International Journal of Environmental Research and Public Health

Epidemiological studies have suggested the role of multiple genetic and environmental factors in the development of non-neoplastic gastrointestinal (GI) diseases; however, little information is available on these factors in the Korean population. Therefore, this cross-sectional study explored the effect of these factors by analyzing the concordance of several benign GI disorders in 525 monozygotic twins compared to that in 122 dizygotic twins aged >20 years from the Healthy Twin Study data of the Korean Genome and Epidemiology Study (2005–2014). Chi-square test, Wilcoxon rank-sum, and binomial and multinomial logistic regression models were used for statistical analysis. There was lack of concordance of gastric/duodenal ulcers and cholelithiasis/cholangitis between monozygotic twins compared to that in dizygotic twins, suggesting that environmental factors may mediate those concordant disease expressions in monozygotic twins. The concordance of intestinal polyps in monozygotic twins was 32% lower than that in dizygotic twins (p = 0.028), indicating that the effect of genetic factors on the risk for intestinal polyp development may be low. In conclusion, the lack or low concordance of several benign GI diseases between monozygotic and dizygotic twin groups suggests the relative importance of environmental factors, indicating that these are preventable diseases. Full article

Grounded in the job demands-resources model, this study examines the moderating role of supervisor support and the mediating role of sports coaches’ work engagement in the relationship between proactive personality and perceived work competence. A total of 261 school sports coaches in Taiwan participated in the study. The results indicated that work engagement positively mediates the relationship between sports coaches’ proactive personality and perceived work competence. Separately, supervisor support weakens the link between proactive personality and work engagement but strengthens the relationship between work engagement and perceived work competence; however, taken together, supervisor support weakens the indirect effects of proactive personality on perceived work competence through job engagement. Under the boundary condition of perceived supervisor support, the sports coaches’ proactive personality is a critical antecedent of perceived work competence through work engagement. We suggest that proactive sports coaches are assets for schools because they possess the drive and energy for self-improvement, promoting organizational progress automatically. Full article

Estimation of children’s chronological age is highly important in human and forensic sciences. The Demirjian method has been reported as accurate for this purpose. The literature review shows some evidence that the accuracy of estimating chronological age via the Demirjian standards is not a straightforward process. The objective of this research is to analyze the reliability of the Demirjian standards in Portuguese and Spanish children and adolescents and adapt it to include sex and group age as contingent factors. Methods: Orthopantomographs of 574 Portuguese and Spanish male and female children and adolescents were employed to test the reliability of the Demirjian method. After testing for inter-rater consistency and age estimation using the Demirjian standards, multiple regression analysis was performed controlling for sex and age group. Results: The Demirjian standards overestimated chronological age for both sexes, mainly for females. Through the development of regression functions, more detailed dental age estimation was performed. The predictive capacities of the Demirjian method and the significant teeth varied as a function of children’s age. The Demirjian global standard predicted over 65% of the variance of the chronological age. Taking a tooth-by-tooth approach, the predictive ability increased by over 70%. Conclusions: The accuracy of estimating chronological age via the Demirjian method is not as reliable as it might appear, judging from the results found according to age group and according to sex crossed with age group. Full article

Objective—The aim was to verify the correlation between cerebral and muscular electrical activity in subjects trained in virtual reality after a stroke. Method—The trial design was a cross-sectional study. Fourteen volunteers who were diagnosed with a stroke participated in the study. The intervention protocol was to perform functional activity with an upper limb using virtual reality. The functional protocol consisted of four one-minute series with a two-minute interval between series in a single session. Results—We observed, at initial rest, a positive correlation between brachii biceps and the frontal canal medial region (F7/F8) (r = 0.59; p = 0.03) and frontal canal lateral region (F3/F4) (r = 0.71; p = 0.006). During the activity, we observed a positive correlation between the anterior deltoid and frontal anterior channel (AF3/AF4) (r = 0.73; p = 0.004). At final rest, we observed a positive correlation between the anterior deltoid and temporal region channel (T7/T8) (r = 0.70; p = 0.005). Conclusions—We conclude that there was no correlation between brain and muscle activity for the biceps brachii muscle in subjects trained with virtual reality. However, there was a positive correlation for the deltoid anterior muscle. Full article

Breast cancer survivors have to deal with notable challenges even after successful treatment, such as body image issues, depression and anxiety, the stress related to changes in lifestyle, and the continual challenges inherent to health management. The literature suggests that emotional abilities, such as emotional intelligence, emotion management, mood repair, and coping play a fundamental role in such challenges. We performed a systematic review to systematize the evidence available on the role of emotional abilities in quality of life and health management in breast cancer survivors. The search was performed on three scientific databases (Pubmed, Scopus, and PsycINFO) and, after applying exclusion criteria, yielded 33 studies, mainly of a cross-sectional nature. The results clearly support the hypothesis that emotional abilities play multiple important roles in breast cancer survivors’ quality of life. Specifically, the review highlighted that coping/emotional management plays multiple roles in breast cancer survivors’ well-being and health management, affecting vitality and general adjustment to cancer positivity and promoting benefit findings related to the cancer experience; however, rare negative results exist in the literature. This review highlights the relevance of emotional abilities to promoting quality of life in breast cancer survivors. Future review efforts may explore other breast cancer survivors’ emotional abilities, aiming at assessing available instruments and proposing tailored psychological interventions. Full article

Objective: Cardiorespiratory fitness (CRF) reference data for Tibetan (Zang ethnicity) children and adolescents at high altitudes in Tibet of China are lacking. The present study aimed to develop sex- and age-specific 20mSRT norms for Chinese Tibetan children and adolescents at high altitudes. Method: A total of 4667 participants from Lhasa (3650 m), Nagqu (4500 m), and Amdo (4700 m) were selected by a stratified random cluster sampling method in two stages. The 20 m SRT test was used to estimate cardiorespiratory fitness. The 20 m SRT norms were developed by the lambda, mu, and sigma method (LMS). Results: The 20 m SRT laps, completed stages/minutes, and the speed at the last complete stage of Chinese Tibetan children and adolescents aged 7–18 years increased with age. Conclusion: Given the importance of CRF for children and adolescents’ health, the government should strengthen the monitoring of the CRF of Tibetan children and adolescents in high-altitude areas, strengthen physical education curriculum reform, and increase the level of physical activity in order to improve the level of CRF in children and adolescents. Full article

Child physical punishment is harmful to children and, as such, is being prohibited by a growing number of countries, including Wales. Parents’ own childhood histories may affect their risks of using child physical punishment. We conducted a national cross-sectional survey of Welsh adults and measured relationships between the number of adverse childhood experiences (ACEs) parents (n = 720 with children aged < 18) had suffered during childhood and their use of physical punishment towards children. Overall, 28.2% of parents reported having ever physically punished a child, and 5.8% reported having done so recently (in the last year). Child physical punishment use increased with the number of ACEs parents reported. Parents with 4+ ACEs were almost three times more likely to have ever physically punished a child and eleven times more likely to have done so recently (vs. those with 0 ACEs). The majority (88.1%) of parents that reported recent child physical punishment had a personal history of ACEs, while over half reported recently having been hit themselves by a child. Child physical punishment is strongly associated with parents’ own ACE exposure and can occur within the context of broader conflict. Prohibiting physical punishment can protect children and, with appropriate family support, may help break intergenerational cycles of violence. Full article

Providing access to a range of basic health services, community-based primary health care (CB-PHC) plays a vital role in achieving the goal of health for all. Driven by a strong political commitment, China’s CB-PHC progress in the past decade has been swift and impressive. However, a well-functioning delivery system for care has yet to be established. This systematic mapping review synthesizes selected evidence on barriers to CB-PHC delivery in urban China and draws lessons for policy development. We performed searches on five electronic databases: CINAHL, MEDLINE, Scopus, Web of Science, and China National Knowledge Infrastructure, and included studies published between 2012 and 2021. The Downs and Black and Critical Appraisal Skills Program checklists were used to assess the quality of eligible papers. We conducted our searches and syntheses following the framework set out in the Primary Health Care Performance Initiative (PHCPI). We synthesized the results of the included studies using a thematic narrative approach and reported according to PRISMA guidelines. Six salient barriers arose from our syntheses of 67 papers: lack of comprehensive health insurance schemes, lack of public awareness, superficial care relationships, gaps in communication, staff shortages and poor training, and second-rate equipment. These barriers are grouped into three subdomains following the PHCPI framework: access, people-centered care, and organization and management. A host of negative impacts of these barriers on community-based health care were also identified. It was not possible to determine clear causes of these barriers from the contributing evidence because of the lack of conceptual frameworks and research methods constraints. Non-eastern regions of China and access-related barriers require further exploration. It follows that, at the national level, the problems are likely more severe than the research suggests. Full article

