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Int. J. Environ. Res. Public Health, Volume 20, Issue 10 (May-2 2023) – 160 articles

Cover Story (view full-size image): In recent years, the proportion of adults with congenital heart disease has steadily risen, creating a new need for healthcare services. In light of the significant changes brought on by the coronavirus pandemic, a redesign of the healthcare system has become necessary. Digital care has arisen as a novel approach to promote a tailored model of specialized care. Given the limited experience with telemedicine for adults with congenital heart disease, this option needs to be outlined, summarizing the most recent research and recommending a patient-specific plan of continued care. View this paper
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10 pages, 1611 KiB  
Article
Research Participant Selection Bias in the Workshop Using Socially Assistive Robots for Older Adults and Its Effect on Population Representativeness
by Toshiharu Igarashi, Ikuko Sugawara, Takenobu Inoue and Misato Nihei
Int. J. Environ. Res. Public Health 2023, 20(10), 5915; https://doi.org/10.3390/ijerph20105915 - 22 May 2023
Cited by 1 | Viewed by 1215
Abstract
Every research participant has their own personality characteristics. For example, older adults assisted by socially assistive robots (SAR) may have their own unique characteristics and may not be representative of the general population of older adults. In this research, we compared the average [...] Read more.
Every research participant has their own personality characteristics. For example, older adults assisted by socially assistive robots (SAR) may have their own unique characteristics and may not be representative of the general population of older adults. In this research, we compared the average personality characteristics of participants in a workshop on robotics recruited directly through posting with those of older Japanese adults to examine participant selection bias and group representativeness for future study of SARs. After a one-week recruitment period, the workshop was attended by 20 older participants (nine males and 11 females) aged between 62 and 86 years. Extroversion among workshop participants was 4.38, 0.40 higher than the average for older adults in Japan. The workshop participants’ openness was 4.55, 1.09 higher than the average for the Japanese elderly. Thus, the results indicate a slight selection bias in the personal characteristics of the participants depending on the recruitment method when compared to the Japan national average for older adults. In addition, only one of 20 participants was below the cutoff on the LSNS-6 score and considered to have a tendency toward social isolation. The development and introduction of socially assistive robots is often being considered to support people in social isolation in their daily lives; however, the results of this study showed that it is difficult to recruit people who tend to be socially isolated when gathering research participants by methods such as posting. Therefore, the effectiveness of the method of recruiting participants should be carefully verified in research regarding socially assistive robots. Full article
(This article belongs to the Section Digital Health)
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12 pages, 343 KiB  
Article
Non-Traditional Physical Education Classes Improve High School Students’ Movement Competency and Fitness: A Mixed-Methods Program Evaluation Study
by Katie M. Heinrich, Cassandra M. Beattie, Derek A. Crawford, Peter Stoepker and Jason George
Int. J. Environ. Res. Public Health 2023, 20(10), 5914; https://doi.org/10.3390/ijerph20105914 - 22 May 2023
Cited by 1 | Viewed by 2212
Abstract
Non-traditional physical education (PE) programs may facilitate functional movement patterns and develop fitness and work capacity to facilitate long-term physical activity. This program evaluation study compared changes in body composition, movement competency, work capacity, and fitness for high school students in CrossFit or [...] Read more.
Non-traditional physical education (PE) programs may facilitate functional movement patterns and develop fitness and work capacity to facilitate long-term physical activity. This program evaluation study compared changes in body composition, movement competency, work capacity, and fitness for high school students in CrossFit or weight training PE; both classes were hypothesized to improve each area, with greater improvements in the CrossFit class. Students participated in 57 min classes 4 days per week for 9 months. Measures including body composition, movement competencies (squat, lunge, push-up, pull-up, hinge, and brace), work capacity (two CrossFit workouts), and fitness (air squats, push-ups, inverted row, plank hold, horizontal and vertical jumps, 5 rep max back squat and press, 500 m bike, and 12 min run) were taken at baseline, midpoint, and post-test. Focus groups to assess students’ experiences and outcomes were conducted at post-test. Students significantly improved in movement competencies (ps = 0.034 to <0.001), work capacity (ps < 0.001), and all fitness tests (ps = 0.036 to <0.001). The CrossFit class was only superior on the 500 m bike. Four themes were identified from the focus groups: (1) increased self-confidence, (2) health improvements, (3) newfound community, and (4) translational sports improvements. Future research should examine changes using an experimental design. Full article
(This article belongs to the Special Issue Health and Fitness Outcomes from High Intensity Group Training)
15 pages, 1483 KiB  
Article
Stress Response Analysis via Dynamic Entropy in EEG: Caregivers in View
by Ricardo Zavala-Yoé, Hafiz M. N. Iqbal, Roberto Parra-Saldívar and Ricardo A. Ramírez-Mendoza
Int. J. Environ. Res. Public Health 2023, 20(10), 5913; https://doi.org/10.3390/ijerph20105913 - 22 May 2023
Viewed by 1326
Abstract
According to the World Health Organization (WHO), stress can be defined as any type of alteration that causes physical, emotional, or psychological tension. A very important concept that is sometimes confused with stress is anxiety. The difference between stress and anxiety is that [...] Read more.
According to the World Health Organization (WHO), stress can be defined as any type of alteration that causes physical, emotional, or psychological tension. A very important concept that is sometimes confused with stress is anxiety. The difference between stress and anxiety is that stress usually has an existing cause. Once that activator has passed, stress typically eases. In this respect, according to the American Psychiatric Association, anxiety is a normal response to stress and can even be advantageous in some circumstances. By contrast, anxiety disorders differ from temporary feelings of anxiousness or nervousness with more intense feelings of fear or anxiety. The Diagnostic and Statistical Manual (DSM-5) explicitly describes anxiety as exorbitant concern and fearful expectations, occurring on most days for at least 6 months, about a series of events. Stress can be measured by some standardized questionnaires; however, these resources are characterized by some major disadvantages, the main one being the time consumed to interpret them; i.e., qualitative information must be transformed to quantitative data. Conversely, a physiological recourse has the advantage that it provides quantitative spatiotemporal information directly from brain areas and it processes data faster than qualitative supplies. A typical option for this is an electroencephalographic record (EEG). We propose, as a novelty, the application of time series (TS) entropies developed by us to inspect collections of EEGs obtained during stress situations. We investigated this database related to 23 persons, with 1920 samples (15 s) captured in 14 channels for 12 stressful events. Our parameters reflected that out of 12 events, event 2 (Family/financial instability/maltreatment) and 10 (Fear of disease and missing an important event) created more tension than the others. In addition, the most active lobes reflected by the EEG channels were frontal and temporal. The former is in charge of performing higher functions, self-control, self monitoring, and the latter is in charge of auditory processing, but also emotional handling. Thus, events E2 and E10 triggering frontal and temporal channels revealed the actual state of participants under stressful situations. The coefficient of variation revealed that E7 (Fear of getting cheated/losing someone) and E11 (Fear of suffering a serious illness) were the events with more changes among participants. In the same sense, AF4, FC5, and F7 (mainly frontal lobe channels) were the most irregular on average for all participants. In summary, by means of dynamic entropy analysis, the goal is to process the EEG dataset in order to elucidate which event and brain regions are key for all participants. The latter will allow us to easily determine which was the most stressful and on which brain zone. This study can be applied to other caregivers datasets. All this is a novelty. Full article
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20 pages, 442 KiB  
Article
What’s Your Pension Story? Women’s Perspectives during the COVID-19 Pandemic on Their Old-Age Pension Status, Past and Present
by Anat Herbst-Debby
Int. J. Environ. Res. Public Health 2023, 20(10), 5912; https://doi.org/10.3390/ijerph20105912 - 22 May 2023
Viewed by 1423
Abstract
This study examines the present and retrospective views of mothers who are nearing or are at retirement age regarding their economic status, pension planning, and perceptions of state pension policy. The paper addresses gaps in the literature on the cross-intersections of employment history, [...] Read more.
This study examines the present and retrospective views of mothers who are nearing or are at retirement age regarding their economic status, pension planning, and perceptions of state pension policy. The paper addresses gaps in the literature on the cross-intersections of employment history, vulnerable economic retirement status, and marital and parental status, thereby adopting a life course perspective. Based on in-depth interviews of thirty-one mothers (ages 59–72) during the COVID-19 pandemic, the findings revealed five themes—economic abuse: an unequal distribution of pension funds following divorce; regrets over past choices; COVID-19 and pensions; the state’s responsibility for old-age economic security; and knowledge is important, and I can help others. The study concludes that the majority of women at these ages perceive their current economic situation as a product of insufficient familiarity with pension plans, while voicing opinions about the state’s irresponsibility regarding people of retirement age. Full article
13 pages, 717 KiB  
Article
Conditions for Social Exclusion Leading to Distress Change in Chinese Lesbian, Gay, and Bisexual (LGB) People
by Chau-kiu Cheung and Eileen Yuk-ha Tsang
Int. J. Environ. Res. Public Health 2023, 20(10), 5911; https://doi.org/10.3390/ijerph20105911 - 22 May 2023
Cited by 3 | Viewed by 1481
Abstract
Lesbian, gay, and bisexual (LGB) people are likely to be at risk of distress because of social exclusion, including the feelings of resentment, resistance, and rejection they might experience from society. Nevertheless, the conditions for social exclusion leading to changes in distress are [...] Read more.
Lesbian, gay, and bisexual (LGB) people are likely to be at risk of distress because of social exclusion, including the feelings of resentment, resistance, and rejection they might experience from society. Nevertheless, the conditions for social exclusion leading to changes in distress are empirically unclear, especially in Chinese LGB people. To examine these conditions, this study surveyed 303 Chinese LGB people in Taiwan, Hong Kong, and various places in Mainland China. For comparability with other LGB studies, the study did not explicitly identify asexual, demisexual, or pansexual people in the LGB group. Results show that the retrospective reporting of social exclusion in 2016 did not significantly and unconditionally predict levels of distress in 2017. However, the reporting of exclusion significantly predicted current distress when the retrospective report of distress in 2016 was high. These results from the stress–vulnerability model indicate that prior distress is a vulnerability condition that allows social exclusion to exert its stressful effect. This study implies the need to prevent the social exclusion of highly distressed LGB people. Full article
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13 pages, 1077 KiB  
Article
The Scorching Truth: Investigating the Impact of Heatwaves on Selangor’s Elderly Hospitalisations
by Kun Hing Yong, Yen Nee Teo, Mohsen Azadbakht, Hai Phung and Cordia Chu
Int. J. Environ. Res. Public Health 2023, 20(10), 5910; https://doi.org/10.3390/ijerph20105910 - 22 May 2023
Cited by 2 | Viewed by 1806
Abstract
Global climate change has contributed to the intensity, frequency, and duration of heatwave events. The association between heatwaves and elderly mortality is highly researched in developed countries. In contrast, heatwave impact on hospital admissions has been insufficiently studied worldwide due to data availability [...] Read more.
Global climate change has contributed to the intensity, frequency, and duration of heatwave events. The association between heatwaves and elderly mortality is highly researched in developed countries. In contrast, heatwave impact on hospital admissions has been insufficiently studied worldwide due to data availability and sensitivity. In our opinion, the relationship between heatwaves and hospital admissions is worthwhile to explore as it could have a profound impact on healthcare systems. Therefore, we aimed to investigate the associations between heatwaves and hospitalisations for the elderly by age group in Selangor, Malaysia, from 2010 to 2020. We further explored the impact of heatwaves on the risks of cause-specific hospital admissions across age groups within the elderly. This study applied generalized additive models (GAMs) with the Poisson family and distributed lag models (DLMs) to estimate the effect of heatwaves on hospitalisations. According to the findings, there was no significant increase in hospitalisations for those aged 60 and older during heatwaves; however, a rise in mean apparent temperature (ATmean) by 1 °C significantly increased the risk of hospital admission by 12.9%. Heatwaves had no immediate effects on hospital admissions among elderly patients, but significant delay effects were identified for ATmean with a lag of 0–3 days. The hospital admission rates of the elderly groups started declining after a 5-day average following the heatwave event. Females were found to be relatively more vulnerable than males during heatwave periods. Consequently, these results can provide a reference to improve public health strategies to target elderly people who are at the greatest risk of hospitalisations due to heatwaves. Development of early heatwave and health warning systems for the elderly would assist with preventing and reducing health risks while also minimising the burden on the whole hospital system in Selangor, Malaysia. Full article
(This article belongs to the Section Environmental Health)
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12 pages, 372 KiB  
Article
Association between the Nursing Practice Environment and Safety Perception with Patient Safety Culture during COVID-19
by Nataly Julissa Membrillo-Pillpe, Jhon Alex Zeladita-Huaman, Kimberlym Jauregui-Soriano, Roberto Zegarra-Chapoñan, Eduardo Franco-Chalco and Gabriela Samillan-Yncio
Int. J. Environ. Res. Public Health 2023, 20(10), 5909; https://doi.org/10.3390/ijerph20105909 - 22 May 2023
Cited by 3 | Viewed by 1991
Abstract
Aims: In this study, we aimed to identify the relationship between nursing practice environments (NPEs) and safety perceptions with patient safety culture (PSC) during COVID-19. Design: We conducted a quantitative, non-experimental, correlational, and cross-sectional study. We interviewed 211 nurses from Peru using two [...] Read more.
Aims: In this study, we aimed to identify the relationship between nursing practice environments (NPEs) and safety perceptions with patient safety culture (PSC) during COVID-19. Design: We conducted a quantitative, non-experimental, correlational, and cross-sectional study. We interviewed 211 nurses from Peru using two scales: PES–NWI and HSOPSC. We used the Shapiro–Wilk test and Spearman’s coefficient and estimated two regression models. Results: NPE was reported as favorable by 45.5% of the participants, and PSC was reported as neutral by 61.1%. Safety perception, the workplace, and NPE predict PSC. All NPE factors were correlated with PSC. However, safety perception, support of nurses subscale, the nurse manager’s ability, and leadership were predictors of PSC. Conclusion: To promote a safe work culture, health institutions should foster leadership that prioritizes safety, strengthens managers’ abilities, encourages interprofessional collaboration, and considers nurses’ feedback for constant improvement. Full article
(This article belongs to the Special Issue New Advances in Nursing Care)
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10 pages, 625 KiB  
Article
Effect of Individualized Coaching at Home on Quality of Life in Subacute Stroke Patients
by Rodeline Telfils, Axelle Gelineau, Jean-Christophe Daviet, Justine Lacroix, Benoit Borel, Emna Toulgui, Maxence Compagnat and Stéphane Mandigout
Int. J. Environ. Res. Public Health 2023, 20(10), 5908; https://doi.org/10.3390/ijerph20105908 - 22 May 2023
Viewed by 1620
Abstract
Background: Stroke causes psychological disorders and cognitive impairments that affect activities of daily living and quality of life. Physical activity (PA) in stroke recovery is beneficial. The benefits of PA on quality of life after stroke are less documented. The aim of [...] Read more.
Background: Stroke causes psychological disorders and cognitive impairments that affect activities of daily living and quality of life. Physical activity (PA) in stroke recovery is beneficial. The benefits of PA on quality of life after stroke are less documented. The aim of the study was to evaluate the effect of a home-based PA incentive program at home in post-stroke patients in the subacute phase on quality of life. Methods: This is a prospective, randomized, single-blind, and monocentric clinical trial. Eighty-three patients were randomly assigned to either an experimental group (EG; n = 42) or to a control group (CG; n = 41). The experimental group followed a home-based PA incentive program for 6 months. Three incentive methods were used: daily monitoring with an accelerometer, weekly telephone calls, and home visits every three weeks. Patients were evaluated before intervention (T0) and after intervention (T1) at 6 months. The control group was a non-intervention group receiving usual care. The outcome was the quality of life with the EuroQol EQ-5D-5L evaluated at baseline and 6 months post-intervention. Results: The mean age was 62.2 years ± 13.6 with a post-stroke time of 77.9 ± 45.1 days. The mean values of the utility index (EQ-5D-5L) in the control group and experimental group at T1 were 0.721 ± 0.207 and 0.808 ± 0.193, respectively (p = 0.02). Discussion: Our study shows a significant difference in the Global QOL index (EQ-5D-5L) between the two groups of subacute stroke patients after 6 months of the individualized coaching program, which combined home visits and weekly telephone calls. Full article
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11 pages, 345 KiB  
Article
Pulmonary Rehabilitation Outcomes of Post-Acute COVID-19 Patients during Different Waves of the Pandemic
by Marc Spielmanns, Corina E. Schaer, Anna-Maria Pekacka-Egli, Sabine Spielmanns, Olberk Ibish, Guzel Gafina, Antonela Stiube and Matthias Hermann
Int. J. Environ. Res. Public Health 2023, 20(10), 5907; https://doi.org/10.3390/ijerph20105907 - 22 May 2023
Cited by 2 | Viewed by 1452
Abstract
(1) Background: Between the beginning of the coronavirus pandemic and summer 2022, we distinguished four pandemic waves, with different characteristics of the affected patients. This study investigated the impact of patient characteristics on the outcome of inpatient pulmonary rehabilitation (PR). (2) Methods: Using [...] Read more.
(1) Background: Between the beginning of the coronavirus pandemic and summer 2022, we distinguished four pandemic waves, with different characteristics of the affected patients. This study investigated the impact of patient characteristics on the outcome of inpatient pulmonary rehabilitation (PR). (2) Methods: Using a prospective approach, the characteristics of post-acute COVID-19 patients of the different waves who participated in inpatient PR were compared based on their assessments and results collected as part of PR (Cumulative Illness Rating Scale (CIRS), six-minute walk test (6-MWT), Pulmonary Function Testing (PFT), and Functional Independent Measurement (FIM). (3) Results: A total of 483 patients were included in the analysis (Wave 1 n = 51, Wave 2 n = 202, Wave 3 n = 84, Wave 4 n = 146). Compared to Wave 3 + 4, patients of Wave 1 + 2 were older (69 vs. 63 years; p < 0.001), had a significantly lower CIRS (13.0 vs. 14.7 points; p = 0.004), had significant better PFT (FVC: 73 vs. 68%pred; p = 0.009; DLCOSB: 58 ± 18 vs. 50 ± 17%pred; p = 0.001), and showed significantly more comorbidities (2.0 vs. 1.6 n/pers.; p = 0.009). Wave 3 + 4 showed significantly greater improvements according to the 6-MWT (147 vs. 188 m; p < 0.001) and the FIM (5.6 vs. 21.1 points; p < 0.001). (4) Conclusions: Patients of the COVID-19 infection waves differed significantly according to their anthropometric data, incidence of comorbidities, and impact of the infection. All cohorts achieved clinically relevant and significant functional improvements during PR, with significant higher improvements in Wave 3 + 4. Full article
(This article belongs to the Special Issue Rehabilitation in the COVID-19 Pandemic)
18 pages, 1224 KiB  
Article
Adverse Childhood Experiences and Mental Health among Students Seeking Psychological Counseling Services
by Francesco Craig, Rocco Servidio, Maria Luigia Calomino, Francesca Candreva, Lucia Nardi, Adriana Palermo, Alberto Polito, Maria Francesca Spina, Flaviana Tenuta and Angela Costabile
Int. J. Environ. Res. Public Health 2023, 20(10), 5906; https://doi.org/10.3390/ijerph20105906 - 22 May 2023
Cited by 2 | Viewed by 2612
Abstract
Recent years have seen a marked rise in the number of students accessing University Psychological Counseling (UPC) services, and their concerns have been increasingly severe. This study aimed to examine the impact of cumulative adverse childhood experiences (ACEs) on mental health in students [...] Read more.
Recent years have seen a marked rise in the number of students accessing University Psychological Counseling (UPC) services, and their concerns have been increasingly severe. This study aimed to examine the impact of cumulative adverse childhood experiences (ACEs) on mental health in students who had approached counseling services (N = 121) and students who had no experience with counseling services (N = 255). Participants completed an anonymous online self-report questionnaire measuring exposure to adverse childhood experiences (ACE-Q), psychological distress (General Anxiety Disorder-7 (GAD-7) and Patient Health Questionnaire-9 (PHQ-9), personality traits (PID-5), and coping strategies. We found that students who approached UPC services scored higher on cumulative ACEs than the non-counseling group. While ACE-Q score was a direct positive predictor of PHQ-9 (p < 0.001), it did not predict GAD-7. Moreover, the results supported the existence of a mediation effect of avoidance coping, detachment, and psychoticism on the indirect effects of ACE-Q score on PHQ-9 or GAD-7. These results underlined the importance of screening for ACEs in a UPC setting because it can help identify students at higher risk for developing mental and physical health problems and provide them with early interventions and support. Full article
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11 pages, 1710 KiB  
Article
Redirected Attention and Impaired Recognition Memory during Exhaustive Cycling Has Implications for Information Processing Models of Effort-Regulation
by Dominic Micklewright, Bernard X. W. Liew and Steffan Kennett
Int. J. Environ. Res. Public Health 2023, 20(10), 5905; https://doi.org/10.3390/ijerph20105905 - 22 May 2023
Viewed by 1413
Abstract
Perception of internal and external cues is an important determinant of pacing behaviour, but little is known about the capacity to attend to such cues as exercise intensity increases. This study investigated whether changes in attentional focus and recognition memory correspond with selected [...] Read more.
Perception of internal and external cues is an important determinant of pacing behaviour, but little is known about the capacity to attend to such cues as exercise intensity increases. This study investigated whether changes in attentional focus and recognition memory correspond with selected psychophysiological and physiological parameters during exhaustive cycling. Methods: Twenty male participants performed two laboratory ramped cycling tests beginning at 50 W and increasing by 0.25 W/s until volitional exhaustion. Ratings of perceived exertion, heart rate and respiratory gas exchange measures were recorded during the first test. During the second test, participants listened to a list of spoken words presented through headphones at a rate of one word every 4 s. Afterwards, their recognition memory for the word pool was measured. Results: Recognition memory performance was found to have strong negative correlations with perceived exertion (p < 0.0001), percentage of peak power output (p < 0.0001), percentage of heart rate reserve (p < 0.0001), and percentage of peak oxygen uptake (p < 0.0001). Conclusions: The results show that, as the physiological and psychophysiological stress of cycling intensified, recognition memory performance deteriorated. This might be due to impairment of memory encoding of the spoken words as they were presented, or because of a diversion of attention away from the headphones, perhaps towards internal physiological sensations as interoceptive sources of attentional load increase with exercise intensity. Information processing models of pacing and performance need to recognise that an athlete’s capacity to attend to and process external information is not constant, but changes with exercise intensity. Full article
(This article belongs to the Special Issue The Role of Emotions on the Physical Exercise)
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21 pages, 3679 KiB  
Review
Trends in Robotics Research in Occupational Safety and Health: A Scientometric Analysis and Review
by Ci-Jyun Liang and Marvin H. Cheng
Int. J. Environ. Res. Public Health 2023, 20(10), 5904; https://doi.org/10.3390/ijerph20105904 - 21 May 2023
Cited by 7 | Viewed by 2635
Abstract
Robots have been deployed in workplaces to assist, work alongside, or collaborate with human workers on various tasks, which introduces new occupational safety and health hazards and requires research efforts to address these issues. This study investigated the research trends for robotic applications [...] Read more.
Robots have been deployed in workplaces to assist, work alongside, or collaborate with human workers on various tasks, which introduces new occupational safety and health hazards and requires research efforts to address these issues. This study investigated the research trends for robotic applications in occupational safety and health. The scientometric method was applied to quantitatively analyze the relationships between robotics applications in the literature. The keywords “robot”, “occupational safety and health”, and their variants were used to find relevant articles. A total of 137 relevant articles published during 2012–2022 were collected from the Scopus database for this analysis. Keyword co-occurrence, cluster, bibliographic coupling, and co-citation analyses were conducted using VOSviewer to determine the major research topics, keywords, co-authorship, and key publications. Robot safety, exoskeletons and work-related musculoskeletal disorders, human–robot collaboration, and monitoring were four popular research topics in the field. Finally, research gaps and future research directions were identified based on the analysis results, including additional efforts regarding warehousing, agriculture, mining, and construction robots research; personal protective equipment; and multi-robot collaboration. The major contributions of the study include identifying the current trends in the application of robotics in the occupational safety and health discipline and providing pathways for future research in this discipline. Full article
(This article belongs to the Special Issue Impact of New Technologies on Occupational Health and Well-Being)
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18 pages, 903 KiB  
Protocol
Exposure to Disinfectants and Cleaning Products and Respiratory Health of Workers and Children in Daycares: The CRESPI Cohort Protocol
by Nicole Le Moual, Orianne Dumas, Pierre Bonnet, Anastasie Eworo Nchama, Barbara Le Bot, Etienne Sévin, Isabelle Pin, Valérie Siroux, Corinne Mandin and The CRESPI Study Group
Int. J. Environ. Res. Public Health 2023, 20(10), 5903; https://doi.org/10.3390/ijerph20105903 - 21 May 2023
Cited by 2 | Viewed by 2447
Abstract
Although cleaning tasks are frequently performed in daycare, no study has focused on exposures in daycares in relation to respiratory health. The CRESPI cohort is an epidemiological study among workers (n~320) and children (n~540) attending daycares. The purpose is to examine the impact [...] Read more.
Although cleaning tasks are frequently performed in daycare, no study has focused on exposures in daycares in relation to respiratory health. The CRESPI cohort is an epidemiological study among workers (n~320) and children (n~540) attending daycares. The purpose is to examine the impact of daycare exposures to disinfectants and cleaning products (DCP) on the respiratory health of workers and children. A sample of 108 randomly selected daycares in the region of Paris has been visited to collect settled dust to analyze semi-volatile organic compounds and microbiota, as well as sample indoor air to analyze aldehydes and volatile organic compounds. Innovative tools (smartphone applications) are used to scan DCP barcodes in daycare and inform their use; a database then matches the barcodes with the products’ compositions. At baseline, workers/parents completed a standardized questionnaire, collecting information on DCP used at home, respiratory health, and potential confounders. Follow-up regarding children’s respiratory health (monthly report through a smartphone application and biannual questionnaires) is ongoing until the end of 2023. Associations between DCP exposures and the respiratory health of workers/children will be evaluated. By identifying specific environments or DCP substances associated with the adverse respiratory health of workers and children, this longitudinal study will contribute to the improvement of preventive measures. Full article
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12 pages, 1089 KiB  
Article
Who Stays, Who Moves on and the Host Population: A Picture of Adolescents’ Perceived Well-Being and Risk Behaviours
by Lorena Charrier, Rosanna Irene Comoretto, Michela Bersia, Paola Dalmasso, Emanuele Koumantakis, Alberto Borraccino, Adriana Baban, Paola Berchialla and Patrizia Lemma
Int. J. Environ. Res. Public Health 2023, 20(10), 5902; https://doi.org/10.3390/ijerph20105902 - 21 May 2023
Cited by 1 | Viewed by 1277
Abstract
The study aims to evaluate the health profile of first- and second-generation Romanian immigrants living in Italy compared to their adolescent peers in the country of origin (Romania) and the host population (Italian-borns). Analyses were performed on the 2013/2014 Health Behaviour in School-aged [...] Read more.
The study aims to evaluate the health profile of first- and second-generation Romanian immigrants living in Italy compared to their adolescent peers in the country of origin (Romania) and the host population (Italian-borns). Analyses were performed on the 2013/2014 Health Behaviour in School-aged Children (HBSC) survey data. Romanian natives showed lower levels of health complaints and higher life satisfaction than Romanian migrants, who were similar to the host population, especially the second-generation ones. A comparable prevalence of being bullied was registered among Romanians, both native and immigrant, with significantly lower levels among Italian natives. Bullying others showed the second-generation migrants share a similar prevalence with the host population. The prevalence of liking school a lot was three times higher among the Romanian natives than among their peers living in Italy. Thanks to the HBSC data, this study is the first to examine the health of adolescent migrants from both the perspective of the host country and the population of origin. The results highlight the need for a more nuanced approach to studying immigrant populations, taking into account both the host country’s perspective and the health patterns of the population of origin. Full article
(This article belongs to the Special Issue Health and Well-Being of Adolescent Immigrants)
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12 pages, 782 KiB  
Article
To Get Vaccinated or Not? The Vaccination Decision-Making by Healthcare Professionals Working in Haematology: A Qualitative Study
by Gian Luca Tunisi, Elisa Ambrosi, Giorgia Zulianello, Elisabetta Allegrini, Domenico Provenzano, Tiziana Rizzello and Federica Canzan
Int. J. Environ. Res. Public Health 2023, 20(10), 5901; https://doi.org/10.3390/ijerph20105901 - 21 May 2023
Viewed by 1599
Abstract
Haematological patients are more susceptible to infections. Vaccination has always been the most effective primary prevention strategy, even during the COVID-19 pandemic. However, the efficacy of vaccines for some haematological patients is low. Although vaccination of Healthcare Workers (HCWs) could protect patients from [...] Read more.
Haematological patients are more susceptible to infections. Vaccination has always been the most effective primary prevention strategy, even during the COVID-19 pandemic. However, the efficacy of vaccines for some haematological patients is low. Although vaccination of Healthcare Workers (HCWs) could protect patients from vaccine-preventable diseases, there is evidence of a high level of hesitation among healthcare workers in Italy. The aim of this study was to explore the attitudes towards vaccination of HCWs caring for haematology patients. Qualitative descriptive design was conducted. Twenty-one HCWs were interviewed. Content analysis was applied to the qualitative data. The following themes were generated from the analysis: “Trust”, “Decision-making process focusing on individual health”, “Decision-making process focusing on community health”, “Changing opinion”, and “Two sides of vaccination commitment”. The most hesitant HCWs were oriented towards individual health. They perceived a lack of benefit from vaccines, feared side effects, or were influenced by negative experiences of others. In contrast, community-health-oriented HCWs showed more positive attitudes towards vaccination. Some hesitant HCWs changed their opinion on vaccination because they began to reflect on the importance of vaccination for the community. The change in opinion of some HCWs interviewed provided insight into the importance of focusing organisational efforts on collective responsibility. Full article
(This article belongs to the Special Issue Sustainability: Challenges for Healthcare)
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10 pages, 325 KiB  
Article
Individual and Contextual Determinants of Flu Vaccination Adherence: A University Nudge Intervention
by Nadia Pecoraro, Francesca Malatesta, Luna Carpinelli, Domenico Fornino, Claudio Giordano, Giuseppina Moccia, Matilde Perillo, Mario Capunzo, Giulia Savarese and Francesco De Caro
Int. J. Environ. Res. Public Health 2023, 20(10), 5900; https://doi.org/10.3390/ijerph20105900 - 21 May 2023
Cited by 2 | Viewed by 1392
Abstract
Introduction: The University of Salerno has implemented a nudge intervention with the aim of promoting vaccine adherence among employees of academia and identifying individual and contextual determinants that influence adherence. Method: A purpose-built questionnaire was used during the reference period of October–December 2022 [...] Read more.
