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Int. J. Environ. Res. Public Health, Volume 18, Issue 2 (January-2 2021) – 433 articles

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Open AccessArticle
The Association between Social Determinants of Health and Self-Reported Diabetic Retinopathy: An Exploratory Analysis
Int. J. Environ. Res. Public Health 2021, 18(2), 792; https://doi.org/10.3390/ijerph18020792 (registering DOI) - 18 Jan 2021
Abstract
One-third of Americans with diabetes will develop diabetic retinopathy (DR), the leading cause of blindness in working-age Americans. Social determinants of health (SDOHs) are conditions in a person’s environment that may impact health. The objective of this study was to determine whether there [...] Read more.
One-third of Americans with diabetes will develop diabetic retinopathy (DR), the leading cause of blindness in working-age Americans. Social determinants of health (SDOHs) are conditions in a person’s environment that may impact health. The objective of this study was to determine whether there is an association between SDOHs and DR in patients with type II diabetes. This cross-section study used data from the 2018 Behavioral Risk Factor Surveillance System (BRFSS). This study included people with self-reported diabetes in the US in 2018 (n = 60,703). Exposure variables included homeownership, marital status, income, health care coverage, completed level of education, and urban vs. rural environment. The outcome variable was DR. Logistic regression analysis were applied to calculate odds ratios (ORs) and 95% confidence intervals (CIs). Alaskan Native/Native American (OR 2.11; 95% CI: 1.14–3.90), out of work (OR 2.82; 95% CI: 1.62–4.92), unable to work (OR 2.14; 95% CI: 1.57–2.91), did not graduate high school (OR 1.91; 95% CI: 1.30–2.79), only graduated high school (OR 1.43; 95% CI 1.08–1.97), or only attended college or technical school without graduating (OR 1.42; 95% CI: 1.09–1.86) were SDOHs associated with DR in patients with diabetes. Health care providers should identify these possible SDOHs affecting their diabetic patients. Full article
(This article belongs to the Special Issue Exploring Clinical Outcomes in Diabetes Patients)
Open AccessArticle
An Experimental Evidence on Eco-Friendly Advertisement Appeals and Intention to Use Bio-Nanomaterial Plastics: Institutional Collectivism and Performance Orientation as Moderators
Int. J. Environ. Res. Public Health 2021, 18(2), 791; https://doi.org/10.3390/ijerph18020791 (registering DOI) - 18 Jan 2021
Abstract
Plastic waste management has become a serious environmental and health concern owing to large amounts of plastic deposits globally. Recently, innovative and sustainable solutions have been introduced (e.g., bio-nanomaterial plastics) to overcome the growing environmental threats. Hence, green marketers need to develop effective [...] Read more.
Plastic waste management has become a serious environmental and health concern owing to large amounts of plastic deposits globally. Recently, innovative and sustainable solutions have been introduced (e.g., bio-nanomaterial plastics) to overcome the growing environmental threats. Hence, green marketers need to develop effective advertising campaigns to enhance the usage of bio-nanomaterial plastics. Past literature has suggested that cultural value-laden advertising appeals can give sustainable behavioral cues to consumers. Hence, this research unfolds the underlying cultural dimensions between the value-laden eco-friendly advertising appeals and intention to use bio-nanomaterial plastics (henceforth IBP). The present study proposes a moderating model in which two dimensions presented in the Global Leadership and Organizational Behavior Effectiveness (henceforth GLOBE) framework interact with the individuals’ perception of eco-friendly advertising appeals (henceforth IPEA) to drive bio-nanomaterial plastics usage. The model was tested by conducting an experimental study on a sample of 364 Pakistani consumers. Findings of structural equation modeling show a significant difference in the relationship between IPEA and IBP, which is moderated by the performance orientation (henceforth PO) and institutional collectivism (henceforth IC) dimensions with diverse intensity. These findings validate the effectiveness of PO and IC (as cultural dimensions) and eco-friendly advertisements that can potentially promote the consumption of bio-nanomaterials plastic. Full article
Open AccessArticle
Preliminary Results of the Planet Nutrition Program on Obesity Parameters in Mexican Schoolchildren: Pilot Single-School Randomized Controlled Trial
Int. J. Environ. Res. Public Health 2021, 18(2), 790; https://doi.org/10.3390/ijerph18020790 (registering DOI) - 18 Jan 2021
Abstract
School-based obesity prevention programs are key to promoting healthy habits. The aim of this study was to evaluate the effect of the Planet Nutrition program on BMI z-score and other parameters compared to a control group of Mexican schoolchildren after 9 weeks of [...] Read more.
School-based obesity prevention programs are key to promoting healthy habits. The aim of this study was to evaluate the effect of the Planet Nutrition program on BMI z-score and other parameters compared to a control group of Mexican schoolchildren after 9 weeks of intervention. The effect of the summer holidays on the BMI z-score was also evaluated at 23 weeks. A pilot randomized controlled trial design was used and 41 schoolchildren were randomized (21 intervention group and 20 control). The program included 18 nutrition education sessions, 20 physical activity classes and six brochures for parents. At 9 weeks, no significant differences were found between the intervention and control groups in the change in BMI z-score (−0.11, 95% CI −0.23, 0.01). Significant differences were observed in some secondary outcomes: body fat percentage (−1.72, 95% CI −3.42, −0.02), waist circumference (−3.45, 95% CI −5.55, −1.36), physical activity (0.44, 95% CI 0.01, 0.88) and nutrition knowledge (1.15, 95% CI 0.27, 2.03). Summer holidays negatively affected the BMI z-score in both groups, reducing the difference observed between groups at 9 weeks (−0.07, 95% CI −0.22,0.07). The Planet Nutrition program showed favorable effects in some obesity and lifestyle parameters in the short term. Full article
Open AccessReview
Is Visual Pedagogy Effective in Improving Cooperation Towards Oral Hygiene and Dental Care in Children with Autism Spectrum Disorder? A Systematic Review and Meta-Analysis
Int. J. Environ. Res. Public Health 2021, 18(2), 789; https://doi.org/10.3390/ijerph18020789 (registering DOI) - 18 Jan 2021
Abstract
Visual pedagogy has emerged as a new approach in improving dental care in children with autism spectrum disorders (ASDs). This paper aimed to evaluate and assess the scientific evidence on the use of visual pedagogy in improving oral hygiene skills and cooperation during [...] Read more.
