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Int. J. Environ. Res. Public Health, Volume 18, Issue 15 (August-1 2021) – 163 articles

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Article
Is Rheumatoid Arthritis Related to Coffee Consumption in Korea? A Nationwide Cross-Sectional Observational Study
Int. J. Environ. Res. Public Health 2021, 18(15), 7880; https://doi.org/10.3390/ijerph18157880 (registering DOI) - 25 Jul 2021
Abstract
Coffee consumption is gradually increasing in Korea. As a result, interest in the relationship between coffee consumption and various diseases is growing. Several factors affect the development of rheumatoid arthritis (RA), and coffee consumption may be related. We conducted a nationwide cross-sectional study [...] Read more.
Coffee consumption is gradually increasing in Korea. As a result, interest in the relationship between coffee consumption and various diseases is growing. Several factors affect the development of rheumatoid arthritis (RA), and coffee consumption may be related. We conducted a nationwide cross-sectional study using data from the Korea National Health and Nutrition Examination Survey (2012–2016). A total of 12,465 eligible participants (4819 men and 7646 women) were included in the study. Participants with RA were defined as those who were diagnosed and currently being treated by physicians. Daily coffee consumption amounts were categorized as none, <1 cup, 1–2 cups, 2–3 cups, and ≥3 cups a day based on a self-report. A multivariable logistic regression model was employed, and we calculated the odds ratios (ORs) and 95% confidence intervals (CIs) for the odds of participants having RA with respect to coffee consumption. Compared to the no-coffee group, the ORs for RA in the <1 cup and 1–2 cups groups were 2.99 (95% CI 0.33–27.28) and 2.63 (95% CI 0.31–22.63) in men, respectively, and the ORs for RA for women in the <1 cup, 1–2 cups, 2–3 cups, and ≥3 cups groups were 0.62 (95% CI 0.31–1.26), 0.67 (95% CI 0.33–1.37), 1.08 (95% CI 0.35–3.36), and 1.43 (95% CI 0.25–8.36), respectively. Our study concludes, therefore, that daily coffee consumption is not related to the prevalence of RA in the general Korean population. Full article
(This article belongs to the Special Issue Chronic Disease Epidemiology: Advances in Research and Methods)
Article
Deep Venous Thrombosis and Risk of Consequent Sepsis Event: A Retrospective Nationwide Population-Based Cohort Study
Int. J. Environ. Res. Public Health 2021, 18(15), 7879; https://doi.org/10.3390/ijerph18157879 (registering DOI) - 25 Jul 2021
Abstract
Deep vein thrombosis causes several acute and chronic vessel complications and puts patients at risk of subsequent sepsis development. This unique study aimed to estimate the risk of sepsis development in DVT patients compared with non-DVT patients. This population-based cohort study used records [...] Read more.
Deep vein thrombosis causes several acute and chronic vessel complications and puts patients at risk of subsequent sepsis development. This unique study aimed to estimate the risk of sepsis development in DVT patients compared with non-DVT patients. This population-based cohort study used records of a longitudinal health insurance database containing two million patients defined in Taiwan’s National Health Insurance Research Database (NHIRD). Our study included patients aged over 20 years with a new diagnosis of DVT with at least two outpatient department visits or an admission between 2001 and 2014. Patients with a diagnosis of sepsis before the index date were excluded. Propensity score matching (PSM) was used to homogenize the baseline characteristics between the two groups. To define the independent risk of the DVT group, a multivariate Cox proportional hazard model was used to estimate the hazard ratios. After PSM, the DVT group (n = 5753) exhibited a higher risk of sepsis (adjusted hazard ratio, aHR, 1.74; 95% CI, 1.59–1.90) compared with non-DVT group (n = 5753). Patients with an increased risk of sepsis were associated with being elderly aged, male, having diabetes, chronic kidney disease, chronic obstructive pulmonary disease, stroke, malignancy, and use of antibiotics. In conclusion, this population-based cohort study demonstrated an increased risk of sepsis in DVT patients compared with non-DVT patients. Thus, early prevention and adequate treatment of DVT is necessary in clinical practice. Full article
(This article belongs to the Special Issue Cardiovascular Diseases and Healthy Aging)
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Article
High BMI and Low Muscular Fitness Predict Low Motor Competence in School-Aged Children Living in Low-Resourced Areas
Int. J. Environ. Res. Public Health 2021, 18(15), 7878; https://doi.org/10.3390/ijerph18157878 (registering DOI) - 25 Jul 2021
Abstract
Childhood obesity is a relatively new problem for Sub-Saharan developing countries. Especially in children with a low socioeconomic background, the link between motor competence, muscular fitness, and body mass index (BMI) remains poorly investigated. Due to the interrelatedness of BMI and physical fitness, [...] Read more.
Childhood obesity is a relatively new problem for Sub-Saharan developing countries. Especially in children with a low socioeconomic background, the link between motor competence, muscular fitness, and body mass index (BMI) remains poorly investigated. Due to the interrelatedness of BMI and physical fitness, the aim of this study is to determine the predictive value of these factors in relation to low motor competence in school-aged children living in low-resourced areas. Motor competence and physical fitness were assessed in 1037 school-aged Ghanaian and South African children using the Performance and Fitness test battery (PERF-FIT). “Low motor competence” was predicted using odds ratios calculated from backward logistic regression analyses. Low motor competence was less prevalent in Ghanaian children (3.7–11.1%) compared to the South African children (21.9–24.2%). Increased BMI and decreased muscular fitness predicted low motor competence in both Ghanaian and South African children. For example, the chance for a Ghanaian child to have low static balance increased by 22.8% (OR = 1.228, p < 0.001) with a 1-point increase in BMI, whereas this decreased by 30.0% (OR = 0.970, p < 0.001) with a 10-cm increase on the standing long jump. In the case of the South African children, if their BMI increased by 1 point, the chance for those children of having low static balance increased by 7.9%, and if their SLJ performance decreased by 10 cm, their chance of low performance increased by 13%. Clearly, motor competence is associated with both BMI and muscular fitness. Policy makers can use this information to counteract the establishment of childhood obesity by promoting weight control through physical activity and stimulating motor competence at school. Full article
(This article belongs to the Section Children's Health)
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Communication
Short and Long-Term Innovations on Dietary Behavior Assessment and Coaching: Present Efforts and Vision of the Pride and Prejudice Consortium
Int. J. Environ. Res. Public Health 2021, 18(15), 7877; https://doi.org/10.3390/ijerph18157877 (registering DOI) - 25 Jul 2021
Abstract
Overweight, obesity and cardiometabolic diseases are major global health concerns. Lifestyle factors, including diet, have been acknowledged to play a key role in the solution of these health risks. However, as shown by numerous studies, and in clinical practice, it is extremely challenging [...] Read more.
Overweight, obesity and cardiometabolic diseases are major global health concerns. Lifestyle factors, including diet, have been acknowledged to play a key role in the solution of these health risks. However, as shown by numerous studies, and in clinical practice, it is extremely challenging to quantify dietary behaviors as well as influencing them via dietary interventions. As shown by the limited success of ‘one-size-fits-all’ nutritional campaigns catered to an entire population or subpopulation, the need for more personalized coaching approaches is evident. New technology-based innovations provide opportunities to further improve the accuracy of dietary assessment and develop approaches to coach individuals towards healthier dietary behaviors. Pride & Prejudice (P&P) is a unique multi-disciplinary consortium consisting of researchers in life, nutrition, ICT, design, behavioral and social sciences from all four Dutch Universities of Technology. P&P focuses on the development and integration of innovative technological techniques such as artificial intelligence (AI), machine learning, conversational agents, behavior change theory and personalized coaching to improve current practices and establish lasting dietary behavior change. Full article
(This article belongs to the Special Issue Digital Health Tools: A Critical Assessment of Long-Term Engagement)
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Article
Minimum Detectable Change of Visual Acuity Measurements Using ETDRS Charts (Early Treatment Diabetic Retinopathy Study)
Int. J. Environ. Res. Public Health 2021, 18(15), 7876; https://doi.org/10.3390/ijerph18157876 (registering DOI) - 25 Jul 2021
Abstract
In our work, we determined the value of visual acuity (VA) with ETDRS charts (Early Treatment Diabetic Retinopathy Study). The purpose of the study was to determine the measurement reliabilities, calculating the correlation coefficient interclass (ICC), the value of the error associated with [...] Read more.
In our work, we determined the value of visual acuity (VA) with ETDRS charts (Early Treatment Diabetic Retinopathy Study). The purpose of the study was to determine the measurement reliabilities, calculating the correlation coefficient interclass (ICC), the value of the error associated with the measure (SEM), and the minimal detectable change (MDC). Forty healthy subjects took part. The mean age was 23.5 ± 3.1 (19 to 26) years. Visual acuities were measured with ETDRS charts (96% ETDRS chart nº 2140) and (10% SLOAN Contrast Eye Test chart nº 2153). The measurements were made (at 4 m) under four conditions: Firstly, photopic conditions with high contrast (HC) and low contrast (LC) and after 15 min of visual rest, mesopic conditions with high and low contrast. Under photopic conditions and high contrast, the ICC = 0.866 and decreased to 0.580 when the luminosity and contrast decreased. The % MDC in the four conditions was always less than 10%. It was minor under photopic conditions and HC (5.83) and maximum in mesopic conditions and LC (9.70). Our results conclude a high reliability of the ETDRS test, which is higher in photopic and high contrast conditions and lower when the luminosity and contrast decreases. Full article
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Article
Effects of a Midwife-Coordinated Maternity Care Intervention (ChroPreg) vs. Standard Care in Pregnant Women with Chronic Medical Conditions: Results from a Randomized Controlled Trial
Int. J. Environ. Res. Public Health 2021, 18(15), 7875; https://doi.org/10.3390/ijerph18157875 (registering DOI) - 25 Jul 2021
Abstract
The proportion of childbearing women with pre-existing chronic medical conditions (CMC) is rising. In a randomized controlled trial, we aimed to evaluate the effects of a midwife-coordinated maternity care intervention (ChroPreg) in pregnant women with CMC. The intervention consisted of three main components: [...] Read more.
The proportion of childbearing women with pre-existing chronic medical conditions (CMC) is rising. In a randomized controlled trial, we aimed to evaluate the effects of a midwife-coordinated maternity care intervention (ChroPreg) in pregnant women with CMC. The intervention consisted of three main components: (1) Midwife-coordinated and individualized care, (2) Additional ante-and postpartum consultations, and (3) Specialized known midwives. The primary outcome was the total length of hospital stay (LOS). Secondary outcomes were patient-reported outcomes measuring psychological well-being and satisfaction with maternity care, health utilization, and maternal and infant outcomes. A total of 362 women were randomized to the ChroPreg intervention (n = 131) or Standard Care (n = 131). No differences in LOS were found between groups (median 3.0 days, ChroPreg group 0.1% lower LOS, 95% CI −7.8 to 7%, p = 0.97). Women in the ChroPreg group reported being more satisfied with maternity care measured by the Pregnancy and Childbirth Questionnaire (PCQ) compared with the Standard Care group (mean PCQ 104.5 vs. 98.2, mean difference 6.3, 95% CI 3.0–10.0, p < 0.0001). In conclusion, the ChroPreg intervention did not reduce LOS. However, women in the ChroPreg group were more satisfied with maternity care. Full article
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Article
A Latent Class Analysis of Health-Related Quality of Life in Korean Older Adults
Int. J. Environ. Res. Public Health 2021, 18(15), 7874; https://doi.org/10.3390/ijerph18157874 (registering DOI) - 25 Jul 2021
Abstract
The present study aimed to confirm latent classes in health-related quality of life (HRQOL) in older adults and investigate the characteristics of participants in each class. It aimed to provide basic data to develop interventions for each quality-of-life class by analysing the predictors [...] Read more.
The present study aimed to confirm latent classes in health-related quality of life (HRQOL) in older adults and investigate the characteristics of participants in each class. It aimed to provide basic data to develop interventions for each quality-of-life class by analysing the predictors of each class. Secondary data from a community health survey in G province since 2019 found a total of 41,872 participants. Of them, 9027 were 65 years or older and residing in G Province in 2019, participated in this study. Mplus 8.5 was used to conduct a latent class analysis of five domains of HRQOL. Four latent classes in the HRQOL of older adults, namely, stable type, physical disability type, emotional disability type, and crisis type were found. Certain variables predicted these classes. Based on the findings of the present study, training on functional mobility and balance to prevent falls in older populations and individualised programmes to promote mental health in them should be provided. Moreover, policies should increase medical accessibility and provide social support for older people with low-incomes. Additionally, since physical, psychological, and social health in older adults are inter-connected, a comprehensive care plan is needed to improve their HRQOL. Full article
(This article belongs to the Special Issue Ageing and Health: A Functional and Psychological Perspective)
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Article
Embodied Energy Use in China’s Transportation Sector: A Multi-Regional Input–Output Analysis
Int. J. Environ. Res. Public Health 2021, 18(15), 7873; https://doi.org/10.3390/ijerph18157873 (registering DOI) - 25 Jul 2021
Abstract
Energy transition in the transport sector (TS) is important for the goals of achieving carbon peak by 2030 and carbon neutrality by 2060 in China. A number of scholars have conducted studies to identify the potential energy savings of the TS and to [...] Read more.
Energy transition in the transport sector (TS) is important for the goals of achieving carbon peak by 2030 and carbon neutrality by 2060 in China. A number of scholars have conducted studies to identify the potential energy savings of the TS and to improve its energy efficiency. Most of them concentrate on the direct energy use (EU). The indirect EU along the supply chain of the TS is often neglected. In this paper, the direct and indirect energy use, i.e., the embodied EU, of China’s TS is measured by applying a multi-regional input–output (MRIO) model, where they are investigated from both the provincial and sectoral perspectives. Results show that intermediate use is the major driving force for the TS’s embodied EU in China. From the sectoral level, supply from sectors such as petroleum refining and coking and demand from the service sector are the main reasons of the TS’s embodied EU. From the provincial perspective, the TS’s embodied EU is driven by low transportation technologies in most provinces located in central and western China. By contrast, abundant economic and social activities are the primary reason for the TS’s embodied EU in most provinces in eastern China. In the terms of interprovincial transfer, the energy embodied in the TS flows from resource-intensive provinces located in central and western China to resource-deficient provinces in eastern China. In addition, a close geographical connection exists in the transfer. Finally, several strategies from the sectoral and provincial levels are provided for policymakers. Full article
(This article belongs to the Section Environmental Science and Engineering)
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Article
Orthopaedic Disorders in Cerebral Palsy in International Cooperation Projects: A Descriptive Cross-Sectional Study
Int. J. Environ. Res. Public Health 2021, 18(15), 7872; https://doi.org/10.3390/ijerph18157872 (registering DOI) - 25 Jul 2021
Abstract
Background: In international cooperation projects that are carried out in less developed and developing countries, a large number of children with disabilities present cerebral palsy (CP). Orthopaedic disorders are frequent complications associated with this disorder. Their prevention and early intervention are essential to [...] Read more.
Background: In international cooperation projects that are carried out in less developed and developing countries, a large number of children with disabilities present cerebral palsy (CP). Orthopaedic disorders are frequent complications associated with this disorder. Their prevention and early intervention are essential to achieve an appropriate therapeutic approach for children with PC and to improve their quality of life. Objective: To describe the treatment approach that is currently used in international cooperation projects for the rehabilitation management of the orthopaedic disorders in children with cerebral palsy. Methods: This is an observational, descriptive, cross-sectional study, carried out by means of an online questionnaire to professionals in the field of Physiotherapy and Rehabilitation working in international cooperation projects. The inclusion criteria were professionals working in the rehabilitation field in development aid, humanitarian action or emergency projects that provided rehabilitation services, working with children with cerebral palsy from 0 to 18 years old. Results: Ninety-eight questionnaires were analysed. The average age of the participants was 33.2 years, they were mainly working in development cooperation projects (83.33%) that were implemented in rehabilitation centres and through community-based rehabilitation services (60%). The projects were located in countries all over the world but mainly on the Asian continent (71.4%). Physiotherapists and orthopaedic technicians (72.22%) were the main professionals working in these projects, followed by occupational therapists and social workers (55.56%). The results indicated that the orthopaedic disorders were very frequent in the sample (66.67%), with hip subluxation (50%), scoliosis (77.78%), kyphosis (61.1%), clubfoot (88.7%) and varus foot (61.11%) standing out. The most commonly used treatment approaches were positioning (88.89%) and the Bobath concept (83.33%). The technical aids that were used by the professionals were ankle foot orthosis (AFO) (94.44%), bracing (66.67%), standing frames (83.33%), moulded seats (100%), corner seats (93.75%) and adapted seats (92.85%). Conclusions: In international cooperation projects, the rehabilitation treatment of children with cerebral palsy is based on a holistic approach. This is reflected in the interventions that are carried out to treat their orthopaedic disorders and in locally produced devices, awareness raising and community education. However, the professionals surveyed considered that the aids or orthoses used are insufficient in the treatment and prevention of orthopaedic disorders in cerebral palsy. Full article
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Article
Loneliness during the COVID-19 Pandemic: A Comparison between Older and Younger People
Int. J. Environ. Res. Public Health 2021, 18(15), 7871; https://doi.org/10.3390/ijerph18157871 (registering DOI) - 25 Jul 2021
Abstract
The precautionary measures and uncertainties surrounding the COVID-19 pandemic have serious psychological impacts on peoples’ mental health. We used longitudinal data from Hiroshima University to investigate loneliness before and during the pandemic among older and younger people in Japan. We provide evidence that [...] Read more.
The precautionary measures and uncertainties surrounding the COVID-19 pandemic have serious psychological impacts on peoples’ mental health. We used longitudinal data from Hiroshima University to investigate loneliness before and during the pandemic among older and younger people in Japan. We provide evidence that loneliness among both older and younger people increased considerably during the pandemic. Although loneliness among younger people is more pervasive, the magnitude of increase in loneliness during the pandemic is higher among older people. Our logit regression analysis shows that age, subjective health status, and feelings of depression are strongly associated with loneliness before and during the pandemic. Moreover, household income and financial satisfaction are associated with loneliness among older people during the pandemic while gender, marital status, living condition, and depression are associated with loneliness among younger people during the pandemic. The evidence of increasing loneliness during the pandemic is concerning for a traditionally well-connected and culturally collectivist society such as Japan. As loneliness has a proven connection with both physical and mental health, we suggest immediate policy interventions to provide mental health support for lonely people so they feel more cared for, secure, and socially connected. Full article
(This article belongs to the Special Issue Epidemiology and Mental Health among Older Adults)
Article
From Exposure to Violence between Mother and Her Intimate Partner to Suicidality Experienced by Urban Adolescents in Chicago’s Southside
Int. J. Environ. Res. Public Health 2021, 18(15), 7870; https://doi.org/10.3390/ijerph18157870 (registering DOI) - 25 Jul 2021
Abstract
Although the relationship between exposure to intimate partner violence and youths’ psychological and other wellbeing has been widely studied, there is limited research about how youths’ exposure to violence between mother and her intimate partner may be related to youth psychological wellbeing. The [...] Read more.
Although the relationship between exposure to intimate partner violence and youths’ psychological and other wellbeing has been widely studied, there is limited research about how youths’ exposure to violence between mother and her intimate partner may be related to youth psychological wellbeing. The study used a sample of urban adolescents in Chicago Southbound to examine whether youths’ exposure to verbal conflict between mother and her intimate partner is related to their suicidality and whether youth depression and aggression may be in between such a linkage. Our findings indicated that one-third of the youth had suicidal thoughts or suicidal/self-hurting attempts. Youths’ exposure to verbal conflict between mother and her intimate partner was associated with their depressive and aggressive symptoms, and depressive symptoms subsequently were linked to suicidality. The findings also showed that youth depressive symptoms and aggressive symptoms were positively correlated, which may influence their associations with suicidality. We concluded that youth exposure to parental intimate partner violence, even comparatively mild forms such as a verbal conflict between mother and her intimate partner, may increase their risk of suicidality by worsening psychological wellbeing. The findings highlight the importance of tackling youth suicidality risks while accounting for their exposure to intimate partner violence including verbal conflicts between parents. Full article
(This article belongs to the Special Issue Child and Youth Mental and Brain Health)
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Article
The Lifestyle of Saudi Medical Students
Int. J. Environ. Res. Public Health 2021, 18(15), 7869; https://doi.org/10.3390/ijerph18157869 (registering DOI) - 25 Jul 2021
Abstract
This study was conducted to investigate medical students’ lifestyle habits, including sleep quality, eating and drinking patterns, physical activity, and social status. Method: This research project is part two of a multi-institutional cross-sectional observational study conducted among medical students from six medical [...] Read more.