Introduction: The University of Salerno has implemented a nudge intervention with the aim of promoting vaccine adherence among employees of academia and identifying individual and contextual determinants that influence adherence. Method: A purpose-built questionnaire was used during the reference period of October–December 2022 in order to assess levels of state anxiety (STAI-Y1), perceived stress (PSS-10), and public sentiments, which influence vaccination behavior, with consequences for the whole population (VCI). Results: Analysis of the results revealed a difference in mean scores on the PSS: those who have always adhered to the vaccination campaign compared to those who have never been vaccinated perceived higher levels of stress (12.01 vs. 11.33; F = 4.744, p = 0.031); furthermore, there was a relationship between the presence/absence of pathologies and VCI (F = 3,93; df = 1; p = 0.04). Conclusions: The University of Salerno’s nudge intervention made its employees more responsible for protecting the health of the academic community and encouraged good adherence to the flu vaccination campaign. University employees, equipped with high cultural tools, sought information primarily from institutional sources indicated by the university during the free vaccination campaign at the university’s vaccine center. Full article
13 pages, 388 KiB  
Article
Postpartum Blues in Fathers: Prevalence, Associated Factors, and Impact on Father-to-Infant Bond
by Claire Baldy, Eloi Piffault, Margaux Chabbert Chopin and Jaqueline Wendland
Int. J. Environ. Res. Public Health 2023, 20(10), 5899; https://doi.org/10.3390/ijerph20105899 - 20 May 2023
Cited by 4 | Viewed by 2017
Abstract
In this study we explored, in men, one of the most common postpartum syndromes in women: the postpartum blues. The aims of the study were (a) to evaluate the prevalence of postpartum blues in fathers, (b) to explore the sociodemographic and perinatal factors [...] Read more.
In this study we explored, in men, one of the most common postpartum syndromes in women: the postpartum blues. The aims of the study were (a) to evaluate the prevalence of postpartum blues in fathers, (b) to explore the sociodemographic and perinatal factors that may be associated with its intensity, and (c) to investigate the relationship between the intensity of blues symptoms and the quality of father-to-infant bonding. Three hundred and three French-speaking fathers living in France completed a sociodemographic and obstetrical questionnaire, the Maternity Blues Questionnaire, and the Postpartum Bonding Questionnaire. The fathers were recruited from two maternity hospitals and a Child and Maternal Health Centre within 10 days of their infant’s birth, or from online forums devoted to parenting. At least 17.5% of fathers experienced postpartum blues. A high level of education was associated with a higher level of postpartum blues symptoms. Dissatisfaction with the maternity care and significant father involvement during pregnancy and delivery predicted more severe postpartum blues symptoms. Symptoms of postpartum blues were positively correlated with impairment in the father-to-infant bond. This study lends support to the existence of postpartum blues among fathers and highlights its possible consequences on early father–infant relationships. Full article
15 pages, 914 KiB  
Article
Built Environment Accessibility and Disability as Predictors of Well-Being among Older Adults: A Norwegian Cross-Sectional Study
by Grace Katharine Forster, Leif Edvard Aarø, Maria Nordheim Alme, Thomas Hansen, Thomas Sevenius Nilsen and Øystein Vedaa
Int. J. Environ. Res. Public Health 2023, 20(10), 5898; https://doi.org/10.3390/ijerph20105898 - 20 May 2023
Cited by 1 | Viewed by 2822
Abstract
Knowledge about the influence environmental factors have on well-being is important to deliver policies supporting healthy ageing and sustainable health equity. An under-researched question is whether and how the built environment plays a role on well-being among older adults with disabilities. This study [...] Read more.
Knowledge about the influence environmental factors have on well-being is important to deliver policies supporting healthy ageing and sustainable health equity. An under-researched question is whether and how the built environment plays a role on well-being among older adults with disabilities. This study explores the relationship between built environment accessibility and disability on psychosocial well-being among older adults. Data were used from the Norwegian Counties Public Health Survey collected during February 2021 in Møre and Romsdal county (N = 8274; age = 60–97, mean = 68.6). General linear modelling was performed to examine the relationship and interaction between built environment accessibility (services, transportation, and nature) and disability on psychosocial well-being (quality of life, thriving, loneliness, and psychological distress). Higher levels of disability and poorer accessibility were each significantly related to lower psychosocial well-being across all variables (p < 0.001). Significant interaction effects were observed between disability and built environment accessibility on thriving (F(8, 5936) = 4.97, p < 0.001, η2 = 0.006) and psychological distress (F(8, 5957) = 3.09, p = 0.002, η2 = 0.004). No significant interaction effects were found for quality of life and loneliness. These findings indicate good built environment accessibility is associated with thriving and reduces psychological distress among older adults with disabilities. This study supports and extends previous findings on the importance of accessible and equipped environments for well-being and may aid policy makers when planning built environments to foster healthy ageing among this population group. Full article
(This article belongs to the Special Issue A Transdisciplinary Approach to Healthy Ageing)
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18 pages, 1209 KiB  
Article
The Feasibility and Acceptability of the Adverse Childhood Experiences Questionnaire in Danish Antenatal Care—A Qualitative Study of Midwives’ Implementation Experiences
by Helle Johnsen, Vibeke de Lichtenberg, Eva Rydahl, Sara Mbaye Karentius, Signe Camilla Hjuler Dueholm, Majbritt Friis-Alstrup, Mette Grønbæk Backhausen, Katrine Røhder, Michaela Louise Schiøtz, Lotte Broberg and Mette Juhl
Int. J. Environ. Res. Public Health 2023, 20(10), 5897; https://doi.org/10.3390/ijerph20105897 - 20 May 2023
Cited by 1 | Viewed by 1875
Abstract
Adverse childhood experiences have a potential lifelong impact on health. A traumatic upbringing may increase antenatal health risks in mothers-to-be and impact child development in their offspring. Yet, little is known about the identification of adverse childhood experiences in antenatal care. The objective [...] Read more.
Adverse childhood experiences have a potential lifelong impact on health. A traumatic upbringing may increase antenatal health risks in mothers-to-be and impact child development in their offspring. Yet, little is known about the identification of adverse childhood experiences in antenatal care. The objective of this study was to explore the feasibility and acceptability of the adverse childhood experiences questionnaire among midwives and factors affecting its implementation. Three Danish maternity wards participated in the study. The data consisted of observations of midwifery visits and informal conversations with midwives, as well as mini group interviews and dialogue meetings with midwives. The data were analysed using systematic text condensation. Analysis of the data revealed three main categories; “Relevance of the adverse childhood experiences questionnaire”, “Challenges related to use of the adverse childhood experiences questionnaire” and “Apprehensions, emotional strain, and professional support”. The findings showed that the adverse childhood experiences questionnaire was feasible to implement in Danish antenatal care. Midwives’ acceptability of the questionnaire was high. Training courses and dialogue meetings motivated the midwives to work with the questionnaire in practice. The main factors affecting the implementation process were time restrictions, worries of overstepping women’s boundaries, and a lack of a specific intervention for women affected by their traumatic upbringing circumstances. Full article
(This article belongs to the Section Women's Health)
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13 pages, 944 KiB  
Article
Hematological Changes in Gas Station Workers
by Isabela Giardini, Katia Soares da Poça, Paula Vieira Baptista da Silva, Valnice Jane Caetano Andrade Silva, Deborah Santos Cintra, Karen Friedrich, Barbara Rodrigues Geraldino, Ubirani Barros Otero and Marcia Sarpa
Int. J. Environ. Res. Public Health 2023, 20(10), 5896; https://doi.org/10.3390/ijerph20105896 - 20 May 2023
Cited by 2 | Viewed by 2218
Abstract
(1) Background: Benzene, toluene, and xylene isomers (BTX) are present in gasoline. Exposure to benzene may lead to the appearance of a series of signs, symptoms, and complications, which are characterized by benzene poisoning, which is an occupational disease. This study evaluated the [...] Read more.