Visual pedagogy has emerged as a new approach in improving dental care in children with autism spectrum disorders (ASDs). This paper aimed to evaluate and assess the scientific evidence on the use of visual pedagogy in improving oral hygiene skills and cooperation during dental care in children with ASDs. The review protocol was registered on the PROSPERO Register (CRD42020183030). Prospective clinical studies, randomized trials, interruptive case series, before and after comparison studies, and cross-sectional studies following the PRISMA guideline were searched in PubMed, Embase, Scopus, and Google Scholar using ad hoc prepared search strings. The search identified 379 papers, of which 342 were excluded after title and abstract evaluation, and 37 full-text papers were analyzed. An additional four papers were added after consulting reference lists. Eighteen papers were disregarded; 23 were finally included, and their potential bias was assessed using ROB-2 and ROBINS-I tools. The wide heterogenicity of the studies included does not allow for conclusive evidence on the effectiveness of visual pedagogy in oral hygiene skills and dental care. Nevertheless, a significant and unilateral tendency of the overall outcomes was found, suggesting that visual pedagogy supports ASD children in improving both oral hygiene skills and cooperation during dental care. Full article
Open AccessArticle
The Relationship between City Size and Carbon Monoxide (CO) Concentration and Their Effect on Heart Rate Variability (HRV)
Int. J. Environ. Res. Public Health 2021, 18(2), 788; https://doi.org/10.3390/ijerph18020788 (registering DOI) - 18 Jan 2021
Abstract
Generally, larger cities are characterized by traffic congestion, which is associated with higher concentrations of pollution, including Carbon Monoxide (CO) pollution. However, this convention requires empirical support on the basis of accurate and reliable measurements. In addition, the assessment of the effect of [...] Read more.
Generally, larger cities are characterized by traffic congestion, which is associated with higher concentrations of pollution, including Carbon Monoxide (CO) pollution. However, this convention requires empirical support on the basis of accurate and reliable measurements. In addition, the assessment of the effect of CO on the autonomic nervous system (ANS), as measured by heart rate variability (HRV), has yielded conflicting results. A majority of the (few) studies on the topic have shown that increases in CO concentration of up to about 10 parts per million (ppm) are associated with a decrease in stress and risk to health in subjects. Beyond the hypothesis postulating city size as a determinant of increased CO concentration, the hypothesis proposing a causal link between CO concentration and HRV balance also requires empirical support. This article compares CO concentrations in a large metropolis with those in a small town, analyzing the relationship between CO and the HRV responses of young women in terms of city size. Four different types of environments were compared, taking into account mediating variables. The study participants spent 35 min in selected environments (a city center, a residential environment, a park, and a home) wearing Polar devices to measure HRV, and portable devices to measure noise thermal load and CO. The average concentrations of CO in each environment were calculated, along with the time distribution of the CO concentration, and the regression slopes between the concentrations of CO and the ANS balance, as measured by the low frequency power/high frequency power ratio (LF/HF) expressed as an HRV index. The results show that, regardless of size, the cities measured were all characterized by low levels of CO, far below the maximal accepted threshold standards, and that urban residents were exposed to these concentrations for less than half of the daytime hours. Furthermore, in contrast to the common view, larger cities do not necessarily accumulate higher concentrations of CO compared to small cities, regardless of the level of transport congestion. This study confirms the findings of the majority of the other studies on the subject, which showed a decrease in stress (as measured by HRV) as a result of an increase in CO concentrations below 7 ppm. Finally, following the assessment of the differential contribution attributed to the different environmental factors, it appears that noise, thermal load, and congestion all contribute more to a higher level of HRV balance than CO. This finding highlights the importance of a multivariable approach to the study, and a remediation of the effect of environmental factors on stress in urban environments. Full article
Open AccessArticle
Impact of Real and Simulated Flights on Psychophysiological Response of Military Pilots
Int. J. Environ. Res. Public Health 2021, 18(2), 787; https://doi.org/10.3390/ijerph18020787 (registering DOI) - 18 Jan 2021
Abstract
Objective: The present research aimed to analyse the autonomic, anxiety, perceived exertion, and self-confidence response during real and simulated flights. Methods: This cross-sectional study participated 12 experienced male pilots (age = 33.08 (5.21)) from the Spanish Air Force. Participants had to [...] Read more.
Objective: The present research aimed to analyse the autonomic, anxiety, perceived exertion, and self-confidence response during real and simulated flights. Methods: This cross-sectional study participated 12 experienced male pilots (age = 33.08 (5.21)) from the Spanish Air Force. Participants had to complete a real and a simulated flight mission randomly. The heart rate variability (HRV), anxiety, self-confidence, and rating of perceived exertion were collected before and after both manoeuvres, and HRV was also collected during both simulated and real flights. Results: When studying the acute effects of real and simulated flights, the mean heart rate, the R-to-R interval, the cognitive anxiety and the perceived exertion were significantly impacted only by real flights. Furthermore, significant differences in the mean heart rate and RR interval were found when compared to the acute effects of real and simulated flights (with higher acute effects observed in real flights). Additionally, when compared the HRV values during simulated and real flights, significant differences were observed in the RR and heart rate mean (with lower RR interval and higher heart rate mean observed during real flights). Conclusion: Real flights significantly reduced the RR interval and cognitive anxiety while increased the heart rate mean and the rating of perceived exertion, whereas simulated flights did not induce any significant change in the autonomic modulation. Full article
Open AccessReview
Postoperative Neurocognitive Disorders in Cardiac Surgery: Investigating the Role of Intraoperative Hypotension. A Systematic Review
Int. J. Environ. Res. Public Health 2021, 18(2), 786; https://doi.org/10.3390/ijerph18020786 (registering DOI) - 18 Jan 2021
Abstract
Perioperative neurocognitive disorders remain a challenging obstacle in patients after cardiac surgery, as they significantly contribute to postoperative morbidity and mortality. Identifying the modifiable risk factors and mechanisms for postoperative cognitive decline (POCD) and delirium (POD) would be an important step forward in [...] Read more.
Perioperative neurocognitive disorders remain a challenging obstacle in patients after cardiac surgery, as they significantly contribute to postoperative morbidity and mortality. Identifying the modifiable risk factors and mechanisms for postoperative cognitive decline (POCD) and delirium (POD) would be an important step forward in preventing such adverse events and thus improving patients’ outcome. Intraoperative hypotension is frequently discussed as a potential risk factor for neurocognitive decline, due to its significant impact on blood flow and tissue perfusion, however the studies exploring its association with POCD and POD are very heterogeneous and present divergent results. This review demonstrates 13 studies found after structured systematic search strategy and discusses the possible relationship between intraoperative hypotension and postoperative neuropsychiatric dysfunction. Full article
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Open AccessArticle
Relationship between Lower Urinary Tract Symptoms and Treatment-Related Behavior in an Eastern European Country: Findings from the LUTS POLAND Study
Int. J. Environ. Res. Public Health 2021, 18(2), 785; https://doi.org/10.3390/ijerph18020785 (registering DOI) - 18 Jan 2021
Abstract
The aim of this study was to investigate the effect of lower urinary tract symptoms (LUTS) on behavior related to treatment of Polish adults aged ≥ 40 years. Methods: We conducted a computer-assisted telephone survey with a study sample stratified by age, sex, [...] Read more.
