International Journal of Environmental Research and Public Health

Background: Family quality of life (FQoL), just like individual quality of life, has become a priority outcome in the policies and services received by persons with intellectual and developmental disabilities (IDD) and their families. Conceptualizing, measuring, and theorizing FQoL has been the object of investigation in recent decades. The goal of this paper is to present a revision of the Spanish Family Quality of Life Scales, the CdVF-E < 18 and the CdVF-E >18, and describe the FQoL of Spanish families with a member with IDD. Methods: The sample included a total of 548 families with a member under 18 years old and 657 families with a member over 18. Based on an Exploratory Factor Analysis (EFA) firstly and a Confirmatory Factor Analysis (CFA) secondly, the two scales’ psychometric properties were explored. Results: The CdVF-ER < 18 and the CdVF-ER > 18 comprise 5 dimensions, containing 35 and 32 items, respectively, and they show good validity and reliability. The families obtained a high FQoL score, although some differences exist between the dimensions on which families with children under and over 18 score highest and lowest. Conclusion: The characteristics of the revised scales facilitate their use by professionals, administrations, and services. Full article

In general, immigrants suffer poor working conditions. This is particularly true in the case of women, who constitute 48% of international migrants, and these poor conditions are closely linked to the sectors they mainly occupy, such as domestic and care-giving services. The aim of the present study was to investigate the working conditions of the female immigrant population living in southern Spain and how these conditions may affect their health. A qualitative study using semi-structured interviews and discussion groups was conducted over one year in 2019, with 61 immigrant women recruited. The sectors occupied by immigrant women were caregiving for dependent people and domestic services. Most of the female immigrants interviewed were working (63.94%), although the majority were employed in an irregular situation, with a very long working day. Among the main risks identified were biological risks, physical attacks, falls, wounds and musculoskeletal complaints related to handling patients and carrying out household chores. Most of them had not taken an occupational health test and did not report accidents occurring in the workplace for fear of losing their jobs. The main health problems were related to physical and mental health (such as musculoskeletal diseases and stress). These findings highlight the importance of making a major change in our perspective regarding the social value of including immigrant women in the labour market and the different aspects related to their health. Full article

Little is known about the effects of malnutrition rates in the long-run. Applying the methodology recommended by the World Health Organization, this study estimates stunting rates for Argentine adult males from the 1850s to the 1950s. We use five large samples of army recruits, prison inmates, militiamen, and electoral records totaling 84,500 cases. These samples provide information about height in Buenos Aires province and the Pampa region, the most fertile, food-producing area of the country. As the study shows, estimated stunting rates remained stable from the 1850s to the 1880s and then declined persistently until the 1950s. The total decline was substantial: if fell from 15.3% in the 1870s to 5.6% in the 1940s, then stagnated. In this 95-year period, stunting rates went from “medium” to “low” levels in the WHO classification of malnutrition intensity. At the end of our study period (the 1950s) the Pampa’s malnutrition rate was only 3.5 to 4 percentage points above contemporary estimates for well-developed economies in Europe and North America. A significant expansion in the region’s production of grains and beef (food availability), combined with a sustained decline in infant mortality (increased health) were probably the two main underlying factors of this long-tern reduction in malnutrition. Yet, this association remains to be determined. Full article

We investigated the effects of oral lactate administration on protein synthesis and degradation factors in rats over 2 h after intake. Seven-week-old male Sprague–Dawley rats were randomly divided into four groups (n = 8/group); their blood plasma levels of lactate, glucose, insulin, and insulin-like growth factor 1 (IGF1) were examined following sacrifice at 0, 30, 60, or 120 min after sodium lactate (2 g/kg) administration. We measured the mRNA expression levels of protein synthesis-related genes (IGF receptor, protein kinase B (Akt), mammalian target of rapamycin (mTOR)) or degradation-related genes (muscle RING-finger protein-1 (MuRF1), atrogin-1) and analyzed the protein expression and phosphorylation (activation) of Akt and mTOR. Post-administration, the plasma lactate concentration increased to 3.2 mmol/L after 60 min. Plasma glucose remained unchanged throughout, while insulin and IGF1 levels decreased after 30 min. The mRNA levels of IGF receptor and mTOR peaked after 60 min, and Akt expression was significantly upregulated from 30 to 120 min. However, MuRF1 and atrogin-1 expression levels were unaffected. Akt protein phosphorylation did not change significantly, whereas mTOR phosphorylation significantly increased after 30 min. Thus, lactate administration increased the mRNA and protein expression of protein-synthesis factors, suggesting that it can potentially promote skeletal muscle synthesis. Full article

