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Int. J. Environ. Res. Public Health, Volume 19, Issue 10 (May-2 2022) – 474 articles

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Article
Assessment of Pain-Related Fear in Indigenous Australian Populations Using the Fear of Pain-9 Questionnaire (FPQ-9)
Int. J. Environ. Res. Public Health 2022, 19(10), 6256; https://doi.org/10.3390/ijerph19106256 (registering DOI) - 20 May 2022
Abstract
In this study, we examined the psychometric properties of the Fear of Pain Questionnaire (FPQ-9) in Indigenous Australian people. FPQ-9, a shorter version of the original Fear of Pain Questionnaire-III, was developed to support the demand for more concise scales with faster administration [...] Read more.
In this study, we examined the psychometric properties of the Fear of Pain Questionnaire (FPQ-9) in Indigenous Australian people. FPQ-9, a shorter version of the original Fear of Pain Questionnaire-III, was developed to support the demand for more concise scales with faster administration time in the clinical and research setting. The psychometric properties of FPQ-9 in Indigenous Australian participants (n = 735) were evaluated with network psychometrics, such as dimensionality, model fit, internal consistency and reliability, measurement invariance, and criterion validity. Our findings indicated that the original FPQ-9 three-factor structure had a poor fit and did not adequately capture pain-related fear in Indigenous Australian people. On removal of two cross-loading items, an adapted version Indigenous Australian Fear of Pain Questionnaire-7 (IA-FPQ-7) displayed good fit and construct validity and reliability for assessing fear of pain in a sample of Indigenous Australian people. The IA-FPQ-7 scale could be used to better understand the role and impact of fear of pain in Indigenous Australian people living with chronic pain. This could allow for more tailored and timely interventions for managing pain in Indigenous Australian communities. Full article
(This article belongs to the Section Health Care Sciences & Services)
Article
Research on the Influence of Education of Farmers’ Cooperatives on the Adoption of Green Prevention and Control Technologies by Members: Evidence from Rural China
Int. J. Environ. Res. Public Health 2022, 19(10), 6255; https://doi.org/10.3390/ijerph19106255 - 20 May 2022
Abstract
The study explores the impact of education of farmers’ cooperatives on members’ green production behavior. The Probit, Oprobit model and the mediation effect model are used to analyze the influence mechanism of the cooperative’s education on the members’ adoption of four types of [...] Read more.
The study explores the impact of education of farmers’ cooperatives on members’ green production behavior. The Probit, Oprobit model and the mediation effect model are used to analyze the influence mechanism of the cooperative’s education on the members’ adoption of four types of green prevention and control technologies and the overall adoption rate, and the instrumental variable method is used for endogeneity treatment and robustness test. The results show that: (1) The education of cooperatives have a significant positive impact on the members’ physical pest control technology, biological pesticide application technology, water and fertilizer integration technology, scientific pesticides reduction technology, and the overall adoption rate plays a critical role. As a result, there is a certain degree of heterogeneity in different intergenerational member groups. (2) The education of cooperatives can significantly enhance members’ cognition of green prevention and control. (3) Through on-the-spot demonstration and general meetings of the members to carry out education, members are more likely to adopt green prevention and control technologies. These findings shed light on the mechanisms by which cooperative’s education affect the green production behavior of cooperative members and provide important policy implications for green agricultural development. Full article
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Review
Effect of Attentional Focus on Sprint Performance: A Meta-Analysis
Int. J. Environ. Res. Public Health 2022, 19(10), 6254; https://doi.org/10.3390/ijerph19106254 - 20 May 2022
Abstract
Sprinting is often seen in a variety of sports. Focusing one’s attention externally before sprinting has been demonstrated to boost sprint performance. The present study aimed to systematically review previous findings on the impact of external focus (EF), in comparison to internal focus [...] Read more.
Sprinting is often seen in a variety of sports. Focusing one’s attention externally before sprinting has been demonstrated to boost sprint performance. The present study aimed to systematically review previous findings on the impact of external focus (EF), in comparison to internal focus (IF), on sprint performance. A literature search was conducted in five electronic databases (APA PsycINFO, PubMed, Scopus, SPORTDiscus, and Web of Science). A random-effects model was used to pool Hedge’s g with 95% confidence intervals (CIs). The meta-analysis included six studies with a total of 10 effect sizes and 166 participants. In general, the EF condition outperformed the IF condition in sprint performance (g = 0.279, 95% CI [0.088, 0.470], p = 0.004). The subgroup analysis, which should be viewed with caution, suggested that the benefits associated with the EF strategy were significant in low-skill sprinters (g = 0.337, 95% CI [0.032, 0.642], p = 0.030) but not significant in high-skill sprinters (g = 0.246, 95% CI [−0.042, 0.533], p = 0.094), although no significant difference was seen between these subgroups (p = 0.670). The reported gain in sprint performance due to attentional focus has practical implications for coaches and athletes, as making tiny adjustments in verbal instructions can lead to significant behavioral effects of great importance in competitive sports. Full article
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Article
Dynamics of a Bacterial Community in the Anode and Cathode of Microbial Fuel Cells under Sulfadiazine Pressure
Int. J. Environ. Res. Public Health 2022, 19(10), 6253; https://doi.org/10.3390/ijerph19106253 - 20 May 2022
Abstract
Microbial fuel cells (MFCs) could achieve the removal of antibiotics and generate power in the meantime, a process in which the bacterial community structure played a key role. Previous work has mainly focused on microbes in the anode, while their role in the [...] Read more.
Microbial fuel cells (MFCs) could achieve the removal of antibiotics and generate power in the meantime, a process in which the bacterial community structure played a key role. Previous work has mainly focused on microbes in the anode, while their role in the cathode was seldomly mentioned. Thus, this study explored the bacterial community of both electrodes in MFCs under sulfadiazine (SDZ) pressure. The results showed that the addition of SDZ had a limited effect on the electrochemical performance, and the maximum output voltage was kept at 0.55 V. As the most abundant phylum, Proteobacteria played an important role in both the anode and cathode. Among them, Geobacter (40.30%) worked for power generation, while Xanthobacter (11.11%), Bradyrhizobium (9.04%), and Achromobacter (7.30%) functioned in SDZ removal. Actinobacteria mainly clustered in the cathode, in which Microbacterium (9.85%) was responsible for SDZ removal. Bacteroidetes, associated with the degradation of SDZ, showed no significant difference between the anode and cathode. Cathodic and part of anodic bacteria could remove SDZ efficiently in MFCs through synergistic interactions and produce metabolites for exoelectrogenic bacteria. The potential hosts of antibiotic resistance genes (ARGs) presented mainly at the anode, while cathodic bacteria might be responsible for ARGs reduction. This work elucidated the role of microorganisms and their synergistic interaction in MFCs and provided a reference to generate power and remove antibiotics using MFCs. Full article
(This article belongs to the Special Issue Wastewater Treatment Technologies and Analysis)
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Article
Impact of Carbon Tax and Subsidy Policies on Original Equipment Manufacturers and Remanufacturing Companies from the Perspective of Carbon Emissions
Int. J. Environ. Res. Public Health 2022, 19(10), 6252; https://doi.org/10.3390/ijerph19106252 - 20 May 2022
Abstract
To analyze the impact of government carbon tax and subsidy policies on the manufac turing industry in the context of carbon peaking and carbon neutrality. This paper constructs a game model based on two government policies: a “carbon tax” policy for the original [...] Read more.
