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Int. J. Environ. Res. Public Health, Volume 19, Issue 21 (November-1 2022) – 904 articles

Cover Story (view full-size image): Tornadoes have received little attention in the comprehensive literature on disaster mental health despite being one of the most prevalent natural hazards in the United States. We systematically reviewed scientific evidence within published research journals on tornadoes and mental health from 1994 to 2021 and extracted data from 29 articles. Based on our review, tornadoes adversely affect mental health in both adult and pediatric populations. Demographics, tornado exposure, post-tornado stressors, and prior exposure to trauma were risk factors that contributed to negative mental health. Having access to physical, social, and psychological resources was found to be a protective factor that contributes to positive outcomes. Together, these findings can serve as a key resource for future mental health services in communities experiencing tornadoes. View this paper
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13 pages, 1480 KiB  
Article
Effects of Capacitive-Resistive Electric Transfer on Sports Performance in Paralympic Swimmers: A Stopped Randomized Clinical Trial
by Luis De Sousa-De Sousa, Hugo G. Espinosa, Jose Luis Maté-Muñoz, Maria del Carmen Lozano-Estevan, Sara Cerrolaza-Tudanca, Manuel Rozalén-Bustín, Samuel Fernández-Carnero and Pablo García-Fernández
Int. J. Environ. Res. Public Health 2022, 19(21), 14620; https://doi.org/10.3390/ijerph192114620 - 7 Nov 2022
Viewed by 1925
Abstract
Throughout history a variety of therapeutic tools have been studied as possible enhancers of sports activities. This study proposes the use of Capacitive-Resistive Electric Transfer (CRET) as a performance booster to paralympic athletes, specifically those belonging to the Spanish Paralympic swimming committee. The [...] Read more.
Throughout history a variety of therapeutic tools have been studied as possible enhancers of sports activities. This study proposes the use of Capacitive-Resistive Electric Transfer (CRET) as a performance booster to paralympic athletes, specifically those belonging to the Spanish Paralympic swimming committee. The study was a randomized, single-blind, and observer-blind, crossover clinical trial. Six athletes were randomly assigned to three groups: one treated with CRET (A); a placebo group (B) and a control group (C). The CRET group attended a twenty-minute session before being subjected to pool trials at distances of 50 and 100 m at maximum performance. Measurements were in two dimensions: time in seconds and the Borg scale for perceived exertion. Comparisons between groups were made with respect to distance and the main variables. In the case of perceived exertion, no significant changes were observed in any of the distances; however, in the case of the time variable, a significant difference was observed between Group A vs. Personal Record at 100 m distance (76.3 ± 6.8 vs. 68.4 ± 3.3). The proposed protocol and level of hyperthermia applied suggest refusal of CRET use for the 100-m distance a few minutes before sports practice. Our analysis suggests the need to modify the presented protocol. ClinicalTrials.gov identifier under NCT number: NCT04336007. Full article
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14 pages, 866 KiB  
Review
Evaluation of Salivary Biomarkers of Periodontal Disease Based on Smoking Status: A Systematic Review
by Jin-won Noh, Jong-Hwa Jang, Hae-Soo Yoon, Kyoung-Beom Kim, Min-Hee Heo, Ha-eun Jang, Young-Jin Kim and Yejin Lee
Int. J. Environ. Res. Public Health 2022, 19(21), 14619; https://doi.org/10.3390/ijerph192114619 - 7 Nov 2022
Cited by 4 | Viewed by 2426
Abstract
Saliva is a useful biomarker for diagnosing oral health conditions, including periodontal disease (PD). Smoking is a risk factor for PD. The aim of this systematic review was to summarize the salivary biomarkers associated with PD based on smoking status. A comprehensive search [...] Read more.
Saliva is a useful biomarker for diagnosing oral health conditions, including periodontal disease (PD). Smoking is a risk factor for PD. The aim of this systematic review was to summarize the salivary biomarkers associated with PD based on smoking status. A comprehensive search of the MEDLINE (via PubMed), EMBASE, Cochrane, SCOPUS, and Web of Sciences databases was conducted up to 1 January 2021 using key terms relevant to the topic of our research and Cochrane methodology and improved with searching a gray literature resource. The methodological quality of all included studies was assessed with the revised Quality Assessment of Diagnostic Accuracy Studies-2. Seven studies were included. Smokers had increased levels of malondialdehyde, sialic acid, salivary cortisol, salivary interleukin 1β, albumin, tissue inhibitor of matrix metalloproteinase (TIMP), and the pyridinoline cross-linked carboxyterminal telopeptide of type I collagen (ICTP), as well as decreased levels of superoxide dismutase, activity of lactate dehydrogenase, activity of enzyme activity of β-glucuronidase, uric acid, matrix metalloproteinase-8 (MMP-8)/TIMP-1 ratio, and combinations of MMP-8 and ICTP. However, mixed results were observed some studies in detecting glutathione peroxidase, MMP-8, and MMP-14. The results were interpreted with caution because of limitations in the number of included studies and the study design. Some salivary biomarkers are potentially useful in combination or alone for diagnosing PD. Methodological and systematic studies are needed to develop more effective biomarkers. Full article
(This article belongs to the Special Issue Approach to Promoting Oral Health)
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11 pages, 330 KiB  
Article
Influence of Selected Indicators of Healthcare System Functioning Evaluation on the Health Result
by Olga Partyka, Monika Pajewska, Aleksandra Czerw, Katarzyna Sygit, Kamila Kmieć, Oleh Lyubinets, Mateusz Niemiec, Mateusz Kaczmarski, Izabela Gąska, Grzegorz Juszczyk, Edyta Krzych-Fałta, Tomasz Banaś, Dariusz A. Kosior, Andrzej Deptała, Artur Kotwas, Ewa Bandurska, Weronika Ciećko and Elżbieta Cipora
Int. J. Environ. Res. Public Health 2022, 19(21), 14618; https://doi.org/10.3390/ijerph192114618 - 7 Nov 2022
Cited by 1 | Viewed by 1788
Abstract
Background: According to the World Health Organization’s statistics, 7 of the 10 main causes of death in 2019 were noncommunicable diseases. Health indicators are measures used to evaluate public health system effectiveness and functioning. Monitoring mortality rates from leading causes, life expectancy and [...] Read more.
Background: According to the World Health Organization’s statistics, 7 of the 10 main causes of death in 2019 were noncommunicable diseases. Health indicators are measures used to evaluate public health system effectiveness and functioning. Monitoring mortality rates from leading causes, life expectancy and other health indicators is essential to address their causes and adapt health systems to react adequately. The aim of this study is to present the dependencies of selected health care indicators and health outcomes. Methods: Based on the literature review conducted, selected health indicators, along with healthcare system data, were analyzed using Pearson’s r correlation. The analyses included data from the Organization for Economic Cooperation and Development (OECD) presented in statistics and the Health at a Glance 2021 report and data collected as part of the preparation of the Financing Global Health 2020 report by the Institute for Health Metrics and Evaluation. Results: Health system resources are linked to health outcomes. The number of medical consultations, the number of nurses per patient or the level of financing of services under general health insurance are related to life expectancy and deaths due to causes that could have been avoided or treated. Conclusions: Life expectancy is positively correlated with access to general health insurance and public expenditure on healthcare. There is a need for all countries to provide their citizens with broad access to healthcare services. Full article
11 pages, 1436 KiB  
Article
The Effect of Cognitive Strategies and Facial Attractiveness on Empathic Neural Responses
by Michela Balconi, Natalia Kopiś-Posiej, Irene Venturella, Emilia Zabielska-Mendyk, Paweł Augustynowicz and Laura Angioletti
Int. J. Environ. Res. Public Health 2022, 19(21), 14617; https://doi.org/10.3390/ijerph192114617 - 7 Nov 2022
Cited by 2 | Viewed by 2135
Abstract
Empathy is a phenomenon that brings together both emotions and an understanding of another person. Recent studies have disentangled the mechanisms of empathy into emotional and cognitive aspects. Event-related potential (ERP) studies suggest that emotional empathy is related to the modulation of the [...] Read more.
