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Int. J. Environ. Res. Public Health, Volume 19, Issue 3 (February-1 2022) – 889 articles

Cover Story (view full-size image): Throughout history, accidental hypothermia has accompanied natural disasters in cold, temperate, and even subtropical regions. We conducted a non-systematic review of the causes and means of preventing accidental hypothermia after natural disasters caused by avalanches, earthquakes, tsunamis, and floods. Before a disaster occurs, preventive measures are required, such as accurate disaster risk analysis for given areas, hazard mapping and warning, protection of existing structures within hazard zones to the greatest extent possible, building of structures outside hazard zones, and organization of rapid and effective rescue. After the event, post hoc analyses of failures and implementation of corrective actions will reduce the risk of accidental hypothermia in future disasters. View this paper.
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Article
“COVID-19 in Trials and Tribulations” Project: A Self-Regulation-Based Support Response for Confined Families through Social Networks
Int. J. Environ. Res. Public Health 2022, 19(3), 1910; https://doi.org/10.3390/ijerph19031910 - 08 Feb 2022
Viewed by 916
Abstract
The COVID-19 pandemic has placed today’s society in an unprecedented scenario. During Portugal’s first home confinement period (March–July 2020), the online-based “COVID-19 in Trials and Tribulations” project was implemented to support families with school-aged children. The project was grounded on the self-regulation framework [...] Read more.
The COVID-19 pandemic has placed today’s society in an unprecedented scenario. During Portugal’s first home confinement period (March–July 2020), the online-based “COVID-19 in Trials and Tribulations” project was implemented to support families with school-aged children. The project was grounded on the self-regulation framework and delivered through Facebook® and Instagram® pages. Being responsive to ongoing developments of the pandemic, activities were conveyed in two phases. Phase 1 occurred during lockdown (school was suspended). Phase 2 occurred while students were enrolled in at-distance (online) school. The present study aimed to examine the reach of the project, while examining the content and format of delivery that generated the most engagement among the users (4500 Facebook® effective followers; 1200 Instagram® effective followers) during the confinement period. Results showed that, at the individual page level, Facebook® had higher reach indicators compared to Instagram®, except for video. At the Facebook® post level, followers and users showed more engagement with the page prior to the at-distance schooling phase; however, videos still generated engagement (p = 0.002). Both the post type (p < 0.01) and frequency (p < 0.001) of publication were suggested to be good predictors of engagement. The information gathered will help design and inform future interventions that may be implemented as new lockdowns are set in place. Full article
(This article belongs to the Special Issue Psychological (Self-)Regulation and Healthy Behavior Promotion)
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Article
Precarious Employment and Chronic Stress: Do Social Support Networks Matter?
Int. J. Environ. Res. Public Health 2022, 19(3), 1909; https://doi.org/10.3390/ijerph19031909 - 08 Feb 2022
Cited by 1 | Viewed by 681
Abstract
Precarious employment has been identified as a potentially damaging stressor. Conversely, social support networks have a well-known protective effect on health and well-being. The ways in which precariousness and social support may interact have scarcely been studied with respect to either perceived stress [...] Read more.
Precarious employment has been identified as a potentially damaging stressor. Conversely, social support networks have a well-known protective effect on health and well-being. The ways in which precariousness and social support may interact have scarcely been studied with respect to either perceived stress or objective stress biomarkers. This research aims to fill this gap by means of a cross-sectional study based on a non-probability quota sample of 250 workers aged 25–60 in Barcelona, Spain. Fieldwork was carried out between May 2019 and January 2020. Employment precariousness, perceived social support and stress levels were measured by means of scales, while individual steroid profiles capturing the chronic stress suffered over a period of a month were obtained from hair samples using a liquid chromatography-tandem mass spectrometry methodology. As for perceived stress, analysis indicates that a reverse buffering effect exists (interaction B = 0.22, p = 0.014). Steroid biomarkers are unrelated to social support, while association with precariousness is weak and only reaches significance at p < 0.05 in the case of women and 20ß dihydrocortisone metabolites. These results suggest that social support can have negative effects on the relationship between perceived health and an emerging stressful condition like precariousness, while its association with physiological measures of stress remains uncertain. Full article
(This article belongs to the Special Issue Social Support and Social Networks in Long-Term Conditions)
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Article
Estonian Dental Students’ Oral Health-Related Knowledge, Attitudes and Behaviours (KAB): National Survey-Based Study
Int. J. Environ. Res. Public Health 2022, 19(3), 1908; https://doi.org/10.3390/ijerph19031908 - 08 Feb 2022
Cited by 2 | Viewed by 736
Abstract
The strategic plan for dentistry and oral health in Estonia of 2030 focuses on oral health promotion and disease prevention through undergraduate dental curricula and fostering public health-oriented research among students. The present study was designed as a descriptive cross-sectional study to evaluate [...] Read more.
The strategic plan for dentistry and oral health in Estonia of 2030 focuses on oral health promotion and disease prevention through undergraduate dental curricula and fostering public health-oriented research among students. The present study was designed as a descriptive cross-sectional study to evaluate oral health-related knowledge, attitudes, and behaviours (KAB) of dental students in Estonia. The study was carried out in the spring semester of 2020, and it used a modified version of the Hiroshima University Dental Behavioural Inventory (HU-DBI). A total of 129 students responded to the survey, constituting a response rate of 93.5% due to the total population sampling (census) technique used in this study and the small target population size. Out of the 124 students included in the final analysis, 79% were females, 62.1% were clinical students, 11.3% reported smoking tobacco at least once a week, and 86.3% reported problematic internet use. The present study found that mean HU-DBI score of Estonian dental students was 8.09 ± 1.22 which is so far the highest recorded HU-DBI score in Europe. There was no significant difference between female vs. male or preclinical vs. clinical students in terms of HU-DBI score. While clinical students reported less faulty oral hygiene practices, such as hard toothbrush use and aggressive toothbrushing, preclinical students reported a slightly higher mean HU-DBI score. Smoking behaviour was more common among male and clinical students, and it was also associated with alcohol drinking and worry about teeth colour and halitosis. Full article
(This article belongs to the Special Issue Oral Health and Disease Prevention)
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Review
Global Perspective of Legionella Infection in Community-Acquired Pneumonia: A Systematic Review and Meta-Analysis of Observational Studies
Int. J. Environ. Res. Public Health 2022, 19(3), 1907; https://doi.org/10.3390/ijerph19031907 - 08 Feb 2022
Viewed by 723
Abstract
Legionnaires’ disease (LD) (Legionella) is a common cause of community-acquired pneumonia (CAP) in those requiring hospitalization. Geographical variation in the importance of Legionella species as an aetiologic agent of CAP is poorly understood. We performed a systematic review and meta-analysis of [...] Read more.