(1) Background: Benzene, toluene, and xylene isomers (BTX) are present in gasoline. Exposure to benzene may lead to the appearance of a series of signs, symptoms, and complications, which are characterized by benzene poisoning, which is an occupational disease. This study evaluated the presence of signs and symptoms related to occupational exposure and whether occupational exposure to BTX is associated with the development of hematological changes. (2) Material and Methods: This cross-sectional epidemiological study included 542 participants, in which 324 were gas station workers (GSWs) and 218 were office workers (OWs) with no occupational exposure to benzene. To characterize the type of exposure (exposed and not exposed), trans,trans-Muconic acid (tt-MA), Hippuric acid (HA), and Methylhippuric acid (MHA) were used as exposure biomarkers. The tt-MA analysis revealed that the GSWs had 0.29 mg/g of urinary creatinine and the OWs had 0.13 mg/g of urinary creatinine. For HA, the GSWs presented 0.49 g/g of creatinine while the OWs presented 0.07. MHA analysis revealed that the GSWs had 1.57 g/g creatinine and the OWs had 0.01 g/g creatinine. Occupation habits and clinical symptoms were collected by questionnaire and blood samples were analyzed for hematological parameters. The persistence of hematological changes was evaluated with three serial blood collections every 15 days followed by laboratory hematological analysis. A descriptive analysis by the Chi-square test method was performed to evaluate the association between occupational exposure to fuels and the occurrence of changes in hematological parameters. (3) Results: In the GSWs, the most described signs and symptoms were somnolence (45.1%), headache (38.3%), dizziness (27.5%), tingling (25.4%), and involuntary movement (25%). Twenty GSWs that presented hematological alterations performed serial collections fifteen days apart. In addition, these workers presented total leukocyte counts above the upper limit and lymphocyte counts close to the lower limit. Leukocytosis and lymphopenia are hematological alterations present in chronic benzene poisoning. (4) Conclusions: The results found an initial change in different hematological parameters routinely used in clinics to evaluate health conditions. These findings reveal the importance of valuing clinical changes, even in the absence of disease, during the health monitoring of gas station workers and other groups that share the same space. Full article
(This article belongs to the Special Issue Benzene: Exposure and Risk Assessment)
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12 pages, 717 KiB  
Article
Resilience and Extrinsic Motivation as Mediators in the Relationship between Fear of Failure and Burnout
by Murat Yıldırım, Ömer Kaynar, Francesco Chirico and Nicola Magnavita
Int. J. Environ. Res. Public Health 2023, 20(10), 5895; https://doi.org/10.3390/ijerph20105895 - 20 May 2023
Cited by 7 | Viewed by 2795
Abstract
Athletes with fear of failure are at risk of developing the symptoms of a wide range of psychological problems, including burnout. Understanding the risks and protective factors of athletes’ psychological health is an essential step in tailoring strategies and interventions to promote athletes’ [...] Read more.
Athletes with fear of failure are at risk of developing the symptoms of a wide range of psychological problems, including burnout. Understanding the risks and protective factors of athletes’ psychological health is an essential step in tailoring strategies and interventions to promote athletes’ psychological and mental health. This study examined the mediating roles of resilience and extrinsic motivation in the relationship between fear of failure and burnout among Turkish athletes. The study included 335 young athletes (93.4% males) whose ages ranged from 18 to 55 years (M = 24.95, SD = 8.22). Participants completed the self-reported measures of fear of failure, resilience, extrinsic motivation, and burnout. The analysis revealed that fear of failure had significant predictive effects on resilience, extrinsic motivation, and burnout. Resilience and extrinsic motivation also had significant predictive effects on burnout. The mediation analysis results showed that both resilience and extrinsic motivation partially mediated the effect of fear of failure on athlete burnout. The findings of the study provide a better insight into the underlying mechanisms between fear of failure and athlete burnout by considering resilience and extrinsic motivation as mediators. These results suggest that the adverse impact of fear of failure on athlete burnout can be mitigated by cultivating resilience and hindering extrinsic motivation. Full article
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12 pages, 308 KiB  
Article
Consumer Views and Experiences of Secondary-Care Services Following REFOCUS-PULSAR Staff Recovery-Oriented Practices Training
by Michelle Kehoe, Ellie Fossey, Vrinda Edan, Lisa Chaffey, Lisa Brophy, Penelope June Weller, Frances Shawyer and Graham Meadows
Int. J. Environ. Res. Public Health 2023, 20(10), 5894; https://doi.org/10.3390/ijerph20105894 - 20 May 2023
Cited by 1 | Viewed by 1386
Abstract
Background: The use of recovery-oriented practice (ROP) can be challenging to implement in mental health services. This qualitative sub-study of the Principles Unite Local Services Assisting Recovery (PULSAR) project explored how consumers perceive their recovery following community mental health staff undertaking specific ROP [...] Read more.
Background: The use of recovery-oriented practice (ROP) can be challenging to implement in mental health services. This qualitative sub-study of the Principles Unite Local Services Assisting Recovery (PULSAR) project explored how consumers perceive their recovery following community mental health staff undertaking specific ROP training. Methods: Using a qualitative participatory methodology, 21 consumers (aged 18–63 years) participated in one-on-one interviews. A thematic analysis was applied. Results: Four main themes were extracted: (1) connection, (2) supportive relationships, (3) a better life, and (4) barriers. Connections to community and professional staff were important to support consumers in their recovery journey. Many consumers were seeking and striving towards a better life that was personal and individual to each of them, and how they made meaning around the idea of a better life. Barriers to recovery primarily focused on a lack of choice. A minor theme of ‘uncertainty’ suggested that consumers struggled to identify what their recovered future might entail. Conclusion: Despite staff undertaking the ROP training, all participants struggled to identify language and aspects of recovery in their interaction with the service, suggesting a need for staff to promote open, collaborative conversations around recovery. A specifically targeted recovery resource might facilitate such conversation. Full article
10 pages, 606 KiB  
Article
Impact of National Tobacco Control Policy on Rates of Hospital Admission for Pneumonia: When Compliance Matters
by Marine Gambaryan, Anna Kontsevaya and Oxana Drapkina
Int. J. Environ. Res. Public Health 2023, 20(10), 5893; https://doi.org/10.3390/ijerph20105893 - 20 May 2023
Viewed by 1216
Abstract
A number of studies claim that tobacco control (TC) regulations are associated with reductions in smoking-related hospitalisation rates, but very few have estimated the impact of TC laws (TCL) at both countrywide and regional levels, and none of them have studied the impact [...] Read more.
