48.4 ± 16.7%; oxidation: 0.49 ± 0.19 g/min; ES = 0.45,0.28) than follicular phase (utilization: 41.8 ± 15.1%; oxidation: 0.41 ± 0.14 g/min). Estradiol-β-17 concentrations were significantly (p < 0.01) greater during the luteal (518.5 ± 285.4 pmol/L; ES = 0.75) than follicular phase (243.8 ± 143.2 pmol/L). Results suggest a greater use of fat and reduced amount of CHO usage during the luteal versus follicular phase, directly related to the change in resting estradiol-β-17. Future research should investigate the role these changes may play in female athletic performance. Full article
28 pages, 432 KiB  
Article
Bullying and Its Associated Individual, Peer, Family and School Factors: Evidence from Malaysian National Secondary School Students
by Vikneswaran Sabramani, Idayu Badilla Idris, Halim Ismail, Thiyagar Nadarajaw, Ezarina Zakaria and Mohammad Rahim Kamaluddin
Int. J. Environ. Res. Public Health 2021, 18(13), 7208; https://doi.org/10.3390/ijerph18137208 - 05 Jul 2021
Cited by 14 | Viewed by 15963
Abstract
Adolescents involved in bullying can be at risk of developing behavioural problems, physical health problems and suicidal ideation. In view of this, a quantitative research design using a cross-sectional study was conducted to determine the prevalence of bullying and associated individual, peer, family [...] Read more.
Adolescents involved in bullying can be at risk of developing behavioural problems, physical health problems and suicidal ideation. In view of this, a quantitative research design using a cross-sectional study was conducted to determine the prevalence of bullying and associated individual, peer, family and school factors. The study involved 4469 Malaysian public-school students who made up the response rate of 89.4%. The students were selected using a randomized multilevel sampling method. The study found that 79.1% of student respondents were involved in bullying as perpetrators (14.4%), victims (16.3%), or bully–victims (48.4%). In a multivariate analysis, the individual domain showed a significant association between students’ bullying involvement and age (OR = 1.38; 95% CI 1.12–1.70), gender (OR = 1.73; 95% CI 1.47–0.91), ethnicity (OR = 0.66; 95% CI 0.47–0.91), duration of time spent on social media during the weekends (OR = 1.43; 95% CI 1.09–1.87) and psychological distress level (OR = 2.55; 95% CI 1.94–3.34). In the peer domain, the significantly associated factors were the number of peers (OR = 0.69; 95% CI 0.56–0.86) and frequency of quarrels or fights with peers (OR = 2.12; 95% CI 1.24–3.26). Among the items in the school domain, the significantly associated factors were students being mischievous in classrooms (OR = 1.52; 95% CI 1.06–2.06), student’s affection towards their teachers (OR = 1.53; 95% CI 1.06–2.20), frequency of appraisal from teachers (OR = 1.49; 95% CI 1.16–1.94), frequency of friends being helpful in classrooms (OR = 1.92; 95% CI 1.09–3.38) and frequency of deliberately skipping class (OR = 2.91; 95% CI 2.90–1.72). As a conclusion, the study revealed high levels and widespread bullying involvement among students in Malaysia. As such, timely bullying preventions and interventions are essential, especially in terms of enhancing their mental health capacity, which substantially influences the reduction in the prevalence rates of bullying involvement among students in Malaysia. Full article
9 pages, 327 KiB  
Article
Exploring the Relationship of Health Beliefs and Self-Care Behaviors Related to Diabetic Foot Ulcers of Type II Diabetes Mellitus Patients: A Cross-Sectional Study
by Meng-Chien Tsai, Hsiao-Ling Chuang, Cheng-Yi Huang, Shu-Hsin Lee, Wen-Chun Liao, Meng-Chih Lee and Ching-Pyng Kuo
Int. J. Environ. Res. Public Health 2021, 18(13), 7207; https://doi.org/10.3390/ijerph18137207 - 05 Jul 2021
Cited by 6 | Viewed by 2916
Abstract
Objective: Diabetic foot ulcers are an invasive complication of diabetes and are increasing. This study investigates the relationship between health beliefs and foot self-care behaviors, among people with type II diabetes. Methods: A cross-sectional design was adopted, and 98 patients were recruited from [...] Read more.
Objective: Diabetic foot ulcers are an invasive complication of diabetes and are increasing. This study investigates the relationship between health beliefs and foot self-care behaviors, among people with type II diabetes. Methods: A cross-sectional design was adopted, and 98 patients were recruited from outpatient clinics of the endocrine department. The questionnaires of Demographic, Diabetes Foot Ulcer Health Belief Scale (Health Beliefs, DFUHBS), and Diabetes Foot Self-Care Behavior Scale (Self Care, DFSBS) were used to collect data. Results: Among the subjects living alone or who had diabetes less than ten years, the score of DFSBS was significantly lower than among those living with families or who had diabetes for ten years or more. The frequency of performing diabetes foot self-care behavior, among males was lower than among females significantly. Although there was no significant difference in the Health Belief total score, there were differences in the benefit subscale. Those who had junior high school level or less or had diabetes less than ten years, their score was significantly lower than those with senior high school level or more or had diabetes ten years or more. In a multivariable regression model, living with family, diabetes duration, and health beliefs explained 42.9% of the variance of diabetic-foot self-care behaviors. Conclusions: Living alone, shorter duration of diabetes, male gender, and lower health belief scores predict less adequate diabetic foot self-care behavior. Health care providers should assess these factors when designing individual care plans. Full article
(This article belongs to the Section Health Behavior, Chronic Disease and Health Promotion)
16 pages, 1355 KiB  
Article
Autism Spectrum Disorder (ASD) and the Family Inclusive Airport Design Experience
by Monica Cerdan Chiscano
Int. J. Environ. Res. Public Health 2021, 18(13), 7206; https://doi.org/10.3390/ijerph18137206 - 05 Jul 2021
Cited by 7 | Viewed by 3683
Abstract
The literature on air travellers with psychiatric disorders is limited. This perspective article highlights various travel-related aspects of autism spectrum disorder (ASD). The airport experience can be stressful for families of children with autism spectrum disorder (FwASDs). The aim of this study was [...] Read more.