Empathy is a phenomenon that brings together both emotions and an understanding of another person. Recent studies have disentangled the mechanisms of empathy into emotional and cognitive aspects. Event-related potential (ERP) studies suggest that emotional empathy is related to the modulation of the amplitude of early ERPs, and cognitive empathy is linked to later ERPs. In the current study, we examined the influences of facial attractiveness on empathic response and the effect of cognitive strategies with setting the participants’ attention to attractiveness or pain. Participants (N= 19) viewed photos of physically attractive and unattractive men and women receiving painful stimulation. The amplitude of the N2 component measured at the frontal regions was more negative in painful stimulation compared to the non-painful, but only for attractive faces. There were no differences between painful and non-painful stimulation for unattractive faces. The amplitude of the P3 measured at the central-parietal region component was more positive in the painful condition compared to the non-painful one, but only when participants performed a pain judgment task. There were no differences in the attractiveness judgment task. This study showed that the attractiveness of a model and drawing the participants’ attention to pain constitute an essential modulator of pain empathy. Full article
(This article belongs to the Section Health Behavior, Chronic Disease and Health Promotion)
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11 pages, 1151 KiB  
Article
Without Them, I Would Never Have Been Able to Carry on” Levers for the Sustained Employment of Patients with Chronic Inflammatory Arthritis: A French Qualitative Study
by Chaima Louati, Yosra Mouelhi, Bernard Kabuth and Céline Clément
Int. J. Environ. Res. Public Health 2022, 19(21), 14616; https://doi.org/10.3390/ijerph192114616 - 7 Nov 2022
Viewed by 1290
Abstract
Background. Chronic inflammatory arthritis (IA) is known to be involved in declining work outcomes and increased risk of experiencing unemployment. The aim of this study is to qualitatively identify the levers for the employment of patients with IA and AI-like conditions. Methods. To [...] Read more.
Background. Chronic inflammatory arthritis (IA) is known to be involved in declining work outcomes and increased risk of experiencing unemployment. The aim of this study is to qualitatively identify the levers for the employment of patients with IA and AI-like conditions. Methods. To accomplish this task, a multi-centered, exploratory qualitative design involving one-on-one semi-directed interviews and a focus group was performed among 18 IA French patients to deepen our understanding of what enables patients to maintain employment despite the limiting, chronic, and expanding nature of their symptoms. Results. Analysis revealed five clusters of levers for the employment of chronic IA patients: The first cluster of levers was based on a set of verbatim records mentioning an overall improvement in the management of the disease. The second cluster of levers was based on a set of verbatim records mentioning the perceived added value of one’s occupation at a personal, familial, or societal scale. The third cluster of levers was based on a set of verbatim records mentioning the perceived interpersonal supportiveness of the professional sphere. The fourth cluster of levers was based on a set of verbatim records mentioning the micro-, meso-, and macro-characteristics of the working environment. The fifth cluster of levers was based on a set of verbatim records mentioning intrapersonal attributes. Conclusions. This study deepens and updates the current knowledge on what empowers patients dealing with chronic AI. These results provide valuable insights for stakeholders involved in designing or deploying employment initiatives for patients with AI. Full article
(This article belongs to the Special Issue Aged Society, Occupational Safety and Health, and Work Sustainability)
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9 pages, 347 KiB  
Article
Phase Angle as a Predictor for Physical Function in Institutionalized Independent Older Adults
by Ana Morais, Soraia Ferreira, Alexandre Duarte Martins, Pablo Tomas-Carus, José Marmeleira and Jose A. Parraca
Int. J. Environ. Res. Public Health 2022, 19(21), 14615; https://doi.org/10.3390/ijerph192114615 - 7 Nov 2022
Cited by 4 | Viewed by 1364
Abstract
The aim of this study was to investigate the relationship between phase angle (PhA) and physical function in institutionalized, independent older adults. Physical function was evaluated using the Senior Fitness Test Battery. PhA was measured by electrical bioimpedance at 50 khz, and body [...] Read more.
The aim of this study was to investigate the relationship between phase angle (PhA) and physical function in institutionalized, independent older adults. Physical function was evaluated using the Senior Fitness Test Battery. PhA was measured by electrical bioimpedance at 50 khz, and body composition parameters were also registered. Results showed that PhA significantly correlated with all physical fitness tests, except for arm curls. Regarding the results of the multivariate analysis, three models were created: Model 1, formed by a dependent variable “PhA” and two predictor variables “8 ft up-and-go” and “6 min walk”; Model 2, formed by a dependent variable “PhA” and three predictor variables “8 ft up-and-go”, “6 min walk” and “30-s chair stand”; and Model 3, formed by a dependent variable “PhA” and four predictor variables “8 ft up-and-go”, “6 min walk”, “30-s chair stand” and “arm curl”. Results showed that predictor variables had a significant influence on the PhA for all three models (Model 1: p = 0.001, 12.5%; Model 2: p = 0.002, 12.9%; and Model 3: p = 0.005, 13.1%). For women, Model 1 showed a significant influence of predictor variables on the PhA (p = 0.030, 9.3%). The results for men in Models 1, 2 and 3 showed significant influences on the PhA (p = 0.002, 31.2%; p = 0.006, 31.6%; and p = 0.016, 31.6%; respectively). This study confirmed previous studies regarding to the relationship between PhA and physical function. It also indicates that PhA could be an excellent predictor of physical function. Full article
15 pages, 1298 KiB  
Article
Assessment of Children’s Metal Exposure via Hand Wipe, Outdoor Soil and Indoor Dust and Their Associations with Blood Biomarkers
by Beibei Wang, Fei Gao, Yujie Li, Chunye Lin, Hongguang Cheng and Xiaoli Duan
Int. J. Environ. Res. Public Health 2022, 19(21), 14614; https://doi.org/10.3390/ijerph192114614 - 7 Nov 2022
Cited by 2 | Viewed by 1590
Abstract
The soil environment contributes considerably to human exposure to metals. This study aimed to comprehensively compare children’s exposure to soil metals using different sampling approaches (i.e., hand wipe, indoor dust and outdoor soil) and assessment strategies, combing the method of external exposure evaluation [...] Read more.
The soil environment contributes considerably to human exposure to metals. This study aimed to comprehensively compare children’s exposure to soil metals using different sampling approaches (i.e., hand wipe, indoor dust and outdoor soil) and assessment strategies, combing the method of external exposure evaluation and the correlation with internal biomarkers. Environmental exposure samples (hand wipe, outdoor soil and indoor dust), blood samples and child-specific exposure factors were simultaneously collected for 60 children aged 3 to 12 years from an area of northwestern China. Eight typical toxic metals were analyzed. Results showed that metal levels in hand wipes were associated with children’s age, years of residency and the ground types of the play areas. Hand-to-mouth contact was an important pathway for children’s metal exposure, with the corresponding oral exposure cancer risk to Cr already exceeding the maximum acceptable level. In comparison, metal concentrations in hand wipes were one to seven times higher than those in outdoor soil and indoor dust. Even greater discrepancies were found for the estimated exposure dose, which could lead to differences of several to dozens of times. In addition, Pb, Mn and Cr in hand wipes were significantly correlated with those in blood, whereas no relationships were found with soil and dust. This study indicates that the selection of different sampling and assessing strategies could lead to great differences in children metal exposure outcomes. It also suggests that hand wipe, which could reflect the true and integrated exposure level and the individual difference, serves as a better matrix to assess children’s metal exposure compared to soil and dust. Further studies should standardize the sampling method for hand wipes and verify its applicability for other age groups. Full article
(This article belongs to the Special Issue Environmental Risk Assessment in Public Health)
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15 pages, 977 KiB  
Article
Air Pollution Management: A Multivariate Analysis of Citizens’ Perspectives and Their Willingness to Use Greener Forms of Transportation
by Silvia Puiu, Mihaela Tinca Udriștioiu and Liliana Velea
Int. J. Environ. Res. Public Health 2022, 19(21), 14613; https://doi.org/10.3390/ijerph192114613 - 7 Nov 2022
Cited by 1 | Viewed by 1918
Abstract
The present research aims to understand how air pollution can be managed by public authorities, both central and local, starting from citizens’ perspectives on the issue. Air quality is a real problem, affecting people at multiple levels. Thus, we introduced the following variables [...] Read more.
