International Journal of Environmental Research and Public Health

Recent studies have documented the presence of microplastics (MPs) in remote areas, including soils or sediments collected in mountain and glacier environments, but information on their presence in snow is scant. The present study aimed at exploring the presence of MPs in residual snow collected in four locations of the Aosta Valley (Western Italian Alps), with different accessibility and human presence. Overall, the µ-FTIR analyses confirmed the presence of 18 MPs in snow, 7 (39%) items were fibres, while 11 (61%) were fragments. Polyethylene (PE; 7 MPs) was the main polymer, followed by polyethylene terephthalate (PET; 3 MPs), high density PE (HDPE; 3 MPs), polyester (2 MPs), while only 1 MP made by low density PE, polypropylene and polyurethane were found. The mean (± SE) concentration of MPs in snow ranged between 0.39 ± 0.39 MPs/L and 4.91 ± 2.48 MPs/L, with a mean of 2.32 ± 0.96 MPs/L for the sampling locations. The concentration of MPs did not statistically differ among locations. Our results suggest that MPs presence in high-mountain ecosystems might depend on deposition through atmospheric precipitations or local sources due to human activities. For these reasons, policies aiming at reducing plastic use and dispersal in mountain areas may be effective in preventing local MP contamination. Full article

Lead (Pb) is a metal toxicant of great public health concern. The present study investigated the applicability of the rat incisor in Pb exposure screening. The levels of lead in teeth (Pb-T) in the crown and root of incisors in laboratory Pb-exposed Sprague Dawley rats were quantified using inductively coupled plasma mass spectrometry (ICP-MS). The crown accumulated much Pb-T than the root of the Sprague Dawley rat incisor. The levels of lead in blood (Pb-B) were positively correlated with the Pb-T in the crown and root incisors of the Sprague Dawley rats. As an application of the Pb-T crown results in experimental rats, we subsequently analyzed the Pb-T in the crown incisors of Pb-exposed wild rats (Rattus rattus) sampled from residential sites within varying distances from an abandoned lead–zinc mine. The Pb-T accumulation in the crown of incisors of R. rattus rats decreased with increased distance away from the Pb–Zn mine. Furthermore, the Pb-T was strongly correlated (r = 0.85) with the Pb levels in the blood. Laser ablation ICP-MS Pb-T mappings revealed a homogenous distribution of Pb in the incisor with an increased intensity of Pb-T localized in the tip of the incisor crown bearing an enamel surface in both Sprague Dawley and R. rattus rats. These findings suggest that Pb-T in the crown incisor may be reflective of the rat’s environmental habitat, thus a possible indicator of Pb exposure. Full article

Self-assessment is among the most impactful processes in student learning. Since no review of this process was found in the field of physical education (PE), the objective of this work was to perform a systematic review of the literature published over the last five years on the self-assessment of PE students in formal education contexts. The review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) standards. Inclusion and exclusion criteria were established to select the articles. A total of three researchers independently applied the above criteria and obtained a total of thirteen studies. After synthesising the results by category, we found that: a majority of the studies were conducted in Europe; all 13 studies covered the educational stages of either secondary or higher education; an even number of qualitative and quantitative approaches were distributed among the studies; some studies focused on specific sports or contents, while others were applicable to any subject; and, finally, depending on the research design adopted, the results described self-assessment strategy processes, improvements in learning, drew descriptive portraits of students regarding health, or reflected students’ positive perceptions of self-assessment. It is necessary to conduct further studies on PE students’ self-assessment, especially in primary education. Full article

The aim of the study was to determine the between-trial and between-day reliability of the Glazer protocol and our multi-activity surface electromyography (sEMG) measurement protocol for pelvic floor muscle (PFM) evaluation. The bioelectrical activity of PFM was collected using an endovaginal electrode in 30 young, Caucasian, nulliparous women (age 22–27, 168.6 ± 5.1 cm, 57.1 ± 11.8 kg). The between-trial and between-day reliability of the original Glazer protocol and the new multi-activity sEMG protocol were assessed during the following phases: pre-baseline rest, phasic (flick) contractions, tonic contractions, endurance contraction, and post-baseline rest. The Glazer protocol was characterized by poor and moderate measurement reliability. The time-domain parameters for the rise and fall of the signal amplitude and median frequency showed poor between-trial and between-day reliability. The mean and peak amplitudes indicated mainly good between-trial and moderate between-days reliability. Our protocol showed moderate to excellent reliability of both time-domain and quantitative parameters of muscle recruitment. In our protocol, the frequency-domain parameters describing muscle fatigue demonstrated much higher reliability than in the case of the Glazer protocol. The most important information obtained in this study was the significant improvement of diagnostic validity in PFM bioelectrical activity evaluation. The higher reliability of our sEMG protocol compared to original Glazer protocol allowed us to suggest that protocol modifications and changes in sEMG signal processing methods were effective in the improvement of PFM assessment quality. The new parameters calculated from the sEMG signal proposed in our sEMG protocol allowed us to obtain additional clinically important information about PFM dysfunctions regarding specific deficits of muscle contraction such as decrease in muscle strength; endurance or coordination related to, e.g., stress urinary incontinence; or pelvic floor muscle imbalance after childbirth. Full article

