11 pages, 359 KiB  
Article
Obstetrical Soft Tissue Trauma during Spontaneous Vaginal Birth in the Romanian Adolescent Population—Multicentric Comparative Study with Adult Population
by Alexandra Matei 1,*, Elena Poenaru 2,*, Mihai Cornel Traian Dimitriu 3, Cristina Zaharia 3, Crîngu Antoniu Ionescu 1, Dan Navolan 4 and Cristian George Furău 5
1 Department of Obstetrics and Gynecology, “Carol Davila” University of Medicine and Pharmacy Doctoral School, 020021 Bucharest, Romania
2 Department of Biostatistics, “Carol Davila” University of Medicine and Pharmacy, 050474 Bucharest, Romania
3 Department of Obstetrics and Gynecology, “Sf. Pantelimon” Emergency Clinical Hospital, 021659 Bucharest, Romania
4 Department of Obstetrics and Gynecology, Victor Babes University of Medicine and Pharmacy, 300041 Timisoara, Romania
5 Department of Obstetrics and Gynecology, Emergency County Hospital, 310037 Arad, Romania
Int. J. Environ. Res. Public Health 2021, 18(21), 11491; https://doi.org/10.3390/ijerph182111491 - 31 Oct 2021
Cited by 4 | Viewed by 2496
Abstract
Romania is a country with high rates of adolescent births, associating scarce comprehensive obstetrical management with this specific population. This research aims to assess soft tissue trauma after vaginal birth in teenage mothers compared to their adult counterparts. A retrospective case-control study was [...] Read more.
Romania is a country with high rates of adolescent births, associating scarce comprehensive obstetrical management with this specific population. This research aims to assess soft tissue trauma after vaginal birth in teenage mothers compared to their adult counterparts. A retrospective case-control study was conducted for one year in two hospitals. All vaginal deliveries were considered; the age cut-off value was considered at 20 years old for case and control groups. Lacerations were divided into three subgroups, considering the involved anatomical region; group I: labial and periurethral lacerations, group II: vaginal and perineal lacerations, and group III: cervical lacerations. There were 1498 women included in the study: 298 young mothers and 1200 adults. Teenagers were more likely to have an episiotomy during vaginal delivery compared to adult women: 56% versus 26.7% (p = 0.00, Pearson Chi-square) and a 1.89 times increased risk for developing additional group II lacerations: p = 0.01, Pearson Chi-square test with Bonferroni correction: OR = 1.89, 95% CI: 1.18–3.02. Group II lacerations were the most frequent type of birth trauma in both study groups. Fetal weight ≥4000 g was associated with a two times higher risk for vaginal and perineal lacerations when age criterion was not considered (OR = 1.98, 95% CI: 1.13–3.47, p = 0.01). The incidence of group I and II lacerations increased with age: from 0% and 9.1% between 10 and 14 years old to 6% and 26.2% between 18 and 19 years old. All groups of lacerations were more often identified in the case group, compared to the adult group. Fetal macrosomia and spontaneously ruptured membranes at admission could not be documented as risk factors for obstetrical injury in young mothers. Episiotomy performed in teenagers was not a protective procedure for group II lacerations. Full article
(This article belongs to the Special Issue Maternal and Children Health and Family Planning)
16 pages, 2530 KiB  
Article
Fluoride Exposure through Different Drinking Water Sources in a Contaminated Basin in Guanajuato, Mexico: A Deterministic Human Health Risk Assessment
by Paulina Farías 1,*, Jesús Alejandro Estevez-García 1, Erika Noelia Onofre-Pardo 1, María Luisa Pérez-Humara 1, Elodia Rojas-Lima 1, Urinda Álamo-Hernández 1 and Diana Olivia Rocha-Amador 2
1 Instituto Nacional de Salud Pública, Universidad No. 655, Colonia Santa María Ahuacatitlán, Cuernavaca 62100, Mexico
2 Departamento de Farmacia, División de Ciencias Naturales y Exactas, Universidad de Guanajuato, Guanajuato 36050, Mexico
Int. J. Environ. Res. Public Health 2021, 18(21), 11490; https://doi.org/10.3390/ijerph182111490 - 31 Oct 2021
Cited by 18 | Viewed by 4679
Abstract
Water fluoride levels above the World Health Organization’s guideline (1.5 mg/L), common in overexploited aquifers, represent a health hazard. Our objective was to assess the health risks posed by exposure to fluoride in different drinking water sources in a contaminated basin in Mexico. [...] Read more.
