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Int. J. Environ. Res. Public Health, Volume 18, Issue 8 (April-2 2021) – 542 articles

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Open AccessArticle
Where to Look for a Remedy? Burnout Syndrome and its Associations with Coping and Job Satisfaction in Critical Care Nurses—A Cross-Sectional Study
Int. J. Environ. Res. Public Health 2021, 18(8), 4390; https://doi.org/10.3390/ijerph18084390 - 20 Apr 2021
Viewed by 229
Abstract
Background: Burnout is a psychological, work-related syndrome associated with long-term exposure to emotional and interpersonal stressors in the workplace. Burnout syndrome in nurses is often caused by an imbalance between work requirements and preparation and fitness for work, a lack of control, insufficient [...] Read more.
Background: Burnout is a psychological, work-related syndrome associated with long-term exposure to emotional and interpersonal stressors in the workplace. Burnout syndrome in nurses is often caused by an imbalance between work requirements and preparation and fitness for work, a lack of control, insufficient performance recognition and a prolonged exposure to stress. Aim: The aims of this study were to explore the associations between levels of burnout syndrome, coping mechanisms and job satisfaction in critical care nurses in multivariate modelling process. A specific aim was also to explore whether coping and job satisfaction in critical care nurses are gender related. Methods: A cross-sectional multicentre study was conducted in a convenience sample of 620 critical care nurses from five university hospitals in Croatia in 2017. The data were collected using the Maslach Burnout Inventory and the Ways of Coping and Job Satisfaction Scale together with the nurses’ demographic profiles and were analysed using a multivariable model. Results: The results showed no significant association between gender, coping mechanisms and job satisfaction. However, significant negative associations between burnout and job satisfaction (OR = 0.01, 95%CI = 0.00–0.02, p < 0.001) and positive association between burnout and passive coping (OR = 9.93, 95%CI = 4.01–24.61, p < 0.001) were found. Conclusion: The association between job satisfaction and burnout in nurses urges hospital management teams to consider actions focused on job satisfaction, probably modifications of the work environment. Given that passive coping may increase the incidence of burnout, it is recommendable for active coping to be implemented in nurses’ training programmes as an essential element of capacity building aimed at reducing the incidence of burnout in nurses. Full article
(This article belongs to the Special Issue Evidence-Based Practice and Advanced Nursing Care)
Open AccessArticle
The Association between Migraine and Abdominal Aortic Aneurysms: A Nationwide Population-Based Cohort Study
Int. J. Environ. Res. Public Health 2021, 18(8), 4389; https://doi.org/10.3390/ijerph18084389 - 20 Apr 2021
Viewed by 209
Abstract
Previous studies have indicated that patients with migraine have a higher prevalence of risk factors known to be associated with cardiovascular diseases. There are also shared epidemiology and molecular mechanisms between migraine and abdominal aortic aneurysm (AAA). We hypothesized that patients with migraine [...] Read more.
Previous studies have indicated that patients with migraine have a higher prevalence of risk factors known to be associated with cardiovascular diseases. There are also shared epidemiology and molecular mechanisms between migraine and abdominal aortic aneurysm (AAA). We hypothesized that patients with migraine could have an increased risk of AAA. To test this hypothesis, we used the National Health Insurance Research Database (NHIRD) to evaluate whether associations exist between migraine and AAA. The data for this nationwide population-based retrospective cohort study were obtained from the NHIRD in Taiwan. The assessed study outcome was the cumulative incidence of AAA in patients with migraine during a 15-year follow-up period. Among the 1,936,512 patients from the NHIRD, 53,668 (2.77%) patients were identified as having been diagnosed with migraine. The patients with migraine had a significantly higher cumulative risk of 3.558 of developing an AAA 5 years after the index date compared with the patients without migraine. At the end of the 15-year follow-up period, a significantly higher incidence of AAA (0.98%) was observed in the patients with migraine than in those without migraine (0.24%). We revealed an association between the development of migraine and AAA. Full article
(This article belongs to the Section Health Care Sciences & Services)
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Open AccessCommunication
Impact of COVID-19 Pandemic on Total Mortality in Poland
Int. J. Environ. Res. Public Health 2021, 18(8), 4388; https://doi.org/10.3390/ijerph18084388 - 20 Apr 2021
Viewed by 214
Abstract
Background: According to published data the number of deaths attributed to COVID-19 is underestimated between 30 and 80%. Aim: The aim of this study is to assess the impact of COVID-19 on total mortality of Poland and the Silesian voivodship. Methods: Secondary epidemiological [...] Read more.
Background: According to published data the number of deaths attributed to COVID-19 is underestimated between 30 and 80%. Aim: The aim of this study is to assess the impact of COVID-19 on total mortality of Poland and the Silesian voivodship. Methods: Secondary epidemiological data on COVID-19 deaths were obtained from the Ministry of Health registry and data on total mortality were gathered from the National Statistical Office and Registry Office in Poland. Three scenarios were used to estimated COVID-19 deaths: real number + an extra 30%, 60%, and 70% excess total deaths. Results: In 2020, there were 73,254, 64,584, and 67,677 excess deaths in comparison to 2017–2019, respectively. For the Silesian voivodship, it was 8339, 7946, and 8701, respectively. The total mean increase in deaths was 16% for the whole country and the Silesian voivodship. The simulation for 30% extra COVID-19 deaths gave COVID-19 mortality equal to 12.5%; n = 50,708 deaths, for extra 60%; 17.9% n = 72,866 and for extra 70%; 19.7% n = 80,251 for Poland; and 11.9% (n = 6072), 17.2% (n = 8740), 24.2% (n = 12,297), respectively, for the Silesian voivodship. Conclusions: The participation of COVID-19 in total deaths should not exceed 20% for Poland and 24% for the Silesian voivodship in 2020. Full article
(This article belongs to the Section Infectious Disease Epidemiology)
Open AccessArticle
Dietary Exposures and Intake Doses to Bisphenol A and Triclosan in 188 Duplicate-Single Solid Food Items Consumed by US Adults
Int. J. Environ. Res. Public Health 2021, 18(8), 4387; https://doi.org/10.3390/ijerph18084387 - 20 Apr 2021
Viewed by 153
Abstract
Few data exist on bisphenol A (BPA) or triclosan (TCS) residue levels in foods consumed by adults in everyday settings. In a further analysis of study data, the objectives were to determine BPA and TCS residue concentrations in duplicate-single solid food items consumed [...] Read more.