Legionnaires’ disease (LD) (Legionella) is a common cause of community-acquired pneumonia (CAP) in those requiring hospitalization. Geographical variation in the importance of Legionella species as an aetiologic agent of CAP is poorly understood. We performed a systematic review and meta-analysis of population-based observational studies that reported the proportion of Legionella infection in patients with CAP (1 January 1990 to 31 May 2020). Using five electronic databases, articles were identified, appraised and reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. The quality of the included studies was assessed using the Newcastle–Ottawa Scale. Univariate and multivariate meta-regression analyses were conducted using study design, WHO region, study quality and healthcare setting as the explanatory variables. We reviewed 2778 studies, of which 219 were included in the meta-analysis. The mean incidence of CAP was 46.7/100,000 population (95% CI: 46.6–46.8). The mean proportion of Legionella as the causative agent for CAP was 4.6% (95% CI: 4.4 to 4.7). Consequently, the mean Legionella incidence rate was 2.8/100,000 population (95% CI: 2.7–2.9). There was significant heterogeneity across all studies I2 = 99.27% (p < 0.0001). After outliers were removed, there was a decrease in the heterogeneity (I2 = 43.53%). Legionella contribution to CAP has a global distribution. Although the rates appear highest in high income countries in temperate regions, there are insufficient studies from low- and middle-income countries to draw conclusions about the rates in these regions. Nevertheless, this study provides an estimate of the mean incidence of Legionella infection in CAP, which could be used to estimate the regional and global burden of LD to support efforts to reduce the impact of this infection as well as to fill important knowledge gaps. Full article
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Article
Prevalence and Demographic, Socioeconomic, and Behavioral Risk Factors of Self-Reported Symptoms of Sexually Transmitted Infections (STIs) among Ever-Married Women: Evidence from Nationally Representative Surveys in Bangladesh
Int. J. Environ. Res. Public Health 2022, 19(3), 1906; https://doi.org/10.3390/ijerph19031906 - 08 Feb 2022
Viewed by 781
Abstract
Sexually transmitted infections (STI) symptoms (e.g., abnormal genital discharge and genital sores/ulcers) are a major public health concern in Bangladesh because the symptoms can indicate an STI and cause sexual and reproductive health complications in women of reproductive age. To our knowledge, no [...] Read more.
Sexually transmitted infections (STI) symptoms (e.g., abnormal genital discharge and genital sores/ulcers) are a major public health concern in Bangladesh because the symptoms can indicate an STI and cause sexual and reproductive health complications in women of reproductive age. To our knowledge, no study examined the prevalence and risk factors of STI symptoms using a nationally representative sample. This study investigates the prevalence of STI symptoms among ever-married women in Bangladesh and the associations of STI symptoms with various demographic, socioeconomic, and behavioral risk factors using the most recent available data (2007, 2011, and 2014) of the Bangladesh Demographic and Health Surveys (BDHS). The BDHS employs a two-stage stratified sampling technique. The analytic sample comprised 41,777 women of reproductive age (15–49 years). Outcome variables included STI symptoms: abnormal genital discharge and genital sores/ulcers. Multivariate logistic regression was employed to find the adjusted odds ratio with a 95% confidence interval to assess the associations of outcome measures with explanatory variables. The study found that the prevalence of abnormal genital discharge and genital sores/ulcers among ever-married women aged 15–49 years was 10% and 6%, respectively. Multivariable analysis revealed that for women aged 25–34 years, those who used contraceptives and married earlier had an increased likelihood of STI symptoms. Furthermore, women from the wealthiest wealth quintile and couple’s joint decision-making were less likely to have STI symptoms. Findings have implications for interventions efforts aiming to improve women’s sexual and reproductive health in Bangladesh. Full article
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Article
Heat Strain and Use of Heat Mitigation Strategies among COVID-19 Healthcare Workers Wearing Personal Protective Equipment—A Retrospective Study
Int. J. Environ. Res. Public Health 2022, 19(3), 1905; https://doi.org/10.3390/ijerph19031905 - 08 Feb 2022
Viewed by 716
Abstract
The combination of an exacerbated workload and impermeable nature of the personal protective equipment (PPE) worn by COVID-19 healthcare workers increases heat strain. We aimed to compare the prevalence of heat strain symptoms before (routine care without PPE) versus during the COVID-19 pandemic [...] Read more.
The combination of an exacerbated workload and impermeable nature of the personal protective equipment (PPE) worn by COVID-19 healthcare workers increases heat strain. We aimed to compare the prevalence of heat strain symptoms before (routine care without PPE) versus during the COVID-19 pandemic (COVID-19 care with PPE), identify risk factors associated with experiencing heat strain, and evaluate the access to and use of heat mitigation strategies. Dutch healthcare workers (n = 791) working at COVID-19 wards for ≥1 week, completed an online questionnaire to assess personal characteristics, heat strain symptoms before and during the COVID-19 pandemic, and the access to and use of heat mitigation strategies. Healthcare workers experienced ~25× more often heat strain symptoms during medical duties with PPE (93% of healthcare workers) compared to without PPE (30% of healthcare workers; OR = 25.57 (95% CI = 18.17–35.98)). Female healthcare workers and those with an age <40 years were most affected by heat strain, whereas exposure time and sports activity level were not significantly associated with heat strain prevalence. Cold drinks and ice slurry ingestion were the most frequently used heat mitigation strategies and were available in 63.5% and 30.1% of participants, respectively. Our findings indicate that heat strain is a major challenge for COVID-19 healthcare workers, and heat mitigations strategies are often used to counteract heat strain. Full article
(This article belongs to the Section Occupational Safety and Health)
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Article
The Effect of Core Stabilization Exercise with the Abdominal Drawing-in Maneuver Technique on Stature Change during Prolonged Sitting in Sedentary Workers with Chronic Low Back Pain
Int. J. Environ. Res. Public Health 2022, 19(3), 1904; https://doi.org/10.3390/ijerph19031904 - 08 Feb 2022
Viewed by 789
Abstract
To enhance stature recovery, lumbar spine stabilization by stimulating the deep trunk muscle activation for compensation forces originating from the upper body was introduced. The abdominal drawing-in maneuver (ADIM) technique has been found mainly to activate deep trunk muscles. The purpose of the [...] Read more.