Water fluoride levels above the World Health Organization’s guideline (1.5 mg/L), common in overexploited aquifers, represent a health hazard. Our objective was to assess the health risks posed by exposure to fluoride in different drinking water sources in a contaminated basin in Mexico. Fluoride was measured in mutual drinking water sources and in the urine of 39 children and women. Risks were estimated through hazard quotient (HQ) by drinking water source. Dental fluorosis was assessed in the children. Mean fluoride water concentrations (mg/L) were: well, 4.2; waterhole, 2.7; bottled, 2.1; rainwater, 0.4. The mean urinary fluoride concentrations (specific gravity adjusted) were 2.1 mg/L and 3.2 mg/L in children and women, respectively. Our multiple linear regression model showed children’s urinary fluoride concentrations increased 0.96 mg/L for every 1 mg/L increase in water fluoride (p < 0.001). Dental fluorosis was diagnosed in 82% of the children, and their HQ according to drinking water source was: well, 1.5; waterhole, 1.1; bottled, 0.8; harvested rainwater, 0.3. The pervasive dental fluorosis indicates a toxic past fluoride exposure; urinary fluoride levels and HQs indicate high exposure and current health risks for most children. Drinking harvested rainwater will likely prevent most of the local fluoride exposure. Full article
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14 pages, 350 KiB  
Article
Prevalence and Risk Factors of Occupational Health Hazards among Health Care Workers of Northern Saudi Arabia: A Multicenter Study
by Ashokkumar Thirunavukkarasu 1,*, Khaloud Amash Hossin Alrawaili 2, Ahmad Homoud Al-Hazmi 1, Umar Farooq Dar 1, Bashayer ALruwaili 1, Ayesha Mallick 1, Farooq Ahmed Wani 3 and Amnah Ibrahim E Alsirhani 4
1 Department of Community and Family Medicine, College of Medicine, Jouf University, Sakaka 72388, Saudi Arabia
2 Department of Public Health, Tarif Al-Salhiya Health Center, Ministry of Health, Turaif 3753, Saudi Arabia
3 Department of Pathology, College of Medicine, Jouf University, Sakaka 72388, Saudi Arabia
4 Department of Family medicine, Ministry of Health, Tabuk Region, Tabuk City 47512, Saudi Arabia
Int. J. Environ. Res. Public Health 2021, 18(21), 11489; https://doi.org/10.3390/ijerph182111489 - 31 Oct 2021
Cited by 9 | Viewed by 6364
Abstract
Health care workers (HCWs) working in different health care facilities are exposed to many hazards, especially during the COVID-19 pandemic. This questionnaire-based cross-sectional study aimed to assess the prevalence, pattern, and risk factors of occupational health hazards faced by 438 randomly selected HCWs [...] Read more.
Health care workers (HCWs) working in different health care facilities are exposed to many hazards, especially during the COVID-19 pandemic. This questionnaire-based cross-sectional study aimed to assess the prevalence, pattern, and risk factors of occupational health hazards faced by 438 randomly selected HCWs from northern Saudi Arabia. The HCWs are commonly exposed to needle stick injuries (34.5%) under the biological hazards category; and work-related stress (69.6%) under the non-biological hazards categories. The significant associated factors were work setting (ref: Primary Health Center: Adjusted OR (AOR) = 2.81, 95%CI = 1.21–4.59, p = 0.017), smoking status (ref.: non-smoker: AOR = 1.73, 95%CI = 1.03–2.91, p = 0.039), and mean sleeping duration per day (AOR = 1.22, 95%CI = 1.04–1.43, p = 0.014) for biological, and smoking status (ref: non-smoker: AOR = 2.16, 95%CI = 1.09–3.29, p = 0.028), and mean sleeping duration per day (AOR = 1.35, 95%CI = 1.07–1.70, p = 0.013) for non-biological categories. This study revealed several risk factors and occupational health hazards that HCWs are exposed to during their work time. Periodic training and follow-up assessments regarding bio-safety measures for the HCWs should be implemented. Finally, future explorative studies are warranted on the feasibility of implementing rotation-based postings for the HCWs in different health care settings. Full article
(This article belongs to the Special Issue Technical and Scientific Research on Occupational Health and Safety)
10 pages, 312 KiB  
Article
Influencing Factors of Subjective Cognitive Impairment in Middle-Aged and Older Adults
by Min Roh, Hyunju Dan and Oksoo Kim *
College of Nursing, Ewha Womans University, Seoul 03760, Korea
Int. J. Environ. Res. Public Health 2021, 18(21), 11488; https://doi.org/10.3390/ijerph182111488 - 31 Oct 2021
Cited by 32 | Viewed by 3455
Abstract
The purpose of this study was to identify the factors affecting subjective cognitive impairment. We analyzed data from the 2019 Korea Community Health Survey and enrolled 68,546 middle-aged adults, aged 50 to 64 years, and 74,547 older adults, aged 65 years and older, [...] Read more.
