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Int. J. Environ. Res. Public Health, Volume 18, Issue 18 (September-2 2021) – 515 articles

Cover Story (view full-size image): Dementia is a major cause of disability in older adults, with a tremendous negative impact on the quality of life (QoL) of people with dementia (PWD). Non-pharmacological treatments have proved helpful in counteracting dementia-related symptoms and promoting QoL in PWD, such as gardening therapy and the therapeutic effect of gardens, based on the positive influence that contact with nature can have on promoting restoration processes, and also on PWD. This systematic review showed the beneficial effects of gardens and gardening therapy on PWD in several domains (behavioral, physical and emotional). The beneficial effects of contact with nature make such interventions a promising approach to investing in sustaining PWD. View this paper.
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20 pages, 1570 KiB  
Article
Performances of Limited Area Models for the WORKLIMATE Heat–Health Warning System to Protect Worker’s Health and Productivity in Italy
by Daniele Grifoni, Alessandro Messeri, Alfonso Crisci, Michela Bonafede, Francesco Pasi, Bernardo Gozzini, Simone Orlandini, Alessandro Marinaccio, Riccardo Mari, Marco Morabito and on behalf of the WORKLIMATE Collaborative Group
Int. J. Environ. Res. Public Health 2021, 18(18), 9940; https://doi.org/10.3390/ijerph18189940 - 21 Sep 2021
Cited by 7 | Viewed by 3183
Abstract
Outdoor workers are particularly exposed to climate conditions, and in particular, the increase of environmental temperature directly affects their health and productivity. For these reasons, in recent years, heat-health warning systems have been developed for workers generally using heat stress indicators obtained by [...] Read more.
Outdoor workers are particularly exposed to climate conditions, and in particular, the increase of environmental temperature directly affects their health and productivity. For these reasons, in recent years, heat-health warning systems have been developed for workers generally using heat stress indicators obtained by the combination of meteorological parameters to describe the thermal stress induced by the outdoor environment on the human body. There are several studies on the verification of the parameters predicted by meteorological models, but very few relating to the validation of heat stress indicators. This study aims to verify the performance of two limited area models, with different spatial resolution, potentially applicable in the occupational heat health warning system developed within the WORKLIMATE project for the Italian territory. A comparison between the Wet Bulb Globe Temperature predicted by the models and that obtained by data from 28 weather stations was carried out over about three summer seasons in different daily time slots, using the most common skill of performance. The two meteorological models were overall comparable for much of the Italian explored territory, while major limits have emerged in areas with complex topography. This study demonstrated the applicability of limited area models in occupational heat health warning systems. Full article
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12 pages, 889 KiB  
Article
Air Pollutant Particles, PM2.5, Exposure and Glaucoma in Patients with Diabetes: A National Population-Based Nested Case–Control Study
by Yun-Wei Chiang, Sheng-Wen Wu, Ci-Wen Luo, Shih-Pin Chen, Chun-Jung Chen, Wen-Ying Chen, Chia-Che Chang, Chuan-Mu Chen and Yu-Hsiang Kuan
Int. J. Environ. Res. Public Health 2021, 18(18), 9939; https://doi.org/10.3390/ijerph18189939 - 21 Sep 2021
Cited by 8 | Viewed by 3022
Abstract
The global prevalence of diabetes mellitus (DM) has reached 20%. Air pollutants with a particle size of less than 2.5 μm (PM2.5) are a globally recognized risk factor for diabetes and glaucoma. We examined whether the risk of glaucoma would decrease [...] Read more.
The global prevalence of diabetes mellitus (DM) has reached 20%. Air pollutants with a particle size of less than 2.5 μm (PM2.5) are a globally recognized risk factor for diabetes and glaucoma. We examined whether the risk of glaucoma would decrease or increase when patients with DM were exposed to different PM2.5 concentrations. Data were obtained from the National Health Insurance Research Database (NHIRD) of Taiwan and the Air Quality Monitoring Network between 2008 and 2013. This nested case–control study involved 197 DM patients with glaucoma and 788 DM patients without glaucoma. Cases and controls were matched (1:4) by gender, age (±5 years), and index date (±6 months), and their data were entered in a logistic regression model adjusted for gender, age, urbanization level, income level, and comorbidities. The odds ratio (OR) of glaucoma at PM2.5 exposure concentration in the fourth quartile (Q4) compared with in the first quartile (Q1) was 1.7 (95% CI: 1.084–2.764). For glaucoma risk, the OR was 1.013 (95% CI: 1.006–1.020) at a PM2.5 exposure concentration in Q1, 1.004 (95% CI: 1.001–1.007) in the third quartile (Q3), and 1.003 (95% CI: 1.001–1.004) in Q4. In the subgroup analysis of patients living in non-emerging towns and non-agricultural towns, the OR for glaucoma in Q4 compared with in Q1 was 2.1 (95% CI: 1.229–3.406) and 1.8 (95% CI: 1.091–2.803), respectively (p trend = 0.001 and 0.011). For patients without migraine, the OR for glaucoma was 1.7 (95% CI: 1.074–2.782; p = 0.006). These results demonstrate that, for patients with DM, PM2.5 increased the risk of glaucoma and PM2.5 was an independent risk factor for glaucoma in patients with DM. Full article
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10 pages, 2292 KiB  
Article
Parental Monitoring, Individual Dispositions, and Alcohol Use Disorder: A Longitudinal Study with Young Swiss Men
by Jimena Sobrino-Piazza, Simon Foster, Natalia Estévez-Lamorte and Meichun Mohler-Kuo
Int. J. Environ. Res. Public Health 2021, 18(18), 9938; https://doi.org/10.3390/ijerph18189938 - 21 Sep 2021
Cited by 1 | Viewed by 2407
Abstract
This paper evaluates the interaction between level of parental monitoring in adolescence and individual dispositions present in early adulthood in the prediction of alcohol use disorder (AUD) in the mid-20s. Data were drawn from the Cohort Study on Substance Use Risk Factors (C-SURF), [...] Read more.
This paper evaluates the interaction between level of parental monitoring in adolescence and individual dispositions present in early adulthood in the prediction of alcohol use disorder (AUD) in the mid-20s. Data were drawn from the Cohort Study on Substance Use Risk Factors (C-SURF), encompassing 4844 young Swiss men who were surveyed three times within a 5-year period. The outcome variable was alcohol use disorder (AUD) as defined in the DSM-5. Independent variables were sensation seeking (Brief Sensation Seeking Scale) and the coping strategies active coping and denial (Brief COPE). Low parental monitoring, high sensation seeking, and high denial were found risk factors of AUD (odds ratio (OR) = 1.21 (1.05–1.40); OR = 1.56 (1.37–1.78); OR = 1.15 (1.01–1.31)). A significant interaction effect was identified between active coping and parental monitoring; high active coping in early adulthood was found protective of AUD, only among individuals who had low parental monitoring in adolescence (OR = 0.70 (0.52–0.96)). In addition to interventions to upskill parents for improving monitoring, other interventions directed to young adults who had disadvantaged family contexts could be implemented, with the aim of enhancing the use of adaptive coping strategies such as active coping. Prevention targeting avoidant coping strategies and sensation seeking should be privileged too. Full article
(This article belongs to the Collection Health Behaviors, Risk Factors, NCDs and Health Promotion)
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22 pages, 1518 KiB  
Systematic Review
Green Space and Health in Mainland China: A Systematic Review
by Hania Rahimi-Ardabili, Thomas Astell-Burt, Phi-Yen Nguyen, Juan Zhang, Yu Jiang, Guang-Hui Dong and Xiaoqi Feng
Int. J. Environ. Res. Public Health 2021, 18(18), 9937; https://doi.org/10.3390/ijerph18189937 - 21 Sep 2021
Cited by 16 | Viewed by 7294
Abstract
Non-communicable diseases (NCDs) have become a major cause of premature mortality and disabilities in China due to factors concomitant with rapid economic growth and urbanisation over three decades. Promoting green space might be a valuable strategy to help improve population health in China, [...] Read more.