The aim of this study was to investigate the effect of lower urinary tract symptoms (LUTS) on behavior related to treatment of Polish adults aged ≥ 40 years. Methods: We conducted a computer-assisted telephone survey with a study sample stratified by age, sex, and place of residence (type, size, urban versus rural) reflecting the entire Polish population. Participants rated the frequency and symptom-specific bother of individual LUTS and their effects on seeking and receiving treatment, treatment satisfaction, and treatment continuation. We adjusted multiple logistic regression models to analyze the simultaneous effects of predictor variables on each dependent variable. Results: Overall, 6005 participants completed the interview. One third (29.6–33.5%) of participants with LUTS were seeking treatment, and 24.0–26.4% received treatment. There was no difference in treatment seeking and receiving between urban and rural areas. Whereas storage and voiding symptoms were significantly related to treatment seeking by both men and women, treatment receiving correlated only with voiding symptoms in men and only with storage symptoms in women. Most respondents who received treatment were satisfied; treatment dissatisfaction was related to the presence of storage symptoms in both men and women. Only 50% of all participants continued their treatment; discontinuation of treatment was statistically more prevalent for women than for men. Conclusion: This investigation, the first population-representative study performed in Eastern Europe, revealed a low frequency of seeking treatment for LUTS. In addition, symptoms that inclined participants to seek treatment might not have been adequately addressed by the treatment they received. We also found a relatively high rate of treatment discontinuation. Clearly, there is a need for both improved patient education about LUTS treatment and a need for increased clinician awareness of the coexistence of different symptoms in men and women plus proactive evaluation by physicians for all types of LUTS and associated bother. Full article
(This article belongs to the Section Health Behavior, Chronic Disease and Health Promotion)
Open AccessFeature PaperArticle
Subjective Psychophysical Experiences in the Course of Inflammatory Bowel Disease—A Comparative Analysis Based on the Polish Pediatric Crohn’s and Colitis Cohort (POCOCO)
Int. J. Environ. Res. Public Health 2021, 18(2), 784; https://doi.org/10.3390/ijerph18020784 (registering DOI) - 18 Jan 2021
Abstract
No gold standard is available to evaluate subjective psychophysical experiences in pediatric inflammatory bowel disease (IBD). We aimed to assess pain, anxiety, and limitations in social activities at diagnosis and the worst flare of the disease in relation to clinical expression, treatment and [...] Read more.
No gold standard is available to evaluate subjective psychophysical experiences in pediatric inflammatory bowel disease (IBD). We aimed to assess pain, anxiety, and limitations in social activities at diagnosis and the worst flare of the disease in relation to clinical expression, treatment and IBD severity. A total of 376 children completed the survey (Crohn’s disease (CD) n = 196; ulcerative colitis (UC) n = 180). The questionnaire included 12 questions regarding pain, anxiety, and social activity, all assessed at recruitment and retrospectively at diagnosis and worst flare using a numeric rating scale. Patients that had ever been treated with systemic glucocorticosteroids scored higher in pain (p < 0.001), anxiety (p = 0.015), and social activity domains (p < 0.016) at worst flare, and the answers correlated with the number of steroid courses (p < 0.0392). The perception of social activity limitations also correlated independently with the number of immunosuppressants (p < 0.0433) and biological agents (p < 0.0494). There was no difference in retrospective perception of pain, anxiety and social activity limitations between CD and UC patients at diagnosis and the worst flare. The level of limitations in social activity correlated with hospitalisations due to relapse, days spent in the hospital, number of relapses, and severe relapses with the strongest association of rho = 0.39 (p = 0.0004). Subjective and retrospective perception of pain, anxiety, and limitations in social activity differs depending on therapy, correlates with treatment modalities, and severity measures such as hospitalisations. Full article
(This article belongs to the Section Children's Health)
Open AccessArticle
The Progressive Public Measures of Saudi Arabia to Tackle Covid-19 and Limit Its Spread
Int. J. Environ. Res. Public Health 2021, 18(2), 783; https://doi.org/10.3390/ijerph18020783 (registering DOI) - 18 Jan 2021
Abstract
Since the beginning of the global novel coronavirus disease (Covid-19) pandemic, the response of governments has varied significantly across the world. This was one of the main reasons behind the difference in the disease fatality rates between countries. In this study, the public [...] Read more.
Since the beginning of the global novel coronavirus disease (Covid-19) pandemic, the response of governments has varied significantly across the world. This was one of the main reasons behind the difference in the disease fatality rates between countries. In this study, the public progressive measures taken in Saudi Arabia (SA) are described in detail. This is a descriptive study in which measures were retrieved via the government official news agency—Saudi Press Agency (SPA). The total number of Covid-19 cases and its fatality rate were obtained/calculated from the Saudi Ministry of Health (MoH) official Covid-19 port, as well as the WHO COVID-19 dashboard. SA took active measures in order to interrupt the spread of Covid-19 which were strict, rapid, and progressive in nature. Social distancing was at the heart of almost every measure taken by the government. The main themes of these interventions are as follows: travel bans, suspending religious activities, closure of non-essential shops, enforcing changes at workplaces, and imposing curfews. This was followed by the gradual return to working life with various precautions to prevent a spike in the number of cases. The imposed measures in SA succeeded in reducing the burden of Covid-19 and its fatality rate. Comparatively, the fatality rate in SA was significantly lower compared to developed countries with better healthcare infrastructure such as the United States and United Kingdom. Full article
Open AccessErratum
Erratum: Rodríguez-Medellín, R., et al. Mexican Validation of the Engagement and Disaffection in Physical Education Scale. Int. J. Environ. Res. Public Health 2020, 17, 1821
Int. J. Environ. Res. Public Health 2021, 18(2), 782; https://doi.org/10.3390/ijerph18020782 (registering DOI) - 18 Jan 2021
Abstract
The authors wish to add the following correction to their paper published in International Journal of Environmental Research and Public Health [...] Full article
Open AccessArticle
Association between Childhood Maltreatment History and Premenstrual Syndrome
Int. J. Environ. Res. Public Health 2021, 18(2), 781; https://doi.org/10.3390/ijerph18020781 (registering DOI) - 18 Jan 2021
Abstract
Childhood maltreatment history has known relationships with various mental and physical diseases; however, little is known about its association with premenstrual syndrome (PMS). In this study, we investigated the association between childhood maltreatment history and PMS among young women in Japan. In a [...] Read more.
