International Journal of Environmental Research and Public Health

Neuropsychological screening tools for mild cognitive impairment (MCI) have been widely used. However, to date, their sensitivity and specificity still remain unsatisfied. This study aims to investigate whether spatial memory can discriminate MCI better than neuropsychological screening tools. A total of 56 healthy older adults and 36 older adults with MCI participated in this study; they performed a spatial cognitive task based on virtual reality (SCT-VR), the Korean version of the Montreal Cognitive Assessment (MoCA-K), and the Wechsler Adult Intelligence Scale-Revised Block Design Test (WAIS-BDT). The discriminant power was compared between the SCT-VR and the MoCA-K, and the reliability and validity of the SCT-VR were analyzed. The spatial memory, assessed by the SCT-VR, showed better sensitivity and specificity (sensitivity: 0.944; specificity: 0.964) than the MoCA-K (sensitivity: 0.857; specificity: 0.746). The test-retest reliability of the SCT-VR was relatively high (ICCs: 0.982, p < 0.001) and the concurrent validity of the SCT-VR with the MoCA-K (r = −0.587, p < 0.001) and the WAIS-BDT (r = −0.594, p < 0.001) was statistically significant. These findings shed light on the importance of spatial memory as a behavioral marker of MCI. The ecologically validated spatial memory tasks based on VR need to be investigated by neuroscientific studies in the future. Full article

Several studies have examined the impact of the COVID-19 pandemic on healthcare workers’ mental health, but only a few have investigated its detrimental effect on the mental well-being of mental health workers (MHWs). Background: The current study aimed to explore the effect of the fear of COVID-19 (FSV-19) on professional quality of life dimensions, namely compassion satisfaction (CS), burnout (BO), and secondary traumatic stress (STS) in MHWs above and beyond sociodemographic and professional factors. Methods: Hierarchical linear regression models were employed to examine the relationship of extreme FSV-19 with CS, BO, and STS in MHWs (n = 224), after considering sociodemographic variables as potential confounding factors. Extreme FSV-19 was operationalized as a binary variable with a cut-off score of ≥16.5 considered as extreme fear. Results: We found that extreme FSV-19 in MHWs is linked with increased compassion fatigue (BO and STS), and this relationship is exacerbated by younger age in regard to BO and by female gender concerning STS. CS remains unaffected by severe FCV-19, and it is higher in older participants. Conclusion: Organizational support is required to protect MHWs’ mental well-being and ensure the quality of care they provide during prolonged crises, such as the COVID-19 pandemic. Measures that intensify a sense of safety, protection, and control against COVID-19 infections in mental health services should be included in the recommendations that may reduce BO and STS among MHWs. Full article

(1) Background: Previous research revealed that increased loneliness resulted in decreased meaning in life (MIL). Little is known, however, about the underlying mechanisms of this relationship. The aim of the study was to determine if the set of positive evaluations of oneself, one’s life, and one’s future discussed by Caprara as positive orientation (POS) was a mediator between loneliness and MIL. (2) Methods: A sample of 304 Polish participants aged 19–45 (M = 25.61 years, SD = 6.1) completed the De Jong Gierveld Loneliness Scale, the Presence subscale of the Meaning in Life Questionnaire, and the Positivity Scale. (3) Results: The study showed that loneliness was negatively associated with POS and MIL, while POS and MIL were positively correlated with each other. It also turned out that POS partially mediated the relationship between loneliness and MIL. (4) Conclusions: The results suggest that, by inhibiting POS, loneliness makes it difficult to perceive life as meaningful. The interrelationships between loneliness, POS, and MIL are discussed in light of the evolutionary theory of loneliness. Full article

Intensive, acute exercise may bring a large systemic inflammatory response marked by substantial increases in inflammatory cytokines and chemokines. One such chemokines–CCL2–is a key factor involved in inflammatory reaction to exercise. The direct aim of the study was to describe the changes in the CCL2 expression levels after anaerobic exercise in well-trained athletes adapted to long-term training and in non-trained participants. The expression of CCL2 mRNA was evaluated in peripheral blood MNCs and CCL2 protein level was observed in blood plasma. The changes were assessed as the response to an acute, intensive bout of exercise (Wingate Anaerobic Test) in two groups of participants: well-trained soccer players and non-trained individuals. An increase of CCL2 expression inn both mRNA and protein levels was observed. The response was greater in non-trained individuals and elevated levels of CCL2 transcripts persisted for more than 24 h after exercise. Well-trained individuals responded more modestly and the effect was attenuated relatively quickly. This shows muscular adaptation to a continuous training regime in well-trained individuals and better control of immune reactions to muscular injury. In non-training individuals, the induction of the inflammatory response was greater, suggesting presence of more serious myotrauma. Full article