Non-communicable diseases (NCDs) have become a major cause of premature mortality and disabilities in China due to factors concomitant with rapid economic growth and urbanisation over three decades. Promoting green space might be a valuable strategy to help improve population health in China, as well as a range of co-benefits (e.g., increasing resilience to climate change). No systematic review has so far determined the degree of association between green space and health outcomes in China. This review was conducted to address this gap. Five electronic databases were searched using search terms on green space, health, and China. The review of 83 publications that met eligibility criteria reports associations indicative of various health benefits from more green space, including mental health, general health, healthier weight status and anthropometry, and more favorable cardiometabolic and cerebrovascular outcomes. There was insufficient evidence to draw firm conclusions on mortality, birth outcomes, and cognitive function, and findings on respiratory and infectious outcomes were inconsistent and limited. Future work needs to examine the health benefits of particular types and qualities of green spaces, as well as to take advantage of (quasi-)experimental designs to test greening interventions within the context of China’s rapid urbanization and economic growth. Full article
(This article belongs to the Section Environmental Health)
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25 pages, 6722 KiB  
Article
Salt-Tolerant Compatible Microbial Inoculants Modulate Physio-Biochemical Responses Enhance Plant Growth, Zn Biofortification and Yield of Wheat Grown in Saline-Sodic Soil
by Udai B. Singh, Deepti Malviya, Shailendra Singh, Prakash Singh, Abhijeet Ghatak, Muhammad Imran, Jai P. Rai, Rajiv K. Singh, Madhab C. Manna, Arun K. Sharma and Anil K. Saxena
Int. J. Environ. Res. Public Health 2021, 18(18), 9936; https://doi.org/10.3390/ijerph18189936 - 21 Sep 2021
Cited by 23 | Viewed by 4280
Abstract
A wide range of root-associated mutualistic microorganisms have been successfully applied and documented in the past for growth promotion, biofertilization, biofortification and biotic and abiotic stress amelioration in major crops. These microorganisms include nitrogen fixers, nutrient mobilizers, bio-remediators and bio-control agents. The present [...] Read more.
A wide range of root-associated mutualistic microorganisms have been successfully applied and documented in the past for growth promotion, biofertilization, biofortification and biotic and abiotic stress amelioration in major crops. These microorganisms include nitrogen fixers, nutrient mobilizers, bio-remediators and bio-control agents. The present study aimed to demonstrate the impact of salt-tolerant compatible microbial inoculants on plant growth; Zn biofortification and yield of wheat (Triticum aestivum L.) crops grown in saline-sodic soil and insight of the mechanisms involved therein are being shared through this paper. Field experiments were conducted to evaluate the effects of Trichoderma harzianum UBSTH-501 and Bacillus amyloliquefaciens B-16 on wheat grown in saline-sodic soil at Research Farm, ICAR-Indian Institute of Seed Sciences, Kushmaur, India. The population of rhizosphere-associated microorganisms changed dramatically upon inoculation of the test microbes in the wheat rhizosphere. The co-inoculation induced a significant accumulation of proline and total soluble sugar in wheat at 30, 60, 90 and 120 days after sowing as compared to the uninoculated control. Upon quantitative estimation of organic solutes and antioxidant enzymes, these were found to have increased significantly in co-inoculated plants under salt-stressed conditions. The application of microbial inoculants enhanced the salt tolerance level significantly in wheat plants grown in saline-sodic soil. A significant increase in the uptake and translocation of potassium (K+) and calcium (Ca2+) was observed in wheat co-inoculated with the microbial inoculants, while a significant reduction in sodium (Na+) content was recorded in plants treated with both the bio-agents when compared with the respective uninoculated control plants. Results clearly indicated that significantly higher expression of TaHKT-1 and TaNHX1 in the roots enhances salt tolerance effectively by maintaining the Na+/K+ balance in the plant tissue. It was also observed that co-inoculation of the test inoculants increased the expression of ZIP transporters (2–3.5-folds) which ultimately led to increased biofortification of Zn in wheat grown in saline-sodic soil. Results suggested that co-inoculation of T. harzianum UBSTH-501 and B. amyloliquefaciens B-16 not only increased plant growth but also improved total grain yield along with a reduction in seedling mortality in the early stages of crop growth. In general, the present investigation demonstrated the feasibility of using salt-tolerant rhizosphere microbes for plant growth promotion and provides insights into plant-microbe interactions to ameliorate salt stress and increase Zn bio-fortification in wheat. Full article
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13 pages, 1073 KiB  
Article
Early or Delayed Onset of Food Intake in Time-Restricted Eating: Associations with Markers of Obesity in a Secondary Analysis of Two Pilot Studies
by Dorothea Kesztyüs, Petra Cermak, Tibor Kesztyüs and Anne Barzel
Int. J. Environ. Res. Public Health 2021, 18(18), 9935; https://doi.org/10.3390/ijerph18189935 - 21 Sep 2021
Cited by 2 | Viewed by 2581
Abstract
Time-restricted eating (TRE) has rapidly gained interest in the public and the scientific community. One presumed mechanism of action is the adaptation of the eating–fasting rhythm to the evolutionary circadian rhythm of the metabolism. Study results regarding the suggestion that earlier beginning of [...] Read more.
Time-restricted eating (TRE) has rapidly gained interest in the public and the scientific community. One presumed mechanism of action is the adaptation of the eating–fasting rhythm to the evolutionary circadian rhythm of the metabolism. Study results regarding the suggestion that earlier beginning of food intake leads to better outcomes are heterogeneous. We conducted a secondary analysis of pooled data from two pilot studies on TRE to examine an association between the timing of onset of food intake with obesity-related outcomes. Participants (n = 99, 83 females aged 49.9 ± 10.8 years) were asked to restrict their daily eating to 8–9 h for three months. Tertiles of the onset of food intake were assessed for changes in anthropometry, blood lipid levels, and health-related quality of life. We detected no significant differences in outcomes between early (before 9:47), medium (9:47–10:50), and late onset (after 10:50) of food intake. However, the duration of the eating period was longest in the group with the earliest (8.6 ± 1.0 h) and shortest in the group with the latest onset (7.5 ± 0.8 h). Subsequently, fasting duration was longest in the last group (16.5 h). This may have compromised the results. More research is needed in this area to address this question. Full article
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18 pages, 400 KiB  
Article
Robots in Healthcare? What Patients Say
by Núria Vallès-Peris, Oriol Barat-Auleda and Miquel Domènech
Int. J. Environ. Res. Public Health 2021, 18(18), 9933; https://doi.org/10.3390/ijerph18189933 - 21 Sep 2021
Cited by 23 | Viewed by 8612
Abstract
In this paper, we analyse patients’ perspectives on the introduction of artificial intelligence (AI) and robotic systems in healthcare. Based on citizens’ experiences when hospitalised for COVID-19, we explore how the opinions and concerns regarding healthcare automation could not be disassociated from a [...] Read more.
In this paper, we analyse patients’ perspectives on the introduction of artificial intelligence (AI) and robotic systems in healthcare. Based on citizens’ experiences when hospitalised for COVID-19, we explore how the opinions and concerns regarding healthcare automation could not be disassociated from a context of high pressure on the health system and lack of resources, and a political discourse on AI and robotics; a situation intensified by the pandemic. Thus, through the analysis of a set of interviews, a series of issues are identified that revolve around the following: the empirical effects of imagined robots, the vivid experience of citizens with the care crisis, the discomfort of the ineffective, the virtualised care assemblages, the human-based face-to-face relationships, and the automatisation of healthcare tasks. In light of these results, we show the variability in patients’ perspectives on AI and robotic systems and explain it by distinguishing two interpretive repertoires that account for different views and opinions: a well-being repertoire and a responsibility repertoire. Both interpretative repertoires are relevant in order to grasp the complexity of citizens’ approaches to automatisation of healthcare. Attending to both allows us to move beyond the dominant (political) discourse of technology markets as the only way to respond to healthcare challenges. Thus, we can analyse and integrate patients’ perspectives to develop AI and robotic systems in healthcare to serve citizens’ needs and collective well-being. Full article
(This article belongs to the Special Issue In the Hands of Technology: Care in the XXI Century)
11 pages, 1866 KiB  
Article
Impact of Rehabilitation Intensity on 3-Year Mortality among Children with Moderate to Severe Cerebral Palsy: A Population-Based Cohort Study
by Chiao-Lin Hsu, Chia-Ling Hung, Shih-Ju Huang, Chun-Hao Yin, Chi-Hsiang Chu, Tsu-Jen Kuo and Yao-Min Hung
Int. J. Environ. Res. Public Health 2021, 18(18), 9932; https://doi.org/10.3390/ijerph18189932 - 21 Sep 2021
Cited by 1 | Viewed by 2361
Abstract
Though numerous studies demonstrated the positive effect of rehabilitation on cerebral palsy (CP) children, there was no literature addressing the role of rehabilitation on mortality among children with CP. Therefore, we aimed to evaluate the impact of rehabilitation intensity on mortality among children [...] Read more.