The present research aims to understand how air pollution can be managed by public authorities, both central and local, starting from citizens’ perspectives on the issue. Air quality is a real problem, affecting people at multiple levels. Thus, we introduced the following variables to better understand the problem and to be able to formulate theoretical and practical implications for public management: the involvement of authorities in reducing air pollution; the involvement of citizens in reducing air pollution; financial incentives for citizens and companies for adopting behaviors that reduce air pollution; green investments in the city; the impact of air pollution on the community; and the need for independent bodies to monitor air pollution. The research methodology used is partial least squares structural equation modelling (PLS-SEM) and the required data were gathered from issuing a survey to citizens from the most important cities in Romania where pollution poses important challenges for the community and for the authorities. The results are useful to public managers in local and central institutions for creating better strategies meant to reduce air pollution, increase air quality, and improve the quality of the citizens’ lives. Full article
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16 pages, 10008 KiB  
Article
Access and Use of Health Services by People with Diabetes from the Item Response Theory
by Isabela Silva Levindo de Siqueira, Rafael Alves Guimarães, Valéria Pagotto, Claci Fátima Weirich Rosso, Sandro Rogério Rodrigues Batista and Maria Alves Barbosa
Int. J. Environ. Res. Public Health 2022, 19(21), 14612; https://doi.org/10.3390/ijerph192114612 - 7 Nov 2022
Cited by 1 | Viewed by 1571
Abstract
The objective of this study was to analyze the indicators of access and use of health services in people with diabetes mellitus. This study used data from the National Health Survey, conducted in Brazil in 2013. The National Health Survey was carried out [...] Read more.
The objective of this study was to analyze the indicators of access and use of health services in people with diabetes mellitus. This study used data from the National Health Survey, conducted in Brazil in 2013. The National Health Survey was carried out with adults aged 18 years or older residing in permanent private households in Brazil. Indicators from 492 individuals with self-reported diabetes mellitus living in the Central–West region of the country were analyzed. Item response theory was used to estimate the score for access to and use of health services. Multiple linear regression was used to analyze factors associated with scores of access and use of health services by people with diabetes mellitus. The mean score of access estimated by the item response theory and use estimated was 51.4, with the lowest score of zero (lowest access and use) and the highest 100 (highest access and use). Among the indicators analyzed, 74.6% reported having received medical care in the last 12 months and 46.4% reported that the last visit occurred in primary care. Only 18.9% had their feet examined and 29.3% underwent eye examinations. Individuals of mixed-race/skin color and those residing outside capital and metropolitan regions had lower access and use scores when compared to white individuals and residents of state capitals, respectively. The study shows several gaps in the indicators of access and use of health services by people with diabetes. People of mixed race/skin color and residents outside the capitals and metropolitan regions had lower scores for access and use, suggesting the need to increase health care in these groups. Full article
(This article belongs to the Section Health Behavior, Chronic Disease and Health Promotion)
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9 pages, 665 KiB  
Article
Physical Activity Frequency and Health-Related Quality of Life in Spanish Children and Adolescents with Asthma: A Cross-Sectional Study
by Ángel Denche-Zamorano, Raquel Pastor-Cisneros, Lara Moreno-Moreno, Jorge Carlos-Vivas, María Mendoza-Muñoz, Nicolás Contreras-Barraza, Miseldra Gil-Marín and Sabina Barrios-Fernández
Int. J. Environ. Res. Public Health 2022, 19(21), 14611; https://doi.org/10.3390/ijerph192114611 - 7 Nov 2022
Cited by 5 | Viewed by 1812
Abstract
Asthma is considered the most prevalent chronic childhood disease worldwide. Physical activity (PA) represents a tool to improve patients with respiratory diseases’ health-related quality of life (HRQoL). A cross-sectional study examining data from the Spanish National Health Survey (ENSE 2017) was carried out [...] Read more.
Asthma is considered the most prevalent chronic childhood disease worldwide. Physical activity (PA) represents a tool to improve patients with respiratory diseases’ health-related quality of life (HRQoL). A cross-sectional study examining data from the Spanish National Health Survey (ENSE 2017) was carried out to investigate the associations between the PAF (physical activity frequency) and health-related quality of life (HRQoL) in asthmatic children and adolescents from 8 to 14 years old (total 11.29 years ± 1.91, boys 11.28 ± 1.90 and 11.29 ± 1.95 girls). Data were obtained from the Children Questionnaire, which was completed by their families or legal guardians, achieving a final sample composed of 240 participants with asthma. Data were taken from Survey 2017 (ENSE 2017), the last one before the COVID-19 pandemic. The results revealed significant associations between the PAF and the HRQoL, finding no significant differences between genders. Full article
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11 pages, 2132 KiB  
Communication
Time-Resolved Kinetic Measurement of Microalgae Agglomeration for Screening of Polysaccharides-Based Coagulants/Flocculants
by Jinxia Zhou, Yunlu Jia, Xiaobei Gong, Hao Liu and Chengwu Sun
Int. J. Environ. Res. Public Health 2022, 19(21), 14610; https://doi.org/10.3390/ijerph192114610 - 7 Nov 2022
Viewed by 1446
Abstract
Time-resolved monitoring of microalgae agglomeration facilitates screening of coagulants/flocculants (CFs) from numerous biopolymer candidates. Herein, a filtering-flowing analysis (FFA) apparatus was developed in which dispersed microalgal cells were separated from coagulates and flocs formed by CFs and pumped into spectrophotometer for real-time quantification. [...] Read more.
Time-resolved monitoring of microalgae agglomeration facilitates screening of coagulants/flocculants (CFs) from numerous biopolymer candidates. Herein, a filtering-flowing analysis (FFA) apparatus was developed in which dispersed microalgal cells were separated from coagulates and flocs formed by CFs and pumped into spectrophotometer for real-time quantification. Polysaccharides-based CFs for Microcystis aeruginosa and several other microalgae were tested. Cationic hydroxyethyl cellulose (CHEC), chitosan quaternary ammonium (CQA) and cationic guar gum (CGG) all triggered coagulation obeying a pseudo-second-order model. Maximal coagulation efficiencies were achieved at their respective critical dosages, i.e., 0.086 g/gM.a. CHEC, 0.022 g/gM.a. CQA, and 0.216 g/gM.a. CGG. Although not active independently, bacterial exopolysaccharides (BEPS) aided coagulation of M. aeruginosa and allowed near 100% flocculation efficiency when 0.115 g/gM.a. CQA and 1.44 g/gM.a. xanthan were applied simultaneously. The apparatus is applicable to other microalgae species including Spirulina platensis, S. maxima, Chlorella vulgaris and Isochrysis galbana. Bio-based CFs sorted out using this apparatus could help develop cleaner processes for both remediation of harmful cyanobacterial blooms and microalgae-based biorefineries. Full article
(This article belongs to the Special Issue Environmental Microbiology and Water Pollution Applications)
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12 pages, 1980 KiB  
Article
Recent Advance Analysis of Recovery in Hospitalized People with COVID-19: A Systematic Review
by Joyce Noelly Vitor Santos, Vanessa Amaral Mendonça, Amanda Cristina Fernandes, Laísa Braga Maia, Nicholas Henschke, Mateus Bastos de Souza, Vanessa Kelly da Silva Lage, Murilo Xavier Oliveira, Angélica de Fátima Silva, Ana Cristina Rodrigues Lacerda, Alessandro Sartorio, Amandine Rapin, Vinícius Cunha de Oliveira and Redha Taiar
Int. J. Environ. Res. Public Health 2022, 19(21), 14609; https://doi.org/10.3390/ijerph192114609 - 7 Nov 2022
Cited by 1 | Viewed by 1864
Abstract
Introduction: COVID-19 is a public health emergency all around the world. Severe illness occurred in about 14% of patients and 5% of patients developed critical illness, but the prognosis for these patients remains unclear. Objective: To describe the prognosis in hospitalized adults with [...] Read more.