To enhance stature recovery, lumbar spine stabilization by stimulating the deep trunk muscle activation for compensation forces originating from the upper body was introduced. The abdominal drawing-in maneuver (ADIM) technique has been found mainly to activate deep trunk muscles. The purpose of the current study was to determine whether 5 weeks of training of deep trunk muscles using the ADIM technique could improve stature recovery, delay trunk muscle fatigue, and decrease pain intensity during prolonged sitting. Thirty participants with chronic low back pain (CLBP) conducted a core stabilization exercise (CSE) with the ADIM technique for 5 weeks. Participants were required to sit for 41 min before and after the exercise intervention. Stature change was measured using a seated stadiometer with a resolution of ±0.006 mm. During sitting, the stature change, pain intensity, and trunk muscle fatigue were recorded. A comparison between measurements at baseline and after 5 weeks of training demonstrated: (i) stature recovery and pain intensity significantly improved throughout the 41 min sitting condition; (ii) the bilaterally trunk muscle showed significantly decreased fatigue. The CSE with the ADIM technique was shown to provide a protective effect on detrimental reductions in stature change and trunk muscle fatigue during prolonged sitting in young participants under controlled conditions in a laboratory. This information may help to prevent the risk of LBP from prolonged sitting activities in real life situations. Full article
(This article belongs to the Special Issue Low Back Pain (LBP))
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Article
An Electromyographic Analysis of Romanian, Step-Romanian, and Stiff-Leg Deadlift: Implication for Resistance Training
Int. J. Environ. Res. Public Health 2022, 19(3), 1903; https://doi.org/10.3390/ijerph19031903 - 08 Feb 2022
Viewed by 924
Abstract
The present study examined the posterior chain muscle excitation in different deadlift variations. Ten competitive bodybuilders (training seniority of 10.6 ± 1.8 years) performed the Romanian (RD), Romanian standing on a step (step-RD), and stiff-leg deadlift (SD) with an 80% 1-RM. The excitation [...] Read more.
The present study examined the posterior chain muscle excitation in different deadlift variations. Ten competitive bodybuilders (training seniority of 10.6 ± 1.8 years) performed the Romanian (RD), Romanian standing on a step (step-RD), and stiff-leg deadlift (SD) with an 80% 1-RM. The excitation of the gluteus maximus, gluteus medius, biceps femoris, semitendinosus, erector spinae longissimus, and iliocostalis was assessed during both the ascending and descending phases. During the ascending phase, the RMS of the gluteus maximus was greater in the step-RD than in the RD (effect size (ES): 1.70, 0.55/2.84) and SD (ES: 1.18, 0.11/2.24). Moreover, a greater RMS was found in the SD than in the RD (ES: 0.99, 0.04/1.95). The RMS of the semitendinosus was greater in the step-RD than in the RD (ES: 0.82, 0.20/1.44) and SD (ES: 3.13, 1.67/4.59). Moreover, a greater RMS was found in the RD than in the SD (ES: 1.38, 0.29/2.48). The RMS of the longissimus was greater in the step-RD than in the RD (ES: 2.12, 0.89/3.34) and SD (ES: 3.28, 1.78/4.78). The descending phase had fewer differences between the exercises. No further differences between the exercises were found. The step-RD increased the overall excitation of the posterior chain muscles, possibly because of the greater range of movement and posterior muscle elongation during the anterior flexion. Moreover, the RD appeared to target the semitendinosus more than the SD, while the latter excited the gluteus maximus more. Full article
(This article belongs to the Special Issue Resistance Exercise/Training to Improve Physical Fitness and Health)
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Article
Patients’ Views on the Design of DiabeText, a New mHealth Intervention to Improve Adherence to Oral Antidiabetes Medication in Spain: A Qualitative Study
Int. J. Environ. Res. Public Health 2022, 19(3), 1902; https://doi.org/10.3390/ijerph19031902 - 08 Feb 2022
Cited by 1 | Viewed by 656
Abstract
Background: Type 2 Diabetes Mellitus (T2DM) is a long-term condition affecting around 10% of people worldwide. This study aimed to explore T2DM patients’ views on DiabeText, a new text messaging intervention to be developed to support adherence to diabetes medication. Methods: A total [...] Read more.
Background: Type 2 Diabetes Mellitus (T2DM) is a long-term condition affecting around 10% of people worldwide. This study aimed to explore T2DM patients’ views on DiabeText, a new text messaging intervention to be developed to support adherence to diabetes medication. Methods: A total of four focus groups were conducted with a purposive sample of people with T2DM (n = 34). The data were analysed by multiple researchers independently, and coded using thematic analysis. Results: There were two main themes that emerged: (1) “patients’ perspectives on unmet needs for diabetes self-management”, and (2) “acceptability and perceived utility of DiabeText”. The patients identified a number of barriers for diabetes self-management, including lack of appropriate information and support with diet and physical activity. Support for medication-taking was not perceived as urgently needed, although several barriers were identified (eating outside, traveling, polymedication, dispensation at the pharmacy). The participants anticipated that the proposed intervention would present high levels of patient acceptability and perceived utility as long as its content addresses the barriers that were identified, and includes specific features (short and clear messages, and personalized information). Conclusion: The proposed intervention has the potential to be well accepted and perceived as useful by T2DM patients who require support not only in terms of medication-taking, but more prominently of lifestyle behaviour. Full article
(This article belongs to the Topic eHealth and mHealth: Challenges and Prospects)
Article
The Impact of Vitamin D Status on COVID-19 Severity among Hospitalized Patients in the Western Region of Saudi Arabia: A Retrospective Cross-Sectional Study
Int. J. Environ. Res. Public Health 2022, 19(3), 1901; https://doi.org/10.3390/ijerph19031901 - 08 Feb 2022
Cited by 1 | Viewed by 743
Abstract
The coronaviruses disease 2019 (COVID-19) spreads continuously worldwide. The new vaccines and drugs have been approved. The prevention of disease is crucial, and some studies reveal the promising effect of alternative therapies such as vitamin D supplementations on COVID-19 prevention, but they still [...] Read more.