Childhood maltreatment history has known relationships with various mental and physical diseases; however, little is known about its association with premenstrual syndrome (PMS). In this study, we investigated the association between childhood maltreatment history and PMS among young women in Japan. In a Japanese city, we approached 3815 women aged 10–60 years who visited a gynecology clinic and one general practice clinic. A questionnaire on childhood maltreatment history and PMS was administered to them. We observed that women with histories of childhood maltreatment demonstrated a significantly increased risk of PMS compared with those without such histories (odds ratio: 1.47, 95% confidence interval: 1.20–1.81). Particularly, women with childhood physical or emotional abuse demonstrated a stronger association with PMS, whereas other forms of childhood maltreatment (emotional neglect, witnessing of intimate-partner violence, or sexual abuse) were not associated with PMS. Our results illustrate that childhood maltreatment may be a risk factor for PMS. Full article
Open AccessReview
Association between Fruit and Vegetable Consumption and Depression Symptoms in Young People and Adults Aged 15–45: A Systematic Review of Cohort Studies
Int. J. Environ. Res. Public Health 2021, 18(2), 780; https://doi.org/10.3390/ijerph18020780 (registering DOI) - 18 Jan 2021
Abstract
Higher consumption of fruit and vegetables has been associated with a lower risk of various chronic diseases including coronary heart disease, obesity, and certain cancers. Recently, fruit and vegetable intake has also been linked with mental health, including depression; however, this area is [...] Read more.
Higher consumption of fruit and vegetables has been associated with a lower risk of various chronic diseases including coronary heart disease, obesity, and certain cancers. Recently, fruit and vegetable intake has also been linked with mental health, including depression; however, this area is largely unexplored studies in young people and adults. This systematic review aimed to evaluate the association between fruit and vegetable intake and depressive symptoms in young people and adults aged 15–45. The review used a predefined protocol registered with International Prospective Register of Systematic Reviews (PROSPERO) database (ID no: CRD42018091642). The systematic review focused on peer-reviewed cohort studies published from 1 January 2000 to 31 August 2020 using searches of six electronic databases. The exposure was fruit and vegetable consumption analysed both separately and/or together, and the outcome was depression or depressive symptoms. Data from eligible studies were extracted according to predefined criteria and the studies were appraised using the Newcastle–Ottawa Scale (NOS) for cohort studies to evaluate for study quality and risk of bias. A total of 12 studies from seven countries were deemed eligible and included in the qualitative synthesis, one study was categorised as “very good” quality, nine studies were “good” quality, and two studies were “moderate” quality by the quality assessment based on the total score for the NOS. The majority of cohort studies support the evidence that fruit consumption is associated with decreased risk of developing depression. However, the inconsistent results were observed when the effects of vegetable consumption were analysed independently, and the effects of fruit and vegetables combined were analysed. Despite this, the evidence seems to be building that a possible association exists, and this may have implications for addressing the burden of mental illness in young people and adults aged 15–45 years. More well-designed prospective cohort studies are needed to provide more robust evidence on the relationship between fruit and vegetable intake and depression. Full article
(This article belongs to the Special Issue Adolescent Depressive Disorder)
Open AccessArticle
Efficacy of Three Commercial Disinfectants in Reducing Microbial Surfaces’ Contaminations of Pharmaceuticals Hospital Facilities
Int. J. Environ. Res. Public Health 2021, 18(2), 779; https://doi.org/10.3390/ijerph18020779 (registering DOI) - 18 Jan 2021
Abstract
To evaluate and validate the efficacy of disinfectants used in our cleaning procedure, in order to reduce pharmaceutical hospital surfaces’ contaminations, we tested the action of three commercial disinfectants on small representative samples of the surfaces present in our hospital cleanrooms. These samples [...] Read more.
To evaluate and validate the efficacy of disinfectants used in our cleaning procedure, in order to reduce pharmaceutical hospital surfaces’ contaminations, we tested the action of three commercial disinfectants on small representative samples of the surfaces present in our hospital cleanrooms. These samples (or coupons) were contaminated with selected microorganisms for the validation of the disinfectants. The coupons were sampled before and after disinfection and the microbial load was assessed to calculate the Log10 reduction index. Subsequently, we developed and validated a disinfection procedure on real surfaces inside the cleanrooms intentionally contaminated with microorganisms, using approximately 107–108 total colony forming units per coupon. Our results showed a bactericidal, fungicidal, and sporicidal efficacy coherent to the acceptance criteria suggested by United States Pharmacopeia 35 <1072>. The correct implementation of our cleaning and disinfection procedure, respecting stipulated concentrations and contact times, led to a reduction of at least 6 Log10 for all microorganisms used. The proposed disinfection procedure reduced the pharmaceutical hospital surfaces’ contaminations, limited the propagation of microorganisms in points adjacent to the disinfected area, and ensured high disinfection and safety levels for operators, patients, and treated surfaces. Full article
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Open AccessReview
Value of Immunizations during the COVID-19 Emergency
Int. J. Environ. Res. Public Health 2021, 18(2), 778; https://doi.org/10.3390/ijerph18020778 (registering DOI) - 18 Jan 2021
Abstract
Recent estimates by World Health Organization (WHO, Geneva, Switzerland) and United Nations International Children’s Emergency Fund (UNICEF) show a significant decline in vaccinal coverage rates in both pediatric and adult populations. The interruption of vaccination services is reported in at least 68 countries, [...] Read more.
Recent estimates by World Health Organization (WHO, Geneva, Switzerland) and United Nations International Children’s Emergency Fund (UNICEF) show a significant decline in vaccinal coverage rates in both pediatric and adult populations. The interruption of vaccination services is reported in at least 68 countries, with the involvement of about 80 million children worldwide. The situation is alarming if we consider that already in the period preceding the pandemic, immunization programs slowed down in various areas of the world. For these reasons, there is the risk of overloading health systems, already under pressure from the pandemic emergency, by employing human and economic resources for the management of epidemic outbreaks from vaccine-preventable diseases. The restoration and integration of vaccination services, the immunization of susceptible individuals as well as the adoption of adequate monitoring and surveillance measures are the main activities adopted by different countries to address the current global health emergency. Full article
(This article belongs to the Special Issue The COVID-19 Pandemic in Europe: Response to Challenges)
Open AccessArticle
Chronic Effects of a Training Program Using a Nasal Inspiratory Restriction Device on Elite Cyclists
Int. J. Environ. Res. Public Health 2021, 18(2), 777; https://doi.org/10.3390/ijerph18020777 (registering DOI) - 18 Jan 2021
Abstract
This study compared the response of a 9-week cycling training on ventilatory efficiency under two conditions: (i) Combined with respiratory muscle training (RMT) using a new nasal restriction device (FeelBreathe) (FB group) and (ii) without RMT (Control group). Eighteen healthy elite cyclists were [...] Read more.
This study compared the response of a 9-week cycling training on ventilatory efficiency under two conditions: (i) Combined with respiratory muscle training (RMT) using a new nasal restriction device (FeelBreathe) (FB group) and (ii) without RMT (Control group). Eighteen healthy elite cyclists were randomly separated into the FB group (n = 10) or Control group (n = 8). Gas exchange was measured breath by breath to measure ventilatory efficiency during an incremental test on a cycloergometer before (Pre) and after (Post) the nine weeks of training. The FB group showed higher peak power (Δ (95%HDI) (0.82 W/kg (0.49, 1.17)), VO2max (5.27 mL/kg/min (0.69, 10.83)) and VT1 (29.3 W (1.8, 56.7)) compared to Control at PostFINAL. The FB group showed lower values from Pre to PostPRE in minute ventilation (VE) (−21.0 L/min (−29.7, −11.5)), Breathing frequency (BF) (−5.1 breaths/min (−9.4, −0.9)), carbon dioxide output (VCO2) (−0.5 L/min (−0.7, −0.2)), respiratory equivalents for oxygen (EqO2) (−0.8 L/min (−2.4, 0.8)), heart rate (HR) (−5.9 beats/min (−9.2, −2.5)),, respiratory exchange ratio (RER) (−0.1 (−0.1, −0.0) and a higher value in inspiratory time (Tin) (0.05 s (0.00, 0.10)), expiratory time (Tex) (0.11 s (0.05, 0.17)) and end-tidal partial pressure of CO2 (PETCO2) (0.3 mmHg (0.1, 0.6)). In conclusion, RMT using FB seems to be a new and easy alternative ergogenic tool which can be used at the same time as day-to-day training for performance enhancement. Full article
(This article belongs to the Special Issue Respiratory Muscle Training for Health and Performance)
Open AccessArticle
Muscular Strength Spurts in Adolescent Male Basketball Players: The INEX Study
Int. J. Environ. Res. Public Health 2021, 18(2), 776; https://doi.org/10.3390/ijerph18020776 (registering DOI) - 18 Jan 2021
Abstract
Although successful performance in basketball requires high levels of muscular strength during adolescence, its development is confounded by the effects of normal growth. We examine the timing, intensity and sequence of muscular strength according to biological age (years from peak height velocity (PHV)) [...] Read more.
Although successful performance in basketball requires high levels of muscular strength during adolescence, its development is confounded by the effects of normal growth. We examine the timing, intensity and sequence of muscular strength according to biological age (years from peak height velocity (PHV)) and hypothesize that young basketball players attain their peak muscular strength spurts around PHV. A total of 160 adolescent male basketballers, aged 11–15 years, were followed bi-annually over 3 consecutive years. The years from attainment of PHV and peak weight velocity (PWV) were estimated and five muscular strength measures (sit-ups, handgrip, seated medicine ball throw, squat jump and countermovement jump) were aligned to years from PHV in 3-month intervals. Strength velocities were estimated using a non-smooth mathematical model. The mean ages at-PHV and at-PWV were 13.90 ± 1.40 years and 13.90 ± 1.79 years, respectively. Maximal velocity in sit-ups was attained 6 months prior to attainment of PHV (intensity = 10.69 repetitions·year−1), whereas maximal velocity in squat jump occurred 6 months after-PHV (intensity = 3.93 cm·year−1). Handgrip strength, seated medicine ball throw and countermovement jump maximal velocity peaked at-PHV (intensity = 8.47 kgf·year−1, intensity = 0.75 m·year−1, intensity = 5.59 cm·year−1, respectively). In general, maximal velocity spurts did not differ in their timing, with the velocities reaching a peak concurrent with PHV and PWV or within 6 months of its attainment. Basketball coaches, as well as strength and conditioning trainers, should consider individual differences in strength development and be aware of rapid periods of growth in stature when planning and designing muscular strength training regimes. Full article
Open AccessArticle
Association between Dyslipidemia and Mercury Exposure in Adults
Int. J. Environ. Res. Public Health 2021, 18(2), 775; https://doi.org/10.3390/ijerph18020775 (registering DOI) - 18 Jan 2021
Abstract
Background—Dyslipidemia is one of the prominent risk factors for cardiovascular disease, which is the leading cause of death worldwide. Dyslipidemia has various causes, including metabolic capacity, genetic problems, physical inactivity, and dietary habits. This study aimed to determine the association between dyslipidemia and [...] Read more.
Background—Dyslipidemia is one of the prominent risk factors for cardiovascular disease, which is the leading cause of death worldwide. Dyslipidemia has various causes, including metabolic capacity, genetic problems, physical inactivity, and dietary habits. This study aimed to determine the association between dyslipidemia and exposure to heavy metals in adults. Methods—Using data from the seventh Korean National Health and Nutrition Examination Survey (2016–2017), 5345 participants aged ≥20 years who were tested for heavy metal levels were analyzed in this study. Multiple logistic regression was conducted to assess the factors affecting the prevalence of dyslipidemia. Results—The risks of dyslipidemia among all and male participants with mercury (Hg) levels of ≥2.75 μg/L (corresponding to the Korean average level) were 1.273 and 1.699 times higher than in those with levels of <2.75 μg/L, respectively. The factors that significantly affected the dyslipidemia risk were age, household income, body mass index, and subjective health status in both males and females. Conclusions—In adult males, exposure to Hg at higher-than-average levels was positively associated with dyslipidemia. These results provide a basis for targeted prevention strategies for dyslipidemia using lifestyle guidelines for reducing Hg exposure and healthy behavioral interventions. Full article
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Open AccessArticle
Analysis of the Spread of COVID-19 in the USA with a Spatio-Temporal Multivariate Time Series Model
Int. J. Environ. Res. Public Health 2021, 18(2), 774; https://doi.org/10.3390/ijerph18020774 (registering DOI) - 18 Jan 2021
Abstract
With the rapid spread of the pandemic due to the coronavirus disease 2019 (COVID-19), the virus has already led to considerable mortality and morbidity worldwide, as well as having a severe impact on economic development. In this article, we analyze the state-level correlation [...] Read more.
With the rapid spread of the pandemic due to the coronavirus disease 2019 (COVID-19), the virus has already led to considerable mortality and morbidity worldwide, as well as having a severe impact on economic development. In this article, we analyze the state-level correlation between COVID-19 risk and weather/climate factors in the USA. For this purpose, we consider a spatio-temporal multivariate time series model under a hierarchical framework, which is especially suitable for envisioning the virus transmission tendency across a geographic area over time. Briefly, our model decomposes the COVID-19 risk into: (i) an autoregressive component that describes the within-state COVID-19 risk effect; (ii) a spatiotemporal component that describes the across-state COVID-19 risk effect; (iii) an exogenous component that includes other factors (e.g., weather/climate) that could envision future epidemic development risk; and (iv) an endemic component that captures the function of time and other predictors mainly for individual states. Our results indicate that maximum temperature, minimum temperature, humidity, the percentage of cloud coverage, and the columnar density of total atmospheric ozone have a strong association with the COVID-19 pandemic in many states. In particular, the maximum temperature, minimum temperature, and the columnar density of total atmospheric ozone demonstrate statistically significant associations with the tendency of COVID-19 spreading in almost all states. Furthermore, our results from transmission tendency analysis suggest that the community-level transmission has been relatively mitigated in the USA, and the daily confirmed cases within a state are predominated by the earlier daily confirmed cases within that state compared to other factors, which implies that states such as Texas, California, and Florida with a large number of confirmed cases still need strategies like stay-at-home orders to prevent another outbreak. Full article
(This article belongs to the Section Public Health Statistics and Risk Assessment)
Open AccessArticle
Community-Based Interventions to Reduce Child Stunting in Rural Guatemala: A Quality Improvement Model
Int. J. Environ. Res. Public Health 2021, 18(2), 773; https://doi.org/10.3390/ijerph18020773 (registering DOI) - 18 Jan 2021
Abstract
Rural Guatemala has one of the highest rates of chronic child malnutrition (stunting) in the world, with little progress despite considerable efforts to scale up evidence-based nutrition interventions. Recent literature suggests that one factor limiting impact is inadequate supervisory support for frontline workers. [...] Read more.