Introduction: COVID-19 is a public health emergency all around the world. Severe illness occurred in about 14% of patients and 5% of patients developed critical illness, but the prognosis for these patients remains unclear. Objective: To describe the prognosis in hospitalized adults with COVID-19. Methods: The MEDLINE, EMBASE, AMED, and COCHRANE databases were searched for studies published up to 28 June 2021 without language restrictions. Descriptors were related to “COVID-19” and “prognosis”. Prospective inception cohort studies that assessed morbidity, mortality and recovery in hospitalized people over 18 years old with COVID-19 were included. Two independent reviewers selected eligible studies and extracted the available data. Acute respiratory distress syndrome (ARDS) and multiple organ failure (MOFS) were considered as outcomes for morbidity and discharge was considered for recovery. The Quality in Prognosis Studies (QUIPS) tool was used to assess risk of bias. Analyses were performed using Comprehensive Meta-Analysis (version 2.2.064). Results: We included 30 inception cohort studies investigating 13,717 people hospitalized with COVID-19 from different countries. The mean (SD) age was 60.90 (21.87) years, and there was high proportion of males (76.19%) and people with comorbidities (e.g., 49.44% with hypertension and 29.75% with diabetes). Findings suggested a high occurrence of morbidity, mainly related to ARDS. Morbidity rates varied across studies from 19% to 36% in hospital wards, and from 13% to 90% in Intensive Care Units—ICU. Mortality rates ranged from 4% to 38% in hospital wards and from 8% to 51% in ICU. Recovery rates ranged up to 94% and 65% in hospital wards and ICU, respectively. The included studies had high risk of bias in the confounding domain. Conclusions: The prognosis of people hospitalized with COVID-19 is an issue for the public health system worldwide, with high morbidity and mortality rates, mainly in ICU and for patients with comorbidities. Its prognosis emphasizes the need for appropriate prevention and management strategies. Full article
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19 pages, 397 KiB  
Article
Health Care Use and Barriers to Care for Chronic Inflammatory Diseases (CID) among First and Second Generation South Asian Immigrant Children and Parents in Ontario Canada
by Andrea Rishworth, Tiffany Cao, Ashika Niraula and Kathi Wilson
Int. J. Environ. Res. Public Health 2022, 19(21), 14608; https://doi.org/10.3390/ijerph192114608 - 7 Nov 2022
Cited by 2 | Viewed by 2321
Abstract
Although immigrants are disproportionately impacted by growing chronic inflammatory disease (CIDs) rates, yet suffer barriers to access health care, little attention has been given to their primary healthcare or specialist healthcare access as it relates to complex, chronic diseases in Canada, a country [...] Read more.
Although immigrants are disproportionately impacted by growing chronic inflammatory disease (CIDs) rates, yet suffer barriers to access health care, little attention has been given to their primary healthcare or specialist healthcare access as it relates to complex, chronic diseases in Canada, a country with universal health care. This study aims to investigate CID health care use and barriers to care among first- and second-generation immigrant South Asian children and parents in the Greater Toronto Area, Ontario. Drawing on analysis of 24 in depth interviews with children and parents (14 children, 10 parents), the results reveal that although CIDs disproportionately affects South Asian immigrants, they encounter health system, geographic, interpersonal, and knowledge barriers to access requisite care. These barriers exist despite participants having a GP, and are compounded further by limited familial systems, culturally insensitive care, and structural inequities that in some instances make parents choose between health access or other basic needs. Although all participants recognized the importance of specialized care, only 11 participants regularly accessed specialized care, creating new schisms in CID management. The findings suggest that a multisectoral approach that address individual and structural level socio-structural drivers of health inequities are needed to create more equitable healthcare access. Full article
(This article belongs to the Special Issue Geographic and Environmental Perspectives on Population Health)
10 pages, 2185 KiB  
Article
Prognostic Performance of Cystatin C in COVID-19: A Systematic Review and Meta-Analysis
by Michal Matuszewski, Yurii Reznikov, Michal Pruc, Frank W. Peacock, Alla Navolokina, Raúl Júarez-Vela, Lukasz Jankowski, Zubaid Rafique and Lukasz Szarpak
Int. J. Environ. Res. Public Health 2022, 19(21), 14607; https://doi.org/10.3390/ijerph192114607 - 7 Nov 2022
Cited by 5 | Viewed by 1887
Abstract
Cystatin C is a specific biomarker of kidney function. We perform this meta-analysis to determine the association of Cystatin C with the COVID-19 severity. In this systematic review and meta-analysis, we searched PubMed, EMBASE, Cochrane library, and Web of Science for studies published [...] Read more.
Cystatin C is a specific biomarker of kidney function. We perform this meta-analysis to determine the association of Cystatin C with the COVID-19 severity. In this systematic review and meta-analysis, we searched PubMed, EMBASE, Cochrane library, and Web of Science for studies published until 2nd September 2022 that reported associations between Cystatin C levels and COVID-19 severity. The analysis was performed using a random-effects model to calculate pooled standard mean difference (SMD). Twenty-five studies were included in the meta-analysis. Pooled analysis showed statistically significant differences of Cystatin C levels among survive vs. decreased patients (0.998 ± 0.225 vs. 1.328 ± 0.475 mg/dL, respectively; SMD = −2.14; 95%CI: −3.28 to −1.01; p < 0.001). Cystatin C levels in COVID-19 severe vs. non-severe groups varied and amounted to 1.485 ± 1.191 vs. 1.014 ± 0.601 mg/dL, respectively (SMD = 1.81; 95%CI: 1.29 to 2.32; p < 0.001). Additionally, pooled analysis showed that Cystatin C levels in patients with acute kidney injury (AKI) was 1.562 ± 0.885 mg/dL, compared to 0.811 ± 0.108 mg/dL for patients without AKI (SMD = 4.56; 95%CI: 0.27 to 8.85; p = 0.04). Summing up, Cystatin C is a potentially very good marker to be used in the context of COVID-19 disease due to the prognosis of patients’ serious condition, risk of AKI and mortality. In addition, Cystatin C could be used as a marker of renal complications in COVID-19 other than AKI due to the need to monitor patients even longer after leaving the hospital. Full article
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14 pages, 931 KiB  
Article
Effects of Service Quality Characteristics of Neighborhood Sports Facilities on User Satisfaction and Reuse Intention of the Elderly during the COVID-19 Pandemic
by Kyoung Hwan Cho, Jeong-Beom Park and Yang Hun Jung
Int. J. Environ. Res. Public Health 2022, 19(21), 14606; https://doi.org/10.3390/ijerph192114606 - 7 Nov 2022
Cited by 1 | Viewed by 1544
Abstract
Purpose: this study aimed to examine the user satisfaction and reuse intention of the elderly for neighborhood sports facilities in South Korea during the COVID-19 pandemic. Methods: this study surveyed 386 Korean elderly individuals aged ≥ 65 years, who were users of neighborhood [...] Read more.