The literature on air travellers with psychiatric disorders is limited. This perspective article highlights various travel-related aspects of autism spectrum disorder (ASD). The airport experience can be stressful for families of children with autism spectrum disorder (FwASDs). The aim of this study was to explore the airport experience of FwASDs using the value co-creation process approach to assist airport managers in designing improved experiences for this specific passenger segment. This study responds to the current climate in which airports are developing awareness programmes in relation to children who require special assistance at airports. The prevalence of children with ASD is 1/68. While a number of airports throughout the world have adopted procedures addressing the needs of those with cognitive impairment, these advances are far from universal. As part of an academic–industry collaboration between Vueling airlines and the Spanish airport operator Aena, 25 FwASDs took part in an inclusive airport research project in the city of Barcelona from November 2015 to April 2016. Employing a qualitative methodology that incorporated focus groups, ethnographic techniques, and post-experience surveys, the study contributes to extending the body of knowledge on the management of the value co-creation process for challenging passenger segments within the airport context. The study explains how ensuring adequate resource allocation to this passenger segment can improve the family-inclusive design of the airport experience and offers managerial recommendations. Full article
(This article belongs to the Special Issue Research on Autism Spectrum Disorders)
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15 pages, 3470 KiB  
Article
Influence of Zooplankton and Environmental Factors on Clear-Water Phase in Lake Paldang, South Korea
by Younbo Sim, Myeong Seop Byeon, Keonhee Kim, Soon Ju Yu and Jong Kwon Im
Int. J. Environ. Res. Public Health 2021, 18(13), 7205; https://doi.org/10.3390/ijerph18137205 - 05 Jul 2021
Cited by 4 | Viewed by 1831
Abstract
Lake Paldang is a complex water system with both fluvial and lacustrine characteristics and the largest artificial dam lake in South Korea. In this study, the different occurrence patterns and causes of the clear-water phase (CWP) were investigated using water quality and hydrological [...] Read more.
Lake Paldang is a complex water system with both fluvial and lacustrine characteristics and the largest artificial dam lake in South Korea. In this study, the different occurrence patterns and causes of the clear-water phase (CWP) were investigated using water quality and hydrological factors at four sites in Lake Paldang. Among the environmental and other factors associated with CWP occurrence, secchi depth and turbidity exhibited significant correlations with precipitation, hydraulic retention time (HRT), and individual and relative abundance (RA) of zooplankton (Cladocera) (p < 0.01). Hence, a change in the HRT because of precipitation could alter the CWP. The Cladocera individuals and RA showed significant correlations with the water temperature, indicating that the emergence of Cladocera in spring as the water temperature rises could cause the CWP. Sensitivity assessments conducted using Bayesian models demonstrated different CWP occurrence sensitivity relationships for the river-type, lake-type, and shallow and deep sites. Turbidity, secchi depth, and zooplankton factors also showed sensitive relationships with CWP occurrence for all sites. The sensitivity to precipitation and HRT was higher in the river-type sites. The lake-type sites, with common Cladocera emergence and long HRT, favored CWP occurrence. Thus, CWP occurrence was dependent on the site characteristics and climate conditions. Full article
(This article belongs to the Special Issue Water Quality and Ecosystem Monitoring, Analysis, and Management)
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9 pages, 3786 KiB  
Case Report
Management of Amelogenesis Imperfecta in Childhood: Two Case Reports
by Mirja Möhn, Julia Camilla Bulski, Norbert Krämer, Alexander Rahman and Nelly Schulz-Weidner
Int. J. Environ. Res. Public Health 2021, 18(13), 7204; https://doi.org/10.3390/ijerph18137204 - 05 Jul 2021
Cited by 5 | Viewed by 7691
Abstract
Amelogenesis imperfecta (AI) is defined as an interruption of enamel formation due to genetic inheritance. To prevent malfunction of the masticatory system and an unaesthetic appearance, various treatment options are described. While restoration with a compomer in the anterior region and stainless steel [...] Read more.
Amelogenesis imperfecta (AI) is defined as an interruption of enamel formation due to genetic inheritance. To prevent malfunction of the masticatory system and an unaesthetic appearance, various treatment options are described. While restoration with a compomer in the anterior region and stainless steel crowns in the posterior region is recommended for deciduous dentition, the challenges when treating such structural defects in mixed or permanent dentition are changing teeth and growing jaw, allowing only temporary restoration. The purpose of this case report is to demonstrate oral rehabilitation from mixed to permanent dentition. The dentition of a 7-year-old patient with AI type I and a 12-year-old patient with AI type II was restored under general anesthesia to improve their poor aesthetics and increase vertical dimension, which are related to problems with self-confidence and reduced oral health quality of life. These two cases show the complexity of dental care for structural anomalies of genetic origin and the challenges in rehabilitating the different phases of dentition. Full article
(This article belongs to the Special Issue Oral Diseases with Orofacial Manifestations)
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10 pages, 361 KiB  
Article
Alcohol-Related Behaviour in Freshmen University Students in Sardinia, Italy
by Alessandra Mereu, Arianna Liori, Claudio Dessì, Mariano Girau, Derrick Clifford Mc Gilliard, Alessandra Sotgiu, Roberta Agabio, Paolo Contu and Claudia Sardu
Int. J. Environ. Res. Public Health 2021, 18(13), 7203; https://doi.org/10.3390/ijerph18137203 - 05 Jul 2021
Cited by 3 | Viewed by 2232
Abstract
This study aims to provide a picture of University of Cagliari students’ alcohol-related behaviour and to explore factors associated with it. Data were collected by administering a questionnaire to 992 freshmen university students from different programs consisting of twelve closed questions, including three [...] Read more.
This study aims to provide a picture of University of Cagliari students’ alcohol-related behaviour and to explore factors associated with it. Data were collected by administering a questionnaire to 992 freshmen university students from different programs consisting of twelve closed questions, including three questions from the Alcohol Use Disorders Identification Test for Consumption (AUDIT-C short form). Three subgroups of alcohol-related behaviour were distinguished (risky drinkers, social drinkers and abstainers). In order to explore factors associated with patterns of alcohol consumption, a multivariate logistic regression was performed. The prevalence of risky drinkers was 35%. A binge-drinking behaviour at least once in the last twelve months was declared by 65% (more widespread in men and in students living away from their parents). Risky consumption is significantly associated with age of onset of alcohol use, living away from parents’ home, drinking outside meals and attending health courses. Regarding the levels of daily alcohol consumption perceived as a health risk, 66% of men and 88% of women indicate values higher than those recommended. The results underline the need for tailored prevention measures. University could be a promising setting to implement actions according to a health promotion perspective, to empower students to control their alcohol consumption. Full article
11 pages, 327 KiB  
Article
Fall-Related Activity Avoidance among Persons with Late Effects of Polio and Its Influence on Daily Life: A Mixed-Methods Study
by Christina Brogårdh, Jan Lexell and Catharina Sjödahl Hammarlund
Int. J. Environ. Res. Public Health 2021, 18(13), 7202; https://doi.org/10.3390/ijerph18137202 - 05 Jul 2021
Cited by 4 | Viewed by 2310
Abstract
Falls are common among persons with late effects of polio (LEoP), which may lead to fear of falling and activity avoidance in everyday life. Here, we assessed the occurrence of fall-related activity avoidance among persons with LEoP and explored how these experiences influenced [...] Read more.
Falls are common among persons with late effects of polio (LEoP), which may lead to fear of falling and activity avoidance in everyday life. Here, we assessed the occurrence of fall-related activity avoidance among persons with LEoP and explored how these experiences influenced daily life. Fourteen ambulatory persons (seven women; mean age 70 years) with LEoP participated. They responded to the modified Survey of Activities and Fear of Falling in the Elderly (mSAFFE) and participated in individual interviews, which were analysed by systematic text condensation. Each quotation was deductively analysed from its representation with regard to mSAFFE. We found that many persons often avoided activities related to standing and walking, for example, taking a bath, performing household chores, walking outdoors, attending social events if there were stairs in the building and travelling by public transport, due to fear of falling, increased pain and fatigability. To facilitate the performance of daily activities participants expressed that strategic thinking and aids were important to use. In conclusion, fall-related activity avoidance is common in persons with LEoP, which negatively influence daily life and social participation. To increase daily functioning in this population, fall-related activity avoidance should be included in a multifaceted fall management program. Full article
(This article belongs to the Special Issue Movement Disorders and Falls in Older Persons)
27 pages, 2384 KiB  
Review
Evidence-Based Effects of High-Intensity Interval Training on Exercise Capacity and Health: A Review with Historical Perspective
by Muhammed Mustafa Atakan, Yanchun Li, Şükran Nazan Koşar, Hüseyin Hüsrev Turnagöl and Xu Yan
Int. J. Environ. Res. Public Health 2021, 18(13), 7201; https://doi.org/10.3390/ijerph18137201 - 05 Jul 2021
Cited by 23 | Viewed by 17815
Abstract
Engaging in regular exercise results in a range of physiological adaptations offering benefits for exercise capacity and health, independent of age, gender or the presence of chronic diseases. Accumulating evidence shows that lack of time is a major impediment to exercise, causing physical [...] Read more.
Engaging in regular exercise results in a range of physiological adaptations offering benefits for exercise capacity and health, independent of age, gender or the presence of chronic diseases. Accumulating evidence shows that lack of time is a major impediment to exercise, causing physical inactivity worldwide. This issue has resulted in momentum for interval training models known to elicit higher enjoyment and induce adaptations similar to or greater than moderate-intensity continuous training, despite a lower total exercise volume. Although there is no universal definition, high-intensity interval exercise is characterized by repeated short bursts of intense activity, performed with a “near maximal” or “all-out” effort corresponding to ≥90% of maximal oxygen uptake or >75% of maximal power, with periods of rest or low-intensity exercise. Research has indicated that high-intensity interval training induces numerous physiological adaptations that improve exercise capacity (maximal oxygen uptake, aerobic endurance, anaerobic capacity etc.) and metabolic health in both clinical and healthy (athletes, active and inactive individuals without any apparent disease or disorder) populations. In this paper, a brief history of high-intensity interval training is presented, based on the novel findings of some selected studies on exercise capacity and health, starting from the early 1920s to date. Further, an overview of the mechanisms underlying the physiological adaptations in response to high-intensity interval training is provided. Full article
(This article belongs to the Special Issue Physiological Adaptations to Endurance Training)
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10 pages, 337 KiB  
Article
Quality of Life and Its Associations with Religiosity and Religious Coping among Outpatients with Psychosis in Singapore
by Kumarasan Roystonn, Laxman Cetty, Anitha Jeyagurunathan, Fiona Devi, Edimansyah Abdin, Soo Teng Tan, Charmaine Tang, Swapna Verma and Mythily Subramaniam
Int. J. Environ. Res. Public Health 2021, 18(13), 7200; https://doi.org/10.3390/ijerph18137200 - 05 Jul 2021
Cited by 4 | Viewed by 2328
Abstract
This cross-sectional study investigated the relationship of religiosity, the use of positive and negative religious coping methods, and quality of life (QOL) among 364 outpatients with psychosis in Singapore. Positive religious coping was significantly associated with better scores on physical (β = 0.51, [...] Read more.
This cross-sectional study investigated the relationship of religiosity, the use of positive and negative religious coping methods, and quality of life (QOL) among 364 outpatients with psychosis in Singapore. Positive religious coping was significantly associated with better scores on physical (β = 0.51, p = 0.02) and psychological (β = 0.64, p = 0.01) QOL domains in the regression model. Negative religious coping was related to worse QOL in all four domains: physical (β = −0.44, p = 0.03), psychological (β = −0.76, p < 0.01), social (β = −0.54, p = 0.03), and environment (β = −0.65, p < 0.01). Increased participation in organizational religious activities was positively associated with higher QOL for psychological (β = 2.47, p < 0.01), social relationships (β = 2.66, p = 0.01), and environment (β = 2.09, p = 0.01) domains. Interestingly, those with no religious affiliation were found with higher scores in the QOL domain for social relationships (β = 4.59, p = 0.02). Religious coping plays an important role for the QOL of outpatients with psychosis. Greater awareness of the importance of religion in this population may improve cultural competence in treatment. Individuals with psychosis may benefit from greater community support and collaboration between clinical and religious community-based organizations to improve social integration and QOL. Full article
(This article belongs to the Special Issue Social Determinants of Mental Health)
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18 pages, 1328 KiB  
Article
Effectiveness of an Academic-Practice Team Approach on Research Capacity Building of Nurses and Public Health Professionals
by Yuwadee Wittayapun and Jiraphat Nawarat
Int. J. Environ. Res. Public Health 2021, 18(13), 7199; https://doi.org/10.3390/ijerph18137199 - 05 Jul 2021
Cited by 1 | Viewed by 2121
Abstract
The purpose of this study was to determine the need for research training among nurses and health professionals in a rural province of Thailand and to evaluate the effectiveness of the interventions designed to address the identified factors. This two-phase study used a [...] Read more.
The purpose of this study was to determine the need for research training among nurses and health professionals in a rural province of Thailand and to evaluate the effectiveness of the interventions designed to address the identified factors. This two-phase study used a cross-sectional design with one-group pre- and post-tests. In phase I, 149 subjects from 16 subdistrict health promoting hospitals and one district hospital were sampled. As an intervention, an academic-practice team approach to research capacity building was designed. Twenty-four volunteers completed a three-time point assessment of intervention in phase II. Data were collected using self-report questionnaires and analyzed using bivariate and multivariate statistics. Phase-I results indicated that 33.6% of subjects were involved in the research implementation. They had a moderate perception of research barriers and capacity. The research experiences, capacity, and barriers associated with the research implementation were described in detail (p < 0.05). The only positive predictor of research implementation was research training (p < 0.001). The intervention improved 24 participants’ competency (p < 0.05). Most of their research proposals had received ethics approval and a small grant. These findings highlight the efforts of innovative research capacity development and its impact on research and health practices among nurses and health professionals. Full article
(This article belongs to the Special Issue Evidence-Based Practice and Advanced Nursing Care)
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16 pages, 424 KiB  
Article
Disasters, Gender, and HIV Infection: The Impact of the 2010 Haiti Earthquake
by Mar Llorente-Marrón, Yolanda Fontanil-Gómez, Montserrat Díaz-Fernández and Patricia Solís García
Int. J. Environ. Res. Public Health 2021, 18(13), 7198; https://doi.org/10.3390/ijerph18137198 - 05 Jul 2021
Cited by 3 | Viewed by 3297
Abstract
Although disasters threaten all people who experience them, they do not affect all members of society in the same way. Its effects are not solely restricted to the economic sphere; they also affect the physical and mental health of those who suffer from [...] Read more.
Although disasters threaten all people who experience them, they do not affect all members of society in the same way. Its effects are not solely restricted to the economic sphere; they also affect the physical and mental health of those who suffer from them, having a particular impact on women and limiting their life chances. The aim of this study was to examine the impact the 2010 Haiti earthquake had on the seropositivity of female survivors. Method: Using data from the Demographic and Health Survey, this study examines the impact of the 2010 Haiti earthquake on gender relations associated with the probability of being HIV positive through the differences-in-differences strategy. Results: A differential of four percentage points is observed in the probability of HIV seropositivity between men and women, favoring men. Additionally, it is observed that the probability of seropositivity intensifies when the cohabitation household is headed by a woman. Conclusion: Disasters are not indifferent to the gender of the people affected. In the second decade of the 21st century, the conclusions obtained show, once again, the need for incorporating the gender perspective into the management of natural hazards in the field of health. This is the case of the differential exposure to HIV after the earthquake in Haiti. Full article
25 pages, 2146 KiB  
Review
Impact of Climate Change on Eye Diseases and Associated Economical Costs
by Lucía Echevarría-Lucas, José Mᵃ Senciales-González, María Eloísa Medialdea-Hurtado and Jesús Rodrigo-Comino
Int. J. Environ. Res. Public Health 2021, 18(13), 7197; https://doi.org/10.3390/ijerph18137197 - 05 Jul 2021
Cited by 14 | Viewed by 4463
Abstract
Climate change generates negative impacts on human health. However, little is known about specific impacts on eye diseases, especially in arid and semi-arid areas where increases in air temperatures are expected. Therefore, the main goals of this research are: (i) to highlight the [...] Read more.
Climate change generates negative impacts on human health. However, little is known about specific impacts on eye diseases, especially in arid and semi-arid areas where increases in air temperatures are expected. Therefore, the main goals of this research are: (i) to highlight the association between common eye diseases and environmental factors; and (ii) to analyze, through the available literature, the health expenditure involved in combating these diseases and the savings from mitigating the environmental factors that aggravate them. Mixed methods were used to assess the cross-variables (environmental factors, eye diseases, health costs). Considering Southern Spain as an example, our results showed that areas with similar climatic conditions could increase eye diseases due to a sustained increase in temperatures and torrential rains, among other factors. We highlight that an increase in eye diseases in Southern Spain is conditioned by the effects of climate change by up to 36.5%; the economic burden of the main eye diseases, extrapolated to the rest of the country, would represent an annual burden of 0.7% of Spain’s Gross Domestic Product. In conclusion, the increase in eye diseases has a strong economic and social impact that could be reduced with proper management of the effects of climate change. We propose a new concept: disease sink, defined as any climate change mitigation action which reduces the incidence or morbidity of disease. Full article
(This article belongs to the Special Issue Climate Change and Environment Health)
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20 pages, 373 KiB  
Article
Thriving from Work: Conceptualization and Measurement
by Susan E. Peters, Glorian Sorensen, Jeffrey N. Katz, Daniel A. Gundersen and Gregory R. Wagner
Int. J. Environ. Res. Public Health 2021, 18(13), 7196; https://doi.org/10.3390/ijerph18137196 - 05 Jul 2021
Cited by 7 | Viewed by 4994
Abstract
Work is a major contributor to our health and well-being. Workers’ thriving is directly influenced by their job design, work environment and organization. The purpose of this report is to describe the qualitative methods used to develop the candidate items for a novel [...] Read more.
Work is a major contributor to our health and well-being. Workers’ thriving is directly influenced by their job design, work environment and organization. The purpose of this report is to describe the qualitative methods used to develop the candidate items for a novel measure of Thriving from Work through a multi-step iterative process including: a literature review, workshop, interviews with experts, and cognitive testing of the candidate items. Through this process, we defined Thriving from Work as the state of positive mental, physical, and social functioning in which workers’ experiences of their work and working conditions enable them to thrive in their overall lives, contributing to their ability to achieve their full potential in their work, home, and community. Thriving from Work was conceptualized into 37 attributes across seven dimensions: psychological, emotional, social, work–life integration, basic needs, experience of work, and health. We ultimately identified, developed and/or modified 87 candidate questionnaire items mapped to these attributes that performed well in cognitive testing in demographically and occupationally diverse workers. The Thriving from Work Questionnaire will be subjected to psychometric testing and item reduction in future studies. Individual items demonstrated face validity and good cognitive response properties and may be used independently from the questionnaire. Full article
(This article belongs to the Special Issue Worker Safety, Health, and Well-Being in the USA)
17 pages, 383 KiB  
Article
Female Genital Mutilation Consequences and Healthcare Received among Migrant Women: A Phenomenological Qualitative Study
by Alba González-Timoneda, Marta González-Timoneda, Antonio Cano Sánchez and Vicente Ruiz Ros
Int. J. Environ. Res. Public Health 2021, 18(13), 7195; https://doi.org/10.3390/ijerph18137195 - 05 Jul 2021
Cited by 7 | Viewed by 3697
Abstract
European healthcare systems are increasingly being challenged to respond to female genital mutilation (FGM). This study explores the FGM experiences of migrant women coming from FGM-practicing countries residing in a European host country. A qualitative phenomenological study was carried out and 23 participants [...] Read more.