Few data exist on bisphenol A (BPA) or triclosan (TCS) residue levels in foods consumed by adults in everyday settings. In a further analysis of study data, the objectives were to determine BPA and TCS residue concentrations in duplicate-single solid food items consumed by adults and to estimate dietary exposure and intake doses per food item. A convenience sample of 50 adults was recruited in North Carolina (2009–2011). Participants completed 24 h food diaries and collected 24 h duplicate-diet solid food samples consumed on days 1 and 2 during sampling weeks 1, 2, and 6. A total of 188 of the collected 776 duplicate-diet solid food samples contained a single, solid food item. BPA and TCS residue levels were quantified in the 188 food items using GC–MS. BPA and TCS were detected in 37% and 58% of these food items, respectively. BPA concentrations were highest in a cheese and tomato sandwich (104 ng/g), whereas the highest TCS concentrations were in a burrito (22.1 ng/g). These chemicals co-occurred in 20% of the samples (maximum = 54.7 ng/g). Maximum dietary intake doses were 429 ng/kg/day for BPA in a vegetable soup with tortilla sample and 72.0 ng/kg/day for TCS in a burrito sample. Full article
(This article belongs to the Special Issue Dietary Exposure to Food Contaminants and Residues)
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Open AccessArticle
Continued Participation of Israeli Adolescents in Online Sports Programs during the COVID-19 Pandemic Is Associated with Higher Resilience
Int. J. Environ. Res. Public Health 2021, 18(8), 4386; https://doi.org/10.3390/ijerph18084386 - 20 Apr 2021
Viewed by 195
Abstract
Background: Coronavirus disease 2019 (COVID-19) has forced adolescents to adapt rapidly to a new reality of physical and social distancing, while introducing a range of new sources of stress and adversity. Our primary aim was to study the relationship between adolescents’ resilience and [...] Read more.
Background: Coronavirus disease 2019 (COVID-19) has forced adolescents to adapt rapidly to a new reality of physical and social distancing, while introducing a range of new sources of stress and adversity. Our primary aim was to study the relationship between adolescents’ resilience and their participation in online sports programs during the COVID-19 pandemic lockdown period. Our secondary aims were to assess the associations between the organized sports programs’ determinants and resilience. Methods: Online surveys designed to examine resilience, lifestyle, psychosocial health and characteristics of the organized sports programs were administered to 473 adolescents who were enrolled in organized sports programs before the COVID-19 pandemic. Results: Adolescents who continued to participate in online structured programs during the lockdown period were significantly more resilient and physically active, had higher self-related health, satisfaction with life, and ability to cope during the pandemic, compared to those who did not participate. Relationships with the adult instructor and levels of physical activity were the most important factors of the programs that were associated with resilience. Conclusions: Participation of adolescents in sports programs is an important resource associated with higher levels of resilience. Youth programs should continue their activities during globally challenging times, such as the COVID-19 pandemic. Full article
(This article belongs to the Section Adolescents)
Open AccessArticle
Quality of Life and Symptoms of PTSD during the COVID-19 Lockdown in Italy
Int. J. Environ. Res. Public Health 2021, 18(8), 4385; https://doi.org/10.3390/ijerph18084385 - 20 Apr 2021
Viewed by 173
Abstract
The COVID-19 pandemic has led to a complete lockdown in many countries and Italy was the first country interested in Europe, as the cases spread very quickly with a high rate of mortality. While the lockdown strategy is an essential step to curb [...] Read more.
The COVID-19 pandemic has led to a complete lockdown in many countries and Italy was the first country interested in Europe, as the cases spread very quickly with a high rate of mortality. While the lockdown strategy is an essential step to curb the exponential rise of COVID-19 cases, it can have a significative impact on mental health on the population involved, that is still not well known and must be explored. The objective of the present research is to investigate the Quality of Life (QoL) and Symptoms of PTSD (PTSS) encountered during the quarantine period (April 2020) due to the spread of COVID-19 in Italy. Participants (N = 1839; 1430 females and 409 males), who were volunteers and anonymous, adults (18–73 years), were drawn from a convenience sample of the general population and asked to fill out an online questionnaire, after giving an informed written consent. The General Health Questionnaire (GH12), used to assess health related QoL, identified 24.5% of respondents as problematic, and the Impact of Event Scale-Revised (IES-R), used to assess PTSS, identified the 23.5% with clinical scores. Results showed that married people/cohabitants, non-workers, and those with a lower level of education perceived a better QoL and less PTSS. The most frequent emotions felt during the first month of quarantine and referred to by participants were sadness (72%), boredom (54.5%), impotence (52%), and anxiety (50%). The COVID-19 pandemic represents one of the most stressful events in recent times worldwide and poses a major challenge for social, economic, and, above all, psychological resources of the population that must be assessed and supported if insufficient. Full article
Open AccessArticle
Assessment of Resilience of the Hellenic Navy Seals by Electrodermal Activity during Cognitive Tasks
Int. J. Environ. Res. Public Health 2021, 18(8), 4384; https://doi.org/10.3390/ijerph18084384 - 20 Apr 2021
Viewed by 196
Abstract
Stress resilience plays a key role in task performance during emergencies, especially in occupations like military special forces, with a routine consisting of unexpected events. Nevertheless, reliable and applicable measurements of resilience in predicting task performance in stressful conditions are still researched. This [...] Read more.
Stress resilience plays a key role in task performance during emergencies, especially in occupations like military special forces, with a routine consisting of unexpected events. Nevertheless, reliable and applicable measurements of resilience in predicting task performance in stressful conditions are still researched. This study aimed to explore the stress response in the Hellenic Navy SEALs (HN-SEALs), using a cognitive–physiological approach. Eighteen candidates under intense preparation for their enlistment in the HN-SEALs and 16 healthy controls (HCs) underwent Stroop tests, along with mental-state and personality examination. Simultaneously, electrodermal activity (EDA) was assessed during each one of cognitive testing procedures. Compared to healthy control values, multiple components of EDA values were found decreased (p < 0.05) in the HN-SEALs group. These results were associated with an increase in resilience level in the HN-SEALs group, since a restricted sympathetic reactivity according to the reduced EDA values was observed during the stressful cognitive testing. This is the first report providing physiological measurements of the sympathetic response of HN-SEALs to a stressful situation and suggests that EDA turns out to be a simple and objective tool of sympathetic activation and it may be used as a complementary index of resilience in HN-SEALs candidates. Full article
Open AccessArticle
Uptake of Tele-Rehabilitation in Finland amongst Rehabilitation Professionals during the COVID-19 Pandemic
Int. J. Environ. Res. Public Health 2021, 18(8), 4383; https://doi.org/10.3390/ijerph18084383 - 20 Apr 2021
Viewed by 279
Abstract
The COVID-19 pandemic has challenged rehabilitation professionals to provide therapy through telepractice. The aims of this study were to investigate and compare the uptake of tele-rehabilitation (TR) in Finland amongst different rehabilitation professions during the COVID-19 pandemic as well as potential differences between [...] Read more.