We aimed to explore the reliability and validity of viral anxiety rating scales (developed for the general population) among healthcare workers. In addition, we compared the psychometric properties of rating scales in accordance with the Generalized Anxiety Scale-7 items (GAD-7) during this COVID-19 pandemic. The viral anxiety of 330 healthcare workers was measured with Stress and Anxiety to Viral Epidemics—9 items (SAVE-9), SAVE-6, Coronavirus Anxiety Scale (CAS), Fear of COVID-19 Scale (FCV-19S), and COVID-19 Anxiety Scale (CAS-7). Factor analyses, item response theory, and Rasch model analyses were conducted to confirm the construct validities of the scales and compare the psychometric properties of rating scales. The receiver operating curve (ROC) analysis examined the cutoff scores of rating scales in accordance with a mild degree of generalized anxiety. The SAVE-9, SAVE-6, CAS, FCV-19S, and CAS-7 scales showed good reliability of internal consistency among healthcare workers. Their construct validity and convergent validity of each scale were similarly good. Furthermore, in comparing the psychometric properties of rating scales, we observed that the CAS scale was the most discriminating and difficult among the scales. The CAS and FCV-19S provided more information and were more efficient than the SAVE-9, SAVE-6, and CAS-7 scales when they were used to measure healthcare workers’ viral anxiety. Viral anxiety rating scales can be applied to healthcare workers with good reliability and validity. Full article

Microorganisms are of critical importance during the composting process. The aim of this study was to reveal the bacterial and fungal compositions of a composting pile of food waste digestate and garden waste, where the succession of the microbial communities was monitored using Illumina MiSeq sequencing. We explored the efficiency of composting of different microorganisms to judge whether the composting system was running successfully. The results showed that the composting process significantly changed the bacterial and fungal structure. Firmicutes, Proteobacteria, and Bacteroidota were the dominant phyla of the bacterial communities, while Ascomycota was the dominant phylum of the fungal communities. Moreover, the highest bacterial and fungal biodiversity occurred in the thermophilic stage. The physical and chemical properties of the final compost products conformed to the national standards of fertilizers. The efficient composting functional microbes, including Cladosporium, Bacillus and Saccharomonospora, emerged to be an important sign of a successfully operating composting system. Full article

With the diversification of medical care and work reform, doctor clerks play a major role today and are recruited to mitigate the burden of doctors worldwide. Their recruitment can improve the working conditions of physicians, facilitate task shifting in rural community hospitals, improve patient care, and help address the lack of healthcare resources. This study used a qualitative method to investigate difficulties in the implementation of doctor clerks and ascertain the features of effective implementation by collecting ethnographic data through field notes and semi-structured interviews with workers. We observed and interviewed 4 doctor clerks, 10 physicians, 14 nurses, 2 pharmacists, 1 nutritionist, and 2 therapists for our study. We clarified the doctor clerk process in rural hospitals through four themes: initial challenge, balance between education and expansion, vision for work progression, and drive for quality of care. We further clarified effectiveness, difficulties, and enhancing factors in implementation. Doctor clerk recruitment and bridging of discrepancies among medical professionals can mitigate professional workloads and improve staff motivation, leading to better interprofessional collaboration and patient care. Full article

Adolescent behavioral health was in crisis before COVID-19. The shutdown and reopening of in-person learning and extracurricular activities may have worsened this crisis. We examined high school athletes’ depression before and during the pandemic. Data were collected as part of a pilot program incorporating Patient Health Questionnaire (PHQ) screenings during high school sports physicals before the COVID-19 lockdown and three timepoints after. Statistical comparisons were made using logistic regression. A total of 927 individual scores were analyzed: 385 from spring 2020; 145 from fall 2020; 163 from fall 2021; and 234 from spring 2022. Fall 2020 students were 3.7 times more likely to have elevated PHQ-2 scores than spring 2020 students (95% CI = 1.8, 7.6). Fall 2021 and spring 2022 scores did not differ significantly from pre-pandemic, although trends of elevated scores persisted (OR = 1.6; 95% CI = 0.7, 3.5, and OR = 1.2; 95% CI = 0.6, 2.4, respectively). A significant difference in PHQ-9 depression severity classification was detected over time (p < 0.01). Elevated PHQ scores were found after the onset of the COVID-19 pandemic. After the initial peak in fall 2020, scores decreased but did not reach pre-pandemic levels. Full article