The purpose of this study was to identify the factors affecting subjective cognitive impairment. We analyzed data from the 2019 Korea Community Health Survey and enrolled 68,546 middle-aged adults, aged 50 to 64 years, and 74,547 older adults, aged 65 years and older, in this study. Multiple logistic regression analysis was performed to identify factors influencing subjective cognitive impairment. Of the participants, 11,926 (17.4%) middle-aged and 21,880 (29.4%) older adults living in the community reported subjective cognitive impairment. Major factors that influenced subjective cognitive impairment in both middle-aged and older adults were gender, subjective stress, depressive symptoms, and alcohol drinking. In contrast to middle-aged adults, the marital status of older adults affected subjective cognitive impairment. Therefore, the factors affecting subjective cognitive impairment in middle-aged and older adults need to be considered for screening and management to prevent cognitive impairment and dementia. In particular, it is necessary to evaluate and manage stress and depressive symptoms from middle age to prevent subjective cognitive impairment. Full article
15 pages, 2441 KiB  
Article
Ecological Health Assessment of Chinese National Parks Based on Landscape Pattern: A Case Study in Shennongjia National Park
by Hang Shu 1,2, Chunwang Xiao 1,2, Ting Ma 1,3,4 and Weiguo Sang 1,2,*
1 Key Laboratory of Ecology and Environment in Minority Areas (Minzu University of China), National Ethnic Affairs Commission of China, Beijing 100081, China
2 College of Life and Environment Science, Minzu University of China, Beijing 100081, China
3 Key Laboratory of Regional Sustainable Development Modeling, Chinese Academy of Sciences, Beijing 100101, China
4 Institute of Geographic Sciences and Natural Resources Research, Chinese Academy of Sciences, Beijing 100101, China
Int. J. Environ. Res. Public Health 2021, 18(21), 11487; https://doi.org/10.3390/ijerph182111487 - 31 Oct 2021
Cited by 36 | Viewed by 4039
Abstract
Assessing the health of the ecosystem based on the landscape pattern of national parks can facilitate policy makers in formulating more targeted conservation policies to better manage national park ecosystems. To analyze the landscape patterns and characteristics of the national park, the ecosystem [...] Read more.
Assessing the health of the ecosystem based on the landscape pattern of national parks can facilitate policy makers in formulating more targeted conservation policies to better manage national park ecosystems. To analyze the landscape patterns and characteristics of the national park, the ecosystem health evaluation index system of the national park was constructed using the vigor-organization-resilience (VOR) model to evaluate the health status. In this study, the Shennongjia National Park in China was selected as a case study area to be assessed using the index system. The results revealed that the patches of construction land and farmland are the largest in number and the most complex in shape, reflecting the obvious fragmentation of construction land and farmland patches. All patch types in this national park were evenly distributed. The results of the analysis showed that the comprehensive index of national park heath, according to the VOR model, is 0.74, indicating that the ecosystems in this study area were in a good state of health. Ecosystems in strictly protected areas of this park had the highest ecosystem health index levels, while the traditional utilization areas had the lowest. Ecosystem health levels were characterized by significant spatial agglomeration characteristics, with high-high aggregation distribution areas, mainly clustered in strictly protected areas, and low-low aggregation distribution, mainly clustered in traditional utilization areas and marginal areas. This study provided a set of ecosystem health assessment systems and their practical use in China’s newly established national parks. Full article
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13 pages, 498 KiB  
Article
Identification of a High-Risk Group of New-Onset Cardiovascular Disease in Occupational Drivers by Analyzing Heart Rate Variability
by Ying-Chuan Wang 1,2, Chung-Ching Wang 1,2, Ya-Hsin Yao 3 and Wei-Te Wu 4,5,6,*
1 Division of Family Medicine, Department of Family and Community Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei 114, Taiwan
2 Division of Occupational Medicine, Department of Family and Community Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei 114, Taiwan
3 School of Medicine, National Defense Medical Center, Taipei 114, Taiwan
4 National Institute of Environmental Health Sciences, National Health Research Institutes, Miaoli 350, Taiwan
5 Institute of Environmental and Occupational Health Sciences, National Yang Ming Chiao Tung University, Taipei 112, Taiwan
6 Department of Healthcare Administration, Asia University, Taichung 413, Taiwan
Int. J. Environ. Res. Public Health 2021, 18(21), 11486; https://doi.org/10.3390/ijerph182111486 - 31 Oct 2021
Cited by 7 | Viewed by 2581
Abstract
Purpose: This cohort study evaluated the effectiveness of noninvasive heart rate variability (HRV) analysis to assess the risk of cardiovascular disease over a period of 8 years. Methods: Personal and working characteristics were collected before biochemistry examinations and 5 min HRV tests from [...] Read more.