The COVID-19 pandemic has challenged rehabilitation professionals to provide therapy through telepractice. The aims of this study were to investigate and compare the uptake of tele-rehabilitation (TR) in Finland amongst different rehabilitation professions during the COVID-19 pandemic as well as potential differences between professions in carrying out TR. In addition, the goal was to explore in more depth therapists’ views about the features that work and challenges of TR. A total of 850 therapists in the physio-, occupational-, speech and language-, and psychotherapy professions participated in the survey that included both quantitative and open-ended questions. The results show that 52% of all the therapists who participated in this study did take up TR with all or most of their clients during the first wave of the COVID-19 pandemic. Of all professionals who have carried out tele-rehabilitation during the pandemic, 46% planned to use TR regularly or probably also after the pandemic. There were also clear differences between the professions. Psychotherapists carried out TR during the pandemic and planned to use it also after the pandemic more often than the other professional groups. The qualitative analysis revealed that therapists identified several beneficial but also multiple challenging features of TR. Psychotherapists reported less challenges than other professions. The pandemic has clearly sped up the use of TR in rehabilitation. Full article
(This article belongs to the Section Digital Health)
Open AccessArticle
Disposal Behavior of Used Masks during the COVID-19 Pandemic in the Moroccan Community: Potential Environmental Impact
Int. J. Environ. Res. Public Health 2021, 18(8), 4382; https://doi.org/10.3390/ijerph18084382 - 20 Apr 2021
Viewed by 281
Abstract
The spread of coronavirus disease-2019 (COVID-19) levied on the Moroccan authorities to increase their mask production capacity, which reached up to 12 million facemask units produced per day. This increase in personal protective equipment (PPE) production and consumption is an efficient tool to [...] Read more.
The spread of coronavirus disease-2019 (COVID-19) levied on the Moroccan authorities to increase their mask production capacity, which reached up to 12 million facemask units produced per day. This increase in personal protective equipment (PPE) production and consumption is an efficient tool to address the spread of COVID-19. However, this results in more plastic and microplastic debris being added into the land and marine environments, which will harm the ecosystem, wildlife, and public health. Such a situation needs deep individual behavior observation and tracking, as well as an assessment of the potential environmental impact of this new type of waste. For this reason, we assessed the Moroccan population’s behavior regarding the use and disposal of facemasks and gloves. An exploratory survey was prepared and shared via social media and email with the population of Rabat-Salé-Kénitra and Casablanca-Settat regions. Additionally, we calculated the estimated number and weight of daily and weekly PPE used and generated by the studied regions. The survey showed that 70% of the respondents threw their discarded masks and gloves in house trash or trash bins after their first use, whereas nearly 30% of respondents admitted that they did not wear masks because they did not leave their homes during the lockdown, while from the 70% of facemask users, more than five million (equivalent to 40,000 kg) of facemasks would be generated and disposed of daily by the community of these regions, which presents 35% of the total engendered facemask waste in Morocco. Accordingly, the environment impact of facemasks showed that the greenhouse gas footprint is about 640 kT CO2 eq./year for the whole of Morocco, while the energy footprint is around 60,000 GWh/year. Furthermore, an urgent multidisciplinary environmental assessment of the potential impact of PPE must be conducted among the 12 Moroccan regions. This study demonstrated the real impact of the COVID-19 PPE on human behavior and the environment and suggests a need for providing new didactic management of facemasks and gloves. Full article
(This article belongs to the Collection COVID-19 Research)
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Open AccessArticle
Obesity among Health-Care Workers: Which Occupations Are at Higher Risk of Being Obese?
Int. J. Environ. Res. Public Health 2021, 18(8), 4381; https://doi.org/10.3390/ijerph18084381 - 20 Apr 2021
Viewed by 203
Abstract
Obesity among health-care workers (HCWs) is an important issue as it can affect both their health condition and their professional capability. Although adult obesity is attributable to occupational factors, few reports are available on Malaysian health-care workers’ obesity and whether different health-care job [...] Read more.
Obesity among health-care workers (HCWs) is an important issue as it can affect both their health condition and their professional capability. Although adult obesity is attributable to occupational factors, few reports are available on Malaysian health-care workers’ obesity and whether different health-care job categories are related to workers’ obesity. This study aimed to determine the prevalence of obesity among HCWs and the association between various HCW job categories and obesity. A cross-sectional study was conducted by analyzing secondary data from the 2019 annual cardiovascular health screening program, which included information regarding all government health-care workers in the east coast region of Peninsular Malaysia. The subject’s body mass index (BMI) was categorized according to WHO criteria. Only 43% of the subjects had a normal BMI, while 33.1% were categorized as overweight, and 21.1% were obese. Different HCWs’ job categories were shown to be significantly associated with their obesity status, with nurses apparently having a higher risk of being obese (Adj OR = 1.91, 95% CI 1.45, 2.53, p-value < 0.001). This study’s results require further exploration of HCWs’ working condition factors and for different job categories that contribute to obesity. Public health intervention programs to combat obesity should be implemented that primarily target HCW groups at the highest risk of obesity. Full article
Open AccessArticle
Effects of Manufacturing Variation in Electronic Cigarette Coil Resistance and Initial Pod Mass on Coil Lifetime and Aerosol Generation
Int. J. Environ. Res. Public Health 2021, 18(8), 4380; https://doi.org/10.3390/ijerph18084380 - 20 Apr 2021
Viewed by 218
Abstract
This work investigated the effects of manufacturing variations, including coil resistance and initial pod mass, on coil lifetime and aerosol generation of Vuse ALTO pods. Random samples of pods were used until failure (where e-liquid was consumed, and coil resistance increased to high [...] Read more.
This work investigated the effects of manufacturing variations, including coil resistance and initial pod mass, on coil lifetime and aerosol generation of Vuse ALTO pods. Random samples of pods were used until failure (where e-liquid was consumed, and coil resistance increased to high value indicating a coil break). Initial coil resistance, initial pod mass, and e-liquid net mass ranged between 0.89 to 1.14 [Ω], 6.48 to 6.61 [g], and 1.88 to 2.00 [g] respectively. Coil lifetime was µ (mean) = 158, σ (standard deviation) = 21.5 puffs. Total mass of e-liquid consumed until coil failure was µ = 1.93, σ = 0.035 [g]. TPM yield per puff of all test pods for the first session (brand new pods) was µ = 0.0123, σ = 0.0003 [g]. Coil lifetime and TPM yield per puff were not correlated with either variation in initial coil resistance or variation in initial pod mass. The absence of e-liquid in the pod is an important factor in causing coil failure. Small bits of the degraded coil could be potentially introduced to the aerosol. This work suggests that further work is required to investigate the effect of e-liquid composition on coil lifetime and TPM yield per puff. Full article
(This article belongs to the Section Health Behavior, Chronic Disease and Health Promotion)
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Open AccessArticle
Transdisciplinary Research on Indoor Environment and Health as a Social Process
Int. J. Environ. Res. Public Health 2021, 18(8), 4379; https://doi.org/10.3390/ijerph18084379 - 20 Apr 2021
Viewed by 181
Abstract
Although issues concerning indoor environments and their interaction with humans span many disciplines, such as aerosol technology, environmental psychology, health, and building physics, they are often studied separately. This study describes a research project with the transdisciplinary aim of bridging such disciplinary boundaries. [...] Read more.