The list of indicators is a form of training material used for the Supports Intensity Scale—Children’s version (SIS-C). It is aimed at helping interviewers distinguishing between extraordinary and age-related typical support needs in children with intellectual and developmental disabilities (IDD) when implementing the SIS-C, and thus improve supports planning. The aim of this study is to adapt and test the list of indicators’ content validity and rating scale’s functioning in Spain. A total of 222 general education teachers reported their agreement with each indicator description using a 5-point rating scale. A total of 353 of 366 indicators showed evidence of content validity, whereas analyses on the rating scale highlighted the necessity of subsuming one of the scale categories within another. The need for developing research-based training materials to develop training programs on the use of the SIS-C to support decision-making concerning supports planning with students with IDD, the relevance of using the latest methodological approaches available when required, and future lines of research are discussed. Full article

(1) Background: The study is focused on the implementation of outcome measurement tools to assess the impact of an assistive device from a loan bank in the lives of people with Amyotrophic Lateral Sclerosis and Neuromuscular Diseases. The secondary purpose is to analyse the correct matching between the person and technology, derived from the counselling of an occupational therapist. (2) Methods: Cross-sectional study. The sample was formed by 28 people with rare neurodegenerative disorders. A specific questionnaire, the Psychosocial Impact of Assistive Device Scale (PIADS), and the Matching Person and Technology (MPT) tool were applied to collect the data. (3) Results: The dimension of the PIADS with the best score was competence, and the variations according to gender were not remarkable. The three dimensions of the PIADS (competence, adaptability, and self-esteem) were correlated positively between them and with the mean score of the MPT tool (p < 0.01). The type of assistive technology (AT), diagnosis, and correct match between person–technology are the main factors that condition a positive impact. (4) Conclusions: The results noted the importance of assessing the needs, demands, and contexts of people with rare neurodegenerative diseases to prescribe the best AT. Loan banks of AT have to be considered a valid service that complements their lack in public health services. Full article

The coupled effect of seawater intrusion and inland freshwater recharge plays an important role in contamination transport in coastal heterogeneous aquifer. In this study, the effects of seawater intrusion and inland recharge on contamination transport were investigated by conducting laboratory experiments and numerical simulations. The laboratory tests were conducted in a sand tank considering two scenarios, namely the conditions of landward and seaward hydraulic gradients. The SEAWAT software was applied for validating the contaminant transport in coastal heterogeneous aquifer. The results indicated that the simulated seawater wedge and contours of the saltwater contaminant matched the observed ones well. The length of the seawater wedge in the scenario of seaward hydraulic gradient was smaller than that in the scenario of landward hydraulic gradient, which reflected that the large quantity of inland recharge have a negative effect on the invasion process of seawater. The plume moved mainly downward in the heterogeneous unconfined aquifer for both scenarios. The pollution plume became concave at the interface between each two layers, which was because the velocity of contaminant plume migration increased gradually from the upper layer to lower layer. The migration direction of the front of the plume was consistent with the direction of hydraulic gradient, which indicated that it was influenced by the water flowing. The maximum area of plume in the scenario of seaward hydraulic gradient was slightly smaller than that in the scenario of landward hydraulic gradient. The maximum area and vertical depth of the pollutant plume were sensitive to the hydraulic conductivity, dispersivity and contamination concentration. This study was of great significance to the controlling of pollution and utilization of freshwater resources in coastal areas. Full article