To analyze the impact of government carbon tax and subsidy policies on the manufac turing industry in the context of carbon peaking and carbon neutrality. This paper constructs a game model based on two government policies: a “carbon tax” policy for the original product and a “subsidy” policy for the remanufactured product, taking the original product and the remanufactured product as the objects. The policy game model is used to study the impact of carbon taxes, government subsidies, and carbon emissions on product quality, sales, and corporate profits. The results show that under the carbon tax and government subsidy policies, the price of remanufactured products will decrease, the quality will increase, sales will improve, and remanufacturers’ profits will increase; these outcomes are conducive to the development of remanufacturing enterprises. Meanwhile, the price of original products will increase, quality will decrease, sales will decline, and original equipment manufacturers will have to develop and adopt low-carbon technologies to achieve sustainable development. This paper provides decision support for the formulation of government carbon emission policy, and theories and methods for the sustainable development of the manufacturing industry. Full article
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Article
The Pathway to China’s Carbon Neutrality Based on an Endogenous Technology CGE Model
Int. J. Environ. Res. Public Health 2022, 19(10), 6251; https://doi.org/10.3390/ijerph19106251 - 20 May 2022
Abstract
Global warming resulting from greenhouse gas emissions has been a worldwide issue facing humanity. Simultaneously, governments have the challenging task of striking a judicious balance between increased economic growth and decreased carbon emissions. Based on the energy-environment-economy triple coupling (3E-CGE) model, we endogenously [...] Read more.
Global warming resulting from greenhouse gas emissions has been a worldwide issue facing humanity. Simultaneously, governments have the challenging task of striking a judicious balance between increased economic growth and decreased carbon emissions. Based on the energy-environment-economy triple coupling (3E-CGE) model, we endogenously integrate climate-friendly technologies into the model’s analysis framework through logic curves and refine and modify the CGE model’s energy use and carbon emission modules. We conduct a scenario simulation and sensitivity analysis on carbon tax, carbon-trading, and climate-friendly technological progress, respectively. The results reveal that carbon tax and carbon trading contribute to reducing carbon emissions in the short-term but achieving the goals of peak carbon and carbon neutrality will cause the collapse of the economic system. In the long-term, climate-friendly technologies are key to achieving the dual carbon goal; the development of such technologies can also stimulate economic development. The best path for China to achieve its dual carbon goals and economic development in the next 40 years involves effectively combining the carbon tax, carbon trading, and a climate-friendly technological progress. Specifically, China can begin trading carbon in high-emissions industries then impose industry-wide carbon taxes. Full article
(This article belongs to the Special Issue Managing a Sustainable and Low-Carbon Society)
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Article
Growth Targets Management, Regional Competition and Urban Land Green Use Efficiency according to Evidence from China
Int. J. Environ. Res. Public Health 2022, 19(10), 6250; https://doi.org/10.3390/ijerph19106250 - 20 May 2022
Abstract
Based on the panel data of 257 prefecture-level cities in China from 2010 to 2017, this paper measured urban land green use efficiency (ULGUE), incorporating undesirable outputs, via the super efficiency slack-based model (SBM). It also explored the effect, mechanism, and heterogeneity of [...] Read more.
Based on the panel data of 257 prefecture-level cities in China from 2010 to 2017, this paper measured urban land green use efficiency (ULGUE), incorporating undesirable outputs, via the super efficiency slack-based model (SBM). It also explored the effect, mechanism, and heterogeneity of growth targets management and regional competition on ULGUE via the time-varying gravitational spatial weight matrix and the spatial self-lagging model. The results show that growth targets management and regional competition have significant positive effects on ULGUE, and enhance the ULGUE by promoting local investment attraction, increasing innovation inputs, optimizing environmental regulations and strengthening commercial activities. Additionally, growth targets management has a more significant effect on eastern cities, non-central cities, and mature urban agglomeration, while regional competition has a more significant effect on central cities, non-central cities, and developmental urban agglomeration. Therefore, considering development as the priority, setting relatively aggressive economic growth targets and optimizing the regional competition mechanism for growth targets management can help improve the ULGUE and promote high-quality economic development in China. Full article
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Article
Brown Dog Tick (Rhipicephalus sanguineus Sensu Lato) Infection with Endosymbiont and Human Pathogenic Rickettsia Spp., in Northeastern México
Int. J. Environ. Res. Public Health 2022, 19(10), 6249; https://doi.org/10.3390/ijerph19106249 - 20 May 2022
Abstract
Of the documented tick-borne diseases infecting humans in México, Rocky Mountain spotted fever (RMSF), caused by the Gram-negative bacterium Rickettsia rickettsii, is responsible for most fatalities. Given recent evidence of brown dog tick, Rhipicephalus sanguineus s.l., as an emerging vector of human [...] Read more.
Of the documented tick-borne diseases infecting humans in México, Rocky Mountain spotted fever (RMSF), caused by the Gram-negative bacterium Rickettsia rickettsii, is responsible for most fatalities. Given recent evidence of brown dog tick, Rhipicephalus sanguineus s.l., as an emerging vector of human RMSF, we aimed to evaluate dogs and their ticks for rickettsiae infections as an initial step in assessing the establishment of this pathosystem in a poorly studied region of northeastern México while evaluating the use of dogs as sentinels for transmission/human disease risk. We sampled owned dogs living in six disadvantaged neighborhoods of Reynosa, northeastern México to collect whole blood and ticks. Of 168 dogs assessed, tick infestation prevalence was 53%, composed of exclusively Rh. sanguineus s. l. (n = 2170 ticks). Using PCR and sequencing, we identified an overall rickettsiae infection prevalence of 4.1% (n = 12/292) in ticks, in which eight dogs harbored at least one infected tick. Rickettsiae infections included Rickettsia amblyommatis and Rickettsia parkeri, both of which are emerging human pathogens, as well as Candidatus Rickettsia andeanae. This is the first documentation of pathogenic Rickettsia species in Rh. sanguineus s.l. collected from dogs from northeastern México. Domestic dog infestation with Rickettsia-infected ticks indicates ongoing transmission; thus, humans are at risk for exposure, and this underscores the importance of public and veterinary health surveillance for these pathogens. Full article
Article
Young Carer Perception of Control: Results of a Phenomenology with a Mixed Sample of Young Carers Accessing Support and Unknown to Services
Int. J. Environ. Res. Public Health 2022, 19(10), 6248; https://doi.org/10.3390/ijerph19106248 - 20 May 2022
Abstract
Identification challenges have resulted in young carers research largely being conducted with those who access support. Positive and negative impacts have been evidenced but there remains little consideration of the wider population. This phenomenology defines young carers as a spectrum of children with [...] Read more.