European healthcare systems are increasingly being challenged to respond to female genital mutilation (FGM). This study explores the FGM experiences of migrant women coming from FGM-practicing countries residing in a European host country. A qualitative phenomenological study was carried out and 23 participants were included. Data were collected through 18 face-to-face open-ended interviews and a focus group and were analysed using Giorgi’s four-step phenomenological approach. Three main themes were derived: “FGM consequences”, “healthcare received” and “tackling FGM”. Participants highlighted obstetric, gynaecological and genitourinary consequences such as haemorrhages, perineal tears, caesarean delivery, risk of infection, dysmenorrhea, urinary tract infections and dysuria; consequences for sexuality, mainly, dyspareunia, loss of sexual interest and decreased quality of sexual intercourse; and psychological consequences such as loss of self-esteem, feelings of humiliation and fear of social and familial rejection. Women perceived a profound lack of knowledge about FGM from health providers and a lack of sensitive and empathetic care. Some women perceived threatening and disproportionate attitudes and reported negative experiences. Participants highlighted the importance of educating, raising awareness and improving prevention and detection strategies. The findings disclose the need to improve training and institutional plans to address structural and attitudinal barriers to health equity across migrant families in their host countries. Full article
16 pages, 1919 KiB  
Review
Periodontal Conditions and Pathogens Associated with Pre-Eclampsia: A Scoping Review
by Jocelyne Gare, Aida Kanoute, Nicolas Meda, Stephane Viennot, Denis Bourgeois and Florence Carrouel
Int. J. Environ. Res. Public Health 2021, 18(13), 7194; https://doi.org/10.3390/ijerph18137194 - 05 Jul 2021
Cited by 21 | Viewed by 4581
Abstract
Background: Pre-eclampsia, the second most frequent direct source of maternal mortality, is a multisystem gestational disorder characterized by proteinuria and maternal hypertension after the 20th gestational week. Although the causes of pre-eclampsia are still discussed, research has suggested that the placenta has a [...] Read more.
Background: Pre-eclampsia, the second most frequent direct source of maternal mortality, is a multisystem gestational disorder characterized by proteinuria and maternal hypertension after the 20th gestational week. Although the causes of pre-eclampsia are still discussed, research has suggested that the placenta has a central place in the pathogenesis of this disease. Moreover, current surveys indicated that periodontal disorders observed during the pregnancy and more particularly, periodontal pathogens could be link to the risk of pre-eclampsia. Objectives: This article aims to review recent studies focusing on periodontal conditions and pathogens associated with pre-eclampsia. Methods: The process followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews guidelines. Results: Metabolic conditions, immunological changes, fluctuating progesterone and estrogen levels of the pregnant woman induce a dysbiosis of the oral microbiota and contribute to increase inflammation of periodontal tissues. Periodontal pathogens could diffuse through the bloodstream inducing a placenta inflammatory response as well as inflammatory molecules produced in response to periodontopathogens could migrate through the bloodstream leading to a placenta inflammatory response. Also, periodontopathogens can colonize the vaginal microbiota through the gastrointestinal tract or during oro-genital contacts. Conclusion: A cumulative bi-directional relationship between periodontal conditions, pathogens and the pre-eclampsia exists. Full article
(This article belongs to the Special Issue Oral Microbiota and Oral Health)
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14 pages, 2552 KiB  
Article
The Challenges of Partnering to Promote Health through Sport
by Alex Donaldson, Kiera Staley, Matthew Cameron, Sarah Dowling, Erica Randle, Paul O’Halloran, Nicola McNeil, Arthur Stukas and Matthew Nicholson
Int. J. Environ. Res. Public Health 2021, 18(13), 7193; https://doi.org/10.3390/ijerph18137193 - 05 Jul 2021
Cited by 6 | Viewed by 2628
Abstract
Interagency partnerships and collaborations underpin a settings-based approach to health promotion in all settings, including sport. This study used an online concept mapping approach to explore the challenges that Regional Sports Assemblies (RSAs) in Victoria, Australia experienced when working in partnerships to develop [...] Read more.
Interagency partnerships and collaborations underpin a settings-based approach to health promotion in all settings, including sport. This study used an online concept mapping approach to explore the challenges that Regional Sports Assemblies (RSAs) in Victoria, Australia experienced when working in partnerships to develop and deliver physical activity programs in a community sport context. Participants from nine RSAs brainstormed 46 unique partnership-related challenges that they then sorted into groups based on similarity of meaning and rated for importance and capacity to manage (6-point scale; 0 = least, 5 = most). A six cluster map (number of statements in cluster, mean cluster importance and capacity ratings)—Co-design for regional areas (4, 4.22, 2.51); Financial resources (3, 4.00, 2.32); Localised delivery challenges (4, 3.72, 2.33); Challenges implementing existing State Sporting Association (SSA) products (9, 3.58, 2.23); Working with clubs (8, 3.43, 2.99); and Partnership engagement (18, 3.23, 2.95)—was considered the most appropriate interpretation of the sorted data. The most important challenge was Lack of volunteer time (4.56). Partnerships to implement health promotion initiatives in sports settings involve multiple challenges, particularly for regional sport organisations working in partnership with community sport clubs with limited human and financial resources, to implement programs developed by national or state-based organisations. Full article
(This article belongs to the Special Issue Health Promotion and Sport)
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16 pages, 1008 KiB  
Review
Neighborhood Characteristics and Cancer Survivorship: An Overview of the Current Literature on Neighborhood Landscapes and Cancer Care
by Sima Namin, Yuhong Zhou, Joan Neuner and Kirsten Beyer
Int. J. Environ. Res. Public Health 2021, 18(13), 7192; https://doi.org/10.3390/ijerph18137192 - 05 Jul 2021
Cited by 5 | Viewed by 2512
Abstract
There is a growing literature on the association between neighborhood contexts and cancer survivorship. To understand the current trends and the gaps in the literature, we aimed to answer the following questions: To what degree, and how, has cancer survivorship research accounted for [...] Read more.