With a reduction in the mortality rate of burn patients, length of stay (LOS) has been increasingly adopted as an outcome measure. Some studies have attempted to identify factors that explain a burn patient’s LOS. However, few have investigated the association between LOS and a patient’s mental and socioeconomic status. There is anecdotal evidence for links between these factors; uncovering these will aid in better addressing the specific physical and emotional needs of burn patients and facilitate the planning of scarce hospital resources. Here, we employ machine learning (clustering) and statistical models (regression) to investigate whether segmentation by socioeconomic/mental status can improve the performance and interpretability of an upstream predictive model, relative to a unitary model. Although we found no significant difference in the unitary model’s performance and the segment-specific models, the interpretation of the segment-specific models reveals a reduced impact of burn severity in LOS prediction with increasing adverse socioeconomic and mental status. Furthermore, the socioeconomic segments’ models highlight an increased influence of living circumstances and source of injury on LOS. These findings suggest that in addition to ensuring that patients’ physical needs are met, management of their mental status is crucial for delivering an effective care plan. Full article

Adolescent suse internet via several devices to gather information or communicate. Sleep, as a key factor of adolescents’ development, contributes to their physical and mental health. Over the past decades insufficient sleep among adolescents has been wide spread, and one of its attributing factors is the increased availability of technology. This review aims to investigate the body of evidence regarding the impact of problematic internet use on adolescent sleep. Extensive search of databases was performed according to PRISMA guidelines for studies published within the last decade, regarding subjects aged 10–19. The final step of the search yielded 12 original studies. The quality of extracted data was evaluated with the AXIS tool, in order to estimate the risk of bias. All studies showed a negative correlation between adolescent sleep and problematic internet use. It was found to affect sleep quality and quantity and provoke insomnia symptoms. Interestingly, adolescent’s sex, parental educational level, type of family and use for leisure or academic reasons appeared as affecting factors of the problematic internet use-sleep relationship. Problematic internet use has several effects on adolescents’ sleep. Results of relevant studies should be embedded in educational interventions addressed to adolescents as well as parents, to eliminate the negative outcomes of problematic internet use on sleep and adolescence’s health in general. Full article

A positive perception of motor skills is important for physical activity participation. The aim was to investigate which modifiable factors predict children’s perceived motor skills. Mothers completed questionnaires when their child was 3.5 and 5 years old. At 5 years old, the children’s perceived motor competence (PMC) was assessed. Separate linear regression models (up to 300 children) examined which factors at each time point predicted children’s PMC, adjusted for relevant confounders. Multivariate models were then run with factors associated (p < 0.10) with perception. At 3.5 years, the time spent with same age and older children (both higher tertiles) and parental physical activity facilitation (sum of facilitation in last month, e.g., taking child to park) were initially associated with higher perception. Dance/gymnastics participation were associated with lower perceptions. Other child behaviours, maternal beliefs, play equipment, and swimming lessons were non-significant. In the final prospective model (n = 226), parental physical activity facilitation when child was 3.5 years old was the only factor to predict PMC. No factors were significant for the cross-sectional analyses at 5 years. Perceptions are formed based on past experiences which may explain why factors at 3.5 years rather than current experiences (when children were 5 years old) were associated with childhood perceptions. Full article

This research examined international Muslim travelers’ intention formation of a non-Islamic country. Our proposed theoretical framework encompassing inconvenient tourism experience, mental health, hedonic value experience, and satisfaction included a sufficient level of predictive power for intent. These variables played a vital role in increasing intention, whereas an inconvenient tourism experience decreases self-rated mental health and hedonic value. Our result also provided meaningful information that boosting Muslim travelers’ mental health, hedonic experience, and satisfaction is essential for minimizing the effect of the inconvenient tourism experience. In addition, gender and age have been shown to play a moderating role in affecting behavioral intention. Full article

Environmental pollution and ecological damage caused by human activities have attracted widespread attention in recent years, and while citizens’ environmental awareness and intentions have increased, their actions may not necessarily change accordingly. This study aims to understand the intention–behavior gap, based on the theory of planned behavior (TPB), by exploring the relationship between intention and pro-environmental behavior on the new waste sorting policy in China. The structural model of extended TPB was tested using sample data from 3113 residents of Changsha, each of whom was asked to complete a two-stage survey. Results demonstrated that perceived policy effectiveness and actual behavioral control positively affect behavioral intention, implementation intention, and pro-environmental behavior. Among them, the actual behavioral control of residents was found to be the most influential factor on behavioral intention and implementation intention, followed by residents’ perceived policy effectiveness. Moreover, behavioral intention and implementation intention mediate the relationship between antecedents and pro-environmental behavior. These findings imply that people with high-level perceptions of policy effectiveness, strong control over actual behavior, strong behavioral intentions, and strong implementation intentions are more likely to engage in pro-environmental behavior. The findings suggest that factors such as perceived policy effectiveness and actual behavioral control should be considered when implementing new policies and campaigns for waste sorting and management. Full article