Though numerous studies demonstrated the positive effect of rehabilitation on cerebral palsy (CP) children, there was no literature addressing the role of rehabilitation on mortality among children with CP. Therefore, we aimed to evaluate the impact of rehabilitation intensity on mortality among children with moderate to severe CP. This retrospective cohort study was conducted by National Health Insurance Research Database in Taiwan. Children (<12 years) with newly diagnosed moderate to severe CP between 1 January 2000 and 31 December 2013 were included. All patients were followed up for 3 years after CP diagnosis or death or until 31 December 2013. The intensity of rehabilitation therapy within 6 months after CP diagnosis was categorized into <6 times and ≥6 times. The Cox proportional hazard analysis was used to determine the association between rehabilitation intensity and all-cause mortality after adjusting age, sex, other demographic factors and comorbidities. Among 3936 severe CP children, 164 (4.2%) died during the 3-year follow-up period. The mortality rate was higher among patients receiving rehabilitation < 6 times within 6 months than those ≥6 times within 6 months after adjusting demographic profile and comorbidities (adjust HR (aHR): 1.96, 95% CI 1.33–2.89, p < 0.001). We found that patients who were younger (aHR: 0.84, 95% CI 0.76–0.92, p < 0.001), who were receiving inpatient care more than twice in 1 year before their CP diagnosis (aHR: 2.88; 95% CI: 1.96–4.23; p < 0.001), and who have pneumonia (aHR: 1.41, 95% CI 1.00–1.96, p = 0.047), epilepsy (aHR: 1.41, 95% CI: 1.02–1.95, p = 0.039) and dysphagia (aHR: 1.55, 95% CI: 1.06–2.26, p = 0.024) have higher risk of mortality. Rehabilitation ≥ 6 times within 6 months has a potentially positive impact on pediatric CP survival. Besides having a younger age, being hospitalized more than twice within a year before diagnosis and having pneumonia, epilepsy and dysphagia were modifiable risk factors in clinical practice for these children. Full article
(This article belongs to the Topic Oncogenomics and Pediatric Health)
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15 pages, 1776 KiB  
Systematic Review
Overweight and Obesity in Patients with Congenital Heart Disease: A Systematic Review
by Laura Willinger, Leon Brudy, Michael Meyer, Renate Oberhoffer-Fritz, Peter Ewert and Jan Müller
Int. J. Environ. Res. Public Health 2021, 18(18), 9931; https://doi.org/10.3390/ijerph18189931 - 21 Sep 2021
Cited by 23 | Viewed by 3951
Abstract
Background: Overweight and obesity have become a major public health concern in recent decades, particularly in patients with chronic health conditions like congenital heart disease (CHD). This systematic review elaborates on the prevalence and the longitudinal development of overweight and obesity in children [...] Read more.
Background: Overweight and obesity have become a major public health concern in recent decades, particularly in patients with chronic health conditions like congenital heart disease (CHD). This systematic review elaborates on the prevalence and the longitudinal development of overweight and obesity in children and adults with CHD. Methods: A systematic literature search was conducted in PubMed, Cochrane, and Scopus from January 2010 to December 2020 on overweight and obesity prevalence in children and adults with CHD. Results: Of 30 included studies, 15 studies evaluated 5680 pediatric patients with CHD, 9 studies evaluated 6657 adults with CHD (ACHD) and 6 studies examined 9273 both pediatric patients and ACHD. Fifteen studies received the quality rating “good”, nine studies “fair”, and six studies “poor”. In children with CHD, overweight prevalence was between 9.5–31.5%, and obesity prevalence was between 9.5–26%; in ACHD, overweight prevalence was between 22–53%, and obesity was between 7–26%. The prevalence of overweight and obesity was thereby similar to the general population. Overweight and obesity have been shown to increase with age. Conclusion: The prevalence of overweight and obesity in children and adults with CHD is similar to the general population, demonstrating that the growing obesity pandemic is also affecting the CHD population. Full article
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11 pages, 893 KiB  
Article
An Exploration of Domain-Specific Sedentary Behaviors in College Students by Lifestyle Factors and Sociodemographics
by Chelsea Carpenter, Sang-Eun Byun, Gabrielle Turner-McGrievy and Delia West
Int. J. Environ. Res. Public Health 2021, 18(18), 9930; https://doi.org/10.3390/ijerph18189930 - 21 Sep 2021
Cited by 15 | Viewed by 4636
Abstract
College students exhibit high levels of sedentary time and/or poor lifestyle factors (e.g., poor sleep, stress, physical inactivity). It is unknown; however, in what domains college students spend their sedentary time and whether there are associations between sedentary time and these lifestyle factors. [...] Read more.
College students exhibit high levels of sedentary time and/or poor lifestyle factors (e.g., poor sleep, stress, physical inactivity). It is unknown; however, in what domains college students spend their sedentary time and whether there are associations between sedentary time and these lifestyle factors. This study examined sedentary behavior of college students by domains, current lifestyle factors and sociodemographics. Undergraduates (n = 272, M age = 20 years, 79% female) self-reported their sedentary behavior, sleep, stress, physical activity, anthropometrics and sociodemographics. Sedentary time was categorized as: total, recreational screen, education and social. Students reported spending > 12 h of their day sedentary on average, with over a third of this time spent in recreational screen time. All categories of sedentary time were significantly correlated with body mass index, and both total sedentary time and screen time were significantly correlated with sleep score, with poorer sleep quality associated with greater sedentary time. Physical activity was negatively correlated with social sedentary time only. Subgroups with elevated sedentary time included minority students, those with low parental education and students with overweight/obesity. Given the negative health impacts of sedentary behavior, college students would likely benefit from interventions tailored to this population which target reducing sedentary time, particularly recreational screen time. Full article
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13 pages, 358 KiB  
Article
Anxiety, Depression and Risk of Post-Traumatic Stress Disorder in Health Workers: The Relationship with Burnout during COVID-19 Pandemic in Italy
by Lucio Ghio, Sara Patti, Giulia Piccinini, Cinzia Modafferi, Eleonora Lusetti, Massimo Mazzella and Massimo Del Sette
Int. J. Environ. Res. Public Health 2021, 18(18), 9929; https://doi.org/10.3390/ijerph18189929 - 21 Sep 2021
Cited by 23 | Viewed by 4616
Abstract
During the COVID-19 pandemic, healthcare workers (HW) have faced an extremely difficult work environment, with an increased workload and traumatic events. Our study aimed to investigate the impact of COVID-19 pandemic on HW’s mental wellbeing. We analyzed the correlations between levels of burnout [...] Read more.