Identification challenges have resulted in young carers research largely being conducted with those who access support. Positive and negative impacts have been evidenced but there remains little consideration of the wider population. This phenomenology defines young carers as a spectrum of children with different experiences and aims to study the larger group. Participants were recruited from schools and projects, resulting in a mixed sample of young carers who were accessing support but also those who were unknown to services. Participants attended three interviews that initially gathered data on their caring role and family circumstances, before focusing on their health and well-being in the context of change. All interviews were transcribed and analysed at a whole-text and in-depth level to identify shared understanding. A study of the wider spectrum enabled the emergence of perception of control over their caring responsibilities as key to routine development. Although high levels of control helped some participants manage their roles, threats to control were identified, including instability in the care receiver’s condition, excessive caring and medical tasks. The original findings demonstrate how researching the wider spectrum can aid understanding of problematic care, and highlights the importance of recruiting young carers as a hard-to-reach group. Full article
Article
Validation of the COVID-19 Digital Health Literacy Instrument in the Italian Language: A Cross-Sectional Study of Italian University Students
Int. J. Environ. Res. Public Health 2022, 19(10), 6247; https://doi.org/10.3390/ijerph19106247 - 20 May 2022
Abstract
The Coronavirus Disease 19 (COVID-19) pandemic and the associated “infodemic” have shown the importance of surveillance and promotion of health literacy, especially for young adults such as university students who use digital media to a very high degree. This study aimed to assess [...] Read more.
The Coronavirus Disease 19 (COVID-19) pandemic and the associated “infodemic” have shown the importance of surveillance and promotion of health literacy, especially for young adults such as university students who use digital media to a very high degree. This study aimed to assess the validity and reliability of the Italian version of the COVID-19 adapted version of the Digital Health Literacy Instrument (DHLI). This cross-sectional study is part of the COVID-19 University Students Survey involving 3985 students from two Italian universities. First, item analysis and internal consistency were assessed. Then, Principal Component Analysis (PCA) and Confirmatory Factor Analyses (CFA) were performed comparing different models. The Italian DHLI showed good psychometric characteristics. The protecting privacy subscale was excluded, given the criticalities presented in the validation process. CFA confirmed the four-factor structure, also including a high-order factor. This result allows using the scale to measure a global level of digital health literacy and consider its levels separately for each construct component: searching the web for information, evaluating reliability, determining personal relevance, and adding self-generated content. Full article
(This article belongs to the Special Issue Health Literacy in the Mediterranean Countries)
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Article
Mortality for Lung Cancer among PVC Baggers Employed in the Vinyl Chloride Industry
Int. J. Environ. Res. Public Health 2022, 19(10), 6246; https://doi.org/10.3390/ijerph19106246 - 20 May 2022
Abstract
Vinyl-chloride monomer (VCM) is classified as a known carcinogen of the liver; for lung cancer, some results suggest a potential association with polyvinyl chloride (PVC) dust. We evaluated the relationship between lung cancer mortality and exposure as PVC baggers in a cohort of [...] Read more.
Vinyl-chloride monomer (VCM) is classified as a known carcinogen of the liver; for lung cancer, some results suggest a potential association with polyvinyl chloride (PVC) dust. We evaluated the relationship between lung cancer mortality and exposure as PVC baggers in a cohort of workers involved in VCM production and polymerization in Porto Marghera (Venice, Italy) considering both employment status and smoking habits. The workers were studied between 1973 and 2017. A subset of them (848 over 1658) was interviewed in the 2000s to collect information about smoking habits and alcohol consumption. Missing values were imputed by the Multivariate Imputation by Chained Equations (MICE) algorithm. We calculated standardized mortality ratios (SMR) and 95% confidence intervals (95% CIs) using regional reference rates by task (never, ever, and exclusively baggers) and by smoking habits. Mortality rate ratios (MRR), adjusted for age, calendar time, time since first exposure, and smoking habits, were obtained via Poisson regression using Rubin’s rule to combine results from imputed datasets calculating the fraction of information due to non-response. Lung cancer mortality was lower than the regional reference in the whole cohort (lung cancer SMR = 0.92; 95% CI 0.75–1.11). PVC baggers showed a 50% increase in lung cancer mortality compared to regional rates (SMR = 1.48; 95% CI 0.82–2.68). In the cohort analyses, a doubled risk of lung cancer mortality among PVC baggers was confirmed after adjustment for smoking and time-dependent covariates (MRR = 1.99, 95% CI 1.04–3.81). Exposure to PVC dust resulting from activity as bagger in a polymerization PVC plant was associated with an increase in lung cancer mortality risk after adjustment for smoking habits. Full article
Article
Determinants of Differences in Health Service Utilization between Older Rural-to-Urban Migrant Workers and Older Rural Residents: Evidence from a Decomposition Approach
Int. J. Environ. Res. Public Health 2022, 19(10), 6245; https://doi.org/10.3390/ijerph19106245 - 20 May 2022
Abstract
Background: The widening gap in health service utilization between different groups in mainland China has become an important issue that cannot be avoided. Our study explored the existence of differences and the causes of the differences in the health service utilization of older [...] Read more.