Smartphone addiction has become a public health issue. To help reduce smartphone addiction, we assessed the combined effect of 24-Hour Movement Behaviors on smartphone addiction during Corona Virus Disease 2019 (COVID-19) home confinement in Foshan, China. Data were collected in a sample of 1323 senior middle school students (mean age ± standard deviation): 16.4 ± 0.9 years; 43.46% males) during the COVID-19 lockdown. Their 24-Hour movement behaviors were assessed by a self-reported questionnaire, The Smartphone Addiction Scale-Short Version (SAS-SV). The compositional multiple linear regression model and compositional isotemporal substitution model were used to examine the association between the time budget composition of the day and smartphone addiction. Smartphone addiction occurred in 671 (50.72%) of the 1323 students. Compared with smartphone-addicted adolescents, non-smartphone-addicted adolescents had more moderate-to-vigorous physical activity (MVPA) and sleep duration (SLP), and less sedentary behavior (SB). The distribution of time spent in 24-Hour movement behaviors was significantly associated with smartphone addiction. The negative effect was found for the proportion of time spent in MVPA or SLP (ilr1-MVPA = −0.453, p < 0.001. ilr1-SLP = −3.641, p < 0.001, respectively) relative to the other three behaviors. Conversely, SB was positively associated with the score of smartphone addiction (ilr1-SB = 2.641, p < 0.001). Reallocating one behavior to remaining behaviors was associated with smartphone addiction. Noticeably, the effects of one behavior replacing another behavior and of one behavior being displaced by another behavior were asymmetric. The 24-Hour movement behaviors of adolescents are closely related to smartphone addiction, and future intervention studies should focus on the compositional attribute of 24-Hour movement behaviors. Full article

This article provides a framework for conceptualizing climate action needs grounded in the nationally determined contributions (NDCs) of the least developed party countries (LDPCs) of the Paris Agreement (PA). It examines the NDCs of 35 LDPCs recorded in the NDC public registry of the United Nations Framework Convention for Climate Change (UNFCCC). A grounded theory approach is adopted to assess what these countries need to materialize their NDCs under the PA. A conceptual framework of needs is figured out through an iterative process of data collection and analysis in three cycles: (1) open and in vivo coding; (2) axial coding; and (3) theoretical or selective coding. The data are analyzed with the help of NVIVO software. The results provide a verifiable framework of needs for climate action, which includes 55 saturated need factors extracted from the writing excerpts of NDCs, 17 sub-categories (axial codes) with climate finance and technology transfer as the most prominent, and 7 theoretical or selective categories with mobilize, educate, governmental, synergic, levels, equity, and public health. It provides a baseline for policy, research, and action from the developed party countries to uphold their PA obligations. Full article

The following study aims to describe the perception of international migrants who use the primary level of care by health personnel and to explore how this perception can affect the care process in the commune of Antofagasta, north of Chile. Methodology: The methodology was qualitative using a phenomenological descriptive design, through which the discourses of the health personnel of three primary health care centers (n = 14) were explored. Results: The participants presented two thematic categories. The first one related to experiences during delivery of care to migrants and included perceptions and beliefs, factors associated with using services, and reasons for consultation. The second category related to stereotypes towards migrants, including prejudices, beliefs about their lives and reasons for migration. Conclusions: The therapeutic relationship with migrants in primary care depends on the health care personnel’s acceptability of this population, hence, allowing the delivery of care based on respect for their culture and rights. Full article

The potential impact of music-making on air quality around musicians was inferred at the outset of the SARS-CoV-2 pandemic from measurements on individual musical instruments and from theoretical considerations. However, it is unclear to what extent playing together in an orchestra under optimal ventilation conditions really increases infection risks for individual musicians. In this study, changes in indoor air quality were assessed by measuring common parameters, i.e., temperature, relative humidity, and carbon dioxide, along with particle counting and determining the presence of airborne pharyngeal bacteria under different seating arrangements. The study was conducted in cooperation with a professional orchestra on a stage ventilated by high volume displacement ventilation. Even with a full line-up, the particle load was only slightly influenced by the presence of the musicians on stage. At the same time, however, a clear increase in pharyngeal flora could be measured in front of individual instrument groups, but independent of seat spacing. Simultaneous measurement of various air parameters and, above all, the determination of relevant indicator bacteria in the air, enables site-specific risk assessment and safe music-making even during a pandemic. Full article

Many small-spacing interchanges (SSI) appear when the density of the expressway interchanges increases. However, the characteristics of traffic accidents in SSI have not been explained clearly. Therefore, this paper systematically takes the G3001 expