International Journal of Environmental Research and Public Health

Adolescents and young adult comprise a significant proportion of India’s population. Although, this group of the population faces serious challenges to their health and well-being. To promote their health and well-being, Centre of Excellence (CoE) at King George’s Medical University, Lucknow, India, serves as an advanced care facility for 10–24-year-old adolescents and young adult women. This paper reports the socio-demographic characteristics of, and health services availed to adolescents and young adults who are visiting the CoE in Lucknow, India. A total of 6038 beneficiaries received clinical services during June 2018–March 2022. Out of total clinical services, 38.37% counselling and 37.53% referral services were utilised. Menstruation (46.29%), sexual and reproductive (28.19%), nutrition (5.91%), and mental health (1.67%) related problems were highly reported. The age of beneficiaries is classified into three categories, i.e., 10–14, 15–19, and 20–24 years. Prevalence of overweight was highest among adolescents aged 20–24 years compared to other age groups. Other than nutrition, late-adolescent girls (15–19) faced more health problems than their counterparts. The percentage of beneficiaries decreased significantly during and post the COVID-19 period (<0.001). Therefore, age-specific programs are currently needed, and interventions need to be designed accordingly. Full article

In recent years, the incidence of depression among adolescents has been increasing yearly, and the severe damage of depression on adolescents’ physical and mental health development has caused extensive concern worldwide. Previous research on adults has confirmed that meaning in life is a crucial buffer factor for depression, and developing meaning in life is an essential task in adolescence. Moreover, prior researchers also pointed out that frequent cognitive failures can induce negative emotions in individuals, whereas mindfulness can regulate individuals’ depression levels. However, few studies have investigated the impact of meaning in life on depression in adolescents and the underlying psychological mechanisms. Accordingly, based on the theoretical framework of the Cognitive Vulnerability–Stress Theory of Depression, this study aimed to explore the relationship between meaning in life and depression in junior high school students, as well as the mediating effect of cognitive failures and the moderating effect of mindfulness. We collected data from 948 adolescents aged 11 to 17 in two junior high schools in Henan Province, China, and tested the theoretical model through the PROCESS macro for SPSS. The results showed that: (1) meaning in life had a significant negative predictive effect on depression (β = −0.24, p < 0.001); (2) cognitive failures partially mediated the relationship between meaning in life and depression (β = 0.31, p < 0.001); (3) the relationship between cognitive failures and depression was moderated by mindfulness (β = −0.05, p < 0.05). This study implied that we could start by cultivating adolescents’ meaning in life and improving their level of mindfulness to prevent and intervene in adolescent depression. Full article

The COVID-19 pandemic has demonstrated the importance of unbiased, real-time statistics of trends in disease events in order to achieve an effective response. Because of reporting delays, real-time statistics frequently underestimate the total number of infections, hospitalizations and deaths. When studied by event date, such delays also risk creating an illusion of a downward trend. Here, we describe a statistical methodology for predicting true daily quantities and their uncertainty, estimated using historical reporting delays. The methodology takes into account the observed distribution pattern of the lag. It is derived from the “removal method”—a well-established estimation framework in the field of ecology. Full article

(1) Background: Early thymectomy is suggested in all clinically indicated myasthenia gravis (MG) patients. However, short-term clinical response after thymectomy in MG patients has been limitedly described in the literature. This study aimed to compare the 5-year post-thymectomy outcomes between thymoma (Th) and non-thymoma (non-Th) MG patients. (2) Methods: MG patients aged ≥18 years who underwent transsternal thymectomy and had tissue histopathology reports in Songklanagarind Hospital between 2002 and 2020 were enrolled in a retrospective review. The differences in the baseline demographics and clinical characteristics between ThMG and non-Th MG patients were studied. We compared the time-weighted averages (TWAs) of daily required dosages of pyridostigmine, prednisolone or azathioprine to efficiently maintain daily living activities and earnings between the MG patient groups during 5 consecutive years following thymectomy. Post-thymectomy clinical status, exacerbations or crises were followed. Descriptive statistics were used for analysis with statistical significance set at p < 0.05. (3) Results: ThMG patients had significantly older ages of onset and shorter times from the MG diagnosis to thymectomy. Male gender was the only significant factor associated with ThMG. TWAs of the daily MG treatment drug dosages required showed no differences between the groups. Additionally, the rates of exacerbations and crises were not different, but decremental trends were shown in both groups after the thymectomies. (4) Conclusions: The daily dosage requirements of MG treatment drugs were not different. There was a trend of decreasing adverse event rates despite no statistically significant differences during the first 5 years after thymectomy in ThMG and non-ThMG patients. Full article

Higher education plays a critical role in achieving the Sustainable Development Goals established in the 2030 Agenda, especially the fourth goal (quality and equality in higher education). Therefore, teacher education must play a central role in providing transformative learning experiences for future teachers that can lead the change to create high quality programs in every school. The purpose of this study was to conduct a gamified experience in Physical Education Teacher Education with two goals: assess the students’ views on the framework and evaluate the teachers’ feelings and thoughts. One teacher-researcher (36 years) and 74 students (19–27 years) enrolled in a Spanish university agreed to participate. A qualitative descriptive method and an action-research design were used. The teacher-researcher completed a personal diary, while the students answered two open-ended questions. From the students’ responses emerged three positive themes (framework, motivation, and transference) and two negatives (boredom and group work); from the teacher-researcher, we received three positive responses (mixed emotions, expectations, and students’ motivation) and one negative (workload). As a conclusion, gamification could be considered a framework that promotes transformative learning. Full article

Ecological management has been implemented to improve individual well-being. However, it remains unclear whether this management has improved health inequality over time. Aiming to examine whether health inequality is caused by ecological management in China, we harnessed a macro-level dataset from 2001 to 2019 across 31 Chinese provinces—combined with gene and dietary culture data—and utilized a bilateral approach to pair provincial data. Empirical results of system Generalized Method of Moments (sys-GMM) estimations in benchmark and extensive models which suggest a negative and statistically significant causal effect of ecological management on health inequality. Specifically, ecological management contributes to decreasing the inequality in the population death rate, the death rate among pregnant women, the underweight newborn rate, the child malnutrition rate, and the infectious disease mortality. The results are robust to weak instruments in the sys-GMM setting and a delayed effect of ecological management. Additionally, the heterogeneity analysis shows that the causal effect of ecological management on decreasing regional health inequality is more significant and higher for subsamples in identical regions than in different regions. Full article

The evaluation of environmental and health governance processes is an important part of the innovation and perfection of modern governance systems. Based on the macropanel samples, this paper analyzes the impact of the health damage caused by air pollution (APHD) on economic growth and the related mechanisms accordingly using the moderate model and the threshold model. The results can be concluded as follows: (1) After locking in the health damage perspective, the APHD has a negative impact on economic growth. When other conditions are met, economic growth will significantly drop by 1.233 percent for each unit increase in the APHD index. (2) There is a moderate effect of governance uncertainty in APHD on economic growth with different characteristics. The combination of governance uncertainty and APHD can significantly inhibit economic growth, and this moderating effect has different impacts due to heterogeneous conditions. Spatially, this inhibitory effect is significantly obvious in the eastern, central, and western regions, while the negative effect is significant in areas north of the Huai River with medium and low self-defense ability. Additionally, compared with the delegating of governance power at the municipal level, when the governance power is delegated at the county level, the interaction between the governance uncertainty constructed by income fiscal decentralization and APHD has a less negative economic effect. (3) There is a threshold effect under the conditions of a low level of decentralization of prevention and control, a high level of investment in governance, and a low level of APHD. However, under the condition of a certain APHD level, when the decentralization level of pollution control is higher than 7.916 and the input level of pollution control in GDP is lower than 1.77%, the negative moderating effect can be effectively reduced. Full article

(1) Background: Self-management is advocated as a feasible, effective intervention to support individuals to actively manage the impact of illness and live healthier lives. We sought to evaluate a piloted self-management model, SET for Health, tailored for individuals living with schizophrenia embedded within ambulatory case management. (2) Methods: A mixed-methods design engaged 40 adults living with schizophrenia in the SET for Health protocol. Functional and symptomatic outcomes were measured by self-report and clinician ratings at baseline and completion of self-management plans, on average one year later. Semi-structured qualitative client interviews invited evaluations of personal experiences with the intervention. (3) Results: Significant improvements were found concerning client illness severity, social and occupational functioning, illness management and functional recovery with reductions in emergency visits and days in hospital. Clients endorsed the value of the intervention. Baseline clinical characteristics did not predict who benefited. Participation contributed to motivational gains and quality of life. (4) Conclusions: Results confirmed self-management support embedded within traditional case management improved clients’ clinical and functional status, and contributed to quality of life. Clients engaged in their recovery and actively used self-management strategies. Self-management can be successfully adopted by clients with schizophrenia regardless of age, gender, education, illness severity or duration. Full article

The circumstances of the COVID-19 lockdown affected many students’ life spheres, including their feeding patterns and snack intake. The main goals of the present study were to: (a) analyze the changes in students’ breakfast and snacking consumption during lockdown, and (b) analyze changes in the content of the students’ snacks using the Healthy Eating Index. This study analyzed data from a sample of 726 students from 36 classes from the late elementary (i.e., fifth grade) through high school (i.e., twelfth grade) from two public schools in the north of Portugal. Data were collected in five moments during the 2020/2021 school year, pre-, during, and post-second lockdown moments. Throughout the five moments, almost 90% of the students ate breakfast, and the majority brought snacks from home to eat in school. Surprisingly, there was an increase in the quality of the snacks consumed during lockdown compared to the pre-lockdown moments (e.g., consumption of more whole and total fruits and less consumption of food with added sugar, saturated fats, refined grains, and fatty acids). Suggestions for healthy behavior promotion will be discussed, such as improving the school food environment and teaching children to prepare healthy lunch boxes. Full article

This article studies the relationship between environmental governance, public health expenditure, and economic growth by introducing human health status into a three-period overlapping generation dynamic general equilibrium (OLG-DGE) model and conducting a policy simulation analysis in a Chinese scenario. The main findings are generalized as follows: (i) The increase in pollution emissions per unit of output will not only lead to the deterioration of public health but also hinder long-term economic growth, while the efficiency of pollution control will improve health and output per labor unit; (ii) Although levying environmental tax will improve health status and life expectancy, it has a non-linear impact on pollution emissions and output per labor unit, which means that there are trade-offs among environmental governance, public health improvement, and economic output; and (iii) Although the increase in the proportion of public health expenditure will improve health status, its impact on life expectancy and economic output is affected by the level of environmental tax. Only when the environmental tax rate is relatively low, will increasing the proportion of public health expenditure extend life expectancy and output per labor unit. Full article

This study was a continuation of our investigation of the spatio-temporal variability of the Bzura River’s water chemistry. Our research is of particular importance in the context of the recent ecological disaster on the Oder River and concerns the international problem of surface water contamination. The study area was a 120 km section of the Bzura River. We tested more measurement points and with a higher sampling frequency than those used in the national monitoring of river water quality. During two hydrological years, 360 water samples were collected. The selected parameters: electrical conductivity, temperature, dissolved oxygen, dissolved organic carbon, nitrates, phosphates, bicarbonates, chlorides, sodium, potassium, calcium, and magnesium were determined. Numerous results exceeded the Polish threshold limits. Spatio-temporal variability and water quality were assessed using principal component analysis (PCA), cluster analysis (CA), and water quality index (WQI) approaches. Many point sources of pollution related to urbanization, agriculture, and industry were detected. Moreover, due to the changing climatic conditions, a significant difference between temporal variability in both years was observed. Our results indicated that it is necessary to increase the number of measurement stations for surface water monitoring; it will allow for a faster detection of the threat. Full article

Background: Telemedicine is increasingly viewed as a tool to provide a wide range of health services. This article presents policy lessons drawn from the evaluation of telemedicine experiments conducted in the Paris region. Methods: We used a mixed method design to study telemedicine projects commissioned by the Paris Regional Health Agency between 2013 and 2017. We combined data analysis of the telemedicine projects, review of the protocols, and interviews with stakeholders. Results: We identified the following reasons for disappointing outcomes: the outcome measure was requested too early during the experiments because payers required information for budgetary decisions; and the learning curve, technical problems, diversion of use, insufficient number of inclusions, and a lack of adherence prevented the demonstration of successful outcomes of the projects. Conclusion: The evaluation of telemedicine should be undertaken after sufficient uptake to ensure barriers to implementation are overcome, and to obtain the sample size necessary for statistical power and reduce the average cost for one telemedicine request. Randomized controlled trials should be encouraged with appropriate funding and the follow-up period should be extended. Full article