Background: The widening gap in health service utilization between different groups in mainland China has become an important issue that cannot be avoided. Our study explored the existence of differences and the causes of the differences in the health service utilization of older rural-to-urban migrant workers in comparison to older rural dwellers. Further, our study explored socioeconomic differences in health service utilization. Methods: The data from the China Labor-Force Dynamic Survey in 2016, the data from the Urban Statistical Yearbook in 2016, and the Statistical Bulletin were used. Our study applied the latest Andersen Model according to China’s current situation. Before we studied health service utilization, we used Coarsened Exact Matching to control the confounding factors. After matching, 2314 respondents were successfully matched (859 older rural-to-urban migrant workers and 1455 older rural dwellers). The Fairlie decomposition method was used to analyze the differences and the sources of health service utilization between older rural-to-urban migrant workers and their rural counterparts. Results: After matching, the probability two-weeks outpatient for older rural-to-urban migrant workers (5.59%) was significantly lower than older rural dwellers (7.57%). The probability of inpatient for older rural-to-urban migrant workers (5.59%) was significantly lower than older rural dwellers (9.07%). Overall, 17.98% of the total difference for two-week outpatient utilization was due to the observed influence factors. Moreover, 71.88% of total difference in inpatient utilization was due to the observed influence factors. Income quantiles (49.57%), health self-assessments (80.91%), and the sex ratio in the community (−102.29%) were significant in the differences in inpatient utilization. Conclusions: The findings provide important insights into the socioeconomic differences in health service utilization among older rural-to-urban migrant workers and older rural residents in China. These insights urge the government to take full account of the heterogeneity in designing health security system reform and public health interventions targeting vulnerable groups. Full article
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Article
Factors Associated with the Participation of Older Adults in Cultural and Sports Activities
Int. J. Environ. Res. Public Health 2022, 19(10), 6244; https://doi.org/10.3390/ijerph19106244 - 20 May 2022
Abstract
In the context of population aging, we have witnessed an increased interest in studying the participation of older persons in cultural and sport activities. The aim of this paper is to identify the participation rate in cultural and sports activities among Romanian older [...] Read more.
In the context of population aging, we have witnessed an increased interest in studying the participation of older persons in cultural and sport activities. The aim of this paper is to identify the participation rate in cultural and sports activities among Romanian older adults and the sociodemographics/behavioral variables that correlate with the participation rate in cultural and sports activities. In order to answer our research questions, we employed a questionnaire-based survey, and we used a nationally representative sample. Results point to low participation in both cultural and sports activities. Gender, residence, education, income, degree of mobility, internet connection, and availability of financial resources are significant variables that correlate with the engagement of older people in cultural and sports activities. Our study could serve as a base for concrete policy measures in the field of health and social inclusion of older persons. Full article
(This article belongs to the Special Issue Exercise, Sport, and Leisure Behaviors in Older Adults)
Article
Binge Eating Disorder Is a Social Justice Issue: A Cross-Sectional Mixed-Methods Study of Binge Eating Disorder Experts’ Opinions
Int. J. Environ. Res. Public Health 2022, 19(10), 6243; https://doi.org/10.3390/ijerph19106243 - 20 May 2022
Abstract
Background: Binge eating disorder is an autonomous DSM-V diagnosis characterized by discrete rapid consumption of objectively large amounts of food without compensation, associated with loss of control and distress. Environmental factors that contribute to binge eating disorder continue to evolve. This mixed-methods cross-sectional [...] Read more.
Background: Binge eating disorder is an autonomous DSM-V diagnosis characterized by discrete rapid consumption of objectively large amounts of food without compensation, associated with loss of control and distress. Environmental factors that contribute to binge eating disorder continue to evolve. This mixed-methods cross-sectional study assessed whether there is consensus among experts in the field about environmental factors that influence adult binge eating disorder pathology. Methods: Fourteen expert binge eating disorder researchers, clinicians, and healthcare administrators were identified internationally based on federal funding, PubMed-indexed publications, active practice in the field, leadership in relevant societies, and/or clinical and popular press distinction. Semi-structured interviews were recorded anonymously and analyzed by ≥2 investigators using reflexive thematic analysis and quantification. Results: Identified themes included: (1) systemic issues and systems of oppression (100%); (2) marginalized and under-represented populations (100%); (3) economic precarity and food/nutrition insecurity/scarcity (93%); (4) stigmatization and its psychological impacts (93%); (5) trauma and adversity (79%); (6) interpersonal factors (64%); (7) social messaging and social media (50%); (8) predatory food industry practices (29%); and (9) research/clinical gaps and directives (100%). Conclusions: Overall, experts call for policy changes around systemic factors that abet binge eating and for greater public education about who can have binge eating disorder. There is also a call to take and account for the narratives and life experiences of individuals with binge eating disorder to better inform our current understanding of the diagnosis and the environmental factors that impact it. Full article
(This article belongs to the Special Issue Eating Disorders: Challenges, Advances and Public Health Insight)
Article
Who Became Lonely during the COVID-19 Pandemic? An Investigation of the Socioeconomic Aspects of Loneliness in Japan
Int. J. Environ. Res. Public Health 2022, 19(10), 6242; https://doi.org/10.3390/ijerph19106242 - 20 May 2022
Abstract
The COVID-19 pandemic has impacted social and economic aspects of people’s lives in different ways, causing them to experience different levels of loneliness. This study examines the extent of loneliness among men and women of various ages in Japan during the pandemic and [...] Read more.
The COVID-19 pandemic has impacted social and economic aspects of people’s lives in different ways, causing them to experience different levels of loneliness. This study examines the extent of loneliness among men and women of various ages in Japan during the pandemic and attempts to determine the underlying causes. We used data from Hiroshima University’s nationwide survey conducted before and during the pandemic in Japan. The sample consists of 3755 participants, of which 67% are men and 33% are women with an average age of 51 years (SD = 13.64). Using mean comparison tests and probit regression models, we show that loneliness is a common occurrence among the Japanese population and that a significant number of people became lonely for the first time during the pandemic. In general, loneliness was greater among younger respondents, but older people became lonelier during the pandemic. Simultaneously, we observed significant differences in loneliness across age and gender subsamples. Although depression and subjective health status contributed to loneliness, we found no single explanation for the loneliness experienced by people during the pandemic; rather, subsample analysis revealed that the causes of loneliness for each group differed. Nevertheless, we discovered that older people are at a higher risk of developing loneliness during the pandemic due to a variety of socioeconomic and behavioral factors. The findings of this study suggest that health authorities should not generalize cases of loneliness, but rather intervene individually in each group to avoid further complications. Full article
Article
Modification Effect of PARP4 and ERCC1 Gene Polymorphisms on the Relationship between Particulate Matter Exposure and Fasting Glucose Level
Int. J. Environ. Res. Public Health 2022, 19(10), 6241; https://doi.org/10.3390/ijerph19106241 - 20 May 2022
Abstract
Particulate matter (PM) has been linked to adverse health outcomes, including insulin resistance (IR). To evaluate the relationships between exposures to PM10, PM2.5–10, and PM2.5; the serum level of fasting glucose, a key IR indicator; and effects [...] Read more.