There is a growing literature on the association between neighborhood contexts and cancer survivorship. To understand the current trends and the gaps in the literature, we aimed to answer the following questions: To what degree, and how, has cancer survivorship research accounted for neighborhood-level effects? What neighborhood metrics have been used to operationalize neighborhood factors? To what degree do the neighborhood level metrics considered in cancer research reflect neighborhood development as identified in the Leadership for Energy and Environmental Design for Neighborhood Development (LEED-ND) guidelines? We first conducted a review guided by PRISMA extension for scoping review of the extant literature on neighborhood effects and cancer survivorship outcomes from January 2000 to January 2021. Second, we categorized the studied neighborhood metrics under six main themes. Third, we assessed the findings based on the LEED-ND guidelines to identify the most relevant neighborhood metrics in association with areas of focus in cancer survivorship care and research. The search results were scoped to 291 relevant peer-reviewed journal articles. Results show that survivorship disparities, primary care, and weight management are the main themes in the literature. Additionally, most articles rely on neighborhood SES as the primary (or only) examined neighborhood level metric. We argue that the expansion of interdisciplinary research to include neighborhood metrics endorsed by current paradigms in salutogenic urban design can enhance the understanding of the role of socioecological context in survivorship care and outcomes. Full article
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24 pages, 2869 KiB  
Article
Leaf Thermal and Chemical Properties as Natural Drivers of Plant Flammability of Native and Exotic Tree Species of the Valparaíso Region, Chile
by Fabián Guerrero, Carla Hernández, Mario Toledo, Lorena Espinoza, Yulian Carrasco, Andrés Arriagada, Ariel Muñoz, Lautaro Taborga, Jan Bergmann and Camilo Carmona
Int. J. Environ. Res. Public Health 2021, 18(13), 7191; https://doi.org/10.3390/ijerph18137191 - 05 Jul 2021
Cited by 14 | Viewed by 4336
Abstract
Forest fires are one of the main environmental threats in Chile. Fires in this Mediterranean climate region frequently affect native forests and exotic plantations, including in several cases urban and rural settlements. Considering the scarcity of information regarding the fire response dynamics of [...] Read more.
Forest fires are one of the main environmental threats in Chile. Fires in this Mediterranean climate region frequently affect native forests and exotic plantations, including in several cases urban and rural settlements. Considering the scarcity of information regarding the fire response dynamics of tree species that are frequently affected by fires, this study aims to establish a flammability classification according to the evolution of the fire initiation risk presented by the most affected forest species in the Valparaíso region. Three exotic species, Eucalyptus globulus, Pinus radiata, and Acacia dealbata, and two native species, Cryptocarya alba and Quillaja saponaria, were studied. Flammability assays indicate that E. globulus, A. dealbata, and C. alba are extremely flammable, whereas P. radiata and Q. saponaria are flammable. Furthermore, E. globulus and A. dealbata have the highest heating values while Q. saponaria has the lowest values. The extreme flammability of E. globulus, A. dealbata, and C. alba indicates a high susceptibility to ignite. Furthermore, the high heat of combustion of E. globulus and A. dealbata can be associated with a high energy release, increasing the risk of fires spreading. In contrast, Q. saponaria has the lowest predisposition to ignite and capacity to release heat. Accordingly, this work shows that all studied tree species contain organic metabolites that are potentially flammable (sesquiterpenes, aliphatic hydrocarbons, alcohol esters, ketones, diterpenes, and triterpenes) and can be considered as drivers of flammability in vegetation. Finally, these preliminary results will aid in the construction of more resilient landscapes in the near future. Full article
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14 pages, 1628 KiB  
Article
Evaluating the Effectiveness of Earplugs in Preventing Noise-Induced Hearing Loss in an Auto Parts Factory in China
by Wei Gong, Liangliang Zhao, Ling Li, Thais C. Morata, Wei Qiu, Huiling Amy Feng and Baoli Zhu
Int. J. Environ. Res. Public Health 2021, 18(13), 7190; https://doi.org/10.3390/ijerph18137190 - 05 Jul 2021
Cited by 9 | Viewed by 3025
Abstract
A survey was administered to 385 noise-exposed workers from an auto parts factory and 1268 non-noise-exposed health department employees in China. Individual 8 h A-weighted equivalent sound levels (LAeq,8h), earplug personal attenuation ratings (PARs), and pure-tone audiometric tests were performed. The [...] Read more.
A survey was administered to 385 noise-exposed workers from an auto parts factory and 1268 non-noise-exposed health department employees in China. Individual 8 h A-weighted equivalent sound levels (LAeq,8h), earplug personal attenuation ratings (PARs), and pure-tone audiometric tests were performed. The average LAeq,8h of noise-exposed workers was 87 dB (A) with a mean PAR of 7 dB. The prevalence of high-frequency hearing loss was 65% for noise-exposed workers and 33% for the non-noise-exposed employees. The use of earplugs had no observable effect on the prevalence of high-frequency hearing loss of the study participants (OR 0.964, 95% CI 0.925–1.005, p = 0.085). No significant relationship between the effectiveness offered by earplug use and high-frequency hearing thresholds at 3, 4, and 6 kHz was found (t = −1.54, p = 0.125). The mandatory requirement of earplug use without individualized training on how to wear HPDs correctly had no detectable effect on the prevention of hearing loss at the auto parts factory. The hearing conservation program at the surveyed factory was not effective. Periodic hearing tests, earplug fit testing, expanding the offer of different types of hearing protection, and employee education about the importance of protecting their hearing were recommended to the occupational health and safety program. Full article
(This article belongs to the Special Issue Hearing Conservation)
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11 pages, 5866 KiB  
Article
Novel Insights into Young Adults’ Perceived Effectiveness of Waterpipe Tobacco-Specific Pictorial Health Warning Labels in Lebanon: Implications for Tobacco Control Policy
by Rima Nakkash, Malak Tleis, Sara Chehab, Wu Wensong, Michael Schmidt, Kenneth D. Ward, Wasim Maziak and Taghrid Asfar
Int. J. Environ. Res. Public Health 2021, 18(13), 7189; https://doi.org/10.3390/ijerph18137189 - 05 Jul 2021
Cited by 5 | Viewed by 2034
Abstract
This study aims to explore the perceived effectiveness of waterpipe (WP) tobacco specific health warning labels (HWLs) among young adult WP smokers and nonsmokers in Lebanon. Before participating in focus group discussions, participants (n = 66; WP smokers n = 30; nonsmokers [...] Read more.
This study aims to explore the perceived effectiveness of waterpipe (WP) tobacco specific health warning labels (HWLs) among young adult WP smokers and nonsmokers in Lebanon. Before participating in focus group discussions, participants (n = 66; WP smokers n = 30; nonsmokers n = 36; age 18–33) completed a brief survey to rate the effectiveness of 12 HWLs’ and rank them according to four risk themes (WP health effects, WP harm to others, WP-specific harm, and WP harm compared to cigarettes). Differences in HWLs ratings by WP smoking status were examined and the top-ranked HWL in each theme were identified. HWLs depicting mouth cancer and harm to babies were rated as the most effective by both WP smokers and non-smokers. WP smokers rated HWLs which depicted harm to children and infants as more effective than non-smokers. The top-ranked HWLs for perceived overall effectiveness were those depicting “oral cancer”, “harm to babies”, “orally transmitted diseases” and “mouth cancer”. HWLs depicting oral lesions and harm to babies were rated as most effective, while HWLs showing the harmful effects of WP secondhand smoke on infants and children were rated as less effective by nonsmokers compared to smokers. Our study provides evidence on the potential effectiveness of HWLs for further evaluation in Lebanon and the Eastern Mediterranean region. The results will inform and guide the development and implementation of tobacco control policy. Full article
(This article belongs to the Special Issue Current Status of Tobacco Control Policies)
12 pages, 2118 KiB  
Article
Impact of Rowing Training on Quality of Life and Physical Activity Levels in Female Breast Cancer Survivors
by Juan Gavala-González, Amanda Torres-Pérez and José Carlos Fernández-García
Int. J. Environ. Res. Public Health 2021, 18(13), 7188; https://doi.org/10.3390/ijerph18137188 - 05 Jul 2021
Cited by 7 | Viewed by 3571
Abstract
The aim of this longitudinal study was to determine whether a rowing training program improved the quality of life and the physical activity levels in female breast cancer survivors (n = 28) (stage 1–4.54%; stage 2–36.36%; stage 3–54.54%; and stage 4–4.54%), diagnosed [...] Read more.
The aim of this longitudinal study was to determine whether a rowing training program improved the quality of life and the physical activity levels in female breast cancer survivors (n = 28) (stage 1–4.54%; stage 2–36.36%; stage 3–54.54%; and stage 4–4.54%), diagnosed 4.68 ± 3.00 years previously, who had undergone a subsequent intervention (preservation 56.53% and total mastectomy 43.47%) and had a current mean age of 52.30 ± 3.78 years. The participants (n = 28) engaged in a 12-week training program, each week comprising three sessions and each session lasting 60–90 min. The short form of the International Physical Activity Questionnaire (IPAQ-SF) and the Short Form 36 Health Survey (SF-36) were also administered. The results showed statistically significant improvements in levels of physical activity and in the dimensions of quality of life. We can conclude that a 12-week rowing training program tailored to women who have had breast cancer increases physical activity levels, leading to improved health status and quality of life. Full article
(This article belongs to the Special Issue Women in Sports and Exercise: From Health to Sports Performance)
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30 pages, 931 KiB  
Article
A Novel Fire Risk Assessment Approach for Large-Scale Commercial and High-Rise Buildings Based on Fuzzy Analytic Hierarchy Process (FAHP) and Coupling Revision
by Yijie Wang, Linzao Hou, Mian Li and Ruixiang Zheng
Int. J. Environ. Res. Public Health 2021, 18(13), 7187; https://doi.org/10.3390/ijerph18137187 - 05 Jul 2021
Cited by 13 | Viewed by 2689
Abstract
In recent years, much more emphasis than before has been placed on fire safety regulations by the local and central authorities of China, which makes fire risk assessments more important. In this paper we propose a new fire risk assessment approach for large-scale [...] Read more.
In recent years, much more emphasis than before has been placed on fire safety regulations by the local and central authorities of China, which makes fire risk assessments more important. In this paper we propose a new fire risk assessment approach for large-scale commercial and high-rise buildings that aims to evaluate the performances of their fire safety systems; this should improve the fire risk management and public safety in those buildings. According to the features of large-scale commercial and high-rise buildings, a fire-risk indexing system was built, and based on it we established a scientific fire risk evaluation system. To this end, the fuzzy analytic hierarchy process (FAHP) was used to assign a reasonable weight to each fire risk factor in the evaluation system. In addition, we revised the original scores by analyzing the coupling relationships among the fire risk factors. To validate our system, we selected 11 buildings in Shandong province and collected their fire safety data. Then, we calculated the final scores for the fire safety management of those buildings, and the results show that: (1) our fire risk evaluation system can assign reasonable weights; (2) the proposed evaluation system is comprehensive and has strong interpretability, since it exploits the coupling relationships among the risk factors. The novelty of the proposed approach lies in that it integrates opinions from multiple experts and utilizes coupling relationships among the factors. Further, the feedback from the approach can find not only the weaknesses in fire risk management, but also the potential causes of fires. As a result, the feedback from our assessment can assist the safety chiefs and inspectors with improving fire risk management. Full article
(This article belongs to the Section Public Health Statistics and Risk Assessment)
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7 pages, 1572 KiB  
Case Report
A Novel Intronic Splice—Site Mutation of the CYP11A1 Gene Linked to Adrenal Insufficiency with 46,XY Disorder of Sex Development
by Pawel Matusik, Agnieszka Gach, Olimpia Zajdel-Cwynar, Iwona Pinkier, Grzegorz Kudela and Aneta Gawlik
Int. J. Environ. Res. Public Health 2021, 18(13), 7186; https://doi.org/10.3390/ijerph18137186 - 05 Jul 2021
Cited by 3 | Viewed by 2445
Abstract
A novel CYP11A1: c.1236 + 5G > A was identified, expanding the mutation spectrum of the congenital adrenal insufficiency with 46,XY sex reversal. In a now 17-year-old girl delivered full-term (G2P2, parents unrelated), adrenal failure was diagnosed in the first year of [...] Read more.