Background: The aim of the study was to compare the emotional state and strength-velocity parameters of patients with frailty and pre-frailty syndrome undertaking a 12-week training programme. Methods: The study was completed by 36 individuals, including 17 with frailty syndrome (FS) and 19 with pre-frailty syndrome (PFS). The age of the subjects ranged from 63 to 89 years, with a mean 69.2 years (±5.0). The Beck Depression Inventory (BDI), Spielberg’s State-Trait Anxiety Inventory (STAI), and Satisfaction with Life Scale (SWLS) were used. The strength of knee muscles was evaluated. The above tests were conducted at two time points: before the training sessions (T1); and after 12 weeks of regular training sessions (T2). Results: After completion of the training programme, statistically significant differences in BDI were observed between the PFS and FS groups (especially in somatic symptoms). Following the training, BDI values in the PFS group were significantly lower (fewer depressive symptoms) than in the FS group. The parameter values describing strength capacities of the lower limbs, both at T1 and T2, proved to be higher in the PFS group. Conclusions: In individuals with pre-frailty and frailty syndrome, the 3-month physical training programme improved the strength parameters of lower limb muscles. An improvement in mood and reduction in depressive symptoms were only observed in the group of subjects with pre-frailty syndrome. Rehabilitation programmes for people with frailty syndrome should include psychotherapeutic activities in addition to physical training in order to improve the psychophysical condition of patients. Full article

Background: Diabetes and physical inactivity are prevalent worldwide. Risk of diabetes is known to be related with insufficient physical activity (PA), but associations with the respective dimensions of PA is unclear. Objective: To describe the patterns of physical activity among Chinese middle- and older-aged individuals and figure out their associations with diabetes risk in different dimensions. Methods: Extracting self-reported data from China Health and Retirement Longitudinal Study (CHARLS, 2015), this study included 6196 participants. Multivariate logistic regression was conducted to determine the association between diabetes risk and PA dimensions such as intensity, frequency, duration, and volume. Results: Concerning frequency, lower diabetes risk was associated with performing vigorous PA at any frequency overall. For duration, smaller odds of diabetes were observed in performing vigorous PA 2–4 h/day (OR 0.46, 95%CI 0.30 to 0.71), moderate PA ≥4 h/day (OR 0.59, 95%CI 0.42 to 0.82) and light PA ≥4 h/day (OR 0.59, 95%CI 0.41 to 0.85) overall. For volume, lower diabetes risk was associated with performing moderate-to-vigorous PA (MVPA) ≥2250 METs/week (OR 0.58, 95%CI 0.42 to 0.81) in middle-aged group (45–64 years), whereas no significant associations between MVPA and diabetes risk were found in older aged group (≥65 years). Conclusions: Our results revealed that physical inactivity is prevalent in China, with a greater proportion in the diabetes group. Lower risk of diabetes was associated with higher frequency, longer duration and longer volume of PA at higher intensity in middle-aged respondents and similar associations at lower intensity for the older adults. Additionally, further well-designed prospective studies are needed to confirm our findings. Full article

Physical activity (PA) refers to any action produced by skeletal muscle that consumes energy. According to the World Health Organization (WHO), PA is the primary element that can improve health at the community level. Obviously, PA plays an important role in the social, physical, and mental development of men and women, as well as in balancing weight. However, the large-scale negative impacts of physical inactivity on health-related issues are also recognized globally, such as obesity, which is the source of many non-communication diseases (NCDs). In Pakistan alone, 46% of deaths occur due to NCD. The majority of NCD deaths are linked to obesity, and Pakistan is the ninth most obese country in the world. Research on obesity caused by sedentary work in Pakistan is lacking, especially among university employees. To fill this gap, the current study mainly focuses on the rising non-communicable disease (NCD) rates among university employees in Pakistan due to a lack of exercise (obesity, in this case), with the help of a self-designed knowledge, attitude, and practice (KAP) questionnaire. Five universities in the Sindh province of Pakistan were surveyed (n = 276), following the concept of Yin–Yang as a theoretical lens. The results of the current study show that the knowledge, behaviors, and attitudes of university employees have a great influence on their body mass index (BMI). The study shows that Pakistani residents’ (especially teaching staff) perceptions and attitudes towards obesity and PA have been instructive, but their practices need to be improved. Full article