Particulate matter (PM) has been linked to adverse health outcomes, including insulin resistance (IR). To evaluate the relationships between exposures to PM10, PM2.5–10, and PM2.5; the serum level of fasting glucose, a key IR indicator; and effects of polymorphisms of two repair genes (PARP4 and ERCC1) on these relations, PMs exposure data and blood samples for glucose measurement and genotyping were collected from 527 Korean elders. Daily average levels of PMs during 8 days, from 7 days before examination to the health examination day (from lag day 7 to lag day 0), were used for association analyses, and mean concentrations of PM10, PM2.5–10, and PM2.5 during the study period were 43.4 µg/m3, 19.9 µg/m3, and 23.6 µg/m3, respectively. All three PMs on lag day 4 (mean, 44.5 µg/m3 for PM10, 19.9 µg/m3 for PM2.5–10, and 24.3 µg/m3 for PM2.5) were most strongly associated with an increase in glucose level (percent change by inter-quartile range-change of PM: (β) = 1.4 and p = 0.0023 for PM10; β = 3.0 and p = 0.0010 for PM2.5–10; and β = 2.0 and p = 0.0134 for PM2.5). In particular, elders with PARP4 G-C-G or ERCC1 T-C haplotype were susceptible to PMs exposure in relation to glucose levels (PARP4 G-C-G: β = 2.6 and p = 0.0006 for PM10, β = 3.5 and p = 0.0009 for PM2.5–10, and β = 1.6 and p = 0.0020 for PM2.5; ERCC1 T-C: β = 2.2 and p = 0.0016 for PM10, β = 3.5 and p = 0.0003 for PM2.5–10, and β = 1.2 and p = 0.0158 for PM2.5). Our results indicated that genetic polymorphisms of PARP4 and ERCC1 could modify the relationship between PMs exposure and fasting glucose level in the elderly. Full article
Article
Mental and Physical Well-Being and Burden in Palliative Care Nursing: A Cross-Setting Mixed-Methods Study
Int. J. Environ. Res. Public Health 2022, 19(10), 6240; https://doi.org/10.3390/ijerph19106240 - 20 May 2022
Abstract
The working routines in palliative care nursing are associated with a variety of causes of stress with regional and setting-specific differences in Germany. This mixed-methods study aimed to investigate the mental and physical well-being among nurses in German palliative and hospice care and [...] Read more.
The working routines in palliative care nursing are associated with a variety of causes of stress with regional and setting-specific differences in Germany. This mixed-methods study aimed to investigate the mental and physical well-being among nurses in German palliative and hospice care and to gain a deeper understanding of procedural and structural aspects that may influence the mental and physical burden in palliative nursing care. The mixed-methods approach combined qualitative interviews, (n = 16) an online survey (n = 101), and subsequent data validation in a focus group (n = 6). Interview and focus group data were analysed using structured qualitative content analysis. Survey data were analysed using descriptive statistics and an explorative quantitative analysis. Moderate to very high levels of stress were reported across all settings, but were highest for nurses in specialized outpatient palliative care settings. Underlying causes of stress related to working conditions in the nursing profession across all palliative care settings were poor working hours, perceived inadequate remuneration, and high demands for documentation. To ensure sustainable high-quality palliative care, adaptations to working conditions that target causes of stress and burden in palliative care nurses are required. Full article
(This article belongs to the Special Issue Physical and Mental Health in the Workplace)
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Identifying the Impacts of Climate Change and Human Activities on Vegetation Cover Changes: A Case Study of the Yangtze River Basin, China
Int. J. Environ. Res. Public Health 2022, 19(10), 6239; https://doi.org/10.3390/ijerph19106239 - 20 May 2022
Abstract
The normalized difference vegetation index (NDVI) is a useful indicator to characterize vegetation development and land use which can effectively monitor changes in ecological environments. As an important area for ecological balance and safety in China, understanding the dynamic changes in land cover [...] Read more.
The normalized difference vegetation index (NDVI) is a useful indicator to characterize vegetation development and land use which can effectively monitor changes in ecological environments. As an important area for ecological balance and safety in China, understanding the dynamic changes in land cover and vegetation of the Yangtze River Basin would be crucial in developing effective policies and strategies to protect its natural environment while promoting sustainable growth. Based on MODIS-NDVI data and meteorological data from 2000 to 2019, the temporal and spatial distribution of vegetation coverage in the Yangtze River Basin during the past 20 years were characterized, and the impacts of human activities and climate change were quantitatively evaluated. We drew the following research conclusions: (1) From 2000 to 2019, the vegetation cover of the Yangtze River Basin presented a fluctuating inter-annual growth trend. Except for the Taihu Lake sub-basin, the vegetation cover in other sub-basins showed an upward trend. (2) The vegetation cover exhibited a spatial distribution pattern of “high in the middle and low in the east and west”, with the multi-year average value of NDVI being 0.5153. (3) Areas with improved vegetation cover were significantly larger than the areas with degraded foliage. The central region has stronger overall trend of change than the east, and the east is stronger than the west. These vegetation cover changes are largely related to anthropogenic activities. (4) Vegetation cover changes due to precipitation and temperature exhibited significant spatial heterogeneity. While both temperature and precipitation influenced vegetation cover, the temperature was the leading climate factor in the area. (5) Anthropogenic and climate factors jointly promoted the change of vegetation cover in the Yangtze River Basin. Human activities contributed 79.29%, while climate change contributed 20.71%. This study could be used in subsequent studies analyzing the influencing factors affecting long-term vegetation cover in large-scale watersheds. Full article
Article
Physical Activity and Food Environments in and around Schools: A Case Study in Regional North-West Tasmania
Int. J. Environ. Res. Public Health 2022, 19(10), 6238; https://doi.org/10.3390/ijerph19106238 - 20 May 2022
Abstract
A better understanding of the physical activity (PA) infrastructure in schools, the walkability of neighborhoods close to schools, and the food environments around schools, particularly in rural, socioeconomically challenged areas such as the North-West (NW) of Tasmania, could be important in the wider [...] Read more.
A better understanding of the physical activity (PA) infrastructure in schools, the walkability of neighborhoods close to schools, and the food environments around schools, particularly in rural, socioeconomically challenged areas such as the North-West (NW) of Tasmania, could be important in the wider effort to improve the health of school-age children. Accordingly, this research aimed to assess PA resources, walkability, and food environments in and around schools in three socioeconomically disadvantaged, regional/rural Local Government Areas (LGAs) of Tasmania, Australia. A census of schools (including assessment of the PA infrastructure quality within school grounds), a walkability assessment, and a census of food outlets surrounding schools (through geospatial mapping) were executed. Most of the schools in the study region had access to an oval, basketball/volleyball/netball court, and free-standing exercise equipment. In all instances (i.e., regardless of school type), the quality of the available infrastructure was substantially higher than the number of incivilities observed. Most schools also had good (i.e., within the first four deciles) walkability. Numerous food outlets were within the walking zones of all schools in the study region, with an abundance of food outlets that predominantly sold processed unhealthy food. Full article
Article
Translation and Cross-Cultural Adaptation of the Cancer Health Literacy Test for Portuguese Cancer Patients: A Pre-Test
Int. J. Environ. Res. Public Health 2022, 19(10), 6237; https://doi.org/10.3390/ijerph19106237 - 20 May 2022
Abstract
Assuming the multidimensionality of health literacy, new complex and comprehensive approaches are more adequate to specific disease contexts, such as cancer. Assessing cancer literacy levels is a priority, since it entails potential serious implications for disease outcomes and patient’s quality of life. This [...] Read more.