This study was conducted to investigate medical students’ lifestyle habits, including sleep quality, eating and drinking patterns, physical activity, and social status. Method: This research project is part two of a multi-institutional cross-sectional observational study conducted among medical students from six medical colleges in Saudi Arabia between September and December 2019. Results: 675 medical students were enrolled electively into the lifestyle study. About half of this number were male students and the majority were aged 18–24 years. Most students (87.6%) slept between 4–8 h a day and over 44% were dissatisfied with their sleep. Only 28.1% had three meals a day; about 40% of them usually or always skipped breakfast. A total of 44% usually or always ate fast food and 44.7% drank 2 L of water per day. Moreover, male students were significantly consuming more fast food than females, p < 0.001. The majority (63.3%) revealed they usually or always drink black coffee daily. Females were significantly more inclined to regular coffee consumption than males, p < 0.001. Only 4.3% exercised for 30 min or more daily. The majority (65%) of the students were introverted; they had few close friends. Yet, 81% were somewhat satisfied or satisfied with their social life. Male students were significantly more satisfied with their social life than females, p = 0.001. Only 4.6% smoked cigarettes daily whereas 7.1% smoked e-cigarettes daily. In contrast, only 0.3% used shisha (hookah) daily. Male medical students were substantially more inclined to e-cigarette use than females (p < 0.001). The top five leisure activities of a medical student were surfing social media (75.9%), watching movies (61.3%), hanging out with friends (58.1%), spending time with their family (55.4%), and browsing the Internet (53.6%). Female medical students were significantly more inclined to surf social media than male medical students, p = 0.022; also, watching movies was preferred for females compared to males, p = 0.006. Conclusion: This study revealed that the majority of these medical students in Saudi Arabia exhibited healthy lifestyles to some extent, and these health-promoting behaviors differed based on sex, especially concerning physical activity and eating patterns. The findings of this study provide relevant information for future actions that will be geared towards effectively decreasing the occurrence of chronic illnesses and improving future doctors’ well-being. Full article
(This article belongs to the Section Health Behavior, Chronic Disease and Health Promotion)
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Commentary
Science Policy to Advance a Climate Change and Health Research Agenda in the United States
Int. J. Environ. Res. Public Health 2021, 18(15), 7868; https://doi.org/10.3390/ijerph18157868 (registering DOI) - 25 Jul 2021
Abstract
Climate change is thought to be one of the greatest public health threats of the 21st century and there has been a tremendous growth in the published literature describing the health implications of climate change over the last decade. Yet, there remain several [...] Read more.
Climate change is thought to be one of the greatest public health threats of the 21st century and there has been a tremendous growth in the published literature describing the health implications of climate change over the last decade. Yet, there remain several critical knowledge gaps in this field. Closing these gaps is crucial to developing effective interventions to minimize the health risks from climate change. In this commentary, we discuss policy trends that have influenced the advancement of climate change and health research in the United States context. We then enumerate specific knowledge gaps that could be addressed by policies to advance scientific research. Finally, we describe tools and methods that have not yet been fully integrated into the field, but hold promise for advancing the science. Prioritizing this advancement offers the potential to improve public health-related policies on climate change. Full article
(This article belongs to the Special Issue Air Pollution and Climate Change-Mediated Health Impacts)
Article
Relationship between Sleep and Hypertension: Findings from the NHANES (2007–2014)
Int. J. Environ. Res. Public Health 2021, 18(15), 7867; https://doi.org/10.3390/ijerph18157867 (registering DOI) - 25 Jul 2021
Abstract
Background: To evaluate the association of sleep factors (sleep duration, self-reported trouble sleeping, diagnosed sleep disorder) and combined sleep behaviors with the risk of hypertension. Methods: We analyzed 12,166 adults aged 30–79 years who participated in the 2007–2014 National Health and Nutrition Examination [...] Read more.
Background: To evaluate the association of sleep factors (sleep duration, self-reported trouble sleeping, diagnosed sleep disorder) and combined sleep behaviors with the risk of hypertension. Methods: We analyzed 12,166 adults aged 30–79 years who participated in the 2007–2014 National Health and Nutrition Examination Survey. Sleep duration, self-reported trouble sleeping and sleep disorders were collected using a standardized questionnaire. We included three sleep factors (sleep duration, self-reported trouble sleeping and sleep disorder) to generate an overall sleep score, ranging from 0 to 3. We then defined the sleep pattern as “healthy sleep pattern” (overall sleep score = 3), “intermediate sleep pattern” (overall sleep score = 2), and “poor sleep pattern” (0 ≤ overall sleep score ≤ 1) based on the overall sleep score. The definition of hypertension was based on self-reported antihypertensive medication use or biological measurement (systolic blood pressure ≥140 mm Hg and/or diastolic blood pressure ≥90 mm Hg). We used weighted logistic regression models to investigate the associations between sleep and hypertension. Results: The overall prevalence of hypertension was 37.8%. A short sleep duration (OR = 1.20, 95% CI: 1.08 to 1.33, p = 0.001), self-reported trouble sleeping (OR = 1.45, 95% CI: 1.28 to 1.65, p < 0.001) and sleep disorder (OR = 1.33, 95% CI: 1.07 to 1.66, p = 0.012) were related to the risk of hypertension. Poor sleep patterns were closely correlated with the risk of hypertension (OR = 1.90, 95% CI: 1.62 to 2.24). Conclusions: Participants with poor sleep patterns were associated with an increased risk for hypertension. Full article
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Study Protocol
Co-Creation Approach with Action-Oriented Research Methods to Strengthen “Krachtvoer”; A School-Based Programme to Enhance Healthy Nutrition in Adolescents
Int. J. Environ. Res. Public Health 2021, 18(15), 7866; https://doi.org/10.3390/ijerph18157866 (registering DOI) - 25 Jul 2021
Abstract
In recent years, the nutritional pattern of the Dutch adolescent has cautiously improved. However, progress can be gained if more Dutch adolescents adhere to the nutritional guidelines. School-based initiatives offer opportunities to deal with the unhealthy eating behaviours of adolescents via nutrition educational [...] Read more.