The coronaviruses disease 2019 (COVID-19) spreads continuously worldwide. The new vaccines and drugs have been approved. The prevention of disease is crucial, and some studies reveal the promising effect of alternative therapies such as vitamin D supplementations on COVID-19 prevention, but they still require sufficient evidence. Therefore, the current retrospective multicenter cross-sectional study aims to determine the primary association between the vitamin D status of hospitalized COVID-19 and its severity as well as mortality. A total of 197 COVID-19 were admitted at King Faisal Hospital, Al Noor Specialist Hospital in Makkah, and at Complex King Faisal Hospital in Taif in the Westering region of Saudi Arabia (SA) between June and August 2020. The demographic and clinical characteristics, laboratory tests included serum 25(OH)D and admission for intensive care unit (ICU), length of stay in the hospital, mechanical ventilation (MV) support, and mortality were recorded and analyzed. Vitamin D deficiency (25(OH)D < 20 ng/mL) was found in 73.10% of all study population. Multiple logistic regression was used after adjusted covariances such as age, gender, diabetes, hypertension, and chronic kidney disease (CKD). No statistically significant was shown for ICU admission [Odd Ratio, OR 1.25 (95% confidence interval, CI 0.41–3.88) p = 0.70], MV support [Odd Ratio, OR 3.12 (95% confidence interval, CI 0.74–13.21) p = 0.12] and mortality [Odd Ratio, OR 2.39 (95% confidence interval, CI 0.31–18.11), p = 0.40]. These data didn’t support the association between serum 25(OH)D and the severity of the disease among hospitalized COVID-19 patients. Full article
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Article
Functional Status, Quality of Life, and Physical Activity of Senior Club Members—A Cross-Sectional Study
Int. J. Environ. Res. Public Health 2022, 19(3), 1900; https://doi.org/10.3390/ijerph19031900 - 08 Feb 2022
Viewed by 568
Abstract
This study aims to assess the functional status, quality of life, and physical activity (PA) of the elderly who are members of senior social clubs. The study included 63 participants (65–95 years old) who were members of a seniors club. The study utilized [...] Read more.
This study aims to assess the functional status, quality of life, and physical activity (PA) of the elderly who are members of senior social clubs. The study included 63 participants (65–95 years old) who were members of a seniors club. The study utilized the following instruments: Barthel scale, Lawton’s scale of Instrumental Activities of Daily Living (IADL), WHO Quality of Life-BREF questionnaire, author’s survey questionnaire containing questions about the type of PA. Duration of membership in the senior club has a statistically significant effect on Barthel index score (F = 19.68, p < 0.001) and Lawton’s IADL scale results (F = 17.59, p < 0.001). All four domains of life quality were strongly related to the duration of attendance to senior clubs. Participants who attended the senior club for more than five years were more likely to report a longer PA duration than participants who attended the senior club for less than 5 years (Chi2 = 25.84, p < 0.001). Attendance to senior social clubs has a strong positive impact on functional status, quality of life, and PA of the elderly. Moreover, our study identified numerous social-demographic factors associated with PA, quality of life, and functional status of senior club members. Full article
(This article belongs to the Special Issue Exercise, Sport, and Leisure Behaviors in Older Adults)
Article
Chronic Pain and Its Association with Depressive Symptoms and Renal Function in Hypertensive Patients
Int. J. Environ. Res. Public Health 2022, 19(3), 1899; https://doi.org/10.3390/ijerph19031899 - 08 Feb 2022
Viewed by 475
Abstract
Chronic pain is a common concern and is considered to be one of the major problems in patients with chronic physical disorders. We studied the effect of pain in patients with hypertension with or without chronic kidney disease (CKD) and the association between [...] Read more.
Chronic pain is a common concern and is considered to be one of the major problems in patients with chronic physical disorders. We studied the effect of pain in patients with hypertension with or without chronic kidney disease (CKD) and the association between pain and symptoms of depression. The study involved 158 hypertensive individuals (59.5% male, mean age 55 years), of whom 47 (29.8%) had CKD (estimated glomerular filtration rate < 60 mL/min/1.73 m2). Pain was assessed with the pain/discomfort domain of the EuroQol-5 D, while depressive symptoms were assessed with the depression module of the Patient health questionnaire (PHQ-9). The prevalence of chronic pain in our sample was 44.3%. Women exhibited chronic pain more often compared to men (57.1% vs. 42.9%, p < 0.001). The presence of CKD was not significantly associated with a higher prevalence of chronic pain among hypertensive patients. Depressive symptoms were significantly associated with the presence of chronic pain. These findings were confirmed in the logistic regression analysis. Chronic pain is common in hypertensive individuals and the association with depression warrants further investigation and may have practical implications in managing these patients. Full article
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Article
Effects of Health Belief, Knowledge, and Attitude toward COVID-19 on Prevention Behavior in Health College Students
Int. J. Environ. Res. Public Health 2022, 19(3), 1898; https://doi.org/10.3390/ijerph19031898 - 08 Feb 2022
Cited by 1 | Viewed by 660
Abstract
This study aimed to identify the factors affecting the practice of COVID-19 prevention behaviors among college students as future medical workers. A cross-sectional online survey was conducted in September 2021. A total of 526 health college students were included in this study. A [...] Read more.
This study aimed to identify the factors affecting the practice of COVID-19 prevention behaviors among college students as future medical workers. A cross-sectional online survey was conducted in September 2021. A total of 526 health college students were included in this study. A hierarchical regression analysis was performed to examine the effect on the practice of COVID-19 prevention behavior. As a result of the analysis, experiences of education on infectious diseases had significant positive effects on the practice of prevention behavior (β = 0.22, p < 0.001). Additionally, a higher COVID-19 health belief had a significant positive effect on the practice of prevention behavior (β = 0.15, p = 0.004). Increased smoking and drinking among lifestyle changes after COVID-19 had significant negative effects on the practice of prevention behavior compared with decreased physical activity (β = −0.12, p = 0.007). Based on these findings, the study discussed the importance of education on the prevention of infectious diseases among health college students, promotion of health beliefs related to infectious diseases, and formation of healthy lifestyle habits in daily life. Full article
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Perspective
Psychomotor Symptoms in Chronic Cocaine Users: An Interpretative Model
Int. J. Environ. Res. Public Health 2022, 19(3), 1897; https://doi.org/10.3390/ijerph19031897 - 08 Feb 2022
Viewed by 554
Abstract
According to the latest estimates, there are around 24.6 million cocaine users worldwide, and it is estimated that around a quarter of the population worldwide has used cocaine at some point in their lifetime. It follows that such widespread consumption represents a major [...] Read more.