Optical remote sensing images obtained in haze weather not only have poor quality, but also have the characteristics of gray color, blurred details and low contrast, which seriously affect their visual effect and applications. Therefore, improving the image clarity, reducing the impact of haze and obtaining more valuable information have become the important aims of remote sensing image preprocessing. Based on the characteristics of haze images, combined with the earlier dark channel method and guided filtering theory, this paper proposed a new image haze removal method based on histogram gradient feature guidance (HGFG). In this method, the multidirectional gradient features are obtained, the atmospheric transmittance map is modified using the principle of guided filtering, and the adaptive regularization parameters are designed to achieve the image haze removal. Different types of image data were used to verify the experiment. The experimental result images have high definition and contrast, and maintain significant details and color fidelity. This shows that the new method has a strong ability to remove haze, abundant detail information, wide adaptability and high application value. Full article

One of the most common oral diseases affecting people wearing dentures is chronic atrophic candidiasis or denture stomatitis (DS). The aim of the paper is to provide an update on the pathogenesis, presentation, and management of DS in general dental practice settings. A comprehensive review of the literature published in the last ten years was undertaken using multiple databases, including PubMed via MEDLINE, EMBASE, and Scopus. The eligible articles were analyzed to identify evidence-based strategies for the management of DS. Despite its multifactorial nature, the leading cause of DS is the development of oral Candida albicans biofilm, which is facilitated by poor oral and denture hygiene, long-term denture wear, ill-fitting dentures, and the porosity of the acrylic resin in the dentures. DS affects between 17 and 75% of the population wearing dentures, with a slight predominance in elderly females. The mucosal denture surfaces and posterior tongue are the common sites of DS, and the affected areas exhibit erythema, the swelling of the palatal mucosa and edema. Oral and denture hygiene protocols, adjusting or re-fabricating poorly adapting dentures, smoking cessation, avoiding nocturnal denture wear, and the administration of topical or systemic antifungals are the mainstay of management. Alternate treatments such as microwave disinfection, phytomedicine, photodynamic therapy, and incorporation of antifungals and nanoparticles into denture resins are being evaluated for the treatment of DS but require further evidence before routine use in clinical practice. In summary, DS is the most common oral inflammatory lesion experienced by denture wearers. Most patients with DS can be managed in general dental practice settings. Effective management by general dental practitioners may be supported by a thorough understanding of the pathogenesis, the recognition of the clinical presentation, and an awareness of contemporary treatment strategies. Full article

Resilience plays an important role in the relationship between adverse childhood experiences (ACEs) and children’s health. Young children are often neglected in ACEs research and suffer from the negative consequences of ACEs. However, few studies have focused on the relationship between ACEs and emotional problems in young Chinese children and the moderating and mediating effect of resilience on this relationship. This study included young children at the beginning of their kindergarten year (n = 874, 42.80 ± 4.09 months) from Wuhu City, China, to examine the mediation and moderation effects of resilience on early-life ACEs and emotional problems. Our results show a positive direct effect of ACEs on emotional problems. Furthermore, a positive indirect effect of ACEs and emotional problems on resilience was found. A moderating effect of resilience was not observed in this study. Our findings (a) highlight the significance of paying more attention to early ACEs and revealing a better understanding of the effect of resilience on ACEs at an early age and (b) indicate that age-specific interventions should be provided to enhance young children’s resilience when exposed to adversity. Full article

Due to an increase in population, urban centers are currently seeing an increase in traffic, resulting in negative consequences such as pollution and congestion. Efforts have been made to promote a modal shift towards the use of more sustainable means of transport, such as walking and cycling, but several deterrents influence the citizens’ perceptions of safety, security and comfort, discouraging their choice of active modes of transport. This study focuses on the importance of providing meaningful information to vulnerable road users (VRUs) to support their perceptions and objectives while moving within urban spaces through a novel concept of route planning. A broad survey of the needs and concerns of VRUs through interviews, focus groups and questionnaires, applied to the Portuguese population of the Metropolitan Area of Porto, led to the development of a new concept of route planners that show personalized routes according to the individual perceptions of each user. This concept is materialized in a route planner prototype that has been extensively tested by potential users. Subjective evaluation and feedback showed the usefulness of the concept and added value to a familiar product, leading to a satisfying experience for participants. This study shows that there is an opportunity to improve these tools to provide a higher degree of power and customization to users on route planning, which includes addressing mobility restrictions and personal perceptions of safety, security and comfort. The ultimate goal of this new approach is to persuade citizens to switch to more sustainable means of transport. Full article