In recent years, the nutritional pattern of the Dutch adolescent has cautiously improved. However, progress can be gained if more Dutch adolescents adhere to the nutritional guidelines. School-based initiatives offer opportunities to deal with the unhealthy eating behaviours of adolescents via nutrition educational interventions. In designing and/or re-designing school-based interventions, it is important to enhance optimal context-oriented implementation adaptation by involving the complex adaptive school system. This paper elaborates on the way of dealing with the dynamic implementation context of the educational programme “Krachtvoer” (ENG: “Power food”) for prevocational schools, how the programme can be adapted to each unique implementation context, and how the programme can be progressively kept up to date. Following a co-creation-guided approach with various intersectoral stakeholders within and outside the school setting, action-oriented mixed research methods (i.e., observations, semi-structured interviews, focus group interviews, programme usage monitoring, and questionnaires) constantly provide input to develop the programme and its implementation strategy via continuous micro-process cycles. Successful co-creation of school-based health promotion seems to be dependent on proper intersectoral cooperation between research and practice communities, a national partner network that can provide project-relevant insights and establish capacity building aimed at improving contextual fit, and a time-investment balance in and between sectors. Full article
(This article belongs to the Section Health Behavior, Chronic Disease and Health Promotion)
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Review
The Impact of the Affordable Care Act on Dental Care: An Integrative Literature Review
Int. J. Environ. Res. Public Health 2021, 18(15), 7865; https://doi.org/10.3390/ijerph18157865 (registering DOI) - 25 Jul 2021
Abstract
The goal of the Patient Protection and Affordable Care Act (ACA) is to increase access to health insurance and decrease health care cost while improving health care quality. With more articles examining the relationship between one of the ACA provisions and dental health [...] Read more.
The goal of the Patient Protection and Affordable Care Act (ACA) is to increase access to health insurance and decrease health care cost while improving health care quality. With more articles examining the relationship between one of the ACA provisions and dental health outcomes, we systematically reviewed the effect of the ACA on dental care coverage and access to dental services. We searched literature using the National Library of Medicine’s Medline (PubMed) and Thomson Reuters’ Web of Science between January 2010 and November 2020. We identified 33 articles related to dental coverage, and access/utilization of dental care services. This systematic review of studies showed that the ACA resulted in gains in dental coverage for adults and children, whereas results were mixed with dental care access. Overall, we found that the policy led to a decrease in cost barriers, an increase in private dental coverage for young adults, and increased dental care use among low-income childless adults. The implementation of the ACA was not directly associated with dental insurance coverage among people in the U.S. However, results suggest positive spillover effects of the ACA on dental care coverage and utilization by people in the national level dataset. Full article
(This article belongs to the Section Health Care Sciences & Services)
Article
Monetizing the Burden of Childhood Asthma Due to Traffic Related Air Pollution in the Contiguous United States in 2010
Int. J. Environ. Res. Public Health 2021, 18(15), 7864; https://doi.org/10.3390/ijerph18157864 (registering DOI) - 25 Jul 2021
Abstract
Background: Traffic-related air pollution (TRAP) refers to the wide range of air pollutants emitted by traffic that are dispersed into the ambient air. Emerging evidence shows that TRAP can increase asthma incidence in children. Living with asthma can carry a huge financial burden [...] Read more.
Background: Traffic-related air pollution (TRAP) refers to the wide range of air pollutants emitted by traffic that are dispersed into the ambient air. Emerging evidence shows that TRAP can increase asthma incidence in children. Living with asthma can carry a huge financial burden for individuals and families due to direct and indirect medical expenses, which can include costs of hospitalization, medical visits, medication, missed school days, and loss of wages from missed workdays for caregivers. Objective: The objective of this paper is to estimate the economic impact of childhood asthma incident cases attributable to nitrogen dioxide (NO2), a common traffic-related air pollutant in urban areas, in the United States at the state level. Methods: We calculate the direct and indirect costs of childhood asthma incident cases attributable to NO2 using previously published burden of disease estimates and per person asthma cost estimates. By multiplying the per person indirect and direct costs for each state with the NO2-attributable asthma incident cases in each state, we were able to estimate the total cost of childhood asthma cases attributable to NO2 in the United States. Results: The cost calculation estimates the total direct and indirect annual cost of childhood asthma cases attributable to NO2 in the year 2010 to be $178,900,138.989 (95% CI: $101,019,728.20–$256,980,126.65). The state with the highest cost burden is California with $24,501,859.84 (95% CI: $10,020,182.62–$38,982,261.250), and the state with the lowest cost burden is Montana with $88,880.12 (95% CI: $33,491.06–$144,269.18). Conclusion: This study estimates the annual costs of childhood asthma incident cases attributable to NO2 and demonstrates the importance of conducting economic impacts studies of TRAP. It is important for policy-making institutions to focus on this problem by advocating and supporting more studies on TRAP’s impact on the national economy and health, including these economic impact estimates in the decision-making process, and devising mitigation strategies to reduce TRAP and the population’s exposure. Full article
Article
Personality Profile in Focal Hand Dystonia: A Cross-Sectional Study
Int. J. Environ. Res. Public Health 2021, 18(15), 7863; https://doi.org/10.3390/ijerph18157863 (registering DOI) - 25 Jul 2021
Abstract
It has been suggested that focal hand dystonia (FHD) should be viewed as a neuropsychiatric disorder rather than as a pure movement disorder. We aimed to compare the personality factors that are common to people with FHD and evaluate how personality factors could [...] Read more.
It has been suggested that focal hand dystonia (FHD) should be viewed as a neuropsychiatric disorder rather than as a pure movement disorder. We aimed to compare the personality factors that are common to people with FHD and evaluate how personality factors could affect the functionality of the upper limbs and community participation. We conducted a cross-sectional case–control study in which 12 people with FHD were matched with 12 age and gender matched healthy control participants. The Big Five Questionnaire; the Quick Disabilities, Arm, Shoulder, and Hand questionnaire; and the Jebsen–Taylor Test of Hand Function were used as assessment measures. Control of emotions was the only variable for which a significant difference was found, with participants with FHD displaying lesser control. Correlations were not observed between different personality profiles, the functionality of the upper limb,s and the perceived participation of people with FHD in activities of daily living. People with FHD may present with low emotional stability, but this does not have a negative impact on the functionality of the upper limbs and activities of daily living. These findings have clinical implications to be considered for interventions, as they suggest that personality aspects, such as extraversion, may not predict for better functionality and perceived participation in activities of daily living. Full article
(This article belongs to the Special Issue Occupational Therapy: Neurorehabilitation of Children and Adults)
Article
The NUPHAC-EU Framework for Nurses’ Role in Interprofessional Pharmaceutical Care: Cross-Sectional Evaluation in Europe
Int. J. Environ. Res. Public Health 2021, 18(15), 7862; https://doi.org/10.3390/ijerph18157862 (registering DOI) - 25 Jul 2021
Abstract
Clear role descriptions promote the quality of interprofessional collaboration. Currently, it is unclear to what extent healthcare professionals consider pharmaceutical care (PC) activities to be nurses’ responsibility in order to obtain best care quality. This study aimed to create and evaluate a framework [...] Read more.
Clear role descriptions promote the quality of interprofessional collaboration. Currently, it is unclear to what extent healthcare professionals consider pharmaceutical care (PC) activities to be nurses’ responsibility in order to obtain best care quality. This study aimed to create and evaluate a framework describing potential nursing tasks in PC and to investigate nurses’ level of responsibility. A framework of PC tasks and contextual factors was developed based on literature review and previous DeMoPhaC project results. Tasks and context were cross-sectionally evaluated using an online survey in 14 European countries. A total of 923 nurses, 240 physicians and 199 pharmacists responded. The majority would consider nurses responsible for tasks within: medication self-management (86–97%), patient education (85–96%), medication safety (83–95%), monitoring adherence (82–97%), care coordination (82–95%), and drug monitoring (78–96%). The most prevalent level of responsibility was ‘with shared responsibility’. Prescription management tasks were considered to be nurses’ responsibility by 48–81% of the professionals. All contextual factors were indicated as being relevant for nurses’ role in PC by at least 74% of the participants. No task nor contextual factor was removed from the framework after evaluation. This framework can be used to enable healthcare professionals to openly discuss allocation of specific (shared) responsibilities and tasks. Full article
(This article belongs to the Special Issue Opportunities and Responsibilities in Pharmaceutical Care)
Article
Epidemiology of Endometriosis in Spain and Its Autonomous Communities: A Large, Nationwide Study
Int. J. Environ. Res. Public Health 2021, 18(15), 7861; https://doi.org/10.3390/ijerph18157861 (registering DOI) - 25 Jul 2021
Abstract
A retrospective population-based study aimed to assess the incidence of endometriosis in the general population in Spain and in each of its autonomous communities. The authors used the incidence of diagnosed endometriosis in the minimum basic dataset at discharge in the national hospital [...] Read more.
A retrospective population-based study aimed to assess the incidence of endometriosis in the general population in Spain and in each of its autonomous communities. The authors used the incidence of diagnosed endometriosis in the minimum basic dataset at discharge in the national hospital discharge registry of Spain. This analysis was carried out with hospital data with a diagnosis of endometriosis (International Classification of Diseases (ICD)-9 code 617.xx and ICD-10 code N80.xx) and covered the period from 1 January 2014 to 31 December 2017 and a population of 12,775,911 women of reproductive age (15–54 years). The data were then analyzed at the national level and separately for each autonomous community. This nationwide Spanish study estimated the overall incidence of endometriosis among autonomous communities in Spain to be 16.1 per 10,000 women (range, 6.8 to 24). The mean age of the 20,547 women diagnosed with endometriosis during the study period was 36.8 ± 5.4 years. The types (proportions) of endometriosis were uterine (28.4%), tubo-ovarian (35.2%), peritoneal (8.1%), vesical (6.8%) and intestinal (3.2%) endometriosis. Further studies are needed to assess the reasons for the decrease in the observed incidence and for the significant differences in the regional incidence rates of this disease. Full article
Article
Emotional Exhaustion, Depersonalization, and Mental Health in Nurses from Huelva: A Cross-Cutting Study during the SARS-CoV-2 Pandemic
Int. J. Environ. Res. Public Health 2021, 18(15), 7860; https://doi.org/10.3390/ijerph18157860 (registering DOI) - 25 Jul 2021
Abstract
Currently, healthcare professionals are particularly vulnerable to the impact of the SARS-CoV-2pandemic since they directly deal with patients suffering from this disease and are in the first line of fire, which increases their risk of contagion. This research examines the prevalence of emotional [...] Read more.
Currently, healthcare professionals are particularly vulnerable to the impact of the SARS-CoV-2pandemic since they directly deal with patients suffering from this disease and are in the first line of fire, which increases their risk of contagion. This research examines the prevalence of emotional exhaustion, depersonalization, and possible non-psychotic psychiatric disorders in 48 male and 270 female nursing professionals of Huelva during the COVID-19 pandemic. To this end, we analyzed the relationship between these dependent variables and considered various sociodemographic variables. The nursing staff of public hospitals in Huelva who have had contact with cases of SARS-CoV-2 in their work environment showed a poorer state of mental health than that of others of this same professional category who have not had contact with this type of situation. Full article
(This article belongs to the Special Issue Occupational Stress and Health: Psychological Burden and Burnout)
Study Protocol
COVID-19 Vaccines Safety Tracking (CoVaST): Protocol of a Multi-Center Prospective Cohort Study for Active Surveillance of COVID-19 Vaccines’ Side Effects
Int. J. Environ. Res. Public Health 2021, 18(15), 7859; https://doi.org/10.3390/ijerph18157859 (registering DOI) - 25 Jul 2021
Abstract
Background: Coronavirus disease (COVID-19) vaccine-related side effects have a determinant role in the public decision regarding vaccination. Therefore, this study has been designed to actively monitor the safety and effectiveness of COVID-19 vaccines globally. Methods: A multi-country, three-phase study including a cross-sectional survey [...] Read more.
Background: Coronavirus disease (COVID-19) vaccine-related side effects have a determinant role in the public decision regarding vaccination. Therefore, this study has been designed to actively monitor the safety and effectiveness of COVID-19 vaccines globally. Methods: A multi-country, three-phase study including a cross-sectional survey to test for the short-term side effects of COVID-19 vaccines among target population groups. In the second phase, we will monitor the booster doses’ side effects, while in the third phase, the long-term safety and effectiveness will be investigated. A validated, self-administered questionnaire will be used to collect data from the target population; Results: The study protocol has been registered at ClinicalTrials.gov, with the identifier NCT04834869. Conclusions: CoVaST is the first independent study aiming to monitor the side effects of COVID-19 vaccines following booster doses, and the long-term safety and effectiveness of said vaccines. Full article
(This article belongs to the Collection COVID-19 Research)
Review
Family Recovery Interventions with Families of Mental Health Service Users: A Systematic Review of the Literature
Int. J. Environ. Res. Public Health 2021, 18(15), 7858; https://doi.org/10.3390/ijerph18157858 (registering DOI) - 25 Jul 2021
Abstract
Introduction: Recovery has become a catalyst for much organisational and cultural change within mental health services. Recovery involves the service user living the best life of their choice despite the presence of mental health challenges. In contrast, recovery of families remains under-developed with [...] Read more.
Introduction: Recovery has become a catalyst for much organisational and cultural change within mental health services. Recovery involves the service user living the best life of their choice despite the presence of mental health challenges. In contrast, recovery of families remains under-developed with minimal attention given to the unique support families may require in their own recovery journeys. This paper aims to place focus on the topic through a systematic review of the literature into family recovery interventions in mental health; Method and Analysis: A PRISMA compliant systematic review was initiated. It included how the reviewers retrieved and selected studies for the systematic review. It outlined the inclusion/exclusion criteria and how these were further developed through the PICO framework. It also outlined how the reviewers assessed issues of bias and quality, as well as the process of data synthesis; Results: Three studies were included in this review. Each focusing on family recovery interventions across the lifespan: Kidstime to family toolkits to family psychoeducation. The benefits and challenges of each intervention to the family were synthesised along with a list of four family recovery enablers that are vital for the implementation of such family recovery interventions; Discussion/Implications for Practice: The results highlight the paucity of quality literature available for family recovery interventions. All three studies scored poorly in terms of quality, with one particular study (Nagi and Davies 2015) lacking quotations from participants to back up their claims. From this study, a number of actions need to be implemented, specifically around the enablers needed to allow for family recovery interventions to be fully implemented. Full article
(This article belongs to the Special Issue International Perspectives on Mental Health Social Work)
Article
COVID-19 Pandemic and Mental Health Status of Saudi Citizens Living Abroad
Int. J. Environ. Res. Public Health 2021, 18(15), 7857; https://doi.org/10.3390/ijerph18157857 (registering DOI) - 25 Jul 2021
Abstract
Background: The COVID-19 pandemic is a global health crisis associated with unprecedented levels of morbidity and mortality worldwide. The COVID-19 pandemic has been suggested to contribute to a great burden on global mental health. We assumed that individuals in quarantine outside their home [...] Read more.
Background: The COVID-19 pandemic is a global health crisis associated with unprecedented levels of morbidity and mortality worldwide. The COVID-19 pandemic has been suggested to contribute to a great burden on global mental health. We assumed that individuals in quarantine outside their home country would be more vulnerable to developing mental health disorders during the current pandemic and might face difficulties in accessing mental health services. Aim: To explore the degree of association between the COVID-19 pandemic and mental health status of Saudi citizens living abroad. Objectives: (1) To measure the prevalence and risk factors of mental health problems among Saudi citizens studying and living abroad during the COVID-19 pandemic; (2) to assess the correlation between the COVID-19 pandemic and mental health status of Saudi citizens living abroad; and (3) to explore the level of anxiety/depression during the COVID-19 pandemic. Methods: A cross-sectional survey was conducted from August 2020 to September 2020 using a self-administrated questionnaire composed of sociodemographic, (GAD-7) and (PHQ-9) scales. Results: A total of 64% of participants experienced psychiatric symptoms during the pandemic, and 34% and 30% met the diagnostic criteria for symptoms of depression and anxiety, respectively. The risk of psychological symptoms was more likely experienced by females, young, single, or divorced, or those who were living alone. In addition, those who lived in the UK and Ireland were more likely to develop depressive and anxiety symptoms. More than 80% appreciated the response of the Saudi government and embassy to meet the MH needs of students undergoing quarantine abroad and in Saudi Arabia. Conclusions: The COVID-19 pandemic represents an unprecedented threat to global mental health. Two-thirds of study participants who were in foreign countries during the COVID-19 pandemic reported anxiety or depressive symptoms. Living away from family and friends was significantly associated with increased loneliness and psychological distress. These and other findings highlight the need to remove barriers preventing easily accessible online mental health services, social and family support, and timely provision of resources. Full article
Article
Disparities in Cancer-Related Avoidable Mortality by the Level of Area Deprivation in South Korea
Int. J. Environ. Res. Public Health 2021, 18(15), 7856; https://doi.org/10.3390/ijerph18157856 (registering DOI) - 25 Jul 2021
Abstract
Background: This study investigated trends in cancer-related avoidable (preventable and treatable) mortality and its association with area deprivation in Korea. Methods: Cancer-related avoidable mortality rates per 100,000 population between 2015 and 2019 were measured using the Causes of Death Statistics. Area Deprivation Index [...] Read more.
Background: This study investigated trends in cancer-related avoidable (preventable and treatable) mortality and its association with area deprivation in Korea. Methods: Cancer-related avoidable mortality rates per 100,000 population between 2015 and 2019 were measured using the Causes of Death Statistics. Area Deprivation Index (ADI) was measured from the Population and Housing Census and information on other independent variables from the Korea Community Health Survey. The gap in avoidable mortality between the more and less deprived groups was expressed as rate ratios (RR) and absolute differences (ADs) with a 95 percent confidence interval (95% CI). The association between avoidable mortality and ADI was investigated through Poisson regression modelling. Results: The more deprived areas had higher avoidable (RR 1.15, 95% CI 1.13–1.17; AD 6.58, 95% CI 5.59–7.57) and preventable (RR 1.19, 95% CI 1.17–1.21; AD 6.22, 95% CI 5.38–7.06) mortality. The overall cancer-related avoidable mortality decreased but the gap between the more and less deprived groups did not decline significantly during the study period. The association between avoidable and preventable mortality and area deprivation remained significant after adjusting for variables, including area levels of smokers and alcohol drinkers. Conclusions: The gap in avoidable mortality signifies the importance of addressing related disparities in cancer. Full article
Article
Music Tempo: A Tool for Regulating Walking Cadence and Physical Activity Intensity in Overweight Adults?
Int. J. Environ. Res. Public Health 2021, 18(15), 7855; https://doi.org/10.3390/ijerph18157855 (registering DOI) - 25 Jul 2021
Abstract
This study investigated if music tempo can prompt a desired walking cadence, and if music can provide a stimulus to regulate physical activity intensity in a longitudinal physical activity intervention with free-living adults. Overweight adults (n = 37; 94.26 ± 17.11 kg; [...] Read more.
This study investigated if music tempo can prompt a desired walking cadence, and if music can provide a stimulus to regulate physical activity intensity in a longitudinal physical activity intervention with free-living adults. Overweight adults (n = 37; 94.26 ± 17.11 kg; 49.63 ± 12.37 years) were randomly assigned to an intervention (IG, n = 17) or usual care group (UC, n = 20) as part of a novel nine-month walking intervention. IG participants walked to self-selected music with a predetermined tempo and received a behavioural change support programme. At baseline, four-, six- and nine-months participants were asked to walk around an elliptical track at their habitual pace (0–2 min) and then in time to a predetermined tempo (2–8 min) designed to elicit moderate intensity. Cadence response (steps/min) was assessed and intensity (heart rate (bpm) recorded using wireless telemetry. A repeated measures general linear model (GLM) examined differences between groups over time (p < 0.05). All data is presented as means ± SD. At each assessment point both groups displayed an immediate cadence adjustment in response to music tempo (p < 0.01) i.e., habitual cadence vs. 3 METs target cadence (p < 0.05) and 3 METs target cadence vs. 5 METs target cadence (p < 0.05). Additionally, IG participants displayed an increased habitual cadence (0–2 min) at each assessment point (p < 0.05; 110 ± 9, 121.80 ± 7.5, 121.46 ± 10, 121.93 ± 7 steps/min respectively). UC participant’s habitual cadence was unchanged from 0–9 months (p > 0.05; 120 ± 10, 116 ± 13, 119 ± 12 and 119 ± 9 steps/min respectively). Music tempo may be a useful regulatory tool to prompt the free-living individual to reach an appropriate stride rate to achieve a walking pace that is at least moderate intensity. It also appears that results may be trainable as throughout the study an increased habitual walking cadence was observed, in the absence of music. Full article
(This article belongs to the Special Issue Physical Activity and Sedentary Behaviour Promotion: Moving Forward)
Article
Integration of Newly Arrived Refugee Children into the German School System
Int. J. Environ. Res. Public Health 2021, 18(15), 7854; https://doi.org/10.3390/ijerph18157854 (registering DOI) - 25 Jul 2021
Viewed by 5
Abstract
Background: The assignment of newly arrived refugee children to the differentiated German school system represents a major challenge for the responsible municipalities. In this explorative research approach, the current assignment procedure, in addition to the necessary assessment of performance and the detection of [...] Read more.