A number of studies claim that tobacco control (TC) regulations are associated with reductions in smoking-related hospitalisation rates, but very few have estimated the impact of TC laws (TCL) at both countrywide and regional levels, and none of them have studied the impact of TCL in relation to compliance with TC regulations. This study evaluates the effects of Russian TCL on hospital admission (HA) rates for pneumonia countrywide and in 10 Russian regions and the extent of these effects in connection with the compliance with TCL. Methods: HA rates for pneumonia from 2005–2019 were analysed to compare the periods before and after the adoption of TCL in 2013. An interrupted time series design and a Poisson regression model were used to estimate the immediate and long-term effects of TCL on pneumonia annual hospitalisation rates after the TCL adoption, compared with the pre-law period. The 10 Russian regions were compared using the TCL implementation scale (TCIS) developed on the basis of the results of the Russian TC policy evaluation survey; Spearman’s rank correlation and linear regression models were employed. Results showed a 14.3% reduction in HA rates for pneumonia (RR 0.88; p = 0.01) after the adoption of TCL in Russia with significant long-term effect after 2013 (RR 0.86; p = 0.006). Regions with better enforcement of TCL exhibited greater reductions in pneumonia HA rates (rsp = −0.55; p = 0.04); (β = −4.21; p = 0.02). Conclusions: TCL resulted in a sustained reduction in pneumonia hospitalisation rates, but these effects, varying by region, may depend on the scale of the TCL enforcement. Full article
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20 pages, 429 KiB  
Article
Theory of Mind and Young Children’s Behaviour: Aggressive, Victimised, Prosocial, and Solitary
by Katie Rix, Claire P. Monks and Sarah O’Toole
Int. J. Environ. Res. Public Health 2023, 20(10), 5892; https://doi.org/10.3390/ijerph20105892 - 20 May 2023
Cited by 1 | Viewed by 2485
Abstract
Theory of mind (ToM) undergoes significant developments during childhood, particularly between the ages of four and seven years. A growing body of research has indicated that children’s social understanding may be related to their social behaviour with peers, in line with Theory Theory [...] Read more.
Theory of mind (ToM) undergoes significant developments during childhood, particularly between the ages of four and seven years. A growing body of research has indicated that children’s social understanding may be related to their social behaviour with peers, in line with Theory Theory which proposes that children’s social cognition is influenced by and influences their peer interactions. The current study examined the relationship between ToM and behaviour among 193 children aged 4–7 years. Children carried out a battery of ToM tasks, and teaching staff reported on children’s aggressive, prosocial, and solitary behaviour and victimisation experiences. Aggression was not directly related to ToM; prosocial behaviour was positively associated with ToM for girls but not boys. Solitary behaviour and victimisation were negatively related to ToM. When this was broken down by gender, there was only a significant association between solitary behaviour and ToM for boys. When controlling for the relationship between behaviours, the only significant predictor of ToM was solitary behaviour for boys. ToM was also a significant predictor of solitary behaviour for boys, demonstrating that there is a bidirectional relationship at play. The findings highlight the importance of looking across these four behaviour types and understanding the relationship between behaviour profiles and ToM for boys and girls separately. Full article
13 pages, 817 KiB  
Article
The Influence of Whey Protein on Muscle Strength, Glycemic Control and Functional Tasks in Older Adults with Type 2 Diabetes Mellitus in a Resistance Exercise Program: Randomized and Triple Blind Clinical Trial
by André Luiz de Seixas Soares, Adriana Machado-Lima, Guilherme Carlos Brech, Júlia Maria D’Andréa Greve, Joselma Rodrigues dos Santos, Thiago Resende Inojossa, Marcelo Macedo Rogero, João Eduardo Nunes Salles, José Maria Santarem-Sobrinho, Catherine L. Davis and Angelica Castilho Alonso
Int. J. Environ. Res. Public Health 2023, 20(10), 5891; https://doi.org/10.3390/ijerph20105891 - 20 May 2023
Cited by 2 | Viewed by 2421
Abstract
Objectives: To evaluate the effect of whey protein (WP) supplementation associated with resistance training (RT) on glycemic control, functional tasks, muscle strength, and body composition in older adults living with type 2 diabetes mellitus (T2DM). Secondly, to evaluate the safety of the protocol [...] Read more.
Objectives: To evaluate the effect of whey protein (WP) supplementation associated with resistance training (RT) on glycemic control, functional tasks, muscle strength, and body composition in older adults living with type 2 diabetes mellitus (T2DM). Secondly, to evaluate the safety of the protocol for renal function. Methods: The population comprised twenty-six older men living with T2DM (68.5 ± 11.5 years old). The participants were randomly assigned to the Protein Group (PG) and the Control Group (CG). The handgrip test and evolution of exercise loads, according to the Omni Resistance Exercise Scale, evaluated muscle strength. Functional tasks were assessed by force platform in three different protocols: Sit-to-Stand, Step/Quick Turn, and Step Up/Over. Body composition was evaluated by bioimpedance and glycemic control and renal function were assessed by biochemical analyses. Both groups performed RT for 12 weeks, twice a week, prioritizing large muscle groups. Protein supplementation was 20 g of whey protein isolate and the CG was supplemented with an isocaloric drink, containing 20 g of maltodextrin. Results: There was a significant difference in muscle strength, according to the evolution of the exercise loads, but it was not confirmed in the handgrip test. However, there was no significant difference between the groups, regarding performance in functional tasks, glycemic control, or body composition. Renal function showed no alteration. Conclusion: The intake of 20 g of WP in older male adults living with T2DM did not increase the effect of RT on muscle strength, functional tasks, and glycemic control. The intervention was proven safe regarding renal function. Full article
(This article belongs to the Section Health Care Sciences & Services)
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18 pages, 2552 KiB  
Article
Assessment of the Environmental Impacts of a Localized Food System and Food Waste Reduction in a Water-Scarce Region Using Diet Optimization Models
by Felix Haifeng Liao, Robert Heinse, Darin Saul, Soren Newman, Li Huang, Colette DePhelps and Steven Peterson
Int. J. Environ. Res. Public Health 2023, 20(10), 5890; https://doi.org/10.3390/ijerph20105890 - 20 May 2023
Viewed by 1712
Abstract
Despite growing interest in fresh local produce across the United States, scaling up local agricultural development might impose new environmental pressures on increasingly scarce water and land resources in specific localities. Drawing upon the case of the Palouse of the US Inland Northwest, [...] Read more.
Despite growing interest in fresh local produce across the United States, scaling up local agricultural development might impose new environmental pressures on increasingly scarce water and land resources in specific localities. Drawing upon the case of the Palouse of the US Inland Northwest, this study evaluates land and water footprints of local foods along with food waste reduction in a water-scarce region. We used both non-robust and robust diet-optimization techniques to estimate the minimum amounts of irrigation water necessary to grow foods locally and to satisfy the local population’s caloric or nutrition needs. Our modeling results indicate that, on an annual basis, an increase of less than 5% of the current freshwater withdrawal on the Palouse could satisfy 10% of the local population’s aspirational demand for locally grown food products, while more than 35% of local foods (by mass) may be wasted. Furthermore, reducing food waste by 50% could simultaneously reduce water use by up to 24%, cropland use by 13%, and pastureland use by 20%. Our findings not only provide intriguing information for access to local food but could also be used to stimulate new efforts to increase consumers’ and retailers’ awareness of environmental benefits associated with food waste reduction. Full article
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12 pages, 368 KiB  
Article
Factors Affecting Delirium in ICU Patients
by I Seul Jeong and Mi-Kyoung Cho
Int. J. Environ. Res. Public Health 2023, 20(10), 5889; https://doi.org/10.3390/ijerph20105889 - 19 May 2023
Cited by 2 | Viewed by 1628
Abstract
This study examined delirium severity using a delirium screening tool and analyzed the predictors, including pain, acuity, level of consciousness, fall risk, and pain score, to increase understanding of delirium and present foundational data for developing nursing interventions for delirium prevention. This was [...] Read more.