During the COVID-19 pandemic, healthcare workers (HW) have faced an extremely difficult work environment, with an increased workload and traumatic events. Our study aimed to investigate the impact of COVID-19 pandemic on HW’s mental wellbeing. We analyzed the correlations between levels of burnout and other mental health disorders and we searched for the presence of specific risk factors of post-traumatic symptomatology related to the pandemic. A structured an on-line questionnaire and validated instruments were completed by a sample of HW from some hospitals in Genoa, Italy. Anxious, depressive, post-traumatic and other psychological symptoms were assessed and risk factors, related to the pandemic, were considered. Then, we investigated the correlation between levels of burnout and the risk of developing psychopathology. A total of 731 HW were screened, and we found increased levels of anxiety (61%), depression (62%), PTSD (34%) and high levels of burnout; especially emotional exhaustion (37%). A statistically significant association between burnout and insomnia, depression, anxiety, and post-traumatic symptoms was demonstrated. This study indicates that during the COVID-19 pandemic, HW showed high levels of psychological distress and that burnout is an important predictor of sufferance. These findings support the idea to provide psychological and psychiatric support for HW. Full article
(This article belongs to the Topic Burden of COVID-19 in Different Countries)
9 pages, 319 KiB  
Article
Impact of Two Different Recruitment Procedures (Random vs. Volunteer Selection) on the Results of Seroepidemiological Study (SARS-CoV-2)
by Maksymilian Gajda, Małgorzata Kowalska and Jan Eugeniusz Zejda
Int. J. Environ. Res. Public Health 2021, 18(18), 9928; https://doi.org/10.3390/ijerph18189928 - 21 Sep 2021
Cited by 8 | Viewed by 2728
Abstract
The proper recruitment of subjects for population-based epidemiological studies is critical to the external validity of the studies and, above all, to the sound and correct interpretation of the findings. Since 2020, the novel coronavirus SARS-CoV-2 pandemic has been a new factor that [...] Read more.
The proper recruitment of subjects for population-based epidemiological studies is critical to the external validity of the studies and, above all, to the sound and correct interpretation of the findings. Since 2020, the novel coronavirus SARS-CoV-2 pandemic has been a new factor that has been, additionally, hindering studies. Therefore, the aim of our study is to compare demographic, socio-economic, health-related characteristics and the frequency of SARS-CoV-2 infection occurrence among the randomly selected group and the group composed of volunteers. We compare two groups of participants from the cross-sectional study assessing the seroprevalence of SARS-CoV-2 coronavirus, which was conducted in autumn 2020, in three cities of the Silesian Voivodeship in Poland. The first group consisted of a randomly selected, nationally representative, age-stratified sample of subjects (1167 participants, “RG” group) and was recruited using personal invitation letters and postal addresses obtained from a national registry. The second group (4321 volunteers, “VG” group) included those who expressed their willingness to participate in response to an advertisement published in the media. Compared with RG subjects, volunteers were more often females, younger and professionally active, more often had a history of contact with a COVID-19 patient, post-contact nasopharyngeal swab, fewer comorbidities, as well as declared the occurrence of symptoms that might suggest infection with SARS-CoV-2. Additionally, in the VG group the percentage of positive IgG results and tuberculosis vaccination were higher. The findings of the study confirm that surveys limited to volunteers are biased. The presence of the bias may seriously affect and distort inference and make the generalizability of the results more than questionable. Although effective control over selection bias in surveys, including volunteers, is virtually impossible, its impact on the survey results is impossible to predict. However, whenever possible, such surveys could include a small component of a random sample to assess the presence and potential effects of selection bias. Full article
16 pages, 385 KiB  
Review
Challenges Associated with Parenting While Incarcerated: A Review
by Monika Dargis and Arielle Mitchell-Somoza
Int. J. Environ. Res. Public Health 2021, 18(18), 9927; https://doi.org/10.3390/ijerph18189927 - 21 Sep 2021
Cited by 9 | Viewed by 6004
Abstract
Of the 2.5 million people who are incarcerated in the United States, over half are parents. While it is well-established that incarceration has a detrimental impact on the children of incarcerated parents, less is known regarding the psychological impact of incarceration on parents [...] Read more.
Of the 2.5 million people who are incarcerated in the United States, over half are parents. While it is well-established that incarceration has a detrimental impact on the children of incarcerated parents, less is known regarding the psychological impact of incarceration on parents themselves. The present review summarizes existing literature on the impact of incarceration on parents retrieved via online databases. Published articles were classified according to their overall themes and summarized. Pertinent studies include the psychological and emotional consequences of incarceration on parents, the experience of parenting while incarcerated, including barriers to parenting, the utility of parenting program interventions during periods of incarceration, and how these results differ for mothers and fathers. While the existing evidence introduces these issues, there is a need for additional research on the impact of incarceration on parents. These areas for future research as well as clinical implications are discussed. Full article
(This article belongs to the Special Issue Effects of Parental Incarceration on the Family)
12 pages, 720 KiB  
Article
Suicidology Post Graduate Curriculum: Priority Topics and Delivery Mechanisms for Suicide Prevention Education
by Jacinta Hawgood, Karolina Krysinska, Maddeline Mooney, Ingrid Ozols, Karl Andriessen, Carmen Betterridge, Diego De Leo and Kairi Kõlves
Int. J. Environ. Res. Public Health 2021, 18(18), 9926; https://doi.org/10.3390/ijerph18189926 - 21 Sep 2021
Cited by 10 | Viewed by 4392
Abstract
Background: There has been limited attention to the development and delivery of tertiary suicide prevention curricula. The aim of this work was to describe the status of postgraduate suicide prevention education, with specific attention on examining the needs of the suicide prevention sector [...] Read more.
Background: There has been limited attention to the development and delivery of tertiary suicide prevention curricula. The aim of this work was to describe the status of postgraduate suicide prevention education, with specific attention on examining the needs of the suicide prevention sector in Australia. Method: An online survey was completed by 76 stakeholders in Australia. Current curriculum learning outcomes from Griffith University’s postgraduate suicidology programs guided the development of the survey. Results: Four key learning domains were rated highest in importance by stakeholders. According to most stakeholders, skills-based qualifications were the most relevant type of qualification, and online modulized education was the most preferred delivery mode. Half of stakeholders supported suicide prevention professional development through a combination of financial support and study leave. Conclusions: The survey provided invaluable feedback regarding the priorities of Australia’s suicide prevention sector for content domains and delivery mechanisms for tertiary suicidology education. The findings showed the preferred type of organizational (employer) support that may be provided for employees to undertake such education. These findings will inform the future developments of Griffith University’s suicidology programs and may motivate other universities to consider offering same or a similar type of education to support the suicide prevention sector toward saving lives. Full article
(This article belongs to the Special Issue Suicide and Suicide Prevention from a Global Perspective)
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13 pages, 22788 KiB  
Article
Application of Pandemic Intelligence in Dynamic Data in Taiwan
by Tzu-Yin Chang, Wen-Ray Su, Hongey Chen, Ming-Wey Huang and Lu-Yen A. Chen
Int. J. Environ. Res. Public Health 2021, 18(18), 9925; https://doi.org/10.3390/ijerph18189925 - 21 Sep 2021
Viewed by 2127
Abstract
Taiwan was successful in containing the spread of the novel coronavirus (COVID-19) in 2020. One major factor in this success was the compilation and provision of comprehensive information about the pandemic. The present study proposes a pandemic intelligence system that provides data on [...] Read more.
Taiwan was successful in containing the spread of the novel coronavirus (COVID-19) in 2020. One major factor in this success was the compilation and provision of comprehensive information about the pandemic. The present study proposes a pandemic intelligence system that provides data on the number of epidemic prevention professionals in each county and city, as well as daily confirmed cases, the demographics of the confirmed cases, and available resources (negative-pressure room beds and artificial ventilation apparatuses) in hospitals. Furthermore, the system provides the location of pharmacies selling masks and their current inventories, as well as the distribution of crowds at popular tourist destinations and social-distance monitoring. The most frequently used map layer in the thematic map of the pandemic is that of crowd distribution during the study period from March 2020 until the end of the same year. The case study used in this investigation for applying the system is represented by the 4-day weekend for Tomb-Sweeping Day of 2020. Through the real-time analysis of dynamic data and the integration of intelligence, the system offers a clear insight into changes in relevant information and, thus, enables the preemptive deployment of control measures by the county/city governments regarding pandemic management. Full article
(This article belongs to the Topic Burden of COVID-19 in Different Countries)
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14 pages, 6427 KiB  
Article
Evaluation of Preventive Treatment Protocols for Patients under Antiresorptive Therapy Undergoing Tooth Extraction at a Swiss University Clinic
by Ellen Pick, Nicolas Leuenberger, Irina Kuster, Nicole Selina Stutzmann, Bernd Stadlinger and Silvio Valdec
Int. J. Environ. Res. Public Health 2021, 18(18), 9924; https://doi.org/10.3390/ijerph18189924 - 21 Sep 2021
Cited by 4 | Viewed by 3328
Abstract
Antiresorptive agent-related osteonecrosis of the jaw (ARONJ) is a dreaded complication in patients with compromised bone metabolism. The purpose of the present study was to examine the occurrence of ARONJ and its related factors among patients with a history of antiresorptive therapy undergoing [...] Read more.