Although issues concerning indoor environments and their interaction with humans span many disciplines, such as aerosol technology, environmental psychology, health, and building physics, they are often studied separately. This study describes a research project with the transdisciplinary aim of bridging such disciplinary boundaries. Semi-structured interviews were conducted with the twelve project members to explore their understanding of transdisciplinarity regarding the conceptual as well as social aspects of collective learning and leadership and the measures taken to achieve this. The interviews were coded in NVivo (QSR International, Doncaster, Australia), which was used to identify themes concerning notions associated with transdisciplinarity, collective leadership, collective intelligence, and learning. A shared understanding of transdisciplinarity meant that the researchers transcended their disciplinary boundaries by moving into each other’s fields. This collective learning process was facilitated by introductory lectures on each other’s fields, contributing to collective leadership and a safe atmosphere. We argue that a transdisciplinary approach is appropriate in order to address indoor environment issues as well other complex problems, for which additional time and resources should be allocated for individual and collective learning processes. Full article
(This article belongs to the Special Issue Outdoor and Indoor Air Quality)
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Open AccessCommunication
Carer Empowerment Is Key to Reduce Dementia Care Inequalities in the Middle East
Int. J. Environ. Res. Public Health 2021, 18(8), 4378; https://doi.org/10.3390/ijerph18084378 - 20 Apr 2021
Viewed by 170
Abstract
Dementia represents a significant problem in the Middle East. Sociocultural and political factors that shape conceptions of health and care tend to stifle research and the dissemination of knowledge throughout the Middle East. These socio-political challenges concerning engagement with individuals living with dementia [...] Read more.
Dementia represents a significant problem in the Middle East. Sociocultural and political factors that shape conceptions of health and care tend to stifle research and the dissemination of knowledge throughout the Middle East. These socio-political challenges concerning engagement with individuals living with dementia and their carers include language barriers, stigmatization, logistical constraints, lack of informal support outside of hospitals, and over-dependence on clinicians for dementia information. There is an urgent need in the Middle East to increase care and support for adults with dementia and their carers, enhance research efforts and improve the dissemination of information related to dementia in the region. One possible way to do so is to begin to promote a knowledge-based culture throughout the Middle East. This can be achieved by aligning traditional deterministic and spiritual perspectives of mental health with more Western, scientific, and evidence-based models. We suggest employing practical, multidimensional approaches to deal with the stated challenges, both at individual and societal levels. Doing so will improve knowledge of dementia and allow health and social care systems in the Middle East to begin to address a growing problem. Full article
(This article belongs to the Special Issue Health Inequalities in Dementia Care)
Open AccessReview
Mini-Implant-Retained Overdentures for the Rehabilitation of Completely Edentulous Maxillae: A Systematic Review and Meta-Analysis
Int. J. Environ. Res. Public Health 2021, 18(8), 4377; https://doi.org/10.3390/ijerph18084377 - 20 Apr 2021
Viewed by 165
Abstract
Purpose: Mini-dental implants (MDIs) have been used to support and retain overdentures, providing patients with a less invasive placement procedure. Although lucrative, the use of MDIs to retain a maxillary overdenture is still not an established treatment modality. This systematic review aims to [...] Read more.
Purpose: Mini-dental implants (MDIs) have been used to support and retain overdentures, providing patients with a less invasive placement procedure. Although lucrative, the use of MDIs to retain a maxillary overdenture is still not an established treatment modality. This systematic review aims to answer the question: Do mini-implant-retained maxillary overdentures provide a satisfactory treatment outcome for complete edentulism? Methods: A systematic search for relevant articles was conducted to include articles published until April 2021 in the following electronic databases: CINAHL, Cochrane, EMBASE, PubMed, and Web of Science. All empirical studies evaluating the biological, survival, or patient-reported outcomes after placing mini-implant-retained overdentures in maxilla were considered for inclusion. The risk of bias was assessed by utilizing the Joanna Briggs Institute critical appraisal checklist. Study screening and data extraction were conducted by three reviewers independently. Results: The electronic search retrieved 1276 titles after omitting duplicates. Twenty articles were considered for full-text review, of which six studies were included in this systematic review. The included studies evaluated a total of 173 participants with a mean age of 66.3 years. The overall mini-implant survival rate was 77.1% (95% CI: 64.7–89.5%) with a mean follow-up time of 1.79 years (range: 6 months to 3 years). Implant survival differed significantly when comparing complete and partial palatal coverage overdentures. Those with complete palatal coverage exhibited less bone loss overall compared to partial coverage overdentures. Participants of all studies reported an increase in the quality of life and in satisfaction after rehabilitation treatment with MDIs. Conclusions: The survival rate of mini-implants retaining an overdenture in the maxilla was observed to be lower than the values reported for traditional implants in the literature. Improvements were observed in all aspects in terms of patient satisfaction, quality of life, oromyofunction, and articulation after the treatment. Full article
(This article belongs to the Special Issue Periodontal and Peri-Implant Diseases)
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Open AccessArticle
SARS-CoV-2 Antibody Screening in Healthcare Workers in Non-Infectious Hospitals in Two Different Regions of Southern Poland (Upper Silesia and Opole Voivodeships): A Prospective Cohort Study
Int. J. Environ. Res. Public Health 2021, 18(8), 4376; https://doi.org/10.3390/ijerph18084376 - 20 Apr 2021
Viewed by 180
Abstract
(1) Background: Detection of asymptomatic or subclinical human coronavirus SARS-CoV-2 infection in healthcare workers (HCWs) is crucial for understanding the overall prevalence of the new coronavirus and its infection potential in public (non-infectious) healthcare units with emergency wards. (2) Methods: We evaluated the [...] Read more.
(1) Background: Detection of asymptomatic or subclinical human coronavirus SARS-CoV-2 infection in healthcare workers (HCWs) is crucial for understanding the overall prevalence of the new coronavirus and its infection potential in public (non-infectious) healthcare units with emergency wards. (2) Methods: We evaluated the host serologic responses, measured with semi-quantitative ELISA tests (IgA, IgG, IgM abs) in sera of 90 individuals in Hospital no. 4 in Bytom, 84 HCWs in the University Hospital in Opole and 25 in a Miasteczko Śląskie local surgery. All volunteers had negative RT-PCR test results or had not had the RT-PCR test performed within 30 days before sampling. The ELISA test was made at two different time points (July/August 2020) with a 2-weeks gap between blood collections to avoid the “serological window” period. (3) Results: The IgG seropositivity of asymptomatic HCWs varied between 1.2% to 10% (Opole vs. Bytom, p < 0.05; all without any symptoms). IgA seropositivity in HCWs was 8.8% in Opole and 7.14% in Bytom. IgM positive levels in HCWs in Opole and Bytom was 1.11% vs. 2.38%, respectively. Individuals with IgA and IgM seropositivity results were observed only in Opole (1.19%). More studies are needed to determine whether these results are generalizable to other populations and geographic as well as socio-demographic locations. (4) Conclusions: 100% of IgG(+) volunteers were free from any symptoms of infection in the 30 days before first or second blood collection and they had no awareness of SARS-CoV-2 infection. Asymptomatic HCWs could spread SARS-CoV-2 infection to other employees and patients. Only regular HCWs RT-PCR testing can reduce the risk of SARS-CoV-2 spreading in a hospital environment. The benefit of combining the detection of specific IgA with that of combined specific IgM/IgG is still uncertain. Full article
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Open AccessArticle
Oxytocin Administration in Low-Risk Women, a Retrospective Analysis of Birth and Neonatal Outcomes
Int. J. Environ. Res. Public Health 2021, 18(8), 4375; https://doi.org/10.3390/ijerph18084375 (registering DOI) - 20 Apr 2021
Viewed by 211
Abstract
Background: In recent years, higher than the recommended rate of oxytocin use has been observed among low-risk women. This study examines the relationship between oxytocin administration and birth outcomes in women and neonates. Methods: A retrospective analysis of birth and neonatal outcomes for [...] Read more.