Purpose: This cohort study evaluated the effectiveness of noninvasive heart rate variability (HRV) analysis to assess the risk of cardiovascular disease over a period of 8 years. Methods: Personal and working characteristics were collected before biochemistry examinations and 5 min HRV tests from the Taiwan Bus Driver Cohort Study (TBDCS) in 2005. This study eventually identified 161 drivers with cardiovascular disease (CVD) and 627 without between 2005 and 2012. Estimation of the hazard ratio was analyzed by using the Cox proportional-hazards model. Results: Subjects with CVD had an overall lower standard deviation of NN intervals (SDNN) than their counterparts did. The SDNN index had a strong association with CVD, even after adjusting for risk factors. Using a median split for SDNN, the hazard ratio of CVD was 1.83 (95% CI = 1.10–3.04) in Model 1 and 1.87 (95% CI = 1.11–3.13) in Model 2. Furthermore, the low-frequency (LF) index was associated with a risk of CVD in the continuous approach. For hypertensive disease, the SDNN index was associated with increased risks in both the continuous and dichotomized approaches. When the root-mean-square of the successive differences (RMSSDs), high frequency (HF), and LF were continuous variables, significant associations with hypertensive disease were observed. Conclusions: This cohort study suggests that SDNN and LF levels are useful for predicting 8 year CVD risk, especially for hypertensive disease. Further research is required to determine preventive measures for modifying HRV dysfunction, as well as to investigate whether these interventions could decrease CVD risk among professional drivers. Full article
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20 pages, 362 KiB  
Article
Australia’s Disability Employment Services Program: Participant Perspectives on Factors Influencing Access to Work
by Alexandra Devine 1,*,†, Marissa Shields 1,†, Stefanie Dimov 1, Helen Dickinson 2, Cathy Vaughan 1, Rebecca Bentley 1, Anthony D. LaMontagne 3 and Anne Kavanagh 1
1 Melbourne School of Population and Global Health, University of Melbourne, Melbourne 3010, Australia
2 School of Business, University of New South Wales, Canberra 2610, Australia
3 School of Health and Social Development, Deakin University, Melbourne 3125, Australia
These authors contributed equally to this work.
Int. J. Environ. Res. Public Health 2021, 18(21), 11485; https://doi.org/10.3390/ijerph182111485 - 31 Oct 2021
Cited by 15 | Viewed by 6062
Abstract
Disability employment programs play a key role in supporting people with disability to overcome barriers to finding and maintaining work. Despite significant investment, ongoing reforms to Australia’s Disability Employment Services (DES) are yet to lead to improved outcomes. This paper presents findings from [...] Read more.
Disability employment programs play a key role in supporting people with disability to overcome barriers to finding and maintaining work. Despite significant investment, ongoing reforms to Australia’s Disability Employment Services (DES) are yet to lead to improved outcomes. This paper presents findings from the Improving Disability Employment Study (IDES): a two-wave survey of 197 DES participants that aims to understand their perspectives on factors that influence access to paid work. Analysis of employment status by type of barrier indicates many respondents experience multiple barriers across vocational (lack of qualifications), non-vocational (inaccessible transport) and structural (limited availability of jobs, insufficient resourcing) domains. The odds of gaining work decreased as the number of barriers across all domains increased with each unit of barrier reported (OR 1.22, 95% CI 1.07, 1.38). Unemployed respondents wanted more support from employment programs to navigate the welfare system and suggest suitable work, whereas employed respondents wanted support to maintain work, indicating the need to better tailor service provision according to the needs of job-seekers. Combined with our findings from the participant perspective, improving understanding of these relationships through in-depth analysis and reporting of DES program data would provide better evidence to support current DES reform and improve models of service delivery. Full article
14 pages, 1712 KiB  
Review
Pediatric Hypothermia: An Ambiguous Issue
by Dominique Singer
Division of Neonatology and Pediatric Critical Care Medicine, University Medical Center Eppendorf, 20246 Hamburg, Germany
Int. J. Environ. Res. Public Health 2021, 18(21), 11484; https://doi.org/10.3390/ijerph182111484 - 31 Oct 2021
Cited by 18 | Viewed by 9267
Abstract
Hypothermia in pediatrics is mainly about small body size. The key thermal factor here is the large surface-to-volume ratio. Although small mammals, including human infants and children, are adapted to higher heat losses through their elevated metabolic rate and thermogenic capacity, they are [...] Read more.