Antiresorptive agent-related osteonecrosis of the jaw (ARONJ) is a dreaded complication in patients with compromised bone metabolism. The purpose of the present study was to examine the occurrence of ARONJ and its related factors among patients with a history of antiresorptive therapy undergoing tooth extraction using preventive protocols at a Swiss university clinic. Data were retrospectively pooled from health records of patients having received a surgical tooth extraction between January 2015 and April 2020 in the Clinic of Cranio-Maxillofacial and Oral surgery, University of Zurich. A total of 970 patients received an extraction with flap elevation or wound closure during this period. A total of 104 patients could be included in the study. Furthermore, variables including age, gender, smoking, risk profile, choice, indication and duration of antiresorptive therapy, number of extractions, extraction site, surgical technique, choice and duration of antibiotics as well as the presence of postoperative inflammatory complications were assessed. Overall, 4 patients developed ARONJ (incidence of 3.8%) after tooth extraction at the same location, without previous signs of osteonecrosis. Preventive methods included predominantly primary wound closure using a full thickness mucoperiosteal flap and prolonged perioperative antibiotic prophylaxis. In accordance with current literature, the applied protocol showed a reliable outcome in preventing ARONJ when a tooth extraction is required. Full article
(This article belongs to the Special Issue Dental Public Health: Issues, Challenges and Opportunities)
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21 pages, 394 KiB  
Article
Between- and within-Group Differences in Fruit and Vegetable Purchases, Consumption, and BMI among Hispanic Farmers’ Market Shoppers Who Use SNAP
by Ginnie Sawyer-Morris, Sara Grajeda, Tara Tracy and Allison Karpyn
Int. J. Environ. Res. Public Health 2021, 18(18), 9923; https://doi.org/10.3390/ijerph18189923 - 21 Sep 2021
Cited by 4 | Viewed by 2800
Abstract
(1) Background: Despite considerable efforts to increase farmers’ market access (FM) and improve household fruit and vegetable (FV) purchasing in low-income communities, little is known about the FV purchasing and consumption characteristics of low-income Hispanic farmers’ market shoppers. (2) Methods: A secondary analysis [...] Read more.
(1) Background: Despite considerable efforts to increase farmers’ market access (FM) and improve household fruit and vegetable (FV) purchasing in low-income communities, little is known about the FV purchasing and consumption characteristics of low-income Hispanic farmers’ market shoppers. (2) Methods: A secondary analysis of baseline data from a farmers’ market study conducted between 2015 and 2017 (n = 2825) was performed. Participants who also received supplemental nutrition assistance program (SNAP) completed a 31-item online survey assessing demographics, health characteristics, and FV purchasing and consumption habits. Descriptive statistics and bivariate analyses were used to assess between- and within-group differences amongst Hispanic and non-Hispanic households. Regression analyses were used to examine associations among BMI, FV purchasing and consumption, and household size for Hispanic and non-Hispanic households as well as for Hispanic subgroups. (3) Results: The sample included 515 Hispanic and 2310 non-Hispanic SNAP-using FM shoppers in 13 states. Despite experiencing significantly higher food insecurity (89% vs. 81%, non-Hispanic), Hispanic shoppers consumed similar amounts of FV (3.04 cups/day) and spent less doing so. Significant subgroup differences were identified for FV purchasing. (4) Conclusions: Findings emphasize the importance of food insecurity and household size in FV interventions and underscore the capacity of Hispanic families to maintain FV consumption. Full article
(This article belongs to the Special Issue Food Consumption and Health Issue)
17 pages, 2700 KiB  
Review
Chronic Stress, Exercise and Cardiovascular Disease: Placing the Benefits and Risks of Physical Activity into Perspective
by Barry A. Franklin, Akash Rusia, Cindy Haskin-Popp and Adam Tawney
Int. J. Environ. Res. Public Health 2021, 18(18), 9922; https://doi.org/10.3390/ijerph18189922 - 21 Sep 2021
Cited by 20 | Viewed by 11025
Abstract
Chronic stress, which has been exacerbated worldwide by the lingering COVID pandemic, has been strongly linked to cardiovascular disease (CVD). In addition, autonomic dysregulation via sustained sympathetic activity has been shown to increase the risk of arrhythmias, platelet aggregation, acute coronary syndromes and [...] Read more.
Chronic stress, which has been exacerbated worldwide by the lingering COVID pandemic, has been strongly linked to cardiovascular disease (CVD). In addition, autonomic dysregulation via sustained sympathetic activity has been shown to increase the risk of arrhythmias, platelet aggregation, acute coronary syndromes and heart failure. Fortunately, effective coping strategies have been shown to attenuate the magnitude of hyperarousal associated with the stress response, including moderate-to-vigorous lifestyle activity and/or structured exercise. A good-to-excellent level of cardiorespiratory fitness also appears to be highly cardioprotective. These beneficial effects have been substantiated by numerous studies that have evaluated the levels of stress reactivity and stress recovery in physically active individuals versus matched sedentary controls, as well as before and after exercise interventions. On the other hand, unaccustomed strenuous exercise in habitually sedentary persons with underlying CVD is associated with a disproportionate incidence of acute cardiac events. Moreover, extreme exercise regimens appear to increase coronary calcification and the likelihood of developing atrial fibrillation. This review summarizes these relations and more, with specific reference to placing the benefits and risks of physical activity into perspective. Full article
(This article belongs to the Special Issue Sport-Exercise and Stress: A Winning Combination)
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14 pages, 2409 KiB  
Article
Suicide Risk Factors among Polish Adults Aged 65 or Older in 2000–2018 Compared with Selected Countries Worldwide
by Witold Śmigielski, Karolina Małek, Tomasz Jurczyk, Karol Korczak, Robert Gajda, Alicja Cicha-Mikołajczyk, Jerzy Piwoński, Joanna Śmigielska-Kolańska, Janusz Śmigielski, Wojciech Drygas and Piotr Gałecki
Int. J. Environ. Res. Public Health 2021, 18(18), 9921; https://doi.org/10.3390/ijerph18189921 - 21 Sep 2021
Cited by 1 | Viewed by 2804
Abstract
The aim of this study was to determine the tendencies of change in suicide frequency among Polish adults aged 65 or older, recognize the importance of available socio-demographic data (age, sex, marital status, and education attainment level) and provide an in-depth psychological understanding [...] Read more.
The aim of this study was to determine the tendencies of change in suicide frequency among Polish adults aged 65 or older, recognize the importance of available socio-demographic data (age, sex, marital status, and education attainment level) and provide an in-depth psychological understanding of the obtained results. We analysed the influence of education and marital status on suicide risk in the Polish adult population aged 65 or older, which has not been previously presented in publications related to the Central Statistical Office or any other research. Our results indicated that male adults aged 65 or older that were single or divorced and with a lower education had a higher risk of death by suicide. In female adults aged 65 or older, those with higher education and who were divorced or married had a higher risk of fatal suicide behaviour meanwhile, single women and widows had a lower risk. The dominant method of suicide among Polish older adults was suicide by hanging, regardless of sex; female older adults were more likely to die by suicide by poisoning or jumping from a height, and male older adults were more likely to die by shooting with a firearm. Although data from recent years highlights a downward trend for suicide rates in Polish older adults, the problem cannot be considered solved. Full article
(This article belongs to the Special Issue Healthy Aging: Past and Future Challenge)
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10 pages, 5442 KiB  
Article
Environmental Risk Perception and Preventive Behavior during the COVID-19 Pandemic in Central Taiwan
by Kuo-Wei Hsu, Jen-Chih Chao and Ching-Yi Hsu
Int. J. Environ. Res. Public Health 2021, 18(18), 9920; https://doi.org/10.3390/ijerph18189920 - 21 Sep 2021
Cited by 3 | Viewed by 2561
Abstract
Due to traffic and industrial and seasonal air pollution, wearing masks outside the home has long been a daily habit for many people in Taiwan. After the emergence of the novel coronavirus (COVID-19), which has an incubation period of up to 14 days, [...] Read more.