Weightlifting is a discipline where technique and anthropometric characteristics are essential to achieve the best results in competitions. This study aims to analyse the relationships between body composition, limb length and barbell kinematics in the performance of weightlifters. It consists of an observational and descriptive study of 19 athletes (12 men [28.50 ± 6.37 years old; 84.58 ± 14.11 kg; 176.18 ± 6.85 cm] and 7 women [27.71 ± 6.34 years old; 64.41 ± 7.63 kg; 166.94 ± 4.11 cm]) who met the inclusion criteria. A level I anthropometrist took anthropometric measures according to the methodology of the International Society for the Advancement of Kinanthropometry (ISAK), and the measurement of the barbell velocity was made with the software Kinovea. In terms of body composition, both genders are within the percentage range of fat mass recommended for this sport. In female weightlifters, there is a positive correlation between foot length, maximal velocity in the Snatch (ρ = 0.775, p = 0.041), and performance indicator in the Snatch and the Clean & Jerk (ρ = 0.964, p < 0.001; ρ = 0.883, p = 0.008, respectively). In male weightlifters, a positive correlation between tibial length and average velocity of the barbell in the Snatch is observed (ρ = 0.848, p < 0.001). Muscle mass percentage correlates positively with performance indicator in both techniques (ρ = 0.634, p = 0.027; ρ = 0.720, p = 0.008). Also, the relative length of the upper limb is negatively correlated with the performance indicator (ρ = −0.602, p = 0.038). Anthropometry and body composition may facilitate skill acquisition among this sport population, contributing to increase the limited body of scientific knowledge related to weightlifting. Full article

Job attractiveness and job satisfaction are important factors in the continuity of employment among healthcare professionals. The aim of this study was to assess job satisfaction and job attractiveness among dental hygienists in Japan. The Japan Dental Hygienists Association conducted a survey of the employment status of Japanese dental hygienists in 2019. Questionnaires were distributed to all 16,722 members, and 8932 were returned (Collection rate: 53.4%). Data from 7869 currently working dental hygienists were analysed in this study. We analysed seven items of job attractiveness, 14 items of job satisfaction, and 13 items of request for improving the working environment. Item response theory and structural equation modelling (SEM) were utilized for the analysis. For attractiveness of dental hygienists’ work, respondents placed greater emphasis on the fact that dental hygienists needed national qualifications rather than on income stability. SEM showed that job satisfaction consisted of two factors, ‘Value for work’ and ‘Working environment’, as did job attractiveness, with ‘Contribution’ and ‘Assured income’. Value for work affects the contribution to people, and, employment environment affects assured income. Improving job satisfaction and work environments could help to improve the employment rate of dental hygienists, which could positively influence patient care. Full article

The Regenerative Endodontic Procedure (REP) is a biologically based method in which a damaged pulp–dentin complex is replaced by a new vital tissue. This umbrella review aimed to critically assess the available systematic reviews (SRs) on REP. An electronic database search was conducted (PubMed-Medline, CENTRAL, Scielo, Web of Science, and LILACS) until December 2020. Studies were included if they were an SR on REP. The Risk of Bias (RoB) of SRs was analyzed using the Measurement Tool to Assess SRs criteria 2 (AMSTAR2). The primary outcome was the methodological quality in each specific section of REP protocols and outcomes. From 403 entries, 29 SRs were included. Regarding the methodological quality, ten studies were of critically low, three of low, fourteen of moderate, and two were rated as high quality. The quality of evidence produced by the available SRs was not favorable. Future high standard SRs and well-designed clinical trials are warranted to better elucidate the clinical protocols and outcomes of REP. Full article