A novel CYP11A1: c.1236 + 5G > A was identified, expanding the mutation spectrum of the congenital adrenal insufficiency with 46,XY sex reversal. In a now 17-year-old girl delivered full-term (G2P2, parents unrelated), adrenal failure was diagnosed in the first year of life based on clinical picture of acute adrenal crisis with vomiting, dehydration, weight loss, hypotension, and electrolyte disturbances. At the time, hormonal tests revealed primary adrenocortical insufficiency and steroid profiles showed lack of products of steroidogenesis, and since then the patient has been treated with substitution doses of hydrocortisone and fludrocortisone. At the age of 14, considering the absence of puberty symptoms, extended diagnostic tests revealed elevated LH levels (26.5 mIU/mL) with pre-puberty FSH levels (4.9 mIU/mL), low estradiol (28 pmol/L), testosterone (<2.5 ng/mL), and extremely high levels of ACTH (4961 pg/mL). A cytogenetic study revealed a 46 XY karyotype. A molecular examination confirmed the missense mutation and a novel splice-site mutation of CYP11A1 gene. Compound heterozygosity for the CYP11A1 gene with a known pathogenic variant in one allele and a novel splice site mutation in the second allele is most probably responsible for congenital adrenal insufficiency with 46,XY sex reversal. We discuss the necessity of cytogenetic test in the case of early onset of adrenal failure in the absence of steroidogenesis metabolites in the steroid profile. Full article
(This article belongs to the Special Issue Differences of Sex Development (DSD) - How to Proceed Properly)
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13 pages, 769 KiB  
Article
Physical Activity and Quality of Life in High School Students: Proposals for Improving the Self-Concept in Physical Education
by Mikel Vaquero-Solís, Miguel Angel Tapia-Serrano, David Hortigüela-Alcalá, Manuel Jacob Sierra-Díaz and Pedro Antonio Sánchez-Miguel
Int. J. Environ. Res. Public Health 2021, 18(13), 7185; https://doi.org/10.3390/ijerph18137185 - 05 Jul 2021
Cited by 14 | Viewed by 4473
Abstract
Adolescence is a critical period for the acquisition of health-related behaviors that will transcend later psychological well-being in adulthood. The present study presents a theoretical model whose objective is to analyze how physical activity predicts an adequate quality of life through self-concept and [...] Read more.
Adolescence is a critical period for the acquisition of health-related behaviors that will transcend later psychological well-being in adulthood. The present study presents a theoretical model whose objective is to analyze how physical activity predicts an adequate quality of life through self-concept and subjective happiness among adolescents. A total of 452 students aged 12 to 15 (M = 13.8; SD = 0.77) from four Compulsory Secondary Education institutes of the Autonomous Community of Extremadura participated, including boys (n = 258) and girls (n = 194). The students reported information on the following variables: physical activity, body mass index, self-concept, subjective happiness, and quality of life. The results show acceptable fit indices for the proposed theoretical model, which showed the importance of physical activity through self-concept and subjective happiness in quality of life: MRLχ2 = 67.533, p < 0.05, CFI = 0.93, TLI = 0.90, SRMR = 0.05, and RMSA = 0.07. Likewise, the model presented a better fit index for males than females. This study draws conclusions on the importance of physical activity as a predictor of quality of life mediated by the perception of self-concept and mood in adolescents. Full article
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12 pages, 2842 KiB  
Article
Can Earth’s Mightiest Heroes Help Children Be Physically Active? Exploring the Immersive Qualities of Les Mills’ and Marvel’s “Move Like the Avengers” Video
by Emily Budzynski-Seymour, Michelle Jones and James Steele
Int. J. Environ. Res. Public Health 2021, 18(13), 7184; https://doi.org/10.3390/ijerph18137184 - 05 Jul 2021
Cited by 1 | Viewed by 3163
Abstract
There have been calls for more enjoyable Physical Activity (PA) interventions which focus on ensuring a positive affective response. This study explored how using a narrative, characters, and music in a video-led PA session might influence the sense of immersion and impact the [...] Read more.
There have been calls for more enjoyable Physical Activity (PA) interventions which focus on ensuring a positive affective response. This study explored how using a narrative, characters, and music in a video-led PA session might influence the sense of immersion and impact the affective response. One hundred and thirty-six participants (boys n = 65, girls n = 71) were recruited, 85% aged between 7 and 11 years old. Participants completed the “Move Like the Avengers” PA video created by Les Mills and Marvel, then complete a survey answering questions on their post activity affective responses, and the use of immersive elements. Positive average affective responses were found (valence mean score: 3.6 ± 2.2, arousal mean score: 5.1 ± 1.0). Analysis revealed the narrative with characters indirectly mediate the valence response through creating a sense of immersion (βstd = 0.122 [95%CI 0.013 to 0.231]; p = 0.012). Musical elements had both a direct (βstd = 0.449 [95%CI 0.264 to 0.634]; p < 0.001), and an indirect (βstd = 0.122 [95%CI 0.014 to 0.229]; p = 0.011) effect upon valence and a direct effect upon arousal (βstd = 0.244 [95%CI 0.006 to 0.482]; p = 0.021). These promising results provide justification for future research into children’s immersive PA. Full article
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11 pages, 2245 KiB  
Article
Evaluation of the Bioaerosol Inactivation Ability of Chitosan-Coated Antimicrobial Filters
by Ying-Fang Hsu, Chi-Yu Chuang and Shinhao Yang
Int. J. Environ. Res. Public Health 2021, 18(13), 7183; https://doi.org/10.3390/ijerph18137183 - 05 Jul 2021
Cited by 5 | Viewed by 1981
Abstract
This work considers the enhancement of indoor bioaerosol removal efficiency by liquid coating of the antimicrobial agent chitosan onto polypropylene fibrous filters (CCFs). Escherichia coli (E. coli) and Bacillus subtilis (B. subtilis) were chosen as the tested bioaerosols. The [...] Read more.
This work considers the enhancement of indoor bioaerosol removal efficiency by liquid coating of the antimicrobial agent chitosan onto polypropylene fibrous filters (CCFs). Escherichia coli (E. coli) and Bacillus subtilis (B. subtilis) were chosen as the tested bioaerosols. The results revealed that 2.5% (w/w) of CCFs have significantly higher bioaerosol survival capability (23% and 34% of E. coli and B. subtilis, respectively), compared to an untreated filter (65% and 64% for E. coli and B. subtilis, respectively). Increasing face velocity and relative humidity during operating CCFs could reduce the bioaerosol removal capability. The regression analysis of the experimental findings demonstrated that the higher coating concentration of chitosan had the most positive influence on bioaerosol removal, while the face velocity and relative humidity had a negative influence, but a milder effect was observed (R2 = 0.83 and 0.81 for E. coli and B. subtilis bioaerosols, respectively). A CCF-loaded air-cleaning device was tested in a real indoor environment and resulted in 80.1% bioaerosol removal within 3 h of operating, which suggests that the chitosan-coated filter has the potential for further application in improving indoor air quality in the future. Full article
(This article belongs to the Special Issue State-of-the-Art Environmental Science and Technology)
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