Background: In recent years, higher than the recommended rate of oxytocin use has been observed among low-risk women. This study examines the relationship between oxytocin administration and birth outcomes in women and neonates. Methods: A retrospective analysis of birth and neonatal outcomes for women who received oxytocin versus those who did not. The sample included 322 women with a low-risk pregnancy. Results: Oxytocin administration was associated with cesarean section (aOR 4.81, 95% CI: 1.80–12.81), instrumental birth (aOR 3.34, 95% CI: 1.45–7.67), episiotomy (aOR 3.79, 95% CI: 2.20–6.52) and length of the second stage (aOR 00:18, 95% CI: 00:04–00:31). In neonatal outcomes, oxytocin in labor was associated with umbilical artery pH ≤ 7.20 (OR 3.29, 95% CI: 1.33–8.14). Admission to neonatal intensive care unit (OR 0.56, 95% CI: 0.22–1.42), neonatal resuscitation (OR 1.04, 95% CI: 0.22–1.42), and Apgar score <7 (OR 0.48, 95% CI: 0.17–1.33) were not associated with oxytocin administration during labor. Conclusions: Oxytocin administration during labor for low-risk women may lead to worse birth outcomes with an increased risk of instrumental birth and cesarean, episiotomy and the use of epidural analgesia for pain relief. Neonatal results may be also worse with an increased proportion of neonates displaying an umbilical arterial pH ≤ 7.20. Full article
(This article belongs to the Collection Women's Reproductive and Maternal Health)
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Open AccessArticle
Factors Associated with COVID-19 Vaccine Hesitancy among People with Epilepsy in Lithuania
Int. J. Environ. Res. Public Health 2021, 18(8), 4374; https://doi.org/10.3390/ijerph18084374 - 20 Apr 2021
Viewed by 193
Abstract
The purpose of our study was to determine the willingness to be vaccinated against COVID-19 and factors associated with vaccine hesitancy among people with epilepsy (PWE). In December 2020, we performed an online cross-sectional survey of PWE and their caregivers in Lithuania before [...] Read more.
The purpose of our study was to determine the willingness to be vaccinated against COVID-19 and factors associated with vaccine hesitancy among people with epilepsy (PWE). In December 2020, we performed an online cross-sectional survey of PWE and their caregivers in Lithuania before the rollout of COVID-19 vaccines to the public. The study sample consisted of 111 respondents (44 (39.6%) male, median age 25 years (range 1 to 70)). From 58 PWE who personally responded to the survey, 27 (46.6%) would be willing to be vaccinated against COVID-19. Among the 53 caregivers, 18 (34.0%) would accept the person they care for to be vaccinated. Willingness to be vaccinated was associated with receiving an influenza shot in 2020 (odds ratio (OR) = 9.17, 95% confidence interval (CI = 1.15–73.47), the beliefs that vaccines are generally safe (OR = 7.90, 95% CI = 2.43–25.74) and that they are the only convenient way to gain immunity (OR = 3.91, 95% CI = 1.02–15.05). Respondents were hesitant to accept the COVID-19 vaccine if they thought it could cause the infection (OR = 0.14, 95% CI = 0.04–0.49). COVID-19 vaccine hesitancy is frequent among PWE and their caregivers. It is probably related to erroneous beliefs about their safety and mechanism of action. Full article
Open AccessCommunication
E-Cigarette Flavors and Frequency of E-Cigarette Use among Adult Dual Users Who Attempt to Quit Cigarette Smoking in the United States: Longitudinal Findings from the PATH Study 2015/16–2016/17
Int. J. Environ. Res. Public Health 2021, 18(8), 4373; https://doi.org/10.3390/ijerph18084373 - 20 Apr 2021
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Abstract
Potential mechanisms by which e-cigarette use may relate to combustible cigarette smoking cessation are not well-understood. We used U.S. nationally representative data to prospectively evaluate the relationship between e-cigarette flavor use and frequency of e-cigarette use among adult cigarette/e-cigarette dual users who attempted [...] Read more.
Potential mechanisms by which e-cigarette use may relate to combustible cigarette smoking cessation are not well-understood. We used U.S. nationally representative data to prospectively evaluate the relationship between e-cigarette flavor use and frequency of e-cigarette use among adult cigarette/e-cigarette dual users who attempted to quit smoking cigarettes. Analyses used Population Assessment of Tobacco and Health (PATH) Study data from adult dual users (2015/16) who attempted to quit smoking between 2015/16 and 2016/17 (Wave 3-Wave 4, n = 685, including those who did/did not quit by 2016/17). E-cigarette flavor use (usual/last flavor, past 30-day flavor; assessed in 2015/16) was categorized into Only tobacco; Only menthol/mint; Only non-tobacco, non-menthol/mint; and Any combination of tobacco, menthol/mint, other flavor(s). The key outcome, evaluated at follow-up in 2016/17, was frequent e-cigarette use, which was defined as use on 20+ of past 30 days. Logistic regression was used to evaluate associations between e-cigarette flavor use in 2015/16 and frequent e-cigarette use at follow-up in 2016/17. Dual users who attempted to quit smoking had greater odds of frequent e-cigarette use at follow-up when they used only non-tobacco, non-menthol/mint flavor than when they used only tobacco flavor as their regular/last e-cigarette flavor (OR = 1.9, 95% CI: 1.1–3.4); findings were no longer significant when adjusted for factors including e-cigarette device type (AOR = 1.4, 95% CI: 0.7–2.8). Past 30-day e-cigarette flavor use results were generally similar, although frequent e-cigarette use at follow-up was highest among those who used any combination of tobacco, menthol/mint, or other flavors. Findings indicate that e-cigarette flavor use among dual users who attempt to quit smoking may be related to e-cigarette use frequency overall, which may indicate a mechanism underlying findings for e-cigarette use and smoking cessation. Further longitudinal research may help to disentangle how e-cigarette characteristics uniquely impact e-cigarette use frequency and smoking cessation/sustained use. Full article
Open AccessArticle
Association between Living with Patients with Dementia and Family Caregivers’ Depressive Symptoms—Living with Dementia Patients and Family Caregivers’ Depressive Symptoms
Int. J. Environ. Res. Public Health 2021, 18(8), 4372; https://doi.org/10.3390/ijerph18084372 - 20 Apr 2021
Viewed by 201
Abstract
Depression among family caregivers is becoming an increasingly important issue due to a growing elderly population. This study aimed to examine the association of living with a patient with dementia and family caregivers’ depressive symptoms, among Korean adults. This study used the data [...] Read more.