Due to traffic and industrial and seasonal air pollution, wearing masks outside the home has long been a daily habit for many people in Taiwan. After the emergence of the novel coronavirus (COVID-19), which has an incubation period of up to 14 days, wearing masks and maintaining social distancing was advised to reduce exposure to this new environmental risk. This study investigates open and semi-open spaces in three districts in central Taiwan, using a non-participant observation method, with the aim of understanding people’s mask-wearing behavior. The results indicate that mask-wearing rates were higher in urban areas than in rural ones and among females than males. By age cohort, mask-wearing was most prevalent among young adults and middle-aged people and least prevalent among minors, with the elderly occupying a middle position. Masks were also more likely to be worn in semi-open spaces than in open ones. This study enriches our understanding of environmental risk perception of the pandemic and of public perceptions, which are vital to increasing the adoption of preventative measures. Full article
(This article belongs to the Special Issue Research about Risk Perception in the Environmental Health Domain)
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7 pages, 308 KiB  
Article
Awareness of Endometriosis Symptoms—A Cross Sectional Survey among Polish Women
by Maja Kotowska, Justyna Urbaniak, Wojciech J. Falęcki, Piotr Łazarewicz, Mateusz Masiak and Iwona Szymusik
Int. J. Environ. Res. Public Health 2021, 18(18), 9919; https://doi.org/10.3390/ijerph18189919 - 21 Sep 2021
Cited by 14 | Viewed by 4253
Abstract
Background: Endometriosis is a chronic inflammatory condition characterized by the presence of endometrial-like tissue outside of the uterine cavity. It affects approximately 6–12% among reproductive-age women. Laparoscopy is still the gold standard for diagnosing it. Since an average of couple of years [...] Read more.
Background: Endometriosis is a chronic inflammatory condition characterized by the presence of endometrial-like tissue outside of the uterine cavity. It affects approximately 6–12% among reproductive-age women. Laparoscopy is still the gold standard for diagnosing it. Since an average of couple of years elapses from the onset of symptoms to the definitive diagnosis, analysis of symptoms could serve as a non-invasive diagnostic tool. Methods: An anonymous survey was distributed online in November 2019. It contained 23 closed questions, which covered two areas: knowledge and awareness of endometriosis symptoms and its presence among respondents. Results: A total of 3319 women completed the survey, of which 328 were diagnosed with endometriosis (9.9%). The symptoms of endometriosis most often indicated by the general population were infertility and dysmenorrhea. In contrast, those least frequently indicated were painful defecation and dysuria. Respondents suffering from endometriosis indicated that they often or sometimes experienced dysmenorrhea (83%, n = 273), pelvic pain not related to menstruation (72%, n = 235), dyspareunia (68%, n = 223) and painful defecation or dysuria (40%, n = 132). Conclusions: Since the search for a non-invasive diagnostic endometriosis marker has been conducted for many years without success so far, it seems that awareness of the clinical presentation and reported symptoms may help to provide earlier diagnoses. Full article
(This article belongs to the Section Women's Health)
10 pages, 2272 KiB  
Article
Mercury Levels in Feathers of Penguins from the Antarctic Peninsula Area: Geographical and Inter-Specific Differences
by Miguel Motas, Silvia Jerez, Marta Esteban, Francisco Valera, José Javier Cuervo and Andrés Barbosa
Int. J. Environ. Res. Public Health 2021, 18(18), 9918; https://doi.org/10.3390/ijerph18189918 - 21 Sep 2021
Cited by 4 | Viewed by 4009
Abstract
Polar regions, symbols of wilderness, have been identified as potential sinks of mercury coming from natural and anthropogenic sources at lower latitudes. Changes in ice coverage currently occurring in some areas such as the Antarctic Peninsula could enhance these phenomena and their impacts [...] Read more.
Polar regions, symbols of wilderness, have been identified as potential sinks of mercury coming from natural and anthropogenic sources at lower latitudes. Changes in ice coverage currently occurring in some areas such as the Antarctic Peninsula could enhance these phenomena and their impacts on local biota. As long-lived species at the top of food chains, seabirds are particularly sensitive to this highly toxic metal with the capacity to be biomagnified. Specifically, their feathers can be useful for Hg monitoring since they mainly accumulate its most toxic and persistent form, methyl-Hg. To that end, feathers of gentoo (Pygoscelis papua), chinstrap (P. antarcticus), and Adélie penguins (P. adeliae) (n = 108) were collected by passive sampling in seven different locations throughout the Antarctic Peninsula area and analyzed by ICP-MS after microwave-digestion. More than 93% of the samples showed detectable Hg levels (range: 6.3–12,529.8 ng g−1 dry weight), and the highest ones were found in the feathers of chinstrap penguins from King George Island. Hg bioconcentration and biomagnification seem to be occurring in the Antarctic food web, giving rise to high but non-toxic Hg levels in penguins, similar to those previously found in Arctic seabirds. Full article
(This article belongs to the Special Issue New Threads in Environmental Toxicology)
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10 pages, 731 KiB  
Article
In Vitro Tumor Cell Growth Inhibition Induced by Lophocereus marginatus (DC.) S. Arias and Terrazas Endophytic Fungi Extracts
by Jesica M. Ramírez-Villalobos, César I. Romo-Sáenz, Karla S. Morán-Santibañez, Patricia Tamez-Guerra, Ramiro Quintanilla-Licea, Alonso A. Orozco-Flores, Ricardo Romero-Arguelles, Reyes Tamez-Guerra, Cristina Rodríguez-Padilla and Ricardo Gomez-Flores
Int. J. Environ. Res. Public Health 2021, 18(18), 9917; https://doi.org/10.3390/ijerph18189917 - 21 Sep 2021
Cited by 11 | Viewed by 2987
Abstract
Endophytic fungi have become potential sources of antitumor agents, particularly against antineoplastic-resistant cancer cells, with marginal or nil adverse effects for the oncological patient. Endophytic fungi were isolated from stems of the Lophocereus marginatus cactus, commonly found in Mexico. Methanol extracts were then [...] Read more.
Endophytic fungi have become potential sources of antitumor agents, particularly against antineoplastic-resistant cancer cells, with marginal or nil adverse effects for the oncological patient. Endophytic fungi were isolated from stems of the Lophocereus marginatus cactus, commonly found in Mexico. Methanol extracts were then obtained from fungus liquid cultures and their effects on tumor cell growth against murine lymphoma (L5178Y-R), human colorectal adenocarcinoma (HT-29), and human breast cancer (MCF-7) cells were evaluated at concentrations ranging from 31 µg/mL to 250 µg/mL via the colorimetric 3- [4,5-dimethylthiazol-2-yl]-2,5-diphenyltetrazoliumbromide reduction assay, using monkey kidney epithelial (MA-104) and human peripheral mononuclear (PBMC) cells as controls. Furthermore, we obtained the IC50 and the selectivity index (SI) was calculated from the IC50 ratio of normal and tumor cells. In addition, molecular identification of fungi showing cytotoxic activity was determined, using internal transcribed spacer molecular markers. PME-H001, PME-H002, PME-H005, PME-H007, and PME-H008 filamentous fungus strain extracts showed significant (p < 0.05) tumor cell growth inhibition. In particular, they significantly (p < 0.05) inhibited L5178Y-R cell growth, whereas the least susceptible cell line was HT-29. The endophytic strain PME-H008 of Cladosporium sp. caused the highest growth inhibition percentage against L5178Y-R and HT-29 cells with 96.6% (p < 0.01) and 42.5% (p < 0.05) respectively, and the highest SIs against L5178Y-R cells with 2.4 and 2.9 for MA-104 and PBMCs, respectively, whereas the PME-H005 extract showed SIs of 2.77 and 1.5 against MCF-7 and L5178Y-R cells, respectively, as compared with PBMCs. In addition, the endophytic strain PME-H007 of Metarhizium anisopliae caused the highest percentage of growth inhibition (p < 0.01) against MCF-7 cells with 55.8% at 250 µg/mL. We demonstrated in vitro antitumor effects of L. marginatus endophytic fungi. Further research will involve the isolation and in vivo testing of bioactive compounds. Full article
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6 pages, 293 KiB  
Brief Report
‘You Learn How to Hate’: Adapting a Healthy Relationship Curriculum Using a Trauma-Informed Race Equity Lens
by Shannon Guillot-Wright, Elizabeth D. Torres, Bianca Obinyan and Jeff R. Temple
Int. J. Environ. Res. Public Health 2021, 18(18), 9916; https://doi.org/10.3390/ijerph18189916 - 21 Sep 2021
Cited by 3 | Viewed by 2448
Abstract
Teen dating violence is a public health concern that can lead to short- and long-term mental and physical health consequences, including depression, anxiety, risky behaviors, and unhealthy future relationships. Research shows that social and structural determinants of health, such as racism, low socio-economic [...] Read more.