Purpose: this study aimed to examine the user satisfaction and reuse intention of the elderly for neighborhood sports facilities in South Korea during the COVID-19 pandemic. Methods: this study surveyed 386 Korean elderly individuals aged ≥ 65 years, who were users of neighborhood sports facilities, from 1 May to 31 August 2022. A total of 386 questionnaires were used for data analysis, which was carried out using SPSS 23.0 statistical software. Descriptive statistics of the mean, standard deviation, and frequency distribution were used at the descriptive level. Moreover, one-way analysis of variance (ANOVA), Scheffe’s post hoc pair-wise comparison analysis, Pearson’s correlation coefficient, and multiple regression analysis were used at the inferential level. The significance level of these tests was considered for less than 0.05. Results: the mechanistic and humanistic service factors of neighborhood sports facilities affected user satisfaction and reuse intention. Furthermore, user satisfaction of the elderly during the COVID-19 pandemic had a positive effect on reuse intention. Conclusion: this study confirmed that the service quality characteristics of neighborhood sports facilities during the COVID-19 pandemic had a positive effect on user satisfaction and intention to continue to exercise among the elderly. Full article
(This article belongs to the Special Issue Advances in Physical Activity, Physical Fitness, and Sports Injury)
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18 pages, 2846 KiB  
Article
Trade and Embodied CO2 Emissions: Analysis from a Global Input–Output Perspective
by Xinsheng Zhou, Qinyang Guo, Yuanyuan Wang and Guofeng Wang
Int. J. Environ. Res. Public Health 2022, 19(21), 14605; https://doi.org/10.3390/ijerph192114605 - 7 Nov 2022
Cited by 8 | Viewed by 2258
Abstract
Global trade drives the world’s economic development, while a large amount of embodied carbon is transferred among different countries and regions. Based on a multi-regional input–output model, the trade embodied carbon transfers of bilateral trade between 185 countries/regions around the world were calculated. [...] Read more.
Global trade drives the world’s economic development, while a large amount of embodied carbon is transferred among different countries and regions. Based on a multi-regional input–output model, the trade embodied carbon transfers of bilateral trade between 185 countries/regions around the world were calculated. On the basis, regional trade embodied carbon transfer patterns and major national trade patterns in six continents, eight major economic cooperation organizations, and six representative countries/regions were further analyzed. The results showed that Europe was the continent with the largest embodied carbon inflows from trade and Africa was the continent with the largest embodied carbon outflows from trade. China was the country which had the largest embodied carbon outflows from trade, while the United States, France, Japan, and Germany were countries which had embodied carbon inflows from trade. OECD, EU, and NAFTA were the economic cooperation organizations with embodied carbon inflows from trade, while BRICS, SCO, RCEP, OPEC, and ASEAN were economic cooperation organizations with embodied carbon outflows from trade. Developed countries such as the United States, France, and the United Kingdom protected their environment by exporting high-value products and importing low-value and carbon-intensive products. Developing countries such as China and Russia earned foreign exchange by exporting carbon-intensive and commodity products at a huge environmental cost. In contrast, Germany, China, and Russia played different roles in the global industrial chain, while Germany exchanged more trade surpluses at lower environmental costs. Therefore, for different countries and regions, their own industries should be actively upgraded to adjust the import and export structure, the cooperation and coordination in all regions of the world should be strengthened, and the transfers of embodied carbon needs to be reduced to make the trade model sustainable. Full article
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18 pages, 1071 KiB  
Article
NAM and TPB Approach to Consumers’ Decision-Making Framework in the Context of Indoor Smart Farm Restaurants
by Kyuhyeon Joo, Junghoon (Jay) Lee and Jinsoo Hwang
Int. J. Environ. Res. Public Health 2022, 19(21), 14604; https://doi.org/10.3390/ijerph192114604 - 7 Nov 2022
Cited by 8 | Viewed by 2564
Abstract
The movement toward smart farming, which has productivity and eco-friendly roles, is emerging in the foodservice industry in the form of indoor smart farm restaurants. The purpose of this study was to investigate the consumer decision-making processes in the context of indoor smart [...] Read more.
The movement toward smart farming, which has productivity and eco-friendly roles, is emerging in the foodservice industry in the form of indoor smart farm restaurants. The purpose of this study was to investigate the consumer decision-making processes in the context of indoor smart farm restaurants. The investigational framework was designed around the norm activation model (NAM) and the theory of planned behavior (TPB), with the moderating role of age. In particular, this study merged NAM and TPB to assess the effect of awareness of consumption consequences on consumers’ attitudes as well as the role played by subjective norms in the formation of personal norms. Data were collected from 304 respondents in South Korea. As a result of structural equation modeling, the proposed hypotheses of causal relationships were generally supported, excluding only the relationship between subjective norm and behavioral intention. The moderating role of age was identified in the relationships between (1) subjective norm and attitude, and (2) personal norm and behavioral intention. This study presents not only theoretical contributions as the first empirical study on consumer behavior in the context of indoor smart farm restaurants but also presents practical suggestions from the perspective of green marketing. Full article
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8 pages, 303 KiB  
Article
Immune Status of Workers with Professional Risk of Being Affected by Chrysotile Asbestos in Kazakhstan
by Sholpan Koigeldinova, Alexey Alexeyev, Zhengisbek Zharylkassyn, Yertay Otarov, Bauyrzhan Omarkulov, Magzhan Tilemissov and Chingiz Ismailov
Int. J. Environ. Res. Public Health 2022, 19(21), 14603; https://doi.org/10.3390/ijerph192114603 - 7 Nov 2022
Viewed by 1335
Abstract
The purpose of this research was to study the particularities of the immune status of workers in the field of chrysotile asbestos production, depending on their work experience and professional risk of being affected by chrysotile dust. The research covered 125 men, who [...] Read more.
The purpose of this research was to study the particularities of the immune status of workers in the field of chrysotile asbestos production, depending on their work experience and professional risk of being affected by chrysotile dust. The research covered 125 men, who were workers at the only enterprise dealing with the extraction and beneficiation of chrysotile ores in Kazakhstan. Indicants of cell immunity were detected by flow cytometry; IgA, IgM, and IgG were detected by a multiplex immunological assay. It was found that, among workers impacted by chrysotile asbestos for more than 15 years, compared with individuals who were not impacted by asbestos dust, the level of CD3+ T-cells was decreased (t = −8.76, p < 0.001), as well as the number of CD4+ T-cells (U = 1246.0, p < 0.001). Moreover, CD8+ T-cells increased (t = 5.308, p = 0.001), and neutrophil phagocytic activity also increased, by 1.2 times (U = 305.5, p < 0.001). It was found that working under the condition of professional contact with chrysotile asbestos dust modifies the indicants of humoral immunity, IgA, IgM, and IgG, to a lesser extent than those of cellular immunity. Full article
14 pages, 2580 KiB  
Article
The Effects of Paroxetine on Benthic Microbial Food Web and Nitrogen Transformation in River Sediments
by Yi Li, Xinqi Chen, Xinzi Wang, Jiahui Shang, Lihua Niu, Longfei Wang, Huanjun Zhang and Wenlong Zhang
Int. J. Environ. Res. Public Health 2022, 19(21), 14602; https://doi.org/10.3390/ijerph192114602 - 7 Nov 2022
Cited by 1 | Viewed by 1377
Abstract
Paroxetine is a common pharmaceutical to treat depression and has been found to pose threats to aquatic organisms. However, little is known about the effects of paroxetine on the nutrient cycle in aquatic environments. Therefore, DNA metabarcoding is used in this study to [...] Read more.