Background: Flexion-rotation test predominantly measures rotation in C1-2 segment. Restriction in flexion-rotation may be due to direct limitation in C1-2, but also to a premature tightening of the alar ligament as a result of lack of movement in C0-1 or C2-3. The aim of this study was to compare the effect of a 20-min single cervical exercise session, with or without manual therapy of C0-1 and C2-3 segment in flexion-rotation test, in patients with chronic neck pain and positive flexion-rotation test. Methods: Randomized controlled clinical trial in 48 subjects (24 manual therapy+exercise/24 exercise). Range of motion and pain during flexion-rotation test, neck pain intensity and active cervical range of motion were measured before and after the intervention. Results: Significant differences were found in favour of the manual therapy group in the flexion-rotation test: right (p < 0.001) and left rotation (p < 0.001); pain during the flexion-rotation test: right (p < 0.001) and left rotation (p < 0.001); neck pain intensity: (p < 0.001); cervical flexion (p < 0.038), extension (p < 0.010), right side-bending (p < 0.035), left side-bending (p < 0.002), right rotation (p < 0.001), and left rotation (p < 0.006). Conclusions: Addition of one C0-C1 and C2-C3 manual therapy session to cervical exercise can immediately improve flexion-rotation test and cervical range of motion and reduce pain intensity. Full article

Municipal solid waste (MSW) must be managed to reduce its impact on environmental matrices and population health as much as possible. In particular, the variables that influence the production, separate waste collection, and costs of MSW must be understood. Although many studies have shown that such factors are specific to an area, the awareness of these factors has created opportunities to implement operations to enable more effective and efficient MSW management services, and to specifically respond to the variables that have the most impact. The deep learning approaches used in this study are effective in achieving this goal and can be used in any other territorial context to ensure that the organizations that deal with these issues are more aware and create useful plans to promote the circular economy. Our findings indicate the important influence of number of rooms in a residential buildings and construction years on MSW production, the combination of services such as municipal collection centers and door-to-door service for separate MSW collection and the characteristics of the residential buildings in the municipalities on MSW management costs. Full article

Objectives. We investigated the association between physical fitness and cognitive status. Further, we examined whether physical fitness mediates the association between cognitive functioning and aging. Design. Cross-sectional study. Setting. Urban and rural Colombian older adults. Methods. 4416 participants from the SABE study were included in the current analysis. Physical fitness was assessed with the handgrip test and the usual gait speed test. Cognitive status was evaluated through the Folstein Mini-Mental State Examination. A parallel mediation path was used to test the possible mediator role of physical fitness between aging and cognitive functioning. Results. Older adults with lower handgrip strength (HGS) were more likely to have mild-cognitive status than older adults with healthy HGS (OR = 1.53, 95% CI = 1.15; 2.02). In addition, older adults with a slower gait speed were more likely to have mild cognitive impairment (OR = 2.05, 95% CI = 1.54; 2.78). Age had an inverse relationship with cognitive function (β = −0.110, 95% CI = −0.130; −0.100) and it was also inversely associated with HGS (β = −0.003, 95% CI = −0.005; −0.002) and gait speed (β = −0.010, 95% CI = −0.011; −0.009). The indirect effects, which indicate that the effect of age on cognitive function is transmitted through mediators, showed that both gait speed (β = −0.028, 95% CI = −0.036; −0.020) and HGS (β = −0.014, 95% CI = −0.024; −0.005) were independent mediators of the detrimental effect of aging on cognitive function. Conclusions. Physical fitness mediates the effects of aging on cognitive functioning. Our findings suggest that physical activity can be a key factor to prevent cognitive deterioration during aging process. Full article

Background: In low-income countries such as Benin, most people have poor access to healthcare services. There is scarcity of evidence about barriers to accessing healthcare services in Benin. Therefore, we examined the magnitude of the problem of access to healthcare services and its associated factors. Methods: We utilized data from the 2017–2018 Benin Demographic and Health Survey (n = 15,928). We examined the associations between the demographic and socioeconomic characteristics of women using multilevel logistic regression. The outcome variable for the study was problem of access to healthcare service. Adjusted odds ratios (AORs) with 95% confidence intervals (95% CI) were estimated. Results: Overall, 60.4% of surveyed women had problems in accessing healthcare services. Partner’s education (AOR = 0.70; 95% CI; 0.55–0.89), economic status (AOR = 0.59; 95% CI; 0.47–0.73), marital status (AOR = 0.44; 95% CI; 0.39–0.51), and parity (AOR = 1.85; 95% CI; 1.45–2.35) were significant individual-level factors associated with problem of access to healthcare. Region (AOR = 5.24; 95% CI; 3.18–8.64) and community literacy level (AOR = 0.69; 95% CI; 0.51–0.94) were the main community-level risk factors. Conclusions: Enhancing husband education through adult education programs, economic empowerment of women, enhancing national education coverage, and providing priority for unmarried and multipara women need to be considered. Additionally, there is the need to ensure equity-based access to healthcare services across regions. Full article