Background: The assignment of newly arrived refugee children to the differentiated German school system represents a major challenge for the responsible municipalities. In this explorative research approach, the current assignment procedure, in addition to the necessary assessment of performance and the detection of learning, mental, or social disabilities of newly arrived refugee children in North Rhine-Westphalia (NRW), Germany, were investigated. Methods: Eight staff members of six relevant Communal Integration Centers (CICs) in NRW were interviewed and a qualitative content analysis was conducted. Results: The current assignment practices varied widely. The binding to guidelines differed; additionally, the school assignment or recommendation largely depended on personal engagement, connections, and attitudes of the relevant CIC staff. None of the CICs used standardized instruments. Instead, the staff assessed the performance with self-developed strategies such as free and playful approaches or self-developed worksheets, and counted on their ‘gut feeling’ and professional experience. Conclusion: The school career and education of newly arrived refugee children in NRW is largely inconsistent and dependent on the responsible CIC (e.g., the allocation of the family) and on the counseling staff member. Additionally, it must be assumed that relevant disabilities remain largely undetected. Full article
(This article belongs to the Special Issue Health of Migrant Children)
Article
Effect of Resonant Frequency Vibration on Delayed Onset Muscle Soreness and Resulting Stiffness as Measured by Shear-wave Elastography
Int. J. Environ. Res. Public Health 2021, 18(15), 7853; https://doi.org/10.3390/ijerph18157853 (registering DOI) - 24 Jul 2021
Viewed by 243
Abstract
This study utilized resonant frequency vibration to the upper body to determine changes in pain, stiffness and isometric strength of the biceps brachii after eccentric damage. Thirty-one participants without recent resistance training were randomized into three groups: a Control (C) group and two [...] Read more.
This study utilized resonant frequency vibration to the upper body to determine changes in pain, stiffness and isometric strength of the biceps brachii after eccentric damage. Thirty-one participants without recent resistance training were randomized into three groups: a Control (C) group and two eccentric exercise groups (No vibration (NV) and Vibration (V)). After muscle damage, participants in the V group received upper body vibration (UBV) therapy for 5 min on days 1–4. All participants completed a visual analog scale (VAS), maximum voluntary isometric contraction (MVIC), and shear wave elastography (SWE) of the bicep at baseline (pre-exercise), 24 h, 48 h, and 1-week post exercise. There was a significant difference between V and NV at 24 h for VAS (p = 0.0051), at 24 h and 1-week for MVIC (p = 0.0017 and p = 0.0016, respectively). There was a significant decrease in SWE for the V group from 24–48 h (p = 0.0003), while there was no significant change in the NV group (p = 0.9341). The use of UBV resonant vibration decreased MVIC decrement and reduced VAS pain ratings at 24 h post eccentric damage. SWE was strongly negatively correlated with MVIC and may function as a predictor of intrinsic muscle state in the time course of recovery of the biceps brachii. Full article
(This article belongs to the Special Issue Regulation of Muscle Mass, Exercise, Metabolism)
Article
Research on the Performance of Human Capital at Different Organizational Levels of Pharmaceutical Corporations: Moderation of Informal Relational Capital
Int. J. Environ. Res. Public Health 2021, 18(15), 7852; https://doi.org/10.3390/ijerph18157852 (registering DOI) - 24 Jul 2021
Viewed by 216
Abstract
As intellectual capital is considered an important strategic resource in knowledge-intensive industries, such as the health and pharmaceutical industries, scholars have developed a deeper understanding of the human capital at different levels of organizations and its interaction with relational capital from informal institutional [...] Read more.
As intellectual capital is considered an important strategic resource in knowledge-intensive industries, such as the health and pharmaceutical industries, scholars have developed a deeper understanding of the human capital at different levels of organizations and its interaction with relational capital from informal institutional stakeholders. This study focused on the role of human capital at different levels of pharmaceutical corporations and the orchestration of human capital at different levels with informal relational capital. By using data regarding Chinese pharmaceutical listed companies from 2001 to 2017, this study found that (1) human capital at the employee level exerted an inverted U-shaped effect on a pharmaceutical firm’s performance, which was negatively moderated by informal institutional relational capital, and (2) based on the upper echelons theory, human capital at the executive level had a monotonic positive impact on a pharmaceutical firm’s performance but was negatively moderated by informal relational capital. We found two arrangements that facilitate the orchestration of intellectual capital components to gain optimal distinctiveness and performance. Full article
Case Report
Rhabdomyosarcoma of the Cervix in a Post-Menopausal Woman—An Unparalleled Phenomenon
Int. J. Environ. Res. Public Health 2021, 18(15), 7851; https://doi.org/10.3390/ijerph18157851 (registering DOI) - 24 Jul 2021
Viewed by 183
Abstract
Rhabdomyosarcoma of the cervix is a soft tissue sarcoma that usually occurs in young women. It is very rare in adulthood. We discuss symptoms, the process of diagnosis of rhabdomyosarcoma embryonale of the cervix in a 61-year-old women and differences in treatment dependent [...] Read more.
Rhabdomyosarcoma of the cervix is a soft tissue sarcoma that usually occurs in young women. It is very rare in adulthood. We discuss symptoms, the process of diagnosis of rhabdomyosarcoma embryonale of the cervix in a 61-year-old women and differences in treatment dependent on patient’s age. A 61-year-old woman with symptoms such as palpable mass in the external cervical opening and post-menopausal hemorrhaging was admitted to the oncology ward where excision of the polyp was performed. Embryonal rhabdomyosarcoma (ERMS) was diagnosed by histopathological examination of obtained tissues. The diagnosis was complemented by chest computed tomography and pelvis magnetic resonance imaging to exclude metastases. A Wertheim–Meigs operation and excision of the ovaries, the fallopian tubes and the surrounding tissue was performed in the course of treatment. In the patient’s follow-up of 25 months to date, there have been no signs of recurrence or symptoms connected to ERMS. Based on the therapeutic outcome, the decision to limit the treatment to a surgical resection was adequate for a post-menopausal patient. Because of the rarity of ERMS in the post-menopausal age, we think that the patient should be carefully followed up to further examine this issue and develop diagnostic and treatment guidelines. Full article
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