Hypothermia in pediatrics is mainly about small body size. The key thermal factor here is the large surface-to-volume ratio. Although small mammals, including human infants and children, are adapted to higher heat losses through their elevated metabolic rate and thermogenic capacity, they are still at risk of hypothermia because of a small regulatory range and an impending metabolic exhaustion. However, some small mammalian species (hibernators) use reduced metabolic rates and lowered body temperatures as adaptations to impaired energy supply. Similar to nature, hypothermia has contradictory effects in clinical pediatrics as well: In neonates, it is a serious risk factor affecting respiratory adaptation in term and developmental outcome in preterm infants. On the other hand, it is an important self-protective response to neonatal hypoxia and an evidence-based treatment option for asphyxiated babies. In children, hypothermia first enabled the surgical repair of congenital heart defects and promotes favorable outcome after ice water drowning. Yet, it is also a major threat in various prehospital and clinical settings and has no proven therapeutic benefit in pediatric critical care. All in all, pediatric hypothermia is an ambiguous issue whose harmful or beneficial effects strongly depend on the particular circumstances. Full article
(This article belongs to the Special Issue Accidental and Environmental Hypothermia)
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8 pages, 338 KiB  
Article
Association of ABCA4 Gene Polymorphisms with Cleft Lip with or without Cleft Palate in the Polish Population
by Alicja Zawiślak 1,2,3,*, Krzysztof Woźniak 4, Xabier Agirre 2, Satish Gupta 5, Beata Kawala 6, Anna Znamirowska-Bajowska 6, Katarzyna Grocholewicz 1, Jan Lubiński 5, Felipe Prosper 2 and Anna Jakubowska 5
1 Department of Interdisciplinary Dentistry, Pomeranian Medical University, 70-111 Szczecin, Poland
2 Centro de Investigación Médica Aplicada, IDISNA, Universidad de Navarra, Avenida Pío XII-55, 31008 Pamplona, Spain
3 Department of Maxillofacial Orthopaedics and Orthodontics, Institute of Mother and Child, 01-211 Warsaw, Poland
4 Department of Orthodontics, Pomeranian Medical University, 70-111 Szczecin, Poland
5 Hereditary Cancer Center, Department of Genetics and Pathology, Pomeranian Medical University, 70-111 Szczecin, Poland
6 Department of Dentofacial Orthopaedics and Orthodontics, Wrocław Medical University, 50-425 Wrocław, Poland
Int. J. Environ. Res. Public Health 2021, 18(21), 11483; https://doi.org/10.3390/ijerph182111483 - 31 Oct 2021
Cited by 8 | Viewed by 2735
Abstract
Background: Non-syndromic cleft lip with/without cleft palate (NSCL/P) is a common congenital condition with a complex aetiology reflecting multiple genetic and environmental factors. Single nucleotide polymorphisms (SNPs) in ABCA4 have been associated with NSCL/P in several studies, although there are some inconsistent results. [...] Read more.
Background: Non-syndromic cleft lip with/without cleft palate (NSCL/P) is a common congenital condition with a complex aetiology reflecting multiple genetic and environmental factors. Single nucleotide polymorphisms (SNPs) in ABCA4 have been associated with NSCL/P in several studies, although there are some inconsistent results. This study aimed to evaluate whether two SNPs in ABCA4, namely rs4147811 and rs560426, are associated with NSCL/P occurrence in the Polish population. Methods: The study included 627 participants: 209 paediatric patients with NSCL/P and 418 healthy newborn controls. DNA was isolated from the saliva of NSCL/P patients and from umbilical cord blood in the controls. Genotyping of rs4147811 and rs560426 was performed using quantitative PCR. Results: The rs4147811 (AG genotype) SNP in ABCA4 was associated with a decreased risk of NSCL/P (odds ratio (OR) 0.57; 95% confidence interval (CI) 0.39–0.84; p = 0.004), whereas the rs560426 (GG genotype) SNP was associated with an increased risk of NSCL/P (OR 2.13; 95% CI 1.31–3.48; p = 0.002). Limitations: This study—based on the correlation between single genetic variants and the occurrence of different phenotypes—might have limited power in detecting relevant, complex inheritance patterns. ORs are often low to moderate when investigating the association of single genes with the risk of a complex trait. Another limitation was the small number of available NSCL/P samples. Conclusions: The results suggest that genetic variations in ABCA4 are important risk markers of NSCL/P in the Polish population. Further investigation in a larger study group is warranted. Full article
11 pages, 314 KiB  
Commentary
Contentious Issues and Future Directions in Adolescent Gambling Research
by Paul Delfabbro 1,* and Daniel L. King 2
1 School of Psychology, The University of Adelaide, Adelaide, SA 5005, Australia
2 College of Education, Psychology and Social Work, Flinders University, Bedford Park, SA 5042, Australia
Int. J. Environ. Res. Public Health 2021, 18(21), 11482; https://doi.org/10.3390/ijerph182111482 - 31 Oct 2021
Cited by 6 | Viewed by 4366
Abstract
Background. There is currently considerable public policy and regulatory interest in the nature and prevalence of underage gambling. Research in this area has purported to show that adolescents are at elevated risk of problem gambling and that early exposure to gambling or gambling-like [...] Read more.