Teen dating violence is a public health concern that can lead to short- and long-term mental and physical health consequences, including depression, anxiety, risky behaviors, and unhealthy future relationships. Research shows that social and structural determinants of health, such as racism, low socio-economic status, and neighborhood conditions, may predispose certain communities to violence. To better understand methods to reduce TDV among ethnically and economically diverse populations, we used a trauma-informed race equity lens to adapt an efficacious prevention program known as Fourth R. This universal program has been shown to reduce some dating violence, substance use, and risky sexual behaviors, but there remains room for improvement. Specifically, more attention to trauma and the importance of societal risk and protective factors may improve the program’s effectiveness. Thus, focus group discussions were conducted with students and we then adapted Fourth R lessons specific to trauma, racism, and discrimination. Major themes discussed are that Fourth R and other prevention programs should focus attention on social and structural issues, such as racism and discrimination. Full article
(This article belongs to the Special Issue Social Equity as a Pathway to Health Equity)
12 pages, 349 KiB  
Article
The Relationships of Watching Television, Computer Use, Physical Activity, and Food Preferences to Body Mass Index: Gender and Nativity Differences among Adolescents in Saudi Arabia
by Ahmad H. Alghadir, Zaheen A. Iqbal and Sami A. Gabr
Int. J. Environ. Res. Public Health 2021, 18(18), 9915; https://doi.org/10.3390/ijerph18189915 - 21 Sep 2021
Cited by 15 | Viewed by 4291
Abstract
Background: Adolescents and ethnic subgroups have been identified at high risks of overweight and its associated complications. Although some studies have investigated overweight, obesity, nutritional status, physical activity, and associated factors among Saudi students, no studies have examined these characteristics among non-Saudi students [...] Read more.
Background: Adolescents and ethnic subgroups have been identified at high risks of overweight and its associated complications. Although some studies have investigated overweight, obesity, nutritional status, physical activity, and associated factors among Saudi students, no studies have examined these characteristics among non-Saudi students or compared non-Saudi to Saudi adolescent students. The objective of this study was to compare differences between Saudi and non-Saudi adolescent students regarding time spent watching television, using computers, engaging in physical activity, and their food preferences. The relationships between these lifestyle behaviors and body mass index by Saudi nativity and gender were tested. Methods: Students aged 12 to 18 years (n = 214) from various schools in Riyadh, Saudi Arabia, completed a self-administered questionnaire that included questions about demographic and anthropometric characteristics, daily after-school routine, physical activity, watching television, using computers, and food preferences. Non-parametric (Mann–Whitney U) tests assessed the statistical differences between Saudi and non-Saudi respondents, and males and females were separately tested. Results: Saudi boys who reported physical activity two to five times per week, the most television time, the most computer time, and the highest frequency of eating fast food and drinking soft drinks had a significantly higher mean body mass index than the non-Saudi boys in their categories. However, there were no significant differences found between the Saudi and non-Saudi girls. Conclusions: High levels of sedentary and low levels of physical activities as well as high consumption of high-fat fast foods and high-sugar drinks threaten the health of Saudi adolescents. Cultural differences in lifestyle between Saudi and non-Saudi families should be considered when developing programs to improve knowledge, attitudes, and behaviors regarding diet quality and physical activity. The objective of this study is more important in the current situation where increased time spent on computers and mobile phones due to online teaching in schools or working from home, decreased physical activity due to precautionary lockdowns, and unchecked eating patterns while spending more time in sedentary activities in homes has become our COVID-19 pandemic lifestyle in all the age groups. A similar study should be replicated on a large scale to study the effect of this lifestyle on our lives in all the age groups. Full article
(This article belongs to the Special Issue Screen-Time and Health in Children and Adolescents)
9 pages, 1518 KiB  
Communication
Impact of Sleep Telementorship in Primary Care: Sleep VA-ECHO (Veterans Affairs-Extension for Community Healthcare Outcomes)
by Brian N. Palen, Elizabeth A. Mattox, Ken He, Lauren A. Beste, Joleen Borgerding, Sarah Patel, David H. Au, Michael F. Chang and Elizabeth C. Parsons
Int. J. Environ. Res. Public Health 2021, 18(18), 9914; https://doi.org/10.3390/ijerph18189914 - 21 Sep 2021
Cited by 4 | Viewed by 2268
Abstract
Sleep VA-ECHO (Veterans Affairs–Extension for Community Healthcare Outcomes) is a national telementorship program intended to improve knowledge about sleep disorders among non-specialty providers. The project goal was to describe the characteristics of Sleep VA-ECHO participants from primary care and their use of program-obtained [...] Read more.
Sleep VA-ECHO (Veterans Affairs–Extension for Community Healthcare Outcomes) is a national telementorship program intended to improve knowledge about sleep disorders among non-specialty providers. The project goal was to describe the characteristics of Sleep VA-ECHO participants from primary care and their use of program-obtained knowledge in practice. Sleep VA-ECHO consisted of 10 voluntary, 75-min teleconference sessions combining didactics and case discussion. Out of 86 participants, 21 self-identified as primary care team members and completed a program evaluation. Participants self-reported their application of knowledge gained, including changes to practice as a result of program participation. These 21 participants represented 18 sites in 11 states and attended a median of 5.0 sessions. They included physicians (29%), nurse practitioners (24%), and registered nurses (24%). Nearly all participants (95%) reported using acquired knowledge to care for their own patients at least once a month; 67% shared knowledge with colleagues at least once a month. Eighty-five percent reported improved quality of sleep care for their patients, and 76% reported an expanded clinical skillset. The greatest self-reported change in practice occurred in patient education about sleep disorders (95%) and non-pharmacologic management of insomnia (81%). Full article
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10 pages, 599 KiB  
Article
The Effect of High-Intensity Accelerations and Decelerations on Match Outcome of an Elite English League Two Football Team
by David Rhodes, Stephen Valassakis, Lukasz Bortnik, Richard Eaves, Damian Harper and Jill Alexander
Int. J. Environ. Res. Public Health 2021, 18(18), 9913; https://doi.org/10.3390/ijerph18189913 - 21 Sep 2021
Cited by 25 | Viewed by 6163
Abstract
Objectives: Previous research has highlighted the frequency of high-intensity accelerations and decelerations in elite football. The influence of these actions on match performance outcomes has not been established. The aim of the present study was to identify the influence of high-intensity accelerations and [...] Read more.
Objectives: Previous research has highlighted the frequency of high-intensity accelerations and decelerations in elite football. The influence of these actions on match performance outcomes has not been established. The aim of the present study was to identify the influence of high-intensity accelerations and decelerations on match performance outcomes (i.e., win, draw, lost). Comparisons were also made between team and positional high-intensity accelerations and decelerations recorded within the games. Methods: 26 elite outfield footballers from an elite English Football League (EFL) Two team completed the present study. Global Positioning System (GPS) technology was utilised to quantify high-intensity accelerations and decelerations during 45 games in a competitive season. Magnitude analysis and the effects of results, positions and fixture periods were observed. Results: Significant effects of results, periods and positions were observed (p ≤ 0.05), with the highest outputs observed in games won. Positionally, fullbacks and centre forwards in a 4–3–3 formation exhibited the greatest frequency of high-intensity accelerations and decelerations. Very large differences were observed between the frequency of high-intensity decelerations compared to accelerations in games won (g = 2.37), drawn (g = 2.99) and lost (g = 3.59). The highest team frequencies of high-intensity accelerations (n = 3330) and decelerations (n = 6482) were completed in games won. Conclusions: The frequency of high-intensity accelerations and decelerations has a significant impact on match performance outcomes in an elite English League Two football team. Consideration needs to be given to specific conditioning and recovery strategies to optimise high-intensity acceleration and deceleration performance in games. Caution should be taken as these findings are representative of one team within the EFL. Full article
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28 pages, 1835 KiB  
Article
Assessing Patient-Perceived Hospital Service Quality and Sentiment in Malaysian Public Hospitals Using Machine Learning and Facebook Reviews
by Afiq Izzudin A. Rahim, Mohd Ismail Ibrahim, Kamarul Imran Musa, Sook-Ling Chua and Najib Majdi Yaacob
Int. J. Environ. Res. Public Health 2021, 18(18), 9912; https://doi.org/10.3390/ijerph18189912 - 21 Sep 2021
Cited by 18 | Viewed by 6207
Abstract
Social media is emerging as a new avenue for hospitals and patients to solicit input on the quality of care. However, social media data is unstructured and enormous in volume. Moreover, no empirical research on the use of social media data and perceived [...] Read more.