Assuming the multidimensionality of health literacy, new complex and comprehensive approaches are more adequate to specific disease contexts, such as cancer. Assessing cancer literacy levels is a priority, since it entails potential serious implications for disease outcomes and patient’s quality of life. This article reports on the translation and cultural adaptation of the Cancer Health Literacy Test to measure cancer literacy in Portuguese cancer patients. A multidisciplinary team of experts ensured the translation and cultural adaptation of the CHLT-30. A pre-test was conducted in two stages to evaluate the Portuguese version (CHLT-30 PT) in a sample of cancer patients (n = 71). Descriptive statistics were used to characterize the sample. Reliability (test–retest and internal consistency) and construct validity of CHLT-30 PT were assessed. The results obtained show a good internal consistency of the tool, respectively (Cronbach’s alpha = 0.86 in the test and 0.80 in the retest). Patients’ raw score mean in both test (23.96) and retest (25.97) and the distribution of scores categories are not statistically different. A suggestive association between higher education level and better total score was found compared to the results reported in CHLT-30-DKspa. The results obtained in the pre-test are favorable, and the instrument is now suitable for the next steps of the validation process. A Portuguese version of this tool will allow outlining patients’ cancer literacy along the cancer care continuum, enabling the identification and implementation of adequate socio-educational strategies with highly positive impacts on health outcomes. Full article
Article
The Association between Postpartum Pelvic Girdle Pain and Pelvic Floor Muscle Function, Diastasis Recti and Psychological Factors—A Matched Case-Control Study
Int. J. Environ. Res. Public Health 2022, 19(10), 6236; https://doi.org/10.3390/ijerph19106236 - 20 May 2022
Abstract
There is uncertainty regarding the association between abdominal morphology, pelvic floor function, and psychological factors in women with postpartum pelvic girdle pain (PGP). The aim of this case-control study was to evaluate the differences between women with and without persistent PGP regarding pelvic [...] Read more.
There is uncertainty regarding the association between abdominal morphology, pelvic floor function, and psychological factors in women with postpartum pelvic girdle pain (PGP). The aim of this case-control study was to evaluate the differences between women with and without persistent PGP regarding pelvic floor function, diastasis recti, and psychological factors 6–24 weeks postpartum. Pelvic floor manometry, palpation examination of abdominal muscles, the International Consultation on Incontinence Questionnaire Short Form, The Depression, Anxiety and Stress Scale—21, and the Pain Catastrophizing Scale were used. The PGP group presented with lower vaginal resting pressure (p < 0.001), more tenderness (p = 0.018) and impaired voluntary activation of pelvic floor muscles (p ≤ 0.001). Women with pain also had more distortion on the level of the anterior abdominal wall (p = 0.001) and more severe diastasis recti (p = 0.046) when compared to pain-free controls. Lower vaginal resting pressure was the strongest factor explaining PGP (OR 0.702, 95%CI 0.502–0.981). There were no differences in terms of the pelvic floor strength, endurance, severity of urinary incontinence and reported distress between the groups. Women with PGP 6–24 weeks postpartum differ in pelvic floor and abdominal muscle function from the pain-free controls. Vaginal resting pressure may be an important factor in pelvic girdle pain shortly postpartum. Further studies are needed to see a trend in changes over time. Full article
(This article belongs to the Collection Women's Reproductive and Maternal Health)
Article
Physical Activity and Sports Participation among Adolescents: Associations with Sports-Related Knowledge and Attitudes
Int. J. Environ. Res. Public Health 2022, 19(10), 6235; https://doi.org/10.3390/ijerph19106235 - 20 May 2022
Abstract
The impact of physical activity and sport on the development of adolescents’ knowledge and attitudes has not been studied sufficiently. We assume that young people with more knowledge of sports will continue to be physically active on their own. The aim of this [...] Read more.
The impact of physical activity and sport on the development of adolescents’ knowledge and attitudes has not been studied sufficiently. We assume that young people with more knowledge of sports will continue to be physically active on their own. The aim of this study is to identify the differences in the sports and physical activity-related knowledge and attitudes of adolescents who engage in organised sports training and those who do not. A total of 1033 6th-grade students from (aged 12.7 ± 0.4 years) 52 schools in Estonia were involved in the study. Logistic regression analysis was used to examine the associations between sports-related knowledge and attitudes towards students participating in organised sports training. The main reasons which hindered adolescents from being active were a lack of suitable equipment, being weaker than others, and laziness. Knowledge of physical activity, higher perceived benefits, and lower barriers to physical activity were the predictors contributing to adolescents’ participation in sports training. The results demonstrated that physically active students have better knowledge of sports and physical activity. Students participating in organised sports training have strong positive benefits from being regularly physically active and feel that sports training maintains their health. Full article
Article
The Impact of Information Presentation and Cognitive Dissonance on Processing Systematic Review Summaries: A Randomized Controlled Trial on Bicycle Helmet Legislation
Int. J. Environ. Res. Public Health 2022, 19(10), 6234; https://doi.org/10.3390/ijerph19106234 - 20 May 2022
Abstract
Background: Summaries of systematic reviews are a reference method for the dissemination of research evidence on the effectiveness of public health interventions beyond the scientific community. Motivated reasoning and cognitive dissonance may interfere with readers’ ability to process the information included in [...] Read more.