Background. There is currently considerable public policy and regulatory interest in the nature and prevalence of underage gambling. Research in this area has purported to show that adolescents are at elevated risk of problem gambling and that early exposure to gambling or gambling-like activities could be a potential precursor to future harm. Method. In this commentary, we provide a critical appraisal of these arguments with reference to major studies in the field of gambling studies. It is argued that adolescent gambling research is a contentious area. Some questions remain concerning the validity of adolescent problem gambling measures, the strength of the association between adolescent and adult gambling and the impact of simulated gambling activities. Results. The paper summarises the conceptual and methodological issues that should be considered and addressed in future studies to strengthen the validity of research in this area. Conclusion. The paper encourages the greater use of harm-based measures, longitudinal and individual-level transition analyses and questions that capture the influence of activities rather than just their temporal sequencing. Full article
12 pages, 987 KiB  
Article
Adiposity and Long-Term Adiposity Change Are Associated with Incident Diabetes: A Prospective Cohort Study in Southwest China
by Yun Chen 1,†, Yiying Wang 2,†, Kelin Xu 1, Jie Zhou 2, Lisha Yu 2, Na Wang 1, Tao Liu 2,* and Chaowei Fu 1,*
1 School of Public Health, Key Laboratory of Public Health Safety, NHC Key Laboratory of Health Technology Assessment, Fudan University, Shanghai 200032, China
2 Guizhou Center for Disease Control and Prevention, Guiyang 550004, China
These authors have contributed equally to this work and share the first authorship.
Int. J. Environ. Res. Public Health 2021, 18(21), 11481; https://doi.org/10.3390/ijerph182111481 - 31 Oct 2021
Cited by 10 | Viewed by 2444
Abstract
In order to estimate the associations of different adiposity indicators and long-term adiposity changes with risk of incident type 2 diabetes (T2DM), we conducted a 10-year prospective cohort study of 7441 adults in Guizhou, China, from 2010 to 2020. Adiposity was measured at [...] Read more.
In order to estimate the associations of different adiposity indicators and long-term adiposity changes with risk of incident type 2 diabetes (T2DM), we conducted a 10-year prospective cohort study of 7441 adults in Guizhou, China, from 2010 to 2020. Adiposity was measured at baseline and follow-up. Cox proportional hazard models were used to estimated hazard ratios (HRs) and 95% confidence intervals (95% CIs). A total of 764 new diabetes cases were identified over an average follow-up of 7.06 years. Adiposity indicators, body mass index (BMI), waist circumference (WC), waist-height ratio (WHtR), and long-term adiposity changes (both weight change and WC change) were significantly associated with an increased risk of T2DM (adjusted HRs: 1.16–1.48). Significant non-linear relationships were found between weight/WC change and incident T2DM. Compared with subjects with stable WC from baseline to follow-up visit, the subjects with WC gain ≥9 cm had a 1.61-fold greater risk of T2DM; those with WC loss had a 30% lower risk. Furthermore, the associations were stronger among participants aged 40 years or older, women, and Han Chinese. Preventing weight or WC gain and promoting maintenance of normal body weight or WC are important approaches for diabetes prevention, especially for the elderly, women, and Han Chinese. Full article
(This article belongs to the Special Issue Diabetes and Obesity: Recent Reviews and Findings)
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14 pages, 739 KiB  
Article
Determinants of Household Energy Choice for Cooking in Northern Sudan: A Multinomial Logit Estimation
by Philbert Mperejekumana 1,2,3, Huan Li 1,2,3, Rucong Wu 1,2,3, Jiaxin Lu 4, Obid Tursunov 5,6, Hussien Elshareef 1,3,4,7, Mohamed S. Gaballah 3,8, Nsengiyumva Jean Nepo 9, Yuguang Zhou 1,3,4,* and Renjie Dong 1,3,4
1 Bioenergy and Environment Science & Technology Laboratory, College of Engineering, China Agricultural University, Beijing 100083, China
2 Key Laboratory of Clean Production and Utilization of Renewable Energy, Ministry of Agriculture and Rural Affairs, Beijing 100083, China
3 National Center for International Research of BioEnergy Science and Technology, Ministry of Science and Technology, Beijing 100083, China
4 School of Ecology and Environment, Beijing Technology and Business University, Beijing 100048, China
5 Department of Power Supply and Renewable Energy Sources, Tashkent Institute of Irrigation and Agricultural Mechanization Engineers, Tashkent 100000, Uzbekistan
6 Research Institute of Forestry, Tashkent 111104, Uzbekistan
7 Department of Agricultural Engineering, College of Agriculture, University of Khartoum, Khartoum 11115, Sudan
8 Department of Marine Environment, National Institute of Oceanography and Fisheries, NIOF, Alexandria 21556, Egypt
9 College of Agriculture Animal Science and Veterinary Medicine, University of Rwanda, Kigali 4285, Rwanda
Int. J. Environ. Res. Public Health 2021, 18(21), 11480; https://doi.org/10.3390/ijerph182111480 - 31 Oct 2021
Cited by 39 | Viewed by 4213
Abstract
Traditional biomass utilization is connected with negative environmental and human health impacts. However, its transition to cleaner cooking fuels is still low where the household’s fuels preferences play an important role in the process. To examine the factors that influence the household’s cooking [...] Read more.