Paroxetine is a common pharmaceutical to treat depression and has been found to pose threats to aquatic organisms. However, little is known about the effects of paroxetine on the nutrient cycle in aquatic environments. Therefore, DNA metabarcoding is used in this study to analyze the effects of paroxetine on multi-trophic microorganisms and nitrogen transformation in river sediments. Although paroxetine has no significant effect on the diversity of microbenthos, changes in benthic nitrogen-converting bacteria are consistent with the change in the various forms of nitrogen in the sediment, indicating that paroxetine affects the nitrogen conversion process by affecting nitrogen-converting bacteria. In addition, it is found that paroxetine has the ability to influence nitrogen transformation in an indirect way by affecting the trophic transfer efficiency of higher trophic levels (meiofauna and protozoa, protozoa and protozoa), subsequently affecting the growth of nitrogen-converting bacteria through a top-down mechanism (i.e., predation).The results show that paroxetine affects nitrogen transformation directly by affecting nitrogen-converting bacteria and indirectly through top-down effects, emphasizing that the assessment of paroxetine’s ecological risks should consider species within different trophic levels. Full article
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12 pages, 366 KiB  
Article
Assessment of Overweight, Obesity, Central Obesity, and Type 2 Diabetes among Adolescents in Qatar: A Cross-Sectional Study
by Sohaila Cheema, Amit Abraham, Katie G. El-Nahas, Rasha Abou-Amona, Abdulla O. Al-Hamaq, Patrick Maisonneuve, Karima Chaabna, Albert B. Lowenfels and Ravinder Mamtani
Int. J. Environ. Res. Public Health 2022, 19(21), 14601; https://doi.org/10.3390/ijerph192114601 - 7 Nov 2022
Cited by 1 | Viewed by 2708
Abstract
Qatar has a high obesity and type 2 diabetes mellitus (T2DM) burden. This study aimed to (1) determine the prevalence of overweight, obesity, and T2DM in 13–17-year-old adolescents and (2) evaluate associations with adolescents’ lifestyle and breastfeeding history, parental weight, and familial T2DM [...] Read more.
Qatar has a high obesity and type 2 diabetes mellitus (T2DM) burden. This study aimed to (1) determine the prevalence of overweight, obesity, and T2DM in 13–17-year-old adolescents and (2) evaluate associations with adolescents’ lifestyle and breastfeeding history, parental weight, and familial T2DM history. A cross-sectional study (double-stage cluster sampling) was conducted in 2018–2020 using a self-administered parental and adolescent questionnaire. In the results, 23.4% of the adolescents (107/459) were overweight; 19.9% (91/459) were obese; and 37.6% (171/459) had evidence of central obesity. Random blood sugar (RBS) was suggestive of prediabetes (≥140 mg/dL) for 23 (5.0%) adolescents and T2DM (≥200 mg/dL) for none. In multivariable analysis, obesity was significantly associated with no breastfeeding (OR = 3.17, 95% CI: 1.09–9.26) compared to breastfed adolescents for ≥6 months, with first-degree family history of T2DM (OR = 2.27; 95% CI: 1.22–4.27), with maternal obesity (OR = 2.40; 95% CI: 1.01–5.70), and with acanthosis nigricans in adolescents (OR = 19.8; 95% CI: 8.38–46.9). Central obesity was significantly associated with maternal obesity (OR = 2.21; 95% CI: 1.14–4.27) and with acanthosis nigricans (OR = 3.67; 95% CI: 1.88–7.18). Acanthosis nigricans (OR = 4.06; 95% CI: 1.41–11.7) was the only factor associated with elevated RBS. Addressing future disease burden among adults in Qatar will require extensive health and well-being programs, focused on healthy lifestyles and behaviors such as nutritious diets, physical activity, stress management, and self-care. Full article
(This article belongs to the Section Health Behavior, Chronic Disease and Health Promotion)
19 pages, 933 KiB  
Article
Loneliness and Social Support among the Middle-Aged and Elderly People with Visual Impairment
by Hui-Ying Chu and Hui-Shan Chan
Int. J. Environ. Res. Public Health 2022, 19(21), 14600; https://doi.org/10.3390/ijerph192114600 - 7 Nov 2022
Cited by 7 | Viewed by 2392
Abstract
Loneliness is associated with depression, sleep disturbance, and an increased risk of cardiovascular disease, and it is a global public health problem. Since physical and mental health have a great impact on loneliness, middle-aged and elderly people who are blind or visually impaired [...] Read more.
Loneliness is associated with depression, sleep disturbance, and an increased risk of cardiovascular disease, and it is a global public health problem. Since physical and mental health have a great impact on loneliness, middle-aged and elderly people who are blind or visually impaired may be more affected by loneliness. Previous research has confirmed that effective social support can enhance physical and mental health and alleviate the negative effects of life stress. Therefore, in this study, we applied a cross-sectional design where data were collected using questionnaires completed in person, by phone, or online for a total of 456 middle-aged and elderly people with visual impairment. We found that the enrolled participants who were unemployed, lacked a stable source of income, lived alone, or were unable to move independently were prone to experiencing high levels of loneliness and low social support, which highlights the necessity of interventions such as counseling to alleviate the sense of loneliness in such groups. During the COVID-19 pandemic, social support measures to reduce the sense of loneliness should be highly encouraged to ensure that middle-aged and elderly people with visual impairment can continue to live independently, and social support seems to be an important factor. Full article
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15 pages, 1378 KiB  
Article
Improving the Safety Performance of Construction Workers through Individual Perception and Organizational Collectivity: A Contrastive Research between Mainland China and Hong Kong
by Xiangcheng Meng and Alan H. S. Chan
Int. J. Environ. Res. Public Health 2022, 19(21), 14599; https://doi.org/10.3390/ijerph192114599 - 7 Nov 2022
Cited by 3 | Viewed by 1940
Abstract
Considering the increasing number in construction accidents in Mainland China and Hong Kong, research on improving the safety performance of construction personnel is important, given the essential role it plays in occupational safety development in industries. The present study aimed to assess the [...] Read more.
Considering the increasing number in construction accidents in Mainland China and Hong Kong, research on improving the safety performance of construction personnel is important, given the essential role it plays in occupational safety development in industries. The present study aimed to assess the improving channels of safety performance through individual perception and organizational collectivity in a quantitative way by integrating safety motivation as the transition role between individual and organizational levels. The questionnaire survey was conducted with 180 participants from Hong Kong and 197 responses from Mainland China. Structural equation modeling was applied to investigate and compare the direct, indirect, and mediating effects among different safety constructs. This study is unique, as it firstly integrates the theories of personal cognition and group interaction together with the mechanism of safety performance development. Such integration can increase the effectiveness of reducing the unsafety of construction workers at both individual and organizational levels, thereby reducing the numbers of construction accidents, and promoting healthy occupational development of the personnel. Full article
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29 pages, 1279 KiB  
Article
Physical Activity and Sedentary Behaviour with Retirement in Maltese Civil Servants: A Dialectical Mixed-Method Study
by Karl Spiteri, John Xerri de Caro, Kate Grafton, Bob Laventure and David R. Broom
Int. J. Environ. Res. Public Health 2022, 19(21), 14598; https://doi.org/10.3390/ijerph192114598 - 7 Nov 2022
Viewed by 1896
Abstract
(1) Background: Retirement is a life event that can influence physical activity (PA) and sedentary behaviour (SB) and can be used as an opportunity to promote positive lifestyle choices. The aims of this study were to (a) to identify changes in PA and [...] Read more.