According to the latest estimates, there are around 24.6 million cocaine users worldwide, and it is estimated that around a quarter of the population worldwide has used cocaine at some point in their lifetime. It follows that such widespread consumption represents a major risk for public health. Long-term use of cocaine, in addition to being related to many cerebral and cardiovascular diseases, is increasingly associated with a higher incidence of psychomotor symptoms and neurodegenerative disorders. In recent years, numerous studies have shown an increased risk of antipsychotic-induced extrapyramidal symptoms (EPSs) in patients with psychotic spectrum disorders comorbid with psychostimulant misuse, particularly of cocaine. In the present paper, we describe the case of a young patient on his first entry into a psychiatric setting with previous cocaine misuse who rapidly presented psychomotor symptoms and was poorly responsive to symptomatic therapy consisting of benzodiazepines and anticholinergics, in relation to the introduction of various antipsychotics (first, second, and third generation). Furthermore, we propose neurobiological mechanisms underlying the hypothesized increased vulnerability to psychomotor symptoms in chronic cocaine abusers. Specifically, we supposed that the chronic administration of cocaine produces important neurobiological changes, causing a complex dysregulation of various neurotransmitter systems, mainly affecting subcortical structures and the dopaminergic and glutamatergic pathways. We believe that a better understanding of these neurochemical and neurobiological processes could have useful clinical and therapeutic implications by providing important indications to increase the risk–benefit ratio in pharmacological choice in patients with psychotic spectrum disorders comorbid with a substance use disorder. Full article
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Article
Professional Mental Health Help-Seeking Amongst Afghan and Iraqi Refugees in Australia: Understanding Predictors Five Years Post Resettlement
Int. J. Environ. Res. Public Health 2022, 19(3), 1896; https://doi.org/10.3390/ijerph19031896 - 08 Feb 2022
Viewed by 767
Abstract
The current longitudinal study sought to identify predictors of professional help seeking for mental health problems amongst Afghan and Iraqi refugees five years post-settlement utilising the Building a New Life in Australia dataset (BNLA). Data were collected via face-to-face or phone interviews across [...] Read more.
The current longitudinal study sought to identify predictors of professional help seeking for mental health problems amongst Afghan and Iraqi refugees five years post-settlement utilising the Building a New Life in Australia dataset (BNLA). Data were collected via face-to-face or phone interviews across five waves from October 2013 to March 2018. Afghan and Iraqi born refugees numbering 1180 and over 18 years of age with a permanent humanitarian visa were included in this study. The results suggest differences in help-seeking behaviors amongst the two ethnic groups. Amongst the Afghan sample, older adults with high psychological distress were more likely to seek help, while living in regional Australia, not requiring interpreters, and knowing how to find out information about government services were related to lower likelihood of help-seeking. Within the Iraqi sample, poor overall health and knowing how to find out about services were related to a greater likelihood of help-seeking, while fewer financial hardships decreased the likelihood of help-seeking. Amongst those with probable PTSD, disability was associated with an increased likelihood of help-seeking while experiencing fewer financial hardships and living in regional Australia resulted in a lower likelihood of help-seeking in this group. These results have implications for promotional material and mental health interventions, suggesting that more integrated services tailored to specific characteristics of ethnic groups are needed. Full article
Editorial
Acknowledgment to Reviewers of International Journal of Environmental Research and Public Health in 2021
Int. J. Environ. Res. Public Health 2022, 19(3), 1895; https://doi.org/10.3390/ijerph19031895 - 08 Feb 2022
Viewed by 789
Abstract
Rigorous peer-reviews are the basis of high-quality academic publishing [...] Full article
Article
Differences in the Correlation between the Built Environment and Walking, Moderate, and Vigorous Physical Activity among the Elderly in Low- and High-Income Areas
Int. J. Environ. Res. Public Health 2022, 19(3), 1894; https://doi.org/10.3390/ijerph19031894 - 08 Feb 2022
Viewed by 624
Abstract
Studies have proved that activity and fitness behaviors are closely related to the quality of life and health status of the elderly. However, different intensities of physical activity (PA)—walking, moderate PA, and vigorous PA—have different correlations with the built environment (BE). This study [...] Read more.
Studies have proved that activity and fitness behaviors are closely related to the quality of life and health status of the elderly. However, different intensities of physical activity (PA)—walking, moderate PA, and vigorous PA—have different correlations with the built environment (BE). This study combines the high and low socioeconomic status (SES) of Guangzhou to establish two types of BE models. The physical activity time of 600 elderly people was collected from questionnaires. Through ArcGIS software, 300 m, 500 m, 800 m, and 1000 m buffer zones were identified, and the land use diversity, street design, population density, distance to destination, distance to public transportation—the five Ds of the BE—were measured. SPSS software was adopted to analyze the correlation between the BE and PA. Results: The PA of people living in low-SES areas was more dependent on the BE, whereas the correlation may be limited in high SES areas. Moreover, in low SES areas, walking was negatively correlated with street connectivity; moderate PA was positively correlated with street connectivity and the shortest distance to the subway station, but negatively correlated with the density of entertainment points of interest (POIs). Studying the relevant factors of the environment can propose better strategies to improve the initiative of the elderly to engage in PA. Full article
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Review
Predicting Infectious Diseases: A Bibliometric Review on Africa
Int. J. Environ. Res. Public Health 2022, 19(3), 1893; https://doi.org/10.3390/ijerph19031893 - 08 Feb 2022
Viewed by 957
Abstract
Africa has a long history of novel and re-emerging infectious disease outbreaks. This reality has attracted the attention of researchers interested in the general research theme of predicting infectious diseases. However, a knowledge mapping analysis of literature to reveal the research trends, gaps, [...] Read more.
Africa has a long history of novel and re-emerging infectious disease outbreaks. This reality has attracted the attention of researchers interested in the general research theme of predicting infectious diseases. However, a knowledge mapping analysis of literature to reveal the research trends, gaps, and hotspots in predicting Africa’s infectious diseases using bibliometric tools has not been conducted. A bibliometric analysis of 247 published papers on predicting infectious diseases in Africa, published in the Web of Science core collection databases, is presented in this study. The results indicate that the severe outbreaks of infectious diseases in Africa have increased scientific publications during the past decade. The results also reveal that African researchers are highly underrepresented in these publications and that the United States of America (USA) is the most productive and collaborative country. The relevant hotspots in this research field include malaria, models, classification, associations, COVID-19, and cost-effectiveness. Furthermore, weather-based prediction using meteorological factors is an emerging theme, and very few studies have used the fourth industrial revolution (4IR) technologies. Therefore, there is a need to explore 4IR predicting tools such as machine learning and consider integrated approaches that are pivotal to developing robust prediction systems for infectious diseases, especially in Africa. This review paper provides a useful resource for researchers, practitioners, and research funding agencies interested in the research theme—the prediction of infectious diseases in Africa—by capturing the current research hotspots and trends. Full article
(This article belongs to the Section Global Health)
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Article
Effect of Heating on Physicochemical Property of Aerosols during Vaping
Int. J. Environ. Res. Public Health 2022, 19(3), 1892; https://doi.org/10.3390/ijerph19031892 - 08 Feb 2022
Viewed by 691
Abstract
Many electronic cigarette manufacturers have offered different types of “high-end mods” that allow for controlled heating of the e-liquid. However, the controlled heating condition can drastically alter the inhaled aerosols’ physical properties and chemical substances, causing potential health risks. To investigate the contribution [...] Read more.