Traditional biomass utilization is connected with negative environmental and human health impacts. However, its transition to cleaner cooking fuels is still low where the household’s fuels preferences play an important role in the process. To examine the factors that influence the household’s cooking fuel choice in Northern Sudan, a multinomial logit model (MNL) was used to analyze data collected from Kassala state in two selected districts, New Halfa and Nahr Atabara. The findings show that the most utilized fuels are still firewood and charcoal, which are used by 63.4% of all respondents. The results also revealed that socioeconomic factors have an impact on household fuel choice, where one additional unit of credit access may boost the possibility of choosing LPG by 22.7%. Furthermore, one additional level of education would reduce 5.4% of charcoal users while simultaneously raising 10% of current liquefied petroleum gas (LPG) users. Therefore, the study suggests initiating mobilization and training programs to raise awareness and encourage the usage of cleaner fuels. This study will provide policymakers with information on household cooking energy utilization while designing and developing policies related to energy. It will also contribute to the expanding body of literature concerning the transition to clean cooking fuels from traditional biomass. Full article
(This article belongs to the Special Issue Solid Fuel Combustion and Air Pollution)
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11 pages, 909 KiB  
Article
A Home-Based Multimedia Pulmonary Rehabilitation Program Improves Clinical Symptoms and Physical Performance of Patients with Chronic Obstructive Pulmonary Disease
by Anoma Santiworakul, Nitita Piya-amornphan and Netchanok Jianramas *
Department of Physical Therapy, School of Allied Health Science, Walailak University, 222 Thasala, Thaiburi, Nakhon Si Thammarat 80160, Thailand
Int. J. Environ. Res. Public Health 2021, 18(21), 11479; https://doi.org/10.3390/ijerph182111479 - 31 Oct 2021
Cited by 3 | Viewed by 3546
Abstract
Home-based pulmonary rehabilitation can decrease symptoms in chronic obstructive pulmonary disease (COPD) patients. The purpose of this study was to compare the effects of a home-based pulmonary rehabilitation by instructive multimedia in the form of videos and flip charts on clinical symptoms and [...] Read more.
Home-based pulmonary rehabilitation can decrease symptoms in chronic obstructive pulmonary disease (COPD) patients. The purpose of this study was to compare the effects of a home-based pulmonary rehabilitation by instructive multimedia in the form of videos and flip charts on clinical symptoms and exercise performance in COPD patients. An eight-week home-based pulmonary rehabilitation program was performed with twenty COPD patients older than 60 years of age with moderate to severe stages. They were separated into two groups: a multimedia group (n = 10) and a control group, which was only provided with telephone monitoring (n = 10). Clinical symptoms were measured by using the clinical COPD questionnaire (CCQ), and exercise performance was measured using a six-minute walk test (6MWT) and an upper-lower limb muscle strengthening test. After 8 weeks, the results showed that both groups showed a statistically significant decrease in the CCQ (p < 0.05). The multimedia group showed a statistically significant increase in the lower-limb muscle strengthening (p < 0.05), while the control group was not found to show a statistically significant increase in the lower-limb muscle strengthening. Therefore, a pulmonary rehabilitation program using multimedia at home can lessen symptoms and improve exercise performance in COPD patients. Full article
(This article belongs to the Topic Artificial Intelligence in Healthcare)
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20 pages, 1209 KiB  
Article
Flexibility during the COVID-19 Pandemic Response: Healthcare Facility Assessment Tools for Resilient Evaluation
by Andrea Brambilla 1,2,*, Tian-zhi Sun 1, Waleed Elshazly 3, Ahmed Ghazy 3, Paul Barach 1,4,5, Göran Lindahl 1,2 and Stefano Capolongo 1
1 Design and Health Lab, Department of Architecture, Built Environment and Construction Engineering (DABC), Politecnico di Milano, 20133 Milan, Italy
2 Center for Healthcare Architecture (CVA), Division of Building Design, Department Architecture and Civil Engineering (ACE), Chalmers University of Technology, SE-412 96 Goteborg, Sweden
3 School of Architecture and Urban Planning (AUIC), Politecnico di Milano, 20133 Milan, Italy
4 Jefferson College of Population Health, Thomas Jefferson University, Philadelphia, PA 19107, USA
5 School of Medicine and Law, Sigmund Freud University, 1020 Vienna, Austria
Int. J. Environ. Res. Public Health 2021, 18(21), 11478; https://doi.org/10.3390/ijerph182111478 - 31 Oct 2021
Cited by 45 | Viewed by 7551
Abstract
Healthcare facilities are facing huge challenges due to the outbreak of COVID-19. Around the world, national healthcare contingency plans have struggled to cope with the population health impact of COVID-19, with healthcare facilities and critical care systems buckling under the extraordinary pressures. COVID-19 [...] Read more.