In the context of rapid urbanization and limited land amount, it is essential to scientifically evaluate the urban land green use efficiency (ULGUE) to promote regional sustainable development. Current studies are of great value for enriching the theoretical system and application research of ULGUE. Still, most of them only consider industrial pollution but ignore carbon emission as an essential environmental influencing indicator. This paper introduced carbon emissions into the input-output indicator system, measured ULGUE of 57 cities in the Yellow River Basin (YRB) over the 2004–2017 periods using the super-efficiency slacked-based measure (Super-SBM) model, analyzed its spatio-temporal patterns with the kernel density estimation (KDE) model and spatial autocorrelation model, and then identified the influencing factors with the Spatial Durbin model (SDM). As shown by the results, firstly, the ULGUE in the YRB over the 2004–2017 periods showed a trend of first decreasing and then increasing. Secondly, the ULGUE exhibited spatio-temporal imbalance characteristics across the YRB. Thirdly, ULGUE was the interaction of multiple indicators, and its influencing factors had spatial spillover effects. All in all, this paper is fundamental to the high-quality development of cities in the background of the Chinese policy of “carbon peak, carbon neutralization”. Full article

Background: Based on findings from previous qualitative studies comparing migrants and Swedish-born persons with diabetes mellitus type 2, it was hypothesized that dissimilarities exist in beliefs about health, including factors of importance for health between groups. Methods: A survey in a diabetes clinic in a migrant-dense area in Sweden. Results: Migrants generally perceived their health as poorer than Swedes, although it was not significantly different. Health mainly meant feeling well, being alert, and healthy and learning to live with disease despite of person’s origin. Studying factors of importance for health, migrants perceived knowledge about the body and treatment to influence health to a lower extent (p 0.009) and use of nature cure remedies to a higher extent (p 0.029) than Swedish-born persons. Conclusions: The findings partly supported the hypothesis that dissimilarities in factors of importance for health exist between migrants and Swedish-born persons, and need to be assessed. Full article

(1) Schools have a significant role in violence prevention activities. This study aimed to first identify profiles of Finnish comprehensive schools based on school violence. The second aim was to examine the associations between profiles concerning health promotion actions, reactive or punitive actions, and school characteristics. (2) The study used the large-scale, nationally representative Benchmarking System of Health Promotion Capacity-Building (BSHPCB) data (n = 2057 schools) completed by the school’s principal together with a student welfare team. The data was analyzed by cluster analysis and Chi-squared and Kruskal–Wallis tests. For post hoc testing, Fisher’s exact test with odds ratios and Mann–Whitney U-test were used. (3) The cluster analysis yielded five profiles of school violence: “No violence”, “Adolescent violence” (violence both among pupils and from pupils towards staff, but not inappropriate behavior from school staff towards pupils), “Not known” (principals either did not respond to these questions or they did not know whether there had been any school violence incidents), “Peer violence” (school violence occurred among pupils but not from pupils towards staff, nor inappropriate behavior from school staff towards pupils), and “All violence” (all types of school violence and inappropriate behavior from school staff towards pupils). These clusters differed according to type of school and municipality. Additionally, both management and monitoring as health promotion actions were related to higher incidence of school violence whereas other actions, such as commitment, resources, common practices, and participation were not related to school violence. (4) The findings of this study indicate that schools have different profiles in terms of school violence and providing evidence and guidance for school violence prevention work. Full article