The prevalence and mortality rates of diabetes are increasing globally, posing severe challenges to health systems. Acupuncture is used worldwide as a non-drug treatment for diabetes. However, empirical evidence of the effect of combined acupuncture and drug treatments on diabetic-associated mortality is limited. This study aimed to examine this association of acupuncture treatment with mortality of type 2 diabetes based on real-world data. A four-year cohort study was conducted in Shanghai between 2015 and 2018, The database consisted of 37,718 patients (acupuncture group: 6865 type 2 diabetes mellitus (T2DM) patients, non-acupuncture (control) group: 30,853 T2DM patients) in 2016. The objective was to analyze the impact of receiving acupuncture prescriptions for diabetes in 2016 on all-cause mortality in 2018 based on real-world data. An Inverse Probability Weighted Regression Adjustment (IPWRA) and Propensity Score Matching (PSM) were used to minimize the bias due to potential confounding variables to increase the reliability of differences in comparisons between the two groups. Our inverse probability weighted regression results suggest that the coefficient of the key dependent variable of accepted acupuncture in 2016 was negative (coefficient: −0.0002; 95% CI: −0.0024–0.0019, p = 0.857), but it is not statistically significant. In robustness check, PSM with the nearest-neighbor method with replacement at a 1:4 ratio and 1:3 ratio and kernel matching showed that the average treatment effect was negative. Therefore, there was a negative correlation between acupuncture combined with other drugs and the mortality of diabetic patients, but it was not statistically significant. Full article

Our aim was to examine measurement invariance of the Flourishing Scale (FS)—a concise measure of psychological wellbeing—across two study samples and by population characteristics among Canadian adolescents. Data were retrieved from 74,501 Canadian secondary school students in Year 7 (2018–2019) of the COMPASS Study and from the original validation of the FS (n = 689). We assessed measurement invariance using a confirmatory factor analysis in which increasingly stringent equality constraints were specified for model parameters between the following groups: study sample (i.e., adolescents vs. adults), gender, grade, and ethno-racial identity. In all models, full measurement invariance of the FS across all sub-groups was demonstrated. Our findings support the validity of the FS for measuring psychological wellbeing among Canadian adolescents in secondary school. Observed differences in FS score among subgroups therefore represent true differences in wellbeing rather than artifacts of differential interpretation. Full article

Indoor cooking is the main cause of particulate matter (PM) within residential houses along with smoking. Even with the range hood turned on, cooking-generated PM can spread quickly into the living room due to the heat generated by the cookstove. In order to improve the PM spread prevention performance of the range hood, a supply of make-up air is needed. Generally, make-up air is supplied through a linear diffuser between the kitchen and living room. In such cases, it is necessary to determine the appropriate location of the supply diffuser. This study evaluates the spread of PM according to different locations of the supply diffuser, which feeds in make-up air. For this purpose, indoor airflow and PM spread were analyzed through CFD (Computational Fluid Dynamics) simulation analysis. By changing the location of the supply diffuser from the contaminant source, PM concentration was analyzed in the kitchen and living room of an apartment house in Korea. Based on the results, the optimal installation location was determined. In this study, 1.5 m from the source was the most effective location of make-up air supply to prevent the spread of cooking-generated particles. Full article

To address the concern of environmental pollution, it is necessary to study the effect of environmental regulation on industrial solid waste emission reduction in China. This paper aimed to analyze the effectiveness of provincial environmental regulation (both formal and informal) on the industrial solid waste emission reduction. The results show that both the effect of formal and informal environmental regulations on industrial solid waste emission intensity present an inverted “U” shape. The threshold value of per capita GDP as an indicator variable is CNY 16,299 and CNY 15,572 respectively. The effect on pollution emission reduction will appear when the value is higher than the threshold, and the two-way transmission mechanism between formal and informal environmental regulations does exist. When GDP per capita exceeds CNY 27,961, there is a phenomenon of “rebound” in the effect of informal environmental regulation on pollution reduction. Based on the findings, it was suggested that both formal and informal environmental regulation should be promoted to achieve the goal of industrial solid waste emission reduction. The coordination between formal and informal environmental regulation should be considered when the government makes policies. Different environmental regulation policies should be implemented in different regions. Informal regulation should be enriched and further promoted. Environmental law should play an important role in maintaining the public’s participation in environmental regulation to prevent the failure of informal environmental regulation. Full article

Community engagement and -education are proposed to foster equity in access to care and to ensure dignity of migrant patients in the last phase of life, but evidence is lacking. We evaluated nine community educational interactive meetings about palliative care (136 participants totally)- co-created with educators from our target groups of Moroccan, Surinamese and Turkish migrants—with a mixed methods approach, including 114 questionnaires, nine observations, nine interviews with educators, and 18 pre- and post- group- and individual interviews with participants. Descriptive and thematic analysis was used. 88% of the participants experienced the meetings as good or excellent. Educators bridged an initial resistance toward talking about this sensitive topic with vivid real-life situations. The added value of the educational meetings were: (1) increased knowledge and awareness about palliative care and its services (2) increased comprehensiveness of participant’s wishes and needs regarding dignity in the last phase; (3) sharing experiences for relief and becoming aware of real-life situations. Community engagement and -education about palliative care for migrants effectively increases knowledge about palliative care and is a first step towards improved access to palliative care services, capacity building and a dignified last phase of life among migrants. Full article

Hispanic children constitute the largest ethnic minority in the United States of America, and yet few studies examine the relationship between mindfulness and Hispanic children’s quality of life. This 2018 study seeks to gain insight into how mindfulness is associated with Hispanic children’s quality of life. We surveyed 96 children in 5th- and 6th-grade classes in three Northern New Jersey elementary schools in 2018. Structure Equation Modeling was used to examine the associations between mindfulness, executive function, social-emotional skills, and quality of life. The results indicate that mindfulness is significantly and directly associated with executive function (β = 0.53), and that executive function is positively associated with social-emotional skills (β = 0.54) and quality of life (β = 0.51) of the sampled Hispanic children. The total effects on quality of life are significant for mindfulness (β = 0.33), executive function (β = 0.62), and social-emotional skills (β = 0.20). The findings shed light upon factors that can affect Hispanic children’s quality of life and call for interventions related to these factors in order to improve their well-being. Full article

The international community has recognized global warming as an impending catastrophe that poses significant threat to life on earth. In response, the signatories of the Paris Agreement (2015) have committed to limit the increase in global mean temperature to < 1.5 °C from pre-industry period, which is defined as 1950–1890. Considering that the protection of human life is a central focus in the Paris Agreement, the naturally endowed properties of the human body to protect itself from environmental extremes should form the core of an integrated and multifaceted solution against global warming. Scholars believe that heat and thermoregulation played important roles in the evolution of life and continue to be a central mechanism that allows humans to explore, labor and live in extreme conditions. However, the international effort against global warming has focused primarily on protecting the environment and on the reduction of greenhouse gases by changing human behavior, industrial practices and government policies, with limited consideration given to the nature and design of the human thermoregulatory system. Global warming is projected to challenge the limits of human thermoregulation, which can be enhanced by complementing innate human thermo-plasticity with the appropriate behavioral changes and technological innovations. Therefore, the primary aim of this review is to discuss the fundamental concepts and physiology of human thermoregulation as the underlying bases for human adaptation to global warming. Potential strategies to extend human tolerance against environmental heat through behavioral adaptations and technological innovations will also be discussed. An important behavioral adaptation postulated by this review is that sleep/wake cycles would gravitate towards a sub-nocturnal pattern, especially for outdoor activities, to avoid the heat in the day. Technologically, the current concept of air conditioning the space in the room would likely steer towards the concept of targeted body surface cooling. The current review was conducted using materials that were derived from PubMed search engine and the personal library of the author. The PubMed search was conducted using combinations of keywords that are related to the theme and topics in the respective sections of the review. The final set of articles selected were considered “state of the art,” based on their contributions to the strength of scientific evidence and novelty in the domain knowledge on human thermoregulation and global warming. Full article

The mental health and related quality of life of runaway adolescents are global public health issues. As few intervention studies have considered the family contexts of runaway adolescents, we aimed to develop an intervention tailored specifically to the needs of this population using an Intervention Mapping protocol. First, a literature review and interviews with runaway adolescents and youth shelter workers were conducted to create a logic model of the problem. Second, the behavioral and environmental outcomes were set to adapt to stressful situations and enable families to become more resourceful in dealing with family adversity, based on the results of needs assessment. Performance objectives and changeable determinants were also created by reviewing the pertinent theories and studies. Third, theory- and evidence-based methods to influence changes in the determinants were identified. Fourth, we designed an eight-session family-based mental health program incorporating individual and family approaches for runaway adolescents. Fifth, we determined that mental health nurses at community mental health centers linked to youth shelters would serve as the program implementers. Finally, we planned a randomized controlled trial to evaluate the effects of our program on improving runaway adolescents’ mental health status and perceived family functioning. Full article

Taiwan’s declining birthrate has changed the housing market, which should become more consumer-oriented in the future. In particular, age-friendly housing has become a salient housing choice among buyers. Age-friendly housing consists of housing units that are suitable for occupants of any age. There are three concepts underlying such housing: aging in place, multigenerational-multiunit living arrangements, and lifetime homes. This study aimed to examine the factors affecting consumers’ choice of age-friendly housing. The participants were residents of Kaohsiung City, and data analysis was performed using a binary logistic model. The empirical results indicated that adult sons/daughters, residents who currently live in the city center, residents who have a high or medium monthly family income, residents who are currently part of a stem family, residents who desire to live under multigenerational-multiunit living arrangements, residents who desire to be a part of a stem family, and residents who prioritize housing type when house-buying are significantly more likely to choose age-friendly housing. These results can serve as a reference regarding age-friendly housing investments for investors, as well as for house buyers who are deliberating between age-friendly housing and ordinary housing. Full article