Social media is emerging as a new avenue for hospitals and patients to solicit input on the quality of care. However, social media data is unstructured and enormous in volume. Moreover, no empirical research on the use of social media data and perceived hospital quality of care based on patient online reviews has been performed in Malaysia. The purpose of this study was to investigate the determinants of positive sentiment expressed in hospital Facebook reviews in Malaysia, as well as the association between hospital accreditation and sentiments expressed in Facebook reviews. From 2017 to 2019, we retrieved comments from 48 official public hospitals’ Facebook pages. We used machine learning to build a sentiment analyzer and service quality (SERVQUAL) classifier that automatically classifies the sentiment and SERVQUAL dimensions. We utilized logistic regression analysis to determine our goals. We evaluated a total of 1852 reviews and our machine learning sentiment analyzer detected 72.1% of positive reviews and 27.9% of negative reviews. We classified 240 reviews as tangible, 1257 reviews as trustworthy, 125 reviews as responsive, 356 reviews as assurance, and 1174 reviews as empathy using our machine learning SERVQUAL classifier. After adjusting for hospital characteristics, all SERVQUAL dimensions except Tangible were associated with positive sentiment. However, no significant relationship between hospital accreditation and online sentiment was discovered. Facebook reviews powered by machine learning algorithms provide valuable, real-time data that may be missed by traditional hospital quality assessments. Additionally, online patient reviews offer a hitherto untapped indication of quality that may benefit all healthcare stakeholders. Our results confirm prior studies and support the use of Facebook reviews as an adjunct method for assessing the quality of hospital services in Malaysia. Full article
(This article belongs to the Special Issue Disease Prediction, Machine Learning, and Healthcare)
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20 pages, 816 KiB  
Article
Housing Poverty and Healthy Aging in China: Evidence from the China Health and Retirement Longitudinal Study
by Peng Nie, Yan Li, Lanlin Ding and Alfonso Sousa-Poza
Int. J. Environ. Res. Public Health 2021, 18(18), 9911; https://doi.org/10.3390/ijerph18189911 - 21 Sep 2021
Cited by 10 | Viewed by 4099
Abstract
Background: Although prior research on the housing–health linkage suggested that those with poor housing conditions are more likely to report poor health, it is dominated by Western studies and offers little evidence on the housing–health relation in China. Scarce is empirical evidence on [...] Read more.
Background: Although prior research on the housing–health linkage suggested that those with poor housing conditions are more likely to report poor health, it is dominated by Western studies and offers little evidence on the housing–health relation in China. Scarce is empirical evidence on the potentially detrimental impact of either qualitative or quantitative housing poverty on health outcomes, especially for seniors in China. This paper aims to fill this void by using data from the 2011–2015 China Health and Retirement Longitudinal Study (CHARLS) to provide a comprehensive analysis of the demographic, socioeconomic, and behavioral factors that contribute to changes in healthy aging among Chinese adults aged 60 and over. Methods: Data collected from 8839 adults aged 60 and over in the 2011 and 2015 CHARLS (3732 in 2011 and 5107 in 2015) were used. We first used six blood-based biomarkers to construct a composite measure of the Chinese Healthy Aging Index (CHAI, ranging from 0 (healthiest) to 12 (unhealthiest)) and then assessed the psychometric properties of the CHAI score, including acceptability, internal consistency, convergent validity, discriminative validity and precision. In addition, we employed both mean-based Blinder–Oaxaca and unconditional quantile regression decomposition to decompose the change in healthy aging within the 2011–2015 period. Results: We overall identified a decrease in CHAI score from 5.69 in 2011 to 5.20 in 2015, which implies an improvement in healthy aging during this period. Our linear decomposition revealed that dependent on the type of measure used (whether quality, quantity, or combined quality–quantity), housing poverty explained 4–8% of the differences in CHAI score. Our distributional decompositions also highlighted an important role for housing poverty in the change in healthy aging, accounting for approximately 7–23% of the explained portion. Within this latter, the relative contribution of housing quantity and quality poverty was more pronounced at the median and upper end of the CHAI distribution. We also found household expenditure to be significantly associated with healthy aging among older Chinese adults and made the largest contribution to the improvement in healthy aging over time. Conclusions: The association between housing poverty and CHAI is independent of household expenditure. Regardless of type, housing poverty is positively associated with a decrease in healthy aging. Thus, improved housing conditions boost healthy aging, and housing amelioration initiatives may offer the most effective solution for augmenting healthy aging in China. Improvement of flush toilets and the access to potable water and a separate kitchen require particular attention. Since high-density congested housing has a negative impact on healthy aging, more attention can also be paid to improvements in the available space for older people. Especially at an institutional level, the government may extend the housing policy from a homeownership scheme to a housing upgrading scheme by improving housing conditions. Full article
(This article belongs to the Section Aging)
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13 pages, 350 KiB  
Article
Lifestyle Parameters in Patients with Diabetes Mellitus and in the General Adult Population—Trends over Five Years: Results of the Austrian National Health Interview Series
by Thomas Ernst Dorner, Christian Lackinger, Sandra Haider and Katharina Viktoria Stein
Int. J. Environ. Res. Public Health 2021, 18(18), 9910; https://doi.org/10.3390/ijerph18189910 - 21 Sep 2021
Cited by 4 | Viewed by 2777
Abstract
Background: Not smoking, performing >150 min of aerobic physical activity (PA) and muscle strengthening exercises/week, and consuming >5 portions of fruit and vegetables/day are lifestyle recommendations for both the general population and people with diabetes mellitus (DM). Methods: A total of 15,771 and [...] Read more.
Background: Not smoking, performing >150 min of aerobic physical activity (PA) and muscle strengthening exercises/week, and consuming >5 portions of fruit and vegetables/day are lifestyle recommendations for both the general population and people with diabetes mellitus (DM). Methods: A total of 15,771 and 15,461 persons from the Austrian Health Interview Surveys 2014 and 2019, respectively, including 4.9% and 6.0% of people with DM, were analysed in terms of their smoking, PA, and nutritional behaviours. Logistic regression models were performed for the lifestyle factors, adjusted for socio-demographic and health-related factors. Adjusted interactions between the survey year and DM on the lifestyle factors were computed. Results: The proportions of smokers were 23.9% and 20.2%, of people complying with the PA recommendations were 24.9% and 21.4%, and with fruit and vegetables recommendations were 7.1% and 5.5%, respectively, with significantly lower proportions of smokers and persons complying with the PA recommendations among people with DM. The fully adjusted odds ratios (95% confidence interval) for people with DM were 1.09 (0.94–1.26), 1.44 (1.23–1.69), and 0.90 (0.71–1.13) for smoking, not complying with PA recommendations, and not complying with fruit and vegetables recommendations, respectively. The proportion of people complying with PA recommendations decreased to a greater extent (p < 0.001) in people with DM (16.5% to 8.3%) compared to people without DM (25.3% to 22.3%). Conclusion: Diabetogenic lifestyle behaviours increased in the general Austrian population in recent years, which was especially true for people with DM regarding PA. Full article
(This article belongs to the Special Issue Health Behaviour and Lifestyle)
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