Rural Guatemala has one of the highest rates of chronic child malnutrition (stunting) in the world, with little progress despite considerable efforts to scale up evidence-based nutrition interventions. Recent literature suggests that one factor limiting impact is inadequate supervisory support for frontline workers. Here we describe a community-based quality improvement intervention in a region with a high rate of stunting. The intervention provided audit and feedback support to frontline nutrition workers through electronic worklists, performance dashboards, and one-on-one feedback sessions. We visualized performance indicators and child nutrition outcomes during the improvement intervention using run charts and control charts. In this small community-based sample (125 households at program initiation), over the two-year improvement period, there were marked improvements in the delivery of program components, such as growth monitoring services and micronutrient supplements. The prevalence of child stunting fell from 42.4 to 30.6%, meeting criteria for special cause variation. The mean length/height-for-age Z-score rose from −1.77 to −1.47, also meeting criteria for special cause variation. In conclusion, the addition of structured performance visualization and audit and feedback components to an existing community-based nutrition program improved child health indicators significantly through improving the fidelity of an existing evidence-based nutrition package. Full article
(This article belongs to the Special Issue Improving the Health of Rural, Minority Populations)
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Open AccessArticle
The Activation of Gluteal, Thigh, and Lower Back Muscles in Different Squat Variations Performed by Competitive Bodybuilders: Implications for Resistance Training
Int. J. Environ. Res. Public Health 2021, 18(2), 772; https://doi.org/10.3390/ijerph18020772 (registering DOI) - 18 Jan 2021
Abstract
The present study investigated the activation of gluteal, thigh, and lower back muscles in different squat variations. Ten male competitive bodybuilders perform back-squat at full (full-BS) or parallel (parallel-BS) depth, using large feet-stance (sumo-BS), and enhancing the feet external rotation (external-rotated-sumo-BS) and front-squat [...] Read more.
The present study investigated the activation of gluteal, thigh, and lower back muscles in different squat variations. Ten male competitive bodybuilders perform back-squat at full (full-BS) or parallel (parallel-BS) depth, using large feet-stance (sumo-BS), and enhancing the feet external rotation (external-rotated-sumo-BS) and front-squat (FS) at 80% 1-RM. The normalized surface electromyographic root-mean-square (sEMG RMS) amplitude of gluteus maximus, gluteus medius, rectus femoris, vastus lateralis, vastus medialis, adductor longus, longissimus, and iliocostalis was recorded during both the ascending and descending phase of each exercise. During the descending phase, greater sEMG RMS amplitude of gluteus maximus and gluteus medius was found in FS vs. all other exercises (p < 0.05). Additionally, FS elicited iliocostalis more than all other exercises. During the ascending phase, both sumo-BS and external-rotated-sumo-BS showed greater vastus lateralis and adductor longus activation compared to all other exercises (p < 0.05). Moreover, rectus femoris activation was greater in FS compared to full-BS (p < 0.05). No between-exercise difference was found in vastus medialis and longissimus showed no between-exercise difference. FS needs more backward stabilization during the descending phase. Larger feet-stance increases thigh muscles activity, possibly because of their longer length. These findings show how bodybuilders uniquely recruit muscles when performing different squat variations. Full article
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Open AccessArticle
COVID-19 Stress and Mental Health of Students in Locked-Down Colleges
Int. J. Environ. Res. Public Health 2021, 18(2), 771; https://doi.org/10.3390/ijerph18020771 (registering DOI) - 18 Jan 2021
Abstract
The impact of the COVID-19 pandemic on the mental health of students in locked-down colleges remains obscure. This study aimed to explore influencing factors for the psychological impact of COVID-19 on Wuhan college students, post-traumatic stress symptoms in particular, so as to inform [...] Read more.
The impact of the COVID-19 pandemic on the mental health of students in locked-down colleges remains obscure. This study aimed to explore influencing factors for the psychological impact of COVID-19 on Wuhan college students, post-traumatic stress symptoms in particular, so as to inform evidence-based strategy development to ameliorate such adverse impacts. An online survey was conducted from 26 to 29 April 2020, and 4355 students enrolled in Wuhan universities and colleges participated. Post-Traumatic Stress Disorder via the Impact of Event-Scale-Revised was assessed. COVID-19 disproportionately affected older male Master’s and doctoral students living in Wuhan. The overall prevalence of PTSD was 16.3%. The three-level socio-interpersonal model of PTSD was empirically validated, and college students faced individual level risks such as infection with COVID-19, close relationship level risks such as family support (infection suspicion of family members, the loss of loved ones, and the family income decrease) and online course difficulties (little interaction, disturbing learning environment, and difficulty in adaption), and distant level risks such as excessive collection of personal information, estrangement of family relatives, and harassment and insult from strangers. The findings suggest the severity of the psychological impact of COVID-19. Mental health services reducing PTSD should be provided. Students who have lost loved ones and suffered family financial loss should be given particular care. Full article
(This article belongs to the Special Issue Challenges in Physical Activity Domain and Psychological Health)
Open AccessArticle
Associations between Pharmacotherapy for Cardiovascular Diseases and Periodontitis
Int. J. Environ. Res. Public Health 2021, 18(2), 770; https://doi.org/10.3390/ijerph18020770 (registering DOI) - 18 Jan 2021
Abstract
The goal of the study was to assess the relationship between cardioprotective medications, i.e., beta-blockers, angiotensin-converting enzyme inhibitors (ACEIs), calcium channel blockers (CCBs), angiotensin II receptor blockers (ARBs), statins, acetylsalicylic acid (ASA), and periodontitis (PD). Background: Xerostomia increases the risk of PD and [...] Read more.