This study examined delirium severity using a delirium screening tool and analyzed the predictors, including pain, acuity, level of consciousness, fall risk, and pain score, to increase understanding of delirium and present foundational data for developing nursing interventions for delirium prevention. This was a retrospective study of 165 patients admitted to three intensive care units (ICUs). the Nursing Delirium Screening Scale (Nu-DESC) was used as a research tool to screen for delirium and measure the degree of delirium. The incidence of delirium in patients was 53.3%, and the average delirium score in the delirium group was 2.40 ± 0.56. Nu-DESC scores were significantly correlated with ICU days, ventilator days, restraint applications, the number of catheters inserted, sedative medication use, the Simplified Acute Physiology Score (SAPS III), the Morse Fall Scale (MFS), the Glasgow Coma Scale (GCS) scores, pain scores, and blood urea nitrogen (BUN). Stepwise multiple linear regression showed that the number of restraint applications, GCS score, ICU days, and BUN levels were factors influencing delirium. Based on the findings, ICU nurses should use delirium screening tools to ensure accurate delirium screening and work to reduce the incidence and degree of delirium by observing factors affecting delirium in patients. Full article
(This article belongs to the Special Issue New Advances in Nursing Care)
17 pages, 729 KiB  
Article
Cancer Prevention Literacy among Different Population Subgroups: Challenges and Enabling Factors for Adopting and Complying with Cancer Prevention Recommendations
by Lena Sharp, Nikolina Dodlek, Diane Willis, Arja Leppänen and Helena Ullgren
Int. J. Environ. Res. Public Health 2023, 20(10), 5888; https://doi.org/10.3390/ijerph20105888 - 19 May 2023
Viewed by 2318
Abstract
It is estimated that 40% of the cancer cases in Europe could be prevented if people had better information and tools to make healthier choices and thereby reduce some of the most important cancer risk factors. The aim of this study is to [...] Read more.
It is estimated that 40% of the cancer cases in Europe could be prevented if people had better information and tools to make healthier choices and thereby reduce some of the most important cancer risk factors. The aim of this study is to gain knowledge and understanding about cancer prevention literacy among people with intellectual disabilities, immigrants, young people and young cancer survivors. In this qualitative study, we conducted six online focus-group interviews, including forty participants, to explore the cancer prevention literacy of four population subgroups and determine how cancer prevention recommendations according to the European Code Against Cancer (ECAC) were perceived. The analysis resulted in the following main categories: current health beliefs and their impacts on how the ECAC recommendations were perceived, communication strategies and sources benefiting or hindering cancer prevention information from reaching out, and how vulnerabilities in these subgroups impact cancer prevention literacy. To improve cancer prevention literacy in Europe, more attention is needed this topic to overcome barriers among different population subgroups. Recommendations include improved and adapted cancer prevention information, support to individuals, as well as societal support, such as easy-access screening and vaccination programmes and regulations related to tobacco, alcohol, and diet. Full article
(This article belongs to the Section Disease Prevention)
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21 pages, 583 KiB  
Article
Self-Management of Diabetes and Associated Factors among Patients Seeking Chronic Care in Tshwane, South Africa: A Facility-Based Study
by Janke Zwane, Perpetua Modjadji, Sphiwe Madiba, Lucky Moropeng, Kabelo Mokgalaboni, Peter Modupi Mphekgwana, Andre Pascal Kengne and Zandile June-Rose Mchiza
Int. J. Environ. Res. Public Health 2023, 20(10), 5887; https://doi.org/10.3390/ijerph20105887 - 19 May 2023
Cited by 3 | Viewed by 2439
Abstract
The burden of diabetes continues to increase in South Africa and a significant number of diabetes patients present at public primary healthcare facilities with uncontrolled glucose. We conducted a facility-based cross-sectional study to determine the diabetes self-management practices and associated factors among out-patients [...] Read more.
The burden of diabetes continues to increase in South Africa and a significant number of diabetes patients present at public primary healthcare facilities with uncontrolled glucose. We conducted a facility-based cross-sectional study to determine the diabetes self-management practices and associated factors among out-patients in Tshwane, South Africa. An adapted validated questionnaire was used to collect data on sociodemography, diabetes knowledge, and summaries of diabetes self-management activities measured in the previous seven days, and over the last eight weeks. Data were analysed using STATA 17. A final sample of 402 diabetes out-patients was obtained (mean age: 43 ± 12 years) and over half of them were living in poor households. The mean total diabetes self-management of score was 41.5 ± 8.2, with a range of 21 to 71. Almost two thirds of patients had average self-management of diabetes, and 55% had average diabetes knowledge. Twenty-two percent of patients had uncontrolled glucose, hypertension (24%) was the common comorbidity, and diabetic neuropathy (22%) was the most common complication. Sex [male: AOR = 0.55, 95% CI: 0.34–0.90], race [Coloured: AOR = 2.84, 95% CI: 1.69–4.77 and White: AOR = 3.84, 95% CI: 1.46–10.1], marital status [divorced: AOR = 3.41, 95% CI: 1.13–10.29], social support [average: AOR = 2.51, 95% CI: 1.05–6.00 and good: AOR = 4.49, 95% CI: 1.61–7.57], body mass index [obesity: AOR = 0.31, 95% CI: 0.10–0.95], diabetes knowledge [average: AOR = 0.58, 95% CI: 0.33–0.10 and good: AOR = 1.86, 95% CI: 0.71–4.91], and uncontrolled glucose [AOR = 2.97, 95% CI: 1.47–5.98] were factors independently predictive of diabetes self-management. This study emphasizes that the self-management of diabetes was mostly on average among patients and was associated with the aforementioned factors. Innovative approaches are perhaps needed to make diabetes education more effective. Face-to-face sessions delivered generally during clinic visits should be better tailored to the individual circumstances of diabetes patients. Considerations should be given to the options of leveraging information technology to ensure the continuity of diabetes education beyond clinic visits. Additional effort is also needed to meet the self-care needs of all patients. Full article
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20 pages, 8242 KiB  
Article
Active and Assisted Living, a Practice for the Ageing Population and People with Cognitive Disabilities: An Architectural Perspective
by Santiago Quesada-García, Pablo Valero-Flores and María Lozano-Gómez
Int. J. Environ. Res. Public Health 2023, 20(10), 5886; https://doi.org/10.3390/ijerph20105886 - 19 May 2023
Cited by 3 | Viewed by 2330
Abstract
The current digital revolution is causing a paradigm shift encompassing all environments in which human beings conduct their daily activities. Technology is starting to govern the world, gradually modifying not only individual and social behaviour, but also ways of living. The necessary adaptation [...] Read more.
The current digital revolution is causing a paradigm shift encompassing all environments in which human beings conduct their daily activities. Technology is starting to govern the world, gradually modifying not only individual and social behaviour, but also ways of living. The necessary adaptation to new information and communication technologies forces societies to rethink both public and private spaces, in which evolution is slower than rapid social transformation. As part of this change, the concept of Active Assisted Living (AAL) has developed. Assisted spaces can be designed to provide older adults, carers, or people who have cognitive disabilities, such as Alzheimer’s disease or other dementias, with a healthier, safer, and more comfortable life, while also affording them greater personal autonomy. AAL aims to improve people’s quality of life and allow them to remain in their own homes for as long as possible, not in residences. This study conducted a critical review about AAL from an architectural point of view. The research adopted a qualitative approach in which we collected the studies during the last twenty years, then used descriptive, narrative and critical analysis methods. Based on these, this paper aims to explain this new technological paradigm, its characteristics, its main development trends, and its implementation limitations. The results obtained show how the development of AAL will be in the next ten years, and how this concept, and its application, can influence architecture and provide the bases for further research into the design of buildings and cities. Full article
(This article belongs to the Topic Healthy, Safe and Active Aging)
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