Background: Summaries of systematic reviews are a reference method for the dissemination of research evidence on the effectiveness of public health interventions beyond the scientific community. Motivated reasoning and cognitive dissonance may interfere with readers’ ability to process the information included in such summaries. Methods: We conducted a web experiment on a panel of university-educated North Americans (N = 259) using a systematic review of the effectiveness of bicycle helmet legislation as a test case. The outcome variables were the perceived tentativeness of review findings and attitude toward bicycle helmet legislation. We manipulated two types of uncertainty: (i) deficient uncertainty (inclusion vs. non-inclusion of information on limitations of the studies included in the review) and (ii) consensus uncertainty (consensual findings showing legislation effectiveness vs. no evidence of effectiveness). We also examined whether reported expertise in helmet legislation and the frequency of wearing a helmet while cycling interact with the experimental factors. Results: None of the experimental manipulations had a main effect on the perceived tentativeness. The presentation of consensual efficacy findings had a positive main effect on the attitude toward the legislation. Self-reported expertise had a significant main effect on the perceived tentativeness, and exposing participants with reported expertise to results showing a lack of evidence of efficacy increased their favorable attitude toward the legislation. Participants’ helmet use was positively associated with their attitude toward the legislation (but not with perceived tentativeness). Helmet use did not interact with the experimental manipulations. Conclusions: Motivated reasoning and cognitive dissonance influence a reader’s ability to process information contained in a systematic review summary. Full article
Article
Positive Humor and Work Withdrawal Behaviors: The Role of Stress Coping Styles in the Hotel Industry Amid COVID-19 Pandemic
Int. J. Environ. Res. Public Health 2022, 19(10), 6233; https://doi.org/10.3390/ijerph19106233 - 20 May 2022
Abstract
Working in the hospitality industry is stressful due to the intensive workload and extended work hours; this stress has increased after the COVID-19 pandemic due to high levels of job insecurity, downsizing, and laying off procedures. Employees in the hotel industry can deal [...] Read more.
Working in the hospitality industry is stressful due to the intensive workload and extended work hours; this stress has increased after the COVID-19 pandemic due to high levels of job insecurity, downsizing, and laying off procedures. Employees in the hotel industry can deal with stress positively by utilizing task-coping styles or negatively by emotion- and avoidance-coping styles. Building on the transactional theory of stress and coping, and the benign violation theory of humor, the current study explores the relationships between positive humor and work withdrawal behaviors with the mediating effects of coping styles. A total of 407 hotel employees participated, and the obtained data were analyzed by structural equation modeling with partial least squares (PLS). The results asserted that affiliative humor is able to reduce coping with stresses via the negative styles and to increase coping with stresses via the positive style. The results also demonstrated the ability of task-coping in reducing work withdrawal behavior. Significant insights into theoretical and practical implications are further discussed. Full article
Case Report
Sibling Separation Due to Parental Divorce: Diagnostic Aspects
Int. J. Environ. Res. Public Health 2022, 19(10), 6232; https://doi.org/10.3390/ijerph19106232 - 20 May 2022
Abstract
Separation of siblings is one of the most difficult diagnostic problems faced by psychologists. Such situations are happening more often in the face of the increasing number of divorces and breakdown of relationships. Therefore, a diagnostic task becomes an in-depth assessment of intra-family [...] Read more.
Separation of siblings is one of the most difficult diagnostic problems faced by psychologists. Such situations are happening more often in the face of the increasing number of divorces and breakdown of relationships. Therefore, a diagnostic task becomes an in-depth assessment of intra-family relationships, ties connecting family members, the preferences of individual people and predicting the long-term consequences of the proposed solutions. The article is dedicated to this problem, and the issue is addressed through the theoretical perspective and the analysis of two cases, i.e., the situation of separated siblings. In the study of children, we present a relatively new method, based on the authors’ clinical experience, which could be used to diagnose the family situation of children. The first goal was to analyze the reasons for the separation of siblings whose parents were in conflict during the separation (first case study) and after the separation (second case study), as well as to assess the functioning of the children resulting from the family breakdown, and the decision to separate them from siblings. The analysis allowed identifying the areas of sibling functioning, which should become the subject of diagnosis when working on expert opinions in divorce cases, or cases establishing contact between parents and children. The second aim of the report was to assess the effectiveness of using play as a diagnostic method in a situation that is a source of stress for the child (family breakdown) and causes tension (the diagnostic process in which this topic is discussed). Full article
Article
Combined Low Plant and High Animal Dietary Pattern Is Associated with a Lower Risk of Anemia among Dyslipidemic Adult Women in Taiwan: A Retrospective Study from 2001 to 2015
Int. J. Environ. Res. Public Health 2022, 19(10), 6231; https://doi.org/10.3390/ijerph19106231 - 20 May 2022
Abstract
Anemia and dyslipidemia often occurs in premenopausal women. This study investigated the association between dietary patterns and anemia among dyslipidemic women in Taiwan. This study recruited 22,631 dyslipidemic women aged 20–45 years between 2001 and 2015. The dietary assessment was collected by a [...] Read more.
Anemia and dyslipidemia often occurs in premenopausal women. This study investigated the association between dietary patterns and anemia among dyslipidemic women in Taiwan. This study recruited 22,631 dyslipidemic women aged 20–45 years between 2001 and 2015. The dietary assessment was collected by a validated food frequency questionnaire. The biochemical data including blood lipids, red blood cells, hemoglobin, hematocrit, and C-reactive protein (CRP) were retrieved from the database. Women with a combined high plant diet (HP) and low animal diet (LA) were associated with a lower prevalence of obesity (11.7%), central obesity (16.0%), high total cholesterol (16.4%), and high low-density lipoprotein cholesterol (11.9%), and had lower hemoglobin (12.9 ± 1.4 g/dL), hematocrit (38.8 ± 3.6%), and CRP levels (20.6 ± 31.4 nmol/L). The low plant diet (LP) + high animal diet (HA) pattern was negatively associated with moderate to severe anemia (OR: 0.76, 95% CI: 0.64–0.92, p = 0.004) compared to the low plant diet (LP) + low animal diet (LA) pattern. However, the HP + LA pattern was positively correlated with moderate to severe anemia (OR: 1.22, 95% CI: 1.04–1.43, p = 0.015). In conclusion, a low plant and high animal diet plays a role in preventing anemia development among dyslipidemic women. Full article
(This article belongs to the Special Issue Impact of Nutrition Dietary Patterns on Health and Quality of Life)
Article
Perceived Work Ability during Enforced Working from Home Due to the COVID-19 Pandemic among Finnish Higher Educational Staff
Int. J. Environ. Res. Public Health 2022, 19(10), 6230; https://doi.org/10.3390/ijerph19106230 - 20 May 2022
Abstract
Background: Due to COVID-19 pandemic, many employees were forced to suddenly shift to working from home (WFH). How this disruption of work affected employees’ work ability is not known. In this study, we investigated the developmental profiles of work ability among Finnish higher [...] Read more.