Depression among family caregivers is becoming an increasingly important issue due to a growing elderly population. This study aimed to examine the association of living with a patient with dementia and family caregivers’ depressive symptoms, among Korean adults. This study used the data of 371,287 participants after excluding those who indicated having dementia themselves from the Korea Community Health Survey of 2018–2019. Depressive symptoms were measured using the Patient Health Questionnaire-9. Data were analyzed using multiple logistic regression. The rates of spouse caregivers having depressive symptoms were 9.4% and 10.8% among men and women, respectively. The odds ratio for risk of depressive symptoms among male and female spouse caregivers in comparison to non-caregivers was 2.65 and 2.28, respectively. In the subgroup analysis, the highest income group was associated with risk of depressive symptoms, with an odds ratio of 4.28 for men, and 3.02 for women. Having a patient with dementia in the family was significantly associated with family caregivers’ depressive symptoms. In particular, when the patient with dementia was a spouse, both women and men were likely to have depressive symptoms. To reduce the burden of caregivers, we need management policies and interventions for family caregivers. Full article
Open AccessArticle
Time Trends of Percutaneous Injuries in Hospital Nurses: Evidence of the Interference between Effects of Adoption of Safety Devices and Organizational Factors
Int. J. Environ. Res. Public Health 2021, 18(8), 4371; https://doi.org/10.3390/ijerph18084371 - 20 Apr 2021
Viewed by 158
Abstract
Few studies have focused on the combined effects of devices and work organization on needlestick injuries trends. The aim of the study was to estimate trends of percutaneous injury rates (IR) in nurses (N) and nurse assistants (NA) over a 10 year period, [...] Read more.
Few studies have focused on the combined effects of devices and work organization on needlestick injuries trends. The aim of the study was to estimate trends of percutaneous injury rates (IR) in nurses (N) and nurse assistants (NA) over a 10 year period, in which passive safety devices were progressively adopted. Percutaneous and mucocutaneous injuries registered in a University Hospital in Northern Italy in Ns and NAs in 2007–2016 were analyzed. Organizational data were also available on shift schedules, turnover, downsizing and age- and skill-mix. We estimated IRs per 100 full-time equivalent workers from Poisson models and their average annual percent changes (APC) from joinpoint regression model. In the entire period, monotonic decreases in percutaneous IRs occurred among day-shift Ns (APC = −20.9%; 95% CI: −29.8%, −12%) and NAs (APC = −15.4%; −32.9%, 2.2%). Joinpoint modeling revealed a turning point in 2012 for night-shift Ns, with a steady decline in 2007–2012 (APC = −19.4%; −27.9%, −10.9%), and an increase thereafter (APC = +13.5%; 1.5%, 25.5%). In comparison to 2008 and 2012, in 2016 night-shift Ns were 5.9 and 2.5 times more likely to be younger and less qualified or experienced than day-shift Ns. The observed declines in percutaneous injury rates occurred in a time period when safety devices were progressively implemented. The causal nature of multiple exposures and organizational procedures in affecting injury time trends should be further addressed by quasi-experimental studies. Full article
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Open AccessArticle
Pharmacist-Led Collaborative Medication Management for the Elderly with Chronic Kidney Disease and Polypharmacy
Int. J. Environ. Res. Public Health 2021, 18(8), 4370; https://doi.org/10.3390/ijerph18084370 - 20 Apr 2021
Viewed by 183
Abstract
Inappropriate polypharmacy is likely in older adults with chronic kidney disease (CKD) owing to the considerable burden of comorbidities. We aimed to describe the impact of pharmacist-led geriatric medication management service (MMS) on the quality of medication use. This retrospective descriptive study included [...] Read more.
Inappropriate polypharmacy is likely in older adults with chronic kidney disease (CKD) owing to the considerable burden of comorbidities. We aimed to describe the impact of pharmacist-led geriatric medication management service (MMS) on the quality of medication use. This retrospective descriptive study included 95 patients who received geriatric MMS in an ambulatory care clinic in a single tertiary-care teaching hospital from May 2019 to December 2019. The average age of the patients was 74.9 ± 7.3 years; 40% of them had CKD Stage 4 or 5. Medication use quality was assessed in 87 patients. After providing MMS, the total number of medications and potentially inappropriate medications (PIMs) decreased from 13.5 ± 4.3 to 10.9 ± 3.8 and 1.6 ± 1.4 to 1.0 ± 1.2 (both p < 0.001), respectively. Furthermore, the number of patients who received three or more central nervous system-active drugs and strong anticholinergic drugs decreased. Among the 354 drug-related problems identified, “missing patient documentation” was the most common, followed by “adverse effect” and “drug not indicated.” The most frequent intervention was “therapy stopped”. In conclusion, polypharmacy and PIMs were prevalent in older adults with CKD; pharmacist-led geriatric MMS improved the quality of medication use in this population. Full article
(This article belongs to the Special Issue Medication Safety and Pharmacy Practice)
Open AccessArticle
Public Health Workforce Burnout in the COVID-19 Response in the U.S.
Int. J. Environ. Res. Public Health 2021, 18(8), 4369; https://doi.org/10.3390/ijerph18084369 - 20 Apr 2021
Viewed by 172
Abstract
While the health impacts of the COVID-19 pandemic on frontline health care workers have been well described, the effects of the COVID-19 response on the U.S. public health workforce, which has been impacted by the prolonged public health response to the pandemic, has [...] Read more.
While the health impacts of the COVID-19 pandemic on frontline health care workers have been well described, the effects of the COVID-19 response on the U.S. public health workforce, which has been impacted by the prolonged public health response to the pandemic, has not been adequately characterized. A cross-sectional survey of public health professionals was conducted to assess mental and physical health, risk and protective factors for burnout, and short- and long-term career decisions during the pandemic response. The survey was completed online using the Qualtrics survey platform. Descriptive statistics and prevalence ratios (95% confidence intervals) were calculated. Among responses received from 23 August and 11 September 2020, 66.2% of public health workers reported burnout. Those with more work experience (1–4 vs. <1 years: prevalence ratio (PR) = 1.90, 95% confidence interval (CI) = 1.08−3.36; 5–9 vs. <1 years: PR = 1.89, CI = 1.07−3.34) or working in academic settings (vs. practice: PR = 1.31, CI = 1.08–1.58) were most likely to report burnout. As of September 2020, 23.6% fewer respondents planned to remain in the U.S. public health workforce for three or more years compared to their retrospectively reported January 2020 plans. A large-scale public health emergency response places unsustainable burdens on an already underfunded and understaffed public health workforce. Pandemic-related burnout threatens the U.S. public health workforce’s future when many challenges related to the ongoing COVID-19 response remain unaddressed. Full article
(This article belongs to the Section Public Health Statistics and Risk Assessment)
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Open AccessReview
The Management of Psychomotor Agitation Associated with Schizophrenia or Bipolar Disorder: A Brief Review
Int. J. Environ. Res. Public Health 2021, 18(8), 4368; https://doi.org/10.3390/ijerph18084368 - 20 Apr 2021
Viewed by 168
Abstract
The early and correct assessment of psychomotor agitation (PMA) is essential to ensure prompt intervention by healthcare professionals to improve the patient’s condition, protect healthcare staff, and facilitate future management. Proper training for recognizing and managing agitation in all care settings is desirable [...] Read more.