Healthcare facilities are facing huge challenges due to the outbreak of COVID-19. Around the world, national healthcare contingency plans have struggled to cope with the population health impact of COVID-19, with healthcare facilities and critical care systems buckling under the extraordinary pressures. COVID-19 has starkly highlighted the lack of reliable operational tools for assessing the level sof flexibility of a hospital building to support strategic and agile decision making. The aim of this study was to modify, improve and test an existing assessment tool for evaluating hospital facilities flexibility and resilience. We followed a five-step process for collecting data by (i) doing a literature review about flexibility principles and strategies, (ii) reviewing healthcare design guidelines, (iii) examining international healthcare facilities case studies, (iv) conducting a critical review and optimization of the existing tool, and (v) assessing the usability of the evaluation tool. The new version of the OFAT framework (Optimized Flexibility Assessment Tool) is composed of nine evaluation parameters and subdivided into measurable variables with scores ranging from 0 to 10. The pilot testing of case studies enabled the assessment and verification the OFAT validity and reliability in support of decision makers in addressing flexibility of hospital design and/or operations. Healthcare buildings need to be designed and built based on principles of flexibility to accommodate current healthcare operations, adapting to time-sensitive physical transformations and responding to contemporary and future public health emergencies. Full article
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15 pages, 679 KiB  
Article
Adolescents’ Alcohol Use: Does the Type of Leisure Activity Matter? A Cross-National Study
by Aranzazu Albertos 1,2,3, Ina Koning 4, Edgar Benítez 2,5,* and Jokin De Irala 2,3
1 School of Education and Psychology, University of Navarra, 31009 Pamplona, Spain
2 Institute for Culture and Society (ICS), 31009 Pamplona, Spain
3 Navarra Institute for Health Research (IdiSNA), 31008 Pamplona, Spain
4 Youth Studies, Interdisciplinary Social Science, Utrecht University, P.O. Box 80140, 3508 TC Utrecht, The Netherlands
5 Instituto de Ciencia de los Datos e Inteligencia Artificial (DATAI), 31009 Pamplona, Spain
Int. J. Environ. Res. Public Health 2021, 18(21), 11477; https://doi.org/10.3390/ijerph182111477 - 31 Oct 2021
Cited by 9 | Viewed by 3241
Abstract
The main objective of this study was to analyze the relationship between structured, unstructured, and family leisure activities on the frequency of adolescent alcohol intake across three different countries (Spain, Peru, and The Netherlands). The self-control of adolescents was also investigated as a [...] Read more.
The main objective of this study was to analyze the relationship between structured, unstructured, and family leisure activities on the frequency of adolescent alcohol intake across three different countries (Spain, Peru, and The Netherlands). The self-control of adolescents was also investigated as a moderator in the relationship between leisure activities and alcohol consumption. Methodology: This research involved 4608 adolescents aged between 12 and 17 from three countries (Spain, Peru, and The Netherlands). In Spain and Peru, data was collected through a self-report questionnaire which was part of the Your Life project. In The Netherlands, a self-questionnaire was used, collected by the University of Utrecht. A multiple logistic regression was performed for each country. Results: The results showed that participation in unstructured leisure activities increased the likelihood of drinking more frequently and more heavily in all three countries. Structured leisure activities, in general, did not have a significant predictive effect on alcohol consumption in any of the countries. Family leisure activities reduced the risk of engaging in yearly alcohol use and yearly binge drinking among adolescents, especially in The Netherlands and Spain. The protective effect of family leisure and unstructured leisure risk on yearly alcohol use applied especially to Dutch adolescents with a low level of self-control. Discussion: The article emphasizes the need for parents to engage in leisure activities with their child; participation in unstructured activities is not to be encouraged. Full article
(This article belongs to the Topic Oncogenomics and Pediatric Health)
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