Since a great number of infant cardiopulmonary arrests occur outside of the hospital, it is crucial to train laypersons in cardiopulmonary resuscitation techniques, especially those professionals that will work with infants and children. The main objective of this study was to evaluate the efectiveness of ventilations performed by professional training students. The secondary objective was to analyze the preference between different ventilation and chest-compression methods. The sample consisted of 32 professional training students, 15 preschool students, and 17 physical education students. The activity was conducted separately for each group, and we provided a 10 min theoretical training about infant basic life support followed by a 45 min practical training using a Laerdal Little Anne QCPR CPR manikin. A practical test in pairs was organized to record the ventilation as performed by the participants, establishing the difference between the efficacious and the non-efficacious ones. Furthermore, we handed out a survey before and after training to evaluate their knowledge. More than 90% of the students completely agreed with the importance of learning cardiopulmonary resuscitation techniques for their professional future. More than half of the sample considered that they perform the rescue breathings with the mouth-to-mouth method better. We observed that through mouth-to-mouth-nose ventilations, the number of effective ventilations was significantly higher than the effective ventilations provided by a self-inflating bag and mask (EffectiveMtoMN 6.42 ± 4.27 vs. EffectiveMask 4.75 ± 3.63 (p = 0.007)), which was the preferred method. In terms of the compression method, hands encircling the chest was preferred by more than 85% of students. Mouth-to-mouth nose ventilation is more efficient than bag-face-mask ventilation in CPR as performed by professional training and physical activity students. This fact must be considered to provide higher-quality training sessions to professional training students. Full article

The increasing radiofrequency (RF) electromagnetic radiation pollution resulting from the development and use of technologies utilizing RF has sparked debate about the possible biological effects of said radiation. Of particular concern is the potential impact on the brain, due to the close proximity of communication devices to the head. The main aim of this study was to examine the effects of long-term exposure to RF on the brains of mice in a real-life scenario simulation compared to a laboratory setting. The animals were exposed continuously for 16 weeks to RF using a household Wi-Fi router and a laboratory device with a frequency of 2.45 GHz, and were compared to a sham-exposed group. Before and after exposure, the mice underwent behavioral tests (open-field test and Y-maze); at the end of the exposure period, the brain was harvested for histopathological analysis and assessment of DNA methylation levels. Long-term exposure of mice to 2.45 GHz RF radiation increased their locomotor activity, yet did not cause significant structural or morphological changes in their brains. Global DNA methylation was lower in exposed mice compared to sham mice. Further research is needed to understand the mechanisms behind these effects and to understand the potential effects of RF radiation on brain function. Full article

Due to the unique geographical location and historical culture, the traditional houses in the southern region of Anhui Province, China (South Anhui) have different indoor environments. In summer and winter, this study adopted a field survey, questionnaire survey, and statistical analysis to carry out a comprehensive field survey on Xixinan Village in South Anhui, and selected a typical traditional residence in the village to evaluate its indoor environment status. The final results show that the overall indoor environment of the traditional houses in South Anhui was awful, including the indoor thermal environment, with high temperature and humidity in summer and cold and humidity in winter. Additionally, the indoor light environment with dim light still had much room for improvement, while the indoor air quality and sound environment were relatively excellent. In addition, this study determined that the neutral temperatures of residents are 15.5 °C and 28.7 °C in winter and summer, respectively, and the comfort range of indoor light intensity is 752.6–1252.5 lx, which determines the adjustment range of indoor environmental parameters for residents’ comfort needs. This paper’s research methods and results provide a reference for the study of residential indoor environments in other regions with similar climatic conditions as South Anhui, and a theoretical basis for architects and engineers to enhance the indoor environment of traditional houses in this region. Full article