The drop immerses calcium chloride aqueous solution was utilized to prepare the zero valent iron-doped polyethersulfone beads (PES/ZVI) for the efficient removal of arsenic from apatite-soil treated waters. The proposed beads can assist in promoting uptake efficiency by hindering ZVI agglomeration due to a high porosity and different active sites. The PES/ZVI beads were characterized by Fourier transform infrared spectroscopy (FTIR), scanning electron microscopy (SEM), thermogravimetric analysis (TGA), and vibrating sample magnetism (VSM). The main objective of this study was to investigate the function of new PES/ZVI beads with an increased removal efficiency for the remediation of arsenic ions from the apatite-soil treated waters. A maximum adsorption removal of 82.39% was achieved when the experiment was performed with 80 mg of adsorbent for a contact time of 180 min. Based on the results, a removal efficiency >90% was obtained after 300 min of shaking time with an arsenic concentration of 20 mg.L⁻¹. The experimental process was fitted with the Langmuir model due to the high R² (0.99) value compared to the Freundlich model (0.91) with an adsorption capacity of 41.32 mg.g⁻¹. The adsorption process speed was limited by pseudo-second-order (R² = 0.999) and the adsorption mechanism nature was endothermic and physical. Full article

We present the design, implementation, and evaluation of an e-service learning course, “Social Marketing for Health Promotion”, offered to full-time and part-time students enrolled in the Master of Public Health at our institution. In a quasi-experimental trial, we introduced e-service learning in 2018, comparing a traditional face-to-face section to a blended course (33% online). Based on the positive feedback received, we progressively increased the online component in the following academic years, reaching 100% online in Fall 2020. We compared the quantitative and qualitative indicators evaluating three e-service learning-course iterations with a face-to-face control. The impact indicators included participation and engagement in the course, the attainment of the learning outcomes, satisfaction with the course, instructors and mode of delivery, and the impact of the experience beyond the classroom. Over the years, we trained 73 students whose engagement with the course remained relatively stable. The attainment of the learning outcomes and general course satisfaction steadily increased over time, demonstrating a positive impact on student learning. Qualitative data illustrate the importance of instructors in setting expectations and guiding students and community partners through a remote-learning process. Full article

The hyporheic zone (HZ) is important for river ecological restoration as the main zone with nitrogen biochemical processes. The engineering of river ecological restoration can significantly change the hydrodynamics, as well as solute transport and reaction processes, but it is still not fully understood. In this study, nitrogen transport and reaction processes were analyzed in the HZ with an in-stream weir structure. An HZ model was built, and three reactions were considered with different design parameters of the weir structure and different permeability characteristics of porous media. The results show that a structure with a greater height on the overlying surface water enables the species to break through deeper porous media. It promotes the mean spatial reaction rates of nitrification and denitrification and results in increased net denitrification in most cases. In addition, increasing the burial depth of the structure leads to the same variation trends in the mean spatial reaction rates as increasing the structure height. Larger permeability coefficients in porous media can enhance flow exchange and increase mean spatial reaction rates. The results can help deepen the understanding of nitrogen transport and transformation in the HZ and optimize the design parameters and location of the in-stream structure. Full article

Aim: This study assessed the influence of performing an additional cognitive task on center of pressure (COP) displacement in the early and advanced stages of patients with Parkinson’s disease (PD) compared to age-matched healthy controls (HCs). Methods: The study included 40 HCs and 62 patients with PD: early PD (n = 38) and advanced PD (n = 24). COP parameters were determined by static posturography during quiet standing with open eyes (ST, single task) and simultaneous performance of a cognitive task (DT, dual task). Cognitive functioning was examined with a Mini Mental State Examination, number-counting-backward test, and number of enunciated words during DT. Results: In the advanced-PD group, DT significantly reduced the sway radius (p = 0.009), area of stabilogram (p = 0.034), medio-lateral length (p = 0.027), and velocity (p = 0.033) compared to ST. In HCs, DT showed a significant increase in the sway radius (p = 0.006), total length (p = 0.039), sway velocity (p = 0.037), anterior–posterior length, and sway velocity. Both PD groups showed worse cognitive performance compared to HCs. Conclusions: Both early and advanced patients with PD showed significant delay in cognitive performance associated with executive function compared to the HCs. During additional cognitive tasks, patients with advanced stages of PD may reduce stabilographic parameters in medio-lateral direction, and this is probably an adaptive strategy to restore balance. Full article