Background: Due to COVID-19 pandemic, many employees were forced to suddenly shift to working from home (WFH). How this disruption of work affected employees’ work ability is not known. In this study, we investigated the developmental profiles of work ability among Finnish higher education employees in a one-year follow-up during the enforced WFH. Secondly, we investigated demographic, organizational, and ergonomic factors associated with the developmental profiles. Methods: A longitudinal web-survey was conducted with four measurement points (April 2020–February 2021). Employees of a Finnish university who answered the questionnaire at baseline and at least at two follow-up surveys (n = 678) were included (71% women, 45% teachers/research staff, 44% supporting staff, 11% hired students). Perceived work ability was measured on a scale of 1–5 in all timepoints. Latent class growth curve analysis was used to identify profiles of work ability. Multinomial logistic regression was used to determine the associations of demographic factors, perceived stress, musculoskeletal pain, functionality of home for work, and organizational support with the work ability profiles. Results: Six distinct work ability profiles were identified. For most (75%), work ability remained stable during the follow-up. A total of 17% had a favourable trend (very good-stable or increasing) of work ability, and 8% had non-favourable (poor-stable or decreasing). Poor ergonomics at home, low organizational support, high stress, and musculoskeletal pain were associated with non-favourable development of work ability. Conclusions: Heterogeneity in development of work ability during forced WFH was found. Several factors were identified through which work ability can be supported. Full article
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Article
Drivers of Household Recycling Behavior in the City of Johannesburg, South Africa
Int. J. Environ. Res. Public Health 2022, 19(10), 6229; https://doi.org/10.3390/ijerph19106229 - 20 May 2022
Abstract
This paper has assessed the relationship between recycling behavior and socio-demographic variables for households in Johannesburg, South Africa. The research also identified the underlying driving factors that motivate recyclers to separate their household waste for recycling. These objectives were addressed by means of [...] Read more.
This paper has assessed the relationship between recycling behavior and socio-demographic variables for households in Johannesburg, South Africa. The research also identified the underlying driving factors that motivate recyclers to separate their household waste for recycling. These objectives were addressed by means of a quantitative survey research design as well as descriptive and inferential statistical methods. Based on the results, the statements that represented attitudes, subjective norms, perceived control, moral norms, situational factors, outcomes, and consequences of recycling were highly agreed to by respondents. Three factors influencing household recycling behavior were identified, namely, recycling benefits, perceived control, and situational variables. The recycling benefits construct explained 45.6% of the variance, followed by the perceived control construct (12%) and the situational variables construct explained 11% of the variance. However, the results of the EFA and multiple regression identified the situational variable as the greatest single driver of household participation in recycling. It is therefore important to overcome situational barriers that the residents of Johannesburg are currently facing if the current household waste separating program is to become successful. This would require simplifying the process of household recycling by providing appropriate knowledge, infrastructure, and the space for waste sorting and its collection. Full article
(This article belongs to the Special Issue Environmental Management and Sustainable City)
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Review
Causes of Shoulder Dysfunction in Diabetic Patients: A Review of Literature
Int. J. Environ. Res. Public Health 2022, 19(10), 6228; https://doi.org/10.3390/ijerph19106228 - 20 May 2022
Abstract
Objective: Understanding the underlying mechanisms behind shoulder dysfunctions in patients with diabetes mellitus. Study Design: Systematic qualitative literature review. Participants: Patients with shoulder dysfunctions and diagnosed with impaired glucose tolerance or diabetes mellitus. Intervention: Published scientific literature containing evidence about the mechanisms of [...] Read more.
Objective: Understanding the underlying mechanisms behind shoulder dysfunctions in patients with diabetes mellitus. Study Design: Systematic qualitative literature review. Participants: Patients with shoulder dysfunctions and diagnosed with impaired glucose tolerance or diabetes mellitus. Intervention: Published scientific literature containing evidence about the mechanisms of shoulder dysfunctions in the diabetic population. Articles were selected based on criteria containing diabetic population, shoulder dysfunction, methodological quality ≥ 6/9 and >20 subjects. Main Outcome measures: range of motion; questionnaires (QoL, UCLA-m, SPADI, DASH); blood glucose, blood HbA1C; calculated capsular stiffness (Kcap); calcification shoulder joint; shoulder dysfunction in patients with glucose metabolism disorders and diabetes mellitus. Results: We found 17 published articles with level 2 and 3 evidence. Multiple factors such as age, duration of diabetes mellitus (DM), glycated hemoglobin (HbA1c), advanced glycation end products (AGE), vascular endothelial growth factor (VEGF), interleukin-1ß (IL-1ß) were shown to be associated with tendon changes and increased capsular stiffness (Kcap) conceivably leading to limited range of motion (ROM) or frozen shoulder. Decreased ROM and frozen shoulder have a significantly higher prevalence in DM than in non-DM. Conclusions: Based on the current literature we confirm a high prevalence of shoulder dysfunctions in patients with diabetes mellitus. The cause of the shoulder complications is unknown, and more research is mandatory to shed more light on the complex interplay between the multifactorial causes of shoulder dysfunction in diabetes mellitus. Full article
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Article
How Income and Income Inequality Drive Depressive Symptoms in U.S. Adults, Does Sex Matter: 2005–2016
Int. J. Environ. Res. Public Health 2022, 19(10), 6227; https://doi.org/10.3390/ijerph19106227 - 20 May 2022
Abstract
Importance: Depression is one of the leading causes of disability in the United States. Depression prevalence varies by income and sex, but more evidence is needed on the role income inequality may play in these associations. Objective: To examine the association between the [...] Read more.
Importance: Depression is one of the leading causes of disability in the United States. Depression prevalence varies by income and sex, but more evidence is needed on the role income inequality may play in these associations. Objective: To examine the association between the Poverty to Income Ratio (PIR)—as a proxy for income—and depressive symptoms in adults ages 20 years and older, and to test how depression was concentrated among PIR. Design: Using the 2005–2016 National Health and Nutrition Examination Survey (NHANES), we employed Negative Binomial Regression (NBRG) in a sample of 24,166 adults. We used a 9-item PHQ (Public Health Questionnaire, PHQ-9) to measure the presence of depressive symptoms as an outcome variable. Additionally, we plotted a concentration curve to explain how depression is distributed among PIR. Results: In comparison with high-income, the low-income population in the study suffered more from greater than or equal to ten on the PHQ-9 by 4.5 and 3.5 times, respectively. The results of NBRG have shown that people with low-PIR (IRR: 1.30, 95% CI: 1.23–1.37) and medium-PIR (IRR: 1.55, 95% CI: 1.46–1.65) have experienced a higher relative risk ratio of having depressive symptoms. Women have a higher IRR (IRR: 1.29, 95% CI: 1.24–1.34) than men. We observed that depression was concentrated among low-PIR men and women, with a higher concentration among women. Conclusion and Relevance: Addressing depression should target low-income populations and populations with higher income inequality. Full article
(This article belongs to the Special Issue Frontiers in the Health Effects of Place and Social Inequality)
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