The early and correct assessment of psychomotor agitation (PMA) is essential to ensure prompt intervention by healthcare professionals to improve the patient’s condition, protect healthcare staff, and facilitate future management. Proper training for recognizing and managing agitation in all care settings is desirable to improve patient outcomes. The best approach is one that is ethical, non-invasive, and respectful of the patient’s dignity. When deemed necessary, pharmacological interventions must be administered rapidly and avoid producing an excessive state of sedation, except in cases of severe and imminent danger to the patient or others. The purpose of this brief review is to raise awareness about best practices for the management of PMA in emergency care situations and consider the role of new pharmacological interventions in patients with agitation associated with bipolar disorder or schizophrenia. Full article
(This article belongs to the Section Health Behavior, Chronic Disease and Health Promotion)
Open AccessArticle
Psychological Impact of the Lockdown Due to the COVID-19 Pandemic in University Workers: Factors Related to Stress, Anxiety, and Depression
Int. J. Environ. Res. Public Health 2021, 18(8), 4367; https://doi.org/10.3390/ijerph18084367 - 20 Apr 2021
Viewed by 154
Abstract
This study aims to explore the psychological impact of the coronavirus disease (COVID-19)-related lockdown in university workers, and to analyse the factors related to their levels of stress, anxiety, and depression. A cross-sectional study was conducted between 8–22 April 2020, 3.5 weeks after [...] Read more.
This study aims to explore the psychological impact of the coronavirus disease (COVID-19)-related lockdown in university workers, and to analyse the factors related to their levels of stress, anxiety, and depression. A cross-sectional study was conducted between 8–22 April 2020, 3.5 weeks after the COVID-19-related lockdown in Spain. We collected sociodemographic and occupational data, in addition to housing, work and health conditions. Coping strategies (Brief COPE-28); level of anxiety, stress, and depression (Depression Anxiety Stress Scales DASS-21); perception of the disease (COVID-19) (Brief Illness Perception Questionnaire BIPQ); and perceived level of social support (Escala Multidimensional de Apoyo Social EMAS) were measured. Multiple linear regression models were fitted to explore the factors related to the level of anxiety, depression, and stress. The sample included 677 subjects. Higher scores in depression, anxiety, and stress occurred among females, younger subjects, administration and service workers; and subjects with a smaller home, as well as those with worse health status, worse quality of sleep, and dysfunctional coping strategies. The COVID-19-related lockdown had a great impact on the mental health of university workers. The participants with specific sociodemographic and occupational characteristics, clinical disorders, and dysfunctional coping strategies were more at risk. Full article
Open AccessArticle
Heat Acclimation Following Heat Acclimatization Elicits Additional Physiological Improvements in Male Endurance Athletes
Int. J. Environ. Res. Public Health 2021, 18(8), 4366; https://doi.org/10.3390/ijerph18084366 - 20 Apr 2021
Viewed by 159
Abstract
The purpose of this study was to assess the effectiveness of heat acclimatization (HAz) followed by heat acclimation (HA) on physiological adaptations. 25 male endurance athletes (age 36 ± 12 y, height 178.8 ± 6.39 cm, body mass 73.03 ± 8.97 kg, and [...] Read more.
The purpose of this study was to assess the effectiveness of heat acclimatization (HAz) followed by heat acclimation (HA) on physiological adaptations. 25 male endurance athletes (age 36 ± 12 y, height 178.8 ± 6.39 cm, body mass 73.03 ± 8.97 kg, and VO2peak 57.5 ± 7.0 mL·kg−1·min−1) completed HAz and HA. HAz was 3 months of self-directed summer training. In the laboratory, a 5-day HA prescribed exercise to target a hyperthermic zone (HZHA) of Trec between 38.50 and 39.75 °C for 60 min. Exercise trials were 60 min of running (59% ± 2% VO2peak) in an environmental chamber (wet bulb globe temperature 29.53 ± 0.63 °C) and administered at: baseline, post-HAz, and post-HAz+HA. Measured variables included internal body temperature (Trec), heart rate (HR), and sweat rate (SR). Repeated measure ANOVAs and post hoc comparisons were used to assess statistically significant (p < 0.05) differences. Trec was lower post-HAz+HA (38.03 ± 0.39 °C) than post-HAz (38.25 ± 0.42 °C, p = 0.009) and baseline (38.29 ± 0.37 °C, p = 0.005). There were no differences between baseline and post-HAz (p = 0.479) in Trec. HR was lower post-HAz (143 ± 12 bpm, p = 0.002) and post-HAz+HA (134 ± 11 bpm, p < 0.001) than baseline (138 ± 14 bpm). HR was lower post-HAz+HA than post-HAz (p = 0.013). SR was higher post-HAz+HA (1.93 ± 0.47 L·h−1) than post-HAz (1.76 ± 0.43 L·h−1, p = 0.027). Combination HAz and HA increased physiological outcomes above HAz. This method can be used to improve performance and safety in addition to HAz alone. Full article
(This article belongs to the Special Issue Exercise and Sport in Stressful Conditions and Environments)
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Open AccessArticle
The Relationship between Suicidality and Socio-Demographic Variables, Physical Disorders, and Psychiatric Disorders: Results from the Singapore Mental Health Study 2016
Int. J. Environ. Res. Public Health 2021, 18(8), 4365; https://doi.org/10.3390/ijerph18084365 - 20 Apr 2021
Viewed by 191
Abstract
Suicidality encompasses suicidal ideation, plans, and attempts. This paper aims to establish associations between suicidality and sociodemographic variables, physical disorders, and psychiatric disorders. The Singapore Mental Health Study 2016 was a population-level epidemiological survey, which determined the prevalence of physical disorders, psychiatric disorders, [...] Read more.
Suicidality encompasses suicidal ideation, plans, and attempts. This paper aims to establish associations between suicidality and sociodemographic variables, physical disorders, and psychiatric disorders. The Singapore Mental Health Study 2016 was a population-level epidemiological survey, which determined the prevalence of physical disorders, psychiatric disorders, and suicidality. Questionnaires were used to determine socio-demographic information. A total of 6216 respondents were interviewed. Lifetime prevalence of suicidal ideation, planning, and attempts were 7.8%, 1.6%, and 1.6%, respectively. All components of suicidality were more likely in those with major depressive disorder, bipolar disorder, generalized anxiety disorder, alcohol use disorder, and chronic pain. Suicidal ideation and attempts were more likely in those with diabetes. Age above 65, being male, and a monthly household income of ≥ SGD 10,000 were associated with a lower likelihood of suicidal ideation. These findings indicate that there are high-risk groups for whom suicidality is a concern, and for whom interventions may be needed. Full article
Open AccessArticle
Individual-Level Determinants of Lifestyle Behavioral Changes during COVID-19 Lockdown in the United States: Results of an Online Survey
Int. J. Environ. Res. Public Health 2021, 18(8), 4364; https://doi.org/10.3390/ijerph18084364 - 20 Apr 2021
Viewed by 215
Abstract
This study examined individual-level determinants of self-reported changes in healthy (diet and physical activity) and addictive (alcohol use, smoking, and vaping) lifestyle behaviors during the initial COVID-19 lockdown period in the USA. A national online survey was administered between May and June 2020 [...] Read more.