Surface evapotranspiration (ET) is an important part of the hydrological cycle. Based on the MOD16 ET product and the data collected by meteorological stations, this study investigated, for the first time, the characteristics, variation trend and influencing factors of actual ET in Ningxia from 2001 to 2020 along temporal and spatial scales using the Theil–Sen median trend analysis, Mann–Kendall test and Hurst index, and predicted the future trend of ET. The results revealed a strong correlation between the MOD16 ET product and ET data collected at meteorological stations (r = 0.837, R² = 0.701). Over the past 20 years, the annual ET in Ningxia showed an overall increasing trend, and the proportion of the increasing area was 96.58%. Quarterly ET varied over time, with the highest value in the third quarter and the lowest value in the second quarter. Annual ET showed a positive correlation with normalized difference vegetation index (NDVI), surface temperature and precipitation but no correlation with relative humidity. Additionally, the Hurst index revealed areas showing a persistent increase in ET, accounting for 84.91% of the total area, indicating that the future trend of ET in Ningxia is consistent with the past trend. Full article

Background: Child obesity rates are increasing worldwide. In Korea, the proportion of overweight students has steadily increased from 21.8% in 2015 to 25.8% in 2019. Childhood obesity causes mental problems, such as depression and social phobia, due to mental stress, feelings of inferiority, and low self-esteem. Methods: This experimental study aimed to verify the effect of the child obesity management program on body changes (height, weight, obesity degree, body mass index [BMI], body fat percentage), eating habits, exercise habits, obesity knowledge, and social support. This child obesity management program applies the nudge technique based on an ecological model and induces autonomous weight management through environmental control. Results: As results of this study, the child obesity management program using the nudge technique developed in this study improved the height (t = −5.19, p < 0.001), obesity degree (z = −3.28, p = 0.001), BMI (z = −3.22, p = 0.001), exercise habits (t = −2.09, p = 0.040), and obesity knowledge of obese children (z = −2.99, p = 0.003). Conclusions: This multidimensional intervention improved obesity by inducing and sustaining behavioral changes in obese children. Therefore, applying the nudge techniques and multidimensional intervention methods based on ecological model are proposed to increase the effectiveness of the health promotion programs. Full article

This opinion article discusses the factors that attract children and teens to athletic careers. The most important attribute for the making of athletes is polished sports talent, followed by psychological, environmental, and incentive factors. Our laboratory studies a red blood cell (RBC) type called GP.Mur, which is rare in most parts of the world besides Southeast Asia. Intriguingly, the prevalence of the GP.Mur blood type is relatively high among Taiwanese elite athletes. The highest frequency of the GP.Mur blood type worldwide is found among Taiwan’s Ami people (88–95% from hospital blood bank surveys in the 1980s). Though the Ami constitute only 0.6–0.8% of the Taiwanese population, from records of national track-and-field games in the past century, 10–60% of the medalists were Ami. Biologically, GP.Mur expression supports blood CO₂ metabolism, which may have implications for athleticism. As many of our study subjects are elite college athletes with the GP.Mur blood type, we contemplated their upbringings and career dilemmas, especially during the difficult COVID-19 pandemic. Beyond individual sports talent, the pandemic particularly tests personal characteristics and socioeconomic support for becoming an athlete. Full article

Emotion regulation is an important aspect of psychological functioning that influences subjective experience and moderates emotional responses throughout the lifetime. Adaptive responses to stressful life events depend on the positive interaction between explicit and implicit emotion regulation strategies, such as mindfulness and defense mechanisms. This study demonstrates how these emotion regulation strategies predict psychological health during the early phase of the COVID-19 pandemic. A convenience sample of 6385 subjects, recruited via snowball sampling on various social media platforms, responded to an online survey assessing psychological reaction to social restrictions imposed to limit the spread of COVID-19 in Italy. Psychological distress, post-traumatic stress symptoms, mindfulness, and defense mechanisms were assessed using SCL-90, IES-R, MAAS, and DMRS-30-SR, respectively. Higher mindfulness was significantly associated with higher overall defensive maturity and a greater use of high-adaptive defenses (p < 0.0001). Both mindfulness and defense mechanisms acted as good predictors of psychological health (R² = 0.541) and posttraumatic symptoms (R² = 0.332), confirming the role of emotion regulation in protecting against maladaptive responses to stressful situations. Full article