The goal of the study was to assess the relationship between cardioprotective medications, i.e., beta-blockers, angiotensin-converting enzyme inhibitors (ACEIs), calcium channel blockers (CCBs), angiotensin II receptor blockers (ARBs), statins, acetylsalicylic acid (ASA), and periodontitis (PD). Background: Xerostomia increases the risk of PD and is a side effect of some pharmacotherapies. Information about the effect of cardioprotective treatment of periodontal status is scarce. Methods: We studied 562 dentate residents of Krakow at the age of 50 to 70 years. Information about treatment was collected using a standardized questionnaire. The pocket depth and clinical attachment level (CAL) were used to ascertain PD. Multivariate logistic regression was applied to assess the relation between cardioprotective medications and PD. Results: PD was found in 74% of participants. The range of cardioprotective drug use among participants was 7% (ARBs) to 32% (beta-blockers). After adjusting for age, sex, number of teeth, smoking, and education, ASA’s use was related to a lower prevalence of PD in all dentate participants (odds ratio (OR) = 0.63, 95% confidence interval (CI): 0.40–0.99). The use of ARBs and statins was found to be associated with a higher prevalence of PD in persons having ≥6 teeth (odds ratio (OR) = 3.57, 95% CI: 1.06–11.99 and OR = 1.81, 95% CI: 1.03–3.16, respectively). Further adjustment for CVD risk factors, history of coronary heart disease, and other chronic diseases did not attenuate the results. There was no significant relation between PD and the use of other cardioprotective drugs. Full article
(This article belongs to the Special Issue Oral and Dental Health)
Open AccessArticle
Stress/Immune Biomarkers in Saliva among Children with ADHD Status
Int. J. Environ. Res. Public Health 2021, 18(2), 769; https://doi.org/10.3390/ijerph18020769 (registering DOI) - 18 Jan 2021
Abstract
Background. This cross-sectional study aimed to evaluate stress and immune biomarkers in saliva samples of attention-deficit/hyperactivity disorder ADHD compared to healthy non-ADHD children. Material and methods. A total of 132 children under 11 years old (8.5 ± 1.1) enrolled in a [...] Read more.
Background. This cross-sectional study aimed to evaluate stress and immune biomarkers in saliva samples of attention-deficit/hyperactivity disorder ADHD compared to healthy non-ADHD children. Material and methods. A total of 132 children under 11 years old (8.5 ± 1.1) enrolled in a cross-sectional study: with confirmed ADHD (n = 60) and healthy controls (n = 72). The clinical evaluation included physical measurements (height, waist, hip circumference, body weight, body mass index BMI, BMI z-score) and unstimulated saliva collection and measurements of free cortisol, salivary alpha-amylase (sAA), and secreted immunoglobulins (sIgA, IgG, and IgM) with quantitative assay (ELISA) analysis. Unpaired t-test, Welch test, or Mann–Whitney U test were applied for group comparisons when appropriate, and the correlation between variables was analyzed with Spearman’s rank coefficient. Results were considered significant at p < 0.05. Results. In the ADHD group, body weight (p ≤ 0.01), BMI (p ≤ 0.009), and hip circumference (p ≤ 0.001) significantly differed, while waist size and BMI z-score did not (p > 0.05). Significant elevation of the salivary sAA (p = 0.03), sIgA (p = 0.02), and IgM (p ≤ 0.001) biomarkers were detected, without differences in the morning cortisol (p > 0.05). Significant correlations between cortisol and BMI, hip size, and IgA, as well as between IgG and sAA and IgA were obtained. Conclusions. Saliva can be used to monitor ADHD status with regard to biomarkers indicating the hypothalamus–pituitary–adrenal axis, as HPA axis, and sympathetic activity. The results indicate that morning collection of saliva in contrast to unchanged salivary cortisol, may evaluate mentioned above system dysregulations by measurements of sAA and immunoglobulins among ADHD children. Full article
(This article belongs to the Special Issue Diagnosis and Treatment of ADHD in Adolescents)
Open AccessArticle
Microplastic Contamination in Snow from Western Italian Alps
Int. J. Environ. Res. Public Health 2021, 18(2), 768; https://doi.org/10.3390/ijerph18020768 (registering DOI) - 18 Jan 2021
Abstract
Recent studies have documented the presence of microplastics (MPs) in remote areas, including soils or sediments collected in mountain and glacier environments, but information on their presence in snow is scant. The present study aimed at exploring the presence of MPs in residual [...] Read more.
Recent studies have documented the presence of microplastics (MPs) in remote areas, including soils or sediments collected in mountain and glacier environments, but information on their presence in snow is scant. The present study aimed at exploring the presence of MPs in residual snow collected in four locations of the Aosta Valley (Western Italian Alps), with different accessibility and human presence. Overall, the µ-FTIR analyses confirmed the presence of 18 MPs in snow, 7 (39%) items were fibres, while 11 (61%) were fragments. Polyethylene (PE; 7 MPs) was the main polymer, followed by polyethylene terephthalate (PET; 3 MPs), high density PE (HDPE; 3 MPs), polyester (2 MPs), while only 1 MP made by low density PE, polypropylene and polyurethane were found. The mean (± SE) concentration of MPs in snow ranged between 0.39 ± 0.39 MPs/L and 4.91 ± 2.48 MPs/L, with a mean of 2.32 ± 0.96 MPs/L for the sampling locations. The concentration of MPs did not statistically differ among locations. Our results suggest that MPs presence in high-mountain ecosystems might depend on deposition through atmospheric precipitations or local sources due to human activities. For these reasons, policies aiming at reducing plastic use and dispersal in mountain areas may be effective in preventing local MP contamination. Full article
(This article belongs to the Special Issue Microplastics in Terrestrial Ecosystems)
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Open AccessArticle
An Investigation of the Wild Rat Crown Incisor as an Indicator of Lead (Pb) Exposure Using Inductively Couple Plasma Mass Spectrometry (ICP-MS) and Laser Ablation ICP-MS
Int. J. Environ. Res. Public Health 2021, 18(2), 767; https://doi.org/10.3390/ijerph18020767 (registering DOI) - 18 Jan 2021
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Abstract
Lead (Pb) is a metal toxicant of great public health concern. The present study investigated the applicability of the rat incisor in Pb exposure screening. The levels of lead in teeth (Pb-T) in the crown and root of incisors in laboratory Pb-exposed Sprague [...] Read more.
Lead (Pb) is a metal toxicant of great public health concern. The present study investigated the applicability of the rat incisor in Pb exposure screening. The levels of lead in teeth (Pb-T) in the crown and root of incisors in laboratory Pb-exposed Sprague Dawley rats were quantified using inductively coupled plasma mass spectrometry (ICP-MS). The crown accumulated much Pb-T than the root of the Sprague Dawley rat incisor. The levels of lead in blood (Pb-B) were positively correlated with the Pb-T in the crown and root incisors of the Sprague Dawley rats. As an application of the Pb-T crown results in experimental rats, we subsequently analyzed the Pb-T in the crown incisors of Pb-exposed wild rats (Rattus rattus) sampled from residential sites within varying distances from an abandoned lead–zinc mine. The Pb-T accumulation in the crown of incisors of R. rattus rats decreased with increased distance away from the Pb–Zn mine. Furthermore, the Pb-T was strongly correlated (r = 0.85) with the Pb levels in the blood. Laser ablation ICP-MS Pb-T mappings revealed a homogenous distribution of Pb in the incisor with an increased intensity of Pb-T localized in the tip of the incisor crown bearing an enamel surface in both Sprague Dawley and R. rattus rats. These findings suggest that Pb-T in the crown incisor may be reflective of the rat’s environmental habitat, thus a possible indicator of Pb exposure. Full article
(This article belongs to the Section Environmental Health)
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Open AccessReview
Systematic Review of Self-Assessment in Physical Education
Int. J. Environ. Res. Public Health 2021, 18(2), 766; https://doi.org/10.3390/ijerph18020766 (registering DOI) - 18 Jan 2021
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Abstract
Self-assessment is among the most impactful processes in student learning. Since no review of this process was found in the field of physical education (PE), the objective of this work was to perform a systematic review of the literature published over the last [...] Read more.