This study examined individual-level determinants of self-reported changes in healthy (diet and physical activity) and addictive (alcohol use, smoking, and vaping) lifestyle behaviors during the initial COVID-19 lockdown period in the USA. A national online survey was administered between May and June 2020 that targeted a representative U.S. sample and yielded data from 1276 respondents, including 58% male and 50% racial/ethnic minorities. We used univariate and multivariable linear regression models to examine the associations of sociodemographic, mental health, and behavioral determinants with self-reported changes in lifestyle behaviors. Some study participants reported increases in healthy lifestyle behaviors since the pandemic (i.e., 36% increased healthy eating behaviors, and 33% increased physical activity). However, they also reported increases in addictive lifestyle behaviors including alcohol use (40%), tobacco use (41%), and vaping (46%). With regard to individual-level determinants, individuals who reported adhering to social distancing guidelines were also more likely to report increases in healthy lifestyle behaviors (β = 0.12, 95% CI 0.04 to 0.21). Conversely, women (β = −0.37, 95% CI −0.62 to −0.12), and unemployed individuals (β = −0.33, 95% CI −0.64 to −0.02) were less likely to report increases in healthy lifestyle behaviors. In addition, individuals reporting anxiety were more likely to report increases in addictive behaviors (β = 0.26, 95% CI 0.09 to 0.43). Taken together, these findings suggest that women and unemployed individuals may benefit from interventions targeting diet and physical activity, and that individuals reporting anxiety may benefit from interventions targeting smoking and alcohol cessation to address lifestyle changes during the pandemic. Full article
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Open AccessArticle
Avoidance of Healthcare Utilization in South Korea during the Coronavirus Disease 2019 (COVID-19) Pandemic
Int. J. Environ. Res. Public Health 2021, 18(8), 4363; https://doi.org/10.3390/ijerph18084363 - 20 Apr 2021
Viewed by 184
Abstract
Avoidance of healthcare utilization among the general population during pandemic outbreaks has been observed and it can lead to a negative impact on population health. The object of this study is to examine the influence of socio-demographic and health-related factors on the avoidance [...] Read more.
Avoidance of healthcare utilization among the general population during pandemic outbreaks has been observed and it can lead to a negative impact on population health. The object of this study is to examine the influence of socio-demographic and health-related factors on the avoidance of healthcare utilization during the global outbreak of a novel coronavirus (COVID-19) in 2020. Data were collected through an online survey four weeks after the Korea Centers for Disease Control and Prevention (KCDC) confirmed the first case in South Korea; 1000 subjects were included in the analysis. The logit model for regression was used to analyze the associations between sociodemographic and health-related factors regarding the avoidance of healthcare utilization. Among the participants, 73.2% avoided healthcare utilization, and there was no significant difference in the prevalence of healthcare avoidance between groups with (72.0%) and without (74.9%) an underlying disease. Sociodemographic characteristics (e.g., gender, age, income level, and residential area) were related to healthcare avoidance. Among the investigated influencing factors, residential areas highly affected by COVID-19 (i.e., Daegu/Gyeoungbuk region) had the most significant effect on healthcare avoidance. This study found a high prevalence of healthcare avoidance among the general population who under-utilized healthcare resources during the COVID-19 outbreak. However, the results reveal that not all societal groups share the burden of healthcare avoidance equally, with it disproportionately affecting those with certain sociodemographic characteristics. This study can inform healthcare under-utilization patterns during emerging infectious disease outbreaks and provide information to public health emergency management for implementing strategies necessary to improve the preparedness of the healthcare system. Full article
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Open AccessArticle
Impact of COVID-19 Lockdown on Sun Exposure of UK Office Workers
Int. J. Environ. Res. Public Health 2021, 18(8), 4362; https://doi.org/10.3390/ijerph18084362 - 20 Apr 2021
Viewed by 133
Abstract
The impact of lockdown due to the COVID-19 pandemic in April–June 2020 on UV exposure of office workers was assessed using an online survey on time spent outdoors and environmental data for different locations in the UK. Without the need for commuting and [...] Read more.
The impact of lockdown due to the COVID-19 pandemic in April–June 2020 on UV exposure of office workers was assessed using an online survey on time spent outdoors and environmental data for different locations in the UK. Without the need for commuting and with the flexibility of homeworking, weekday time spent outdoors was higher in the 2020 lockdown than in the same period in 2017. The weekday erythema effective radiant exposure was higher in 2020 due to an additional 45 min outdoors in the late afternoon that was not observed in 2017 and high UV levels due to extremely sunny weather in spring. The lockdown did not impact the frequency of time spent outdoors around midday, which was still governed by work commitments, and at the weekends, no difference between 2020 and 2017 was observed. In 2020, responders felt that time outdoors was very important for their health and well-being. Full article
(This article belongs to the Special Issue Occupational Health and Safety: Outdoor Workers and Sun Exposure)
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Open AccessReview
SARS/MERS/SARS-CoV-2 Outbreaks and Burnout Syndrome among Healthcare Workers. An Umbrella Systematic Review
Int. J. Environ. Res. Public Health 2021, 18(8), 4361; https://doi.org/10.3390/ijerph18084361 - 20 Apr 2021
Viewed by 180
Abstract
The coronavirus-19 (COVID-19) pandemic is putting a severe strain on all healthcare systems. Several occupational risk factors are challenging healthcare workers (HCWs) who are at high risk of mental health outcomes, including Burnout Syndrome (BOS). BOS is a psychological syndrome characterized by emotional [...] Read more.
The coronavirus-19 (COVID-19) pandemic is putting a severe strain on all healthcare systems. Several occupational risk factors are challenging healthcare workers (HCWs) who are at high risk of mental health outcomes, including Burnout Syndrome (BOS). BOS is a psychological syndrome characterized by emotional exhaustion, depersonalization, and low personal accomplishment. An umbrella review of systematic reviews and meta-analyses concerning BOS and coronavirus (SARS/MERS/SARS-CoV-2) outbreaks was carried out on PubMed Central/Medline, Cochrane Library, PROSPERO, and Epistemonikos databases. Data relating to COVID-19 is insufficient, but in previous SARS and MERS outbreaks about one-third of HCWs manifested BOS. This prevalence rate is similar to the figure recorded in some categories of HCWs exposed to chronic occupational stress and poor work organization during non-epidemic periods. Inadequate organization and worsening working conditions during an epidemic appear to be the most likely causes of BOS. Preventive care and workplace health promotion programs could be useful for protecting healthcare workers during pandemics, as well as during regular health activities. Full article
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