Water is indispensable to keeping the functions of the human body working properly, including that of the brain. The purpose of this research was to explore the impacts of water supplementation on cognitive performance and mood, and to determine the optimum amount of water to alleviate detriments of dehydration after 12 h water restriction. A randomized controlled trial was implemented among 64 young adults from Baoding, China. Fasting overnight for 12 h, and at 8:00 a.m. on day 2, osmolality of first morning urine and blood, cognitive performance, and mood were assessed as the dehydration test. Then, participants were randomly separated into four groups: water supplementation groups (WS groups 1, 2, and 3 with 500, 200, and 100 mL purified water, respectively) and no water supplementation group (NW group). Participants in WS groups were instructed to drink the water within 10 min, while those in NW group drank no water. After 90 min, the same measurements were taken as the rehydration test. There was significant interaction between TIME and VOLUME in thirst when comparing dehydration with rehydration tests (F = 6.172, p = 0.001). Significant thirst reductions were found in WS group 1 and WS group 2 (p = 0.003; p = 0.041), and a significant increase was found in the NW group (p = 0.039). In the rehydration test, significant interactions between TIME and VOLUME were found in scores of anger, fatigue, and TMD (total mood disturbance) (F = 3.815, p = 0.014; F = 10.429, p < 0.001; F = 5.246, p < 0.001), compared to the dehydration test. Scores of anger were only decreased in WS group 2 (p = 0.025), and scores of fatigue and TMD decreased in WS group 1 and WS group 2 (all p < 0.05). Significant interaction between TIME and VOLUME was only found for operation span test scores (F = 2.816, p = 0.047), with scores being only higher in WS group 1 in the rehydration test compared to the dehydration test (p = 0.003). Comparing WS group 1 and WS group 2, scores of thirst, fatigue, and TMD did not differ significantly (p > 0.05). Water supplementation improved working memory and attenuated anger, fatigue, and TMD. A small amount of water (200 mL) was sufficient to attenuate thirst, anger, fatigue, and TMD of young adults, but the larger volume (500 mL) appeared to be necessary to improve working memory. The amount of 500 mL was the optimum volume to improve the cognitive performance and mood among young adults. Full article

Despite the proved potential to harness ocean energy off the Mexican coast, one of the main aspects that have restrained the development of this industry is the lack of information regarding the environmental and social impacts of the devices and plants. Under this premise, a review of literature that could help identifying the potential repercussions of energy plants on those fields was performed. The available studies carried out around the world show a clear tendency to use indicators to assess impacts specifically related to the source of energy to be converted. The information gathered was used to address the foreseeable impacts on a hypothetical case regarding the deployment of an Ocean Thermal Energy Conversion (OTEC) plant off the Chiapas coast in Mexico. From the review it was found that for OTEC plants, the most important aspect to be considered is the discharge plume volume and its physicochemical composition, which can lead to the proliferation of harmful algal blooms. Regarding the case study, it is interesting to note that although the environmental impacts need to be mitigated and monitored, they can be somehow alleviated considering the potential social benefits of the energy industry. Full article

The significant deterioration of economic prosperity in Greece during the economic crisis decreased patients’ ability to pay. Thus, the objective of this study is to determine the factors affecting healthcare affordability in Greece during an economic recession. This study used data from the European Union Statistics on Income and Living Conditions (EU-SILC) 2016. The sample consisted of 18,255 households. Healthcare affordability was regressed on geographic characteristics as well as several variables that refer to the households’ financial condition. Region of residence, ability to make ends meet, and capacity to cope with unexpected financial expenses were found to be statistically significant. Using sample sizes of 1000 and 1096 adults, respectively, the European Quality of Life Surveys (EQLS) of 2007 and 2016 were also used as data sources. Economic crisis was expressed with a dummy variable: (1) 0: 2007, and (2) 1: 2016. Difficulty in responding to healthcare costs was regressed on survey year and several demographic, socioeconomic, and health characteristics, revealing that individuals were more likely to face difficulties in responding to healthcare costs during the economic crisis. These results confirm the mechanism on the basis of which economic crises affect healthcare access: primarily through the effects of demand-side barriers. Full article