(1) Background: Retirement is a life event that can influence physical activity (PA) and sedentary behaviour (SB) and can be used as an opportunity to promote positive lifestyle choices. The aims of this study were to (a) to identify changes in PA and SB resulting from retirement and (b) to explore predictors of any changes in PA and SB following retirement in Maltese civil servants. (2) Methods: a hybrid mixed-method (MM) study, using first quantitative followed by qualitative methods, of civil servants aged ≥60 years, who were followed during their retirement transition for two years. A proportion of the research participants in the MM study retired while the others remained employed. Questionnaires and semi-structured interviews were used to collect data. (3) Results: there were no changes in total PA and sitting behaviour with retirement in Maltese civil servants. People who retired carried out more domestic PA compared to when they were in employment, which resulted in more moderate-intensity PA behaviour. People perceived that their sitting time increased with retirement in the qualitative interviews, but this was not observed in the quantitative data. Past PA behaviour was an important predictor of future PA behaviour, but not for SB. (4) Conclusions: A change in PA occurs with the retirement transition. However, the uptake of exercise is a personal choice that is dependent on previous experience. Increasing SB is perceived as part of the retirement plan but is not necessarily seen in the measured quantitative data. Full article
(This article belongs to the Special Issue Physical Activity and Health in Middle-Aged and Older Adults)
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14 pages, 771 KiB  
Article
The Effect of Breaking Up Sedentary Time with Calisthenics on Neuromuscular Function: A Preliminary Study
by Emily Mear, Valerie Frances Gladwell and Jamie Pethick
Int. J. Environ. Res. Public Health 2022, 19(21), 14597; https://doi.org/10.3390/ijerph192114597 - 7 Nov 2022
Cited by 2 | Viewed by 2690
Abstract
The ageing process results in reduced neuromuscular function. This alongside prolonged sedentary behaviour is associated with decreased muscle strength, force control and ability to maintain balance. Breaking up sedentary time with regular bouts of physical activity has numerous health benefits, though the effects [...] Read more.
The ageing process results in reduced neuromuscular function. This alongside prolonged sedentary behaviour is associated with decreased muscle strength, force control and ability to maintain balance. Breaking up sedentary time with regular bouts of physical activity has numerous health benefits, though the effects on neuromuscular function are unknown. This study investigated the effect of breaking up sedentary time with calisthenic exercise on neuromuscular function. 17 healthy adults (33 ± 13.1 years), who spent ≥6 h/day sitting, were assigned to a four-week calisthenics intervention (n = 8) or control group (n = 9). The calisthenics intervention involved performing up to eight sets of exercises during the working day (09:00–17:00); with one set consisting of eight repetitions of five difference exercises (including squats and lunges). Before and immediately after the intervention, measures of knee extensor maximal voluntary contraction (MVC) and submaximal force control (measures of the magnitude and complexity of force fluctuations), and dynamic balance (Y balance test) were taken. The calisthenics intervention resulted in a significant increase in knee extensor MVC (p = 0.036), significant decreases in the standard deviation (p = 0.031) and coefficient of variation (p = 0.016) of knee extensor force fluctuations during contractions at 40% MVC, and a significant increase in Y balance test posterolateral reach with left leg stance (p = 0.046). These results suggest that breaking up sedentary time with calisthenics may be effective at increasing muscle strength, force steadiness and dynamic balance all of which might help reduce the effects of the ageing process. Full article
(This article belongs to the Special Issue New Trends in Sport Healthcare)
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20 pages, 3566 KiB  
Article
Problems and Strategies of Allocating Public Service Resources in Rural Areas in the Context of County Urbanization
by Muzhe Pan, Yaofu Huang, Yawen Qin, Xun Li and Wei Lang
Int. J. Environ. Res. Public Health 2022, 19(21), 14596; https://doi.org/10.3390/ijerph192114596 - 7 Nov 2022
Cited by 6 | Viewed by 1904
Abstract
Imbalances in allocating public service resources are a universal problem worldwide, especially in urban and rural areas. As a developing country with a significant imbalance between urban and rural areas, China is representative of the unbalanced allocation of public service resources. Presently, China [...] Read more.
Imbalances in allocating public service resources are a universal problem worldwide, especially in urban and rural areas. As a developing country with a significant imbalance between urban and rural areas, China is representative of the unbalanced allocation of public service resources. Presently, China has entered the county urbanization stage. Therefore, this study can provide a new way to realize the equalization of urban and rural public services with the county as the basic unit. Taking counties as the primary study area, this paper analyzes the new trends of population mobility in China’s counties. It combines large-scale questionnaires and field surveys to investigate the new demand of rural residents for public services and the shortcomings of public service resource allocation. First, the county seat attracts a concentration of the county’s rural residents and returning population, whose high expectations for the county seat’s education and medical services have not yet been met. Second, the township assumes the vital function of elementary school education and medical services in rural areas, and the rural children have a great demand for elementary school education services in the township. However, there are still apparent shortcomings in support of teaching facilities and the quality of education services. Third, the problem of aging and hollowing out in rural areas is serious, and the education, medical and elderly service needs of left-behind children and the elderly are difficult to be guaranteed. Finally, this paper proposes targeted planning strategies and policy recommendations for allocating county public service resources at three levels based on the “county–town–village” hierarchy. Full article
(This article belongs to the Special Issue Spatial Patterns and Driving Factors of Modern Urban-Rural System)
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15 pages, 755 KiB  
Review
Rubber Antioxidants and Their Transformation Products: Environmental Occurrence and Potential Impact
by Jing Xu, Yanfen Hao, Zhiruo Yang, Wenjuan Li, Wenjing Xie, Yani Huang, Deliang Wang, Yuqing He, Yong Liang, Julius Matsiko and Pu Wang
Int. J. Environ. Res. Public Health 2022, 19(21), 14595; https://doi.org/10.3390/ijerph192114595 - 7 Nov 2022
Cited by 16 | Viewed by 4691
Abstract
Antioxidants are prevalently used during rubber production to improve rubber performance, delay aging, and extend service life. However, recent studies have revealed that their transformation products (TPs) could adversely affect environmental organisms and even lead to environmental events, which led to great public [...] Read more.
Antioxidants are prevalently used during rubber production to improve rubber performance, delay aging, and extend service life. However, recent studies have revealed that their transformation products (TPs) could adversely affect environmental organisms and even lead to environmental events, which led to great public concern about environmental occurrence and potential impacts of rubber antioxidants and their TPs. In this review, we first summarize the category and application of rubber antioxidants in the world, and then demonstrate the formation mechanism of their TPs in the environment, emphasizing their influence on the ozone oxidative degradation. The potential toxic effects of antioxidants and their TPs are further reviewed to improve understanding of their biological health impact and environmental risks. Finally, the environmental occurrences of antioxidants and their TPs are summarized and their environmental impacts are demonstrated based on the recent studies. Due to the currently limited understanding on the toxic and biological effects of these compounds, further studies are required in order to better assess various TPs of these antioxidants and their environmental impact. To our knowledge, this is the first review on antioxidants and their TPs in the environment, which may elevate the environmental risk awareness of rubber products and their TPs in the near future. Full article
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17 pages, 1320 KiB  
Article
Transvenous Lead Extraction in Adult Patient with Leads Implanted in Childhood-Is That the Same Procedure as in Other Adult Patients?
by Andrzej Kutarski, Wojciech Jacheć, Anna Polewczyk, Dorota Nowosielecka, Maria Miszczak-Knecht, Monika Brzezinska and Katarzyna Bieganowska
Int. J. Environ. Res. Public Health 2022, 19(21), 14594; https://doi.org/10.3390/ijerph192114594 - 7 Nov 2022
Cited by 2 | Viewed by 1370
Abstract
Background: Lead management in children and young adults is still a matter of debate. Methods: To assess the course of transvenous lead extraction (TLE) in adults with pacemakers implanted in childhood (CIP) we compared 98 CIP patients with a control group consisting of [...] Read more.