Self-assessment is among the most impactful processes in student learning. Since no review of this process was found in the field of physical education (PE), the objective of this work was to perform a systematic review of the literature published over the last five years on the self-assessment of PE students in formal education contexts. The review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) standards. Inclusion and exclusion criteria were established to select the articles. A total of three researchers independently applied the above criteria and obtained a total of thirteen studies. After synthesising the results by category, we found that: a majority of the studies were conducted in Europe; all 13 studies covered the educational stages of either secondary or higher education; an even number of qualitative and quantitative approaches were distributed among the studies; some studies focused on specific sports or contents, while others were applicable to any subject; and, finally, depending on the research design adopted, the results described self-assessment strategy processes, improvements in learning, drew descriptive portraits of students regarding health, or reflected students’ positive perceptions of self-assessment. It is necessary to conduct further studies on PE students’ self-assessment, especially in primary education. Full article
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Open AccessArticle
The Reliability of Pelvic Floor Muscle Bioelectrical Activity (sEMG) Assessment Using a Multi-Activity Measurement Protocol in Young Women
Int. J. Environ. Res. Public Health 2021, 18(2), 765; https://doi.org/10.3390/ijerph18020765 (registering DOI) - 18 Jan 2021
Viewed by 66
Abstract
The aim of the study was to determine the between-trial and between-day reliability of the Glazer protocol and our multi-activity surface electromyography (sEMG) measurement protocol for pelvic floor muscle (PFM) evaluation. The bioelectrical activity of PFM was collected using an endovaginal electrode in [...] Read more.
The aim of the study was to determine the between-trial and between-day reliability of the Glazer protocol and our multi-activity surface electromyography (sEMG) measurement protocol for pelvic floor muscle (PFM) evaluation. The bioelectrical activity of PFM was collected using an endovaginal electrode in 30 young, Caucasian, nulliparous women (age 22–27, 168.6 ± 5.1 cm, 57.1 ± 11.8 kg). The between-trial and between-day reliability of the original Glazer protocol and the new multi-activity sEMG protocol were assessed during the following phases: pre-baseline rest, phasic (flick) contractions, tonic contractions, endurance contraction, and post-baseline rest. The Glazer protocol was characterized by poor and moderate measurement reliability. The time-domain parameters for the rise and fall of the signal amplitude and median frequency showed poor between-trial and between-day reliability. The mean and peak amplitudes indicated mainly good between-trial and moderate between-days reliability. Our protocol showed moderate to excellent reliability of both time-domain and quantitative parameters of muscle recruitment. In our protocol, the frequency-domain parameters describing muscle fatigue demonstrated much higher reliability than in the case of the Glazer protocol. The most important information obtained in this study was the significant improvement of diagnostic validity in PFM bioelectrical activity evaluation. The higher reliability of our sEMG protocol compared to original Glazer protocol allowed us to suggest that protocol modifications and changes in sEMG signal processing methods were effective in the improvement of PFM assessment quality. The new parameters calculated from the sEMG signal proposed in our sEMG protocol allowed us to obtain additional clinically important information about PFM dysfunctions regarding specific deficits of muscle contraction such as decrease in muscle strength; endurance or coordination related to, e.g., stress urinary incontinence; or pelvic floor muscle imbalance after childbirth. Full article
Open AccessArticle
Examining the Suitability of the List of Indicators Describing Age-Related Typical Support Needs
Int. J. Environ. Res. Public Health 2021, 18(2), 764; https://doi.org/10.3390/ijerph18020764 (registering DOI) - 18 Jan 2021
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Abstract
The list of indicators is a form of training material used for the Supports Intensity Scale—Children’s version (SIS-C). It is aimed at helping interviewers distinguishing between extraordinary and age-related typical support needs in children with intellectual and developmental disabilities (IDD) when implementing the [...] Read more.
The list of indicators is a form of training material used for the Supports Intensity Scale—Children’s version (SIS-C). It is aimed at helping interviewers distinguishing between extraordinary and age-related typical support needs in children with intellectual and developmental disabilities (IDD) when implementing the SIS-C, and thus improve supports planning. The aim of this study is to adapt and test the list of indicators’ content validity and rating scale’s functioning in Spain. A total of 222 general education teachers reported their agreement with each indicator description using a 5-point rating scale. A total of 353 of 366 indicators showed evidence of content validity, whereas analyses on the rating scale highlighted the necessity of subsuming one of the scale categories within another. The need for developing research-based training materials to develop training programs on the use of the SIS-C to support decision-making concerning supports planning with students with IDD, the relevance of using the latest methodological approaches available when required, and future lines of research are discussed. Full article
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Open AccessArticle
How Loan Bank of Assistive Technology Impacts on Life of Persons with Amyotrophic Lateral Sclerosis and Neuromuscular Diseases: A Collaborative Initiative
Int. J. Environ. Res. Public Health 2021, 18(2), 763; https://doi.org/10.3390/ijerph18020763 - 18 Jan 2021
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Abstract
(1) Background: The study is focused on the implementation of outcome measurement tools to assess the impact of an assistive device from a loan bank in the lives of people with Amyotrophic Lateral Sclerosis and Neuromuscular Diseases. The secondary purpose is to analyse [...] Read more.
(1) Background: The study is focused on the implementation of outcome measurement tools to assess the impact of an assistive device from a loan bank in the lives of people with Amyotrophic Lateral Sclerosis and Neuromuscular Diseases. The secondary purpose is to analyse the correct matching between the person and technology, derived from the counselling of an occupational therapist. (2) Methods: Cross-sectional study. The sample was formed by 28 people with rare neurodegenerative disorders. A specific questionnaire, the Psychosocial Impact of Assistive Device Scale (PIADS), and the Matching Person and Technology (MPT) tool were applied to collect the data. (3) Results: The dimension of the PIADS with the best score was competence, and the variations according to gender were not remarkable. The three dimensions of the PIADS (competence, adaptability, and self-esteem) were correlated positively between them and with the mean score of the MPT tool (p < 0.01). The type of assistive technology (AT), diagnosis, and correct match between person–technology are the main factors that condition a positive impact. (4) Conclusions: The results noted the importance of assessing the needs, demands, and contexts of people with rare neurodegenerative diseases to prescribe the best AT. Loan banks of AT have to be considered a valid service that complements their lack in public health services. Full article
(This article belongs to the Special Issue Assistive Technologies for Children, Young People and Adults)
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