Many electronic cigarette manufacturers have offered different types of “high-end mods” that allow for controlled heating of the e-liquid. However, the controlled heating condition can drastically alter the inhaled aerosols’ physical properties and chemical substances, causing potential health risks. To investigate the contribution of heating on aerosol properties, we used four common power settings in the mods to conduct a physicochemical analysis. Our data showed that the aerosol mass and nicotine content in the aerosols increased at high power. Additionally, high power led to aerosolization of a viscous component in the e-liquid, increasing the viscosity of aerosol. However, the pH of the aerosol was constant regardless of the applied power. In addition, high-power operation made nicotine prone to oxidation, resulting in the color of the aerosol turning yellow. Lastly, we demonstrated that e-cigarette aerosol could contain various metals, including aluminum, arsenic, cadmium, chromium, copper, iron, magnesium, nickel, lead, and zinc. Even though these metal contents proportionally increased with the power setting, they remained far below the recommended exposure limits. Our finding demonstrates that the heating conditions of the e-cigarette change the physicochemical properties of the aerosols and their metal contents, thereby possibly affecting users’ oral and respiratory systems. Full article
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Article
Differential Trajectories of Fathers’ Postpartum Depressed Mood: A Latent Class Growth Analysis Approach
Int. J. Environ. Res. Public Health 2022, 19(3), 1891; https://doi.org/10.3390/ijerph19031891 - 08 Feb 2022
Viewed by 452
Abstract
Parental psychological well-being is essential to the wellness of the family. However, longitudinal investigations into fathers’ postpartum depressed mood are limited. This study aimed to identify the typologies of depressed mood trajectories over the first year postpartum among Taiwanese fathers and to examine [...] Read more.
Parental psychological well-being is essential to the wellness of the family. However, longitudinal investigations into fathers’ postpartum depressed mood are limited. This study aimed to identify the typologies of depressed mood trajectories over the first year postpartum among Taiwanese fathers and to examine the factors associated with such typologies. We retrieved data from a nationwide longitudinal study on child development and care in Taiwan. A total of 396 fathers, who completed at least one of the three interviews when their children were 3, 6, and 12 months old between 2016 and 2017, were included in this analysis. Conditional latent class growth analysis was conducted to identify the classifications of the fathers’ depressed mood trajectories in the first year postpartum and to estimate the effects of covariates on individuals’ membership of a trajectory class. Three classes of depressed mood trajectories were identified. The high increasing group consisted of 11% of the participants; the moderate increasing and the low decreasing groups consisted of 28% and 61% of the participants, respectively. Financial stress was associated with the fathers’ likelihood of being in the high increasing group compared with their likelihood of being in the low decreasing group (OR = 2.28, CI = 1.16–4.47). The result may be related to the difference in gender roles and social expectations. Full article
(This article belongs to the Section Mental Health)
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Article
Highly Efficient Removal of Nitrate and Phosphate to Control Eutrophication by the Dielectrophoresis-Assisted Adsorption Method
Int. J. Environ. Res. Public Health 2022, 19(3), 1890; https://doi.org/10.3390/ijerph19031890 - 08 Feb 2022
Viewed by 536
Abstract
The removal of excessive amounts of nitrate and phosphate from water sources, especially agricultural wastewater, has been of high significance to control eutrophication in aquatic systems. Here, a new method is reported for the removal of nitrate and phosphate simultaneously from wastewater based [...] Read more.
The removal of excessive amounts of nitrate and phosphate from water sources, especially agricultural wastewater, has been of high significance to control eutrophication in aquatic systems. Here, a new method is reported for the removal of nitrate and phosphate simultaneously from wastewater based on the combination of the solution-phased adsorption (ADS) and dielectrophoresis (DEP) techniques. The plant ash was first selected as the adsorbent by screening tests, followed by a systematic investigation of using the adsorbent to remove nitrate and phosphate from wastewater under various experimental conditions, including the testing of adsorbent dosage, pretreatment time, water flow rate, and electrode voltage. The analysis of the adsorbent particles was also performed by scanning electron microscope (SEM) analysis, the energy dispersive X-ray spectroscopy (EDX) test, and the measurement of Zeta potentials. Compared with the ADS method alone, the introduction of DEP into the purification process has greatly increased the removal rate by 66.06% for nitrate and 43.04% for phosphate, respectively. In the meantime, it is observed that the processing time has been greatly reduced by 92% with the assistance of DEP. Full article
(This article belongs to the Special Issue Wastewater Pollution and Control)
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Review
Empathy in Human–Robot Interaction: Designing for Social Robots
Int. J. Environ. Res. Public Health 2022, 19(3), 1889; https://doi.org/10.3390/ijerph19031889 - 08 Feb 2022
Viewed by 995
Abstract
For a service robot to serve travelers at an airport or for a social robot to live with a human partner at home, it is vital for robots to possess the ability to empathize with human partners and express congruent emotions accordingly. We [...] Read more.
For a service robot to serve travelers at an airport or for a social robot to live with a human partner at home, it is vital for robots to possess the ability to empathize with human partners and express congruent emotions accordingly. We conducted a systematic review of the literature regarding empathy in interpersonal, virtual agents, and social robots research with inclusion criteria to analyze empirical studies in a peer-reviewed journal, conference proceeding, or a thesis. Based on the review, we define empathy for human–robot interaction (HRI) as the robot’s (observer) capability and process to recognize the human’s (target) emotional state, thoughts, and situation, and produce affective or cognitive responses to elicit a positive perception of humans. We reviewed all prominent empathy theories and established a conceptual framework that illuminates critical components to consider when designing an empathic robot, including the empathy process, outcome, and the observer and target characteristics. This model is complemented by empirical research involving empathic virtual agents and social robots. We suggest critical factors such as domain dependency, multi-modality, and empathy modulation to consider when designing, engineering, and researching empathic social robots. Full article
(This article belongs to the Special Issue Mobile Health Interventions)
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Review
A Guide to Different Intensities of Exercise, Vaccination, and Sports Nutrition in the Course of Preparing Elite Athletes for the Management of Upper Respiratory Infections during the COVID-19 Pandemic: A Narrative Review
Int. J. Environ. Res. Public Health 2022, 19(3), 1888; https://doi.org/10.3390/ijerph19031888 - 08 Feb 2022
Viewed by 1091
Abstract
Elite athletes use high-intensity training to maintain their fitness level. However, intense training can harm the immune system, making athletes suspectable to COVID-19 and negatively affecting their performance. In addition, the diet of athletes should be appreciated more as it is another influencer [...] Read more.