Background: Lead management in children and young adults is still a matter of debate. Methods: To assess the course of transvenous lead extraction (TLE) in adults with pacemakers implanted in childhood (CIP) we compared 98 CIP patients with a control group consisting of adults with pacemakers implanted in adulthood (AIP). Results: CIP patients differed from AIP patients with respect to indications for TLE and pacing history. CIP patients were four–eight times more likely to require second-line or advanced tools. Furthermore, CIP patients more often than AIP were prone to developing complications: major complications (MC) (any) 2.6 times; hemopericardium 3.2 times; severe tricuspid valve damage 4.4 times; need for rescue cardiac surgery 3.7 times. The rate of procedural success was 11% lower because of 4.8 times more common lead remnants and 3.1 times more frequent permanently disabling complications. Conclusions: Due to system-related risk factors TLE in CIP patients is more difficult and complex. TLE in CIP is associated with an increased risk of MC and incomplete lead removal. A conservative strategy of lead management, acceptable in very old patients seems to be less suitable in CIP because it creates a subpopulation of patients at high risk of major complications during TLE in the future. Full article
(This article belongs to the Special Issue Transvenous Lead Extraction—Hot Topics in Lead Management)
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19 pages, 1026 KiB  
Article
Defining the Primary Work Stress Factors of Chinese Coal Miners—A Mixed-Methods Study
by Hongxi Di, Shujahat Ali and Yiming Lu
Int. J. Environ. Res. Public Health 2022, 19(21), 14593; https://doi.org/10.3390/ijerph192114593 - 7 Nov 2022
Cited by 1 | Viewed by 1464
Abstract
Background: Studies have indicated that coal miners in China have higher levels of perceived job stress. However, few studies have investigated the work stress structure of coal miners. Objective: Our study focused on the work stress of coal miners in China, with a [...] Read more.
Background: Studies have indicated that coal miners in China have higher levels of perceived job stress. However, few studies have investigated the work stress structure of coal miners. Objective: Our study focused on the work stress of coal miners in China, with a primary aim to determine the work stress structure of coal miners in China using a mixed-methods approach. Methods: Semi-structured interviews were performed with thirty-three people (team leaders and frontline coal miners) conducted with participants from various state-owned large- and medium-sized coal mines in China. Grounded theory was used to construct an initial model for the concept of coal miners’ work stress. Using the results of this initial survey and findings in the existing literature, we then constructed a preliminary questionnaire regarding coal miners’ work stress and administered the questionnaire to 900 coal miners in the Shaanxi, Henan, Inner Mongolia, and Gansu provinces. Results: The results show that the work stress structure for coal miners differs from that for other occupational types in China, due to differences in the Chinese culture and foreign cultural influences. We revised our questionnaire based on these considerations and administered a new survey to the frontline production workers in coal mines. The preliminary questionnaires were revised and analyzed through exploratory and confirmatory factor analysis, resulting in a final formal model for work stress, which was supported by content and structural validity. Conclusion: In this research, we used the framework of grounded theory to conduct an empirical analysis of the structure model of coal miners’ work stress. The findings support that the primary work stress factors of Chinese coal miners included the stress of the work environment, job responsibility, interpersonal relationships, career development, the family environment, and organizational systems. Coal enterprises should therefore always take these factors into consideration when developing and implementing safety management policies aimed at to improve the occupational health status of coal miners. Full article
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10 pages, 329 KiB  
Article
Association of Long Noncoding RNA HOTAIR Polymorphism and the Clinical Manifestations of Diabetic Retinopathy
by Chih-Chun Chuang, Kai Wang, Yi-Sun Yang, Edy Kornelius, Chih-Hsin Tang, Chia-Yi Lee, Hsiang-Wen Chien and Shun-Fa Yang
Int. J. Environ. Res. Public Health 2022, 19(21), 14592; https://doi.org/10.3390/ijerph192114592 - 7 Nov 2022
Cited by 4 | Viewed by 1456
Abstract
The aim of the current study is to evaluate the possible correlation between the single-nucleotide polymorphisms (SNP) of HOX transcript antisense intergenic RNA (HOTAIR) and the clinical characteristics of diabetic retinopathy (DR). Four loci of HOTAIR SNPs, including rs920778 (T/C), rs12427129 (C/T), rs4759314 [...] Read more.
The aim of the current study is to evaluate the possible correlation between the single-nucleotide polymorphisms (SNP) of HOX transcript antisense intergenic RNA (HOTAIR) and the clinical characteristics of diabetic retinopathy (DR). Four loci of HOTAIR SNPs, including rs920778 (T/C), rs12427129 (C/T), rs4759314 (A/G), and rs1899663 (G/T), were genotyped via the TaqMan allelic discrimination for 276 DR individuals and 452 non-DR patients. The distribution frequency of HOTAIR SNP rs12427129 CT [adjusted odds ratio (AOR): 1.571, 95% CI: 1.025–2.408, p = 0.038], HOTAIR SNP rs12427129 CT+TT (AOR: 1.611, 95% CI: 1.061–2.446, p = 0.025), and HOTAIR SNP rs1899663 TT (AOR: 2.443, 95% CI: 1.066–5.595, p = 0.035) were significantly higher in the DR group. Moreover, the proliferative diabetic retinopathy (PDR) subgroup revealed a significantly higher distribution of HOTAIR SNP rs12427129 CT+TT (AOR: 2.016, 95% CI: 1.096–3.710, p = 0.024) and HOTAIR SNP rs1899663 TT (AOR: 4.693, 95% CI: 1.765–12.479, p = 0.002), and the distribution frequencies of HOTAIR SNP rs12427129 CT (AOR: 3.722, 95% CI: 1.555–8.909, p = 0.003), HOTAIR SNP rs12427129 CT+TT (AOR: 4.070, 95% CI: 1.725–9.600, p = 0.001), and HOTAIR SNP rs1899663 TT (AOR: 11.131, 95% CI: 1.521–81.490, p = 0.018) were significantly higher in the female PDR subgroup. Regarding the clinical characters, the DR patients with HOTAIR SNP rs1899663 GT+TT revealed a significantly shorter duration of diabetes compared to the DR patients with HOTAIR SNP rs1899663 GG (10.54 ± 8.19 versus 12.79 ± 7.73, p = 0.024). In conclusion, HOTAIR SNP rs12427129 and rs1899663 are strongly correlated to the presence of DR, especially for a female with PDR. Full article
12 pages, 370 KiB  
Article
Factors Associated with Anxiety, Depression, and Stress in Peruvian University Students during the COVID-19 Pandemic
by Palmer J. Hernández-Yépez, Carlos O. Muñoz-Pino, Valeria Ayala-Laurel, Pavel J. Contreras-Carmona, Fiorella Inga-Berrospi, Víctor J. Vera-Ponce, Virgilo E. Failoc-Rojas, César Johan Pereira-Victorio and Mario J. Valladares-Garrido
Int. J. Environ. Res. Public Health 2022, 19(21), 14591; https://doi.org/10.3390/ijerph192114591 - 7 Nov 2022
Cited by 10 | Viewed by 2646
Abstract
During the COVID-19 pandemic, university students have adopted measures that completely transformed their educational environment, and this has generated an increase in psychological stress. The present study aimed to identify the factors associated with anxiety, depression, and stress in students at a university [...] Read more.
During the COVID-19 pandemic, university students have adopted measures that completely transformed their educational environment, and this has generated an increase in psychological stress. The present study aimed to identify the factors associated with anxiety, depression, and stress in students at a university in Peru during the COVID-19 pandemic in 2020. We conducted a cross-sectional analytical study in students in Lima, Peru. The DASS-21 scale was used to measure levels of depression, anxiety, and stress and associate it with socio-educational and COVID-19-related variables using generalized linear models with Poisson distribution, log link, and robust variance. Of 400 students surveyed, 19.2%, 23.2% and 17.2% of students presented depression, anxiety, and stress, respectively. The frequency of depression (PR = 0.91, 95%CI: 0.84–0.99), anxiety (PR = 0.90, 95%CI: 0.83–0.99) and stress (PR = 0.92, 95%CI: 0.86–0.99) was lower in women. The students of the engineering and business faculty presented a higher frequency of anxiety (PR = 1.11, 95%CI: 1.00–1.22). There was a greater frequency of presenting anxiety, depression and stress in students who worked in a different area of health or did not work. Our results suggest the importance of promoting mental health awareness campaigns in university students due to the constant academic load they have. Full article
(This article belongs to the Special Issue Emotion Regulation and COVID-Related Stress Management)
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