Elite athletes use high-intensity training to maintain their fitness level. However, intense training can harm the immune system, making athletes suspectable to COVID-19 and negatively affecting their performance. In addition, the diet of athletes should be appreciated more as it is another influencer of the immune system, especially during the COVID 19 pandemic. The other important issue elite athletes face currently is vaccination and its possible intervention with their training. The present study attempts to discuss the impact of different training intensities, nutritional strategies, and vaccination on the immune system function in elite athletes. To this end, Scopus, ISC, PubMed, Web of Science, and Google Scholar databases were searched from 1988 to 2021 using the related keywords. The results of our review showed that although high-intensity exercise can suppress the immune system, elite athletes should not stop training in the time of infection but use low- and moderate-intensity training. Moderate-intensity exercise can improve immune function and maintain physical fitness. In addition, it is also better for athletes not to undertake high-intensity training at the time of vaccination, but instead perform moderate to low-intensity training. Furthermore, nutritional strategies can be employed to improve immune function during high-intensity training periods. Full article
(This article belongs to the Section Exercise and Health)
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Article
Depressive and Sexual Disorders during the First and Second Wave of the COVID-19 Pandemic among Young Polish Women
Int. J. Environ. Res. Public Health 2022, 19(3), 1887; https://doi.org/10.3390/ijerph19031887 - 08 Feb 2022
Cited by 1 | Viewed by 598
Abstract
We investigated whether long-term social restrictions and COVID-19 exposure have different impacts on the mental and sexual health of Polish women compared to the effects experienced at the beginning of the pandemic. An online survey was conducted among Polish women via Facebook groups. [...] Read more.
We investigated whether long-term social restrictions and COVID-19 exposure have different impacts on the mental and sexual health of Polish women compared to the effects experienced at the beginning of the pandemic. An online survey was conducted among Polish women via Facebook groups. The Beck Depression Inventory (BDI) and Female Sexual Function Index (FSFI) scores were compared for the first wave (April–May 2020) and the second wave (November 2020 to February 2021) of the pandemic. We enrolled 1644 participants (mean age 25.11 ± 7.09 years) during the first wave and 720 participants (mean age 23.23 ± 5.34 years) during the second wave of COVID-19 pandemic. Significant differences were observed in libido levels and frequency of sexual activity before and during the first and second wave of the COVID-19 pandemic (both p < 0.001). The percentage of participants under psychiatric or psychological care increased from 6.5% to 14.44% and those who were anxious about the health conditions of loved ones increased from 57.5% to 65.14%. BDI scores increased significantly from 11 (IQR 5–18) to 12 (IQR 7–20). The change in the FSFI score was not significant (27.01 ± 7.61 vs. 26.38 ± 7.76). The COVID-19 pandemic affected various aspects of human life, including sexual life. The data obtained during the first and the second wave of the COVID-19 pandemic in Poland showed that female sexual dysfunction did not differ, but depressive symptoms and fear intensified. Full article
(This article belongs to the Special Issue Sexual Health in the Time of COVID-19)
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Article
How Do Ecosystem Services Affect Poverty Reduction Efficiency? A Panel Data Analysis of State Poverty Counties in China
Int. J. Environ. Res. Public Health 2022, 19(3), 1886; https://doi.org/10.3390/ijerph19031886 - 08 Feb 2022
Viewed by 549
Abstract
Scientific evaluation of the interaction between poverty reduction efficiency (PRE) and ecosystem services (ES) in state poverty counties is essential in promoting the rural revitalization strategy and the construction of an ecological civilization. Using the DEA model, the InVEST model, and fixed-effect panel [...] Read more.
Scientific evaluation of the interaction between poverty reduction efficiency (PRE) and ecosystem services (ES) in state poverty counties is essential in promoting the rural revitalization strategy and the construction of an ecological civilization. Using the DEA model, the InVEST model, and fixed-effect panel data, this study was analyzed using the panel data of 832 poverty counties in China for 2010–2019 to evaluate the relationship between poverty reduction efficiency and ecosystem services. The main results are as follows: (1) The overall poverty reduction efficiency showed an upward trend, while ES exhibited a declining trend with spatial heterogeneity. The poverty reduction efficiency of state poverty counties in the western region increased rapidly. (2) The impact of different types of ecosystem services on poverty reduction efficiency varied considerably. Habitat quality was significantly negatively impacted, while food production and carbon storage showed significant positive effects. There was a significant positive relationship between ecosystem services and poverty reduction efficiency in all regions, with the eastern region having the strongest correlation. (3) The panel regression analysis showed a significant positive impact. The environmental parameters were the primary factors affecting poverty reduction efficiency, while economic and social factors were the driving and external factors. The rural revitalization strategy should strive towards the win-win effect of ecological protection and economic development. Full article
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Article
Factors Involved in the Food Choices of Diners in a Kibbutz Communal Dining Room Buffet: A Qualitative Study
Int. J. Environ. Res. Public Health 2022, 19(3), 1885; https://doi.org/10.3390/ijerph19031885 - 08 Feb 2022
Viewed by 597
Abstract
Improving nutrition improves health outcomes. Eating in a catering system may provide an environment for promoting healthy dietary choices. To map the factors that shape the food choices of diners who routinely eat in catering systems, we collected and analyzed qualitative data about [...] Read more.
Improving nutrition improves health outcomes. Eating in a catering system may provide an environment for promoting healthy dietary choices. To map the factors that shape the food choices of diners who routinely eat in catering systems, we collected and analyzed qualitative data about diners’ perceptions of their food choices in communal dining rooms in three kibbutzim in Israel. From May to July 2014, we conducted in-depth, semi-structured, face-to-face interviews with 13 diners who ate at least three lunches per week in the kibbutz’s dining room. Data analysis followed thematic analysis principles. Two categories of themes emerged from the interviews. In the personal context category, the themes identified were eating as a task and attempts to control one’s eating. In the contextual aspects of eating in the catering system category, themes identified were eating in the dining room as a default, the characteristics of the food served, routine, and personal versus public aspects. The sub-theme of the diners’ freedom of choice emerged in the two categories of themes. Diners’ wishes of maintaining their freedom of choice may be an important contribution to the debate of whether catering systems should provide only healthy foods, which may jeopardize diners’ freedom of choice. Full article
Article
Clinical Outcomes Following a Change in Gestational Diabetes Mellitus Diagnostic Criteria Due to the COVID-19 Pandemic: A Case-Control Study
Int. J. Environ. Res. Public Health 2022, 19(3), 1884; https://doi.org/10.3390/ijerph19031884 - 08 Feb 2022
Cited by 1 | Viewed by 655
Abstract
Background: Due to COVID-19, many centres adopted a change to the diagnosis of GDM. Methods: A case-control study of antenatal patients between 1 April and 30 June in 2019 and 2020 looking at detection rates of GDM, use of medication, obstetric, and fetal [...] Read more.
Background: Due to COVID-19, many centres adopted a change to the diagnosis of GDM. Methods: A case-control study of antenatal patients between 1 April and 30 June in 2019 and 2020 looking at detection rates of GDM, use of medication, obstetric, and fetal outcomes. Results: During COVID-19, the rate of positive GDM tests approximately halved (20% (42/210) in 2020 vs. 42.2% (92/218) in 2019, (p < 0.01)) with higher rates of requirement for insulin at diagnosis (21.4% (2020) vs. 2.2% (2019); p < 0.01), and at term (31% (2020) vs. 5.4% (2019); p < 0.01). and metformin at diagnosis (4.8% (2020) vs. 1.1% (2019); p < 0.01), and at term (14.3% (2020) vs. 7.6% (2019) p < 0.01), with no differences in birth outcomes. Conclusions: There was likely an underdiagnosis of GDM while women at a higher risk of hyperglycaemia were correctly identified. The GTT should be maintained as the gold-standard test where possible, with provisions made for social distancing during testing if required. Full article
(This article belongs to the Special Issue Maternal Medicine)
Brief Report
Health and Economic Impact of Atrial Fibrillation of Workers in Italy: Social Security Benefits
Int. J. Environ. Res. Public Health 2022, 19(3), 1883; https://doi.org/10.3390/ijerph19031883 - 08 Feb 2022
Viewed by 472
Abstract
Background: The aim of this research was to analyze trends in social security applications in Italy as a result of the onset of atrial fibrillation, analyzing data pertaining to the classification of professions and assessing the economic impact on the social security system. [...] Read more.
Background: The aim of this research was to analyze trends in social security applications in Italy as a result of the onset of atrial fibrillation, analyzing data pertaining to the classification of professions and assessing the economic impact on the social security system. Methods: We analyzed all applications for invalidity allowances and invalidity pensions throughout Italy over a 10-year period from 01.01.2009 to 31.12.2019, giving specific attention to all reports indicating atrial fibrillation as the principal diagnosis (Cod. ICD-9-CM 427.31). We then extracted the relative expenditure data for said benefits. The results of all analyses have been collated in tables. Results: Over the period in question, a total of 3468 applications for assistance were filed throughout Italy indicating a diagnosis of atrial fibrillation, of which 58% were rejected, 41% qualified for an invalidity allowance, and only 1.1% qualified for a pension. On average, every year, 1100 workers received social security benefits as a result of a diagnosis of atrial fibrillation, which equates to an average annual expenditure of EUR 10 million. A comparison of the data from the first observation year (2009) with data from the last (2019) shows a rising trend in the number of beneficiaries and consequently in expenses. Conclusions: The social security assistance provided by the Italian government by means of the National Institute of Social Security is fundamental to social cohesion and to those who are either permanently disabled from working or those with a significantly diminished earning capacity. This assistance is associated with a significant financial cost, which requires careful monitoring. Full article
(This article belongs to the Special Issue Preventive and Social Medicine in Outbreak Era)
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Article
Evaluating Teaching Effectiveness of Medical Humanities in an Integrated Clerkship Program by a Novel Prospective Propensity Score Matching Framework
Int. J. Environ. Res. Public Health 2022, 19(3), 1882; https://doi.org/10.3390/ijerph19031882 - 08 Feb 2022
Viewed by 586
Abstract
Background: This study aims to rigorously compare the effectiveness of the educational programs of a new integrated clinical clerkship in medicine (3 months) and surgery (3 months) at a cancer center with the conventional subspecialty-based rotations at a tertiary teaching hospital, by this [...] Read more.
Background: This study aims to rigorously compare the effectiveness of the educational programs of a new integrated clinical clerkship in medicine (3 months) and surgery (3 months) at a cancer center with the conventional subspecialty-based rotations at a tertiary teaching hospital, by this prospective, pre-post comparative method. Methods: Between 2013–2016, we compared 69 students who had selected the integrated clerkship that emphasized clinical competency and medical humanities training with 138 matched peers who had completed conventional clerkships during the same period. Outcome measures for medical humanities included empathy, patient-centeredness, and other values and skills related to holistic health care professionalism by introducing prospective propensity score matching (PSM). Results: At baseline, no significant between-group differences existed. At the completion of the core clerkships, students receiving the integrative clerkship had significantly higher scores on the Patient–Practitioner Orientation Scale (PPOS) and the Professionalism Climate in Clinical Teaching Environment (PCI), and similar Jefferson Scale of Physician Empathy Student Version (JSPE) scores, as compared with the comparison group. We also found that the students in this program did not perform worse than those in the traditional internship group in the comprehensive and formative OSCE medical clinical skills test. Conclusions: Our study develops an empirical basis for rigorous evaluation to design medical education to improve the medical humanities values and skills of interns. Features of the new integrated clerkship program that we developed include substantial participation by the students in patient-centered in-hospital culture, as well as reflection, discussion, and feedback on actual clinical cases. Full article
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Article
The Effects of Dynamic Complexity on Drivers’ Secondary Task Scanning Behavior under a Car-Following Scenario
Int. J. Environ. Res. Public Health 2022, 19(3), 1881; https://doi.org/10.3390/ijerph19031881 - 08 Feb 2022
Cited by 1 | Viewed by 510
Abstract
The user interface of vehicle interaction systems has become increasingly complex in recent years, which makes these devices important factors that contribute to accidents. Therefore, it is necessary to study the impact of dynamic complexity on the carrying capacity of secondary tasks under [...] Read more.
The user interface of vehicle interaction systems has become increasingly complex in recent years, which makes these devices important factors that contribute to accidents. Therefore, it is necessary to study the impact of dynamic complexity on the carrying capacity of secondary tasks under different traffic scenarios. First, we selected vehicle speed and vehicle spacing as influencing factors in carrying out secondary tasks. Then, the average single scanning time, total scanning time, and scanning times were selected as evaluation criteria, based on the theories of cognitive psychology. Lastly, we used a driving simulator to conduct an experiment under a car-following scenario and collect data on scanning behavior by an eye tracker, to evaluate the performance of the secondary task. The results show that the relationship between the total scanning time, scanning times, and the vehicle speed can be expressed by an exponential model, the relationship between the above two indicators and the vehicle spacing can be expressed by a logarithmic model, and the relationship with the total number of icons can be expressed by a linear model. Combined with the above relationships and the evaluation criteria for driving secondary tasks, the maximum number of icons at different vehicle speeds and vehicle spacings can be calculated to reduce the likelihood of accidents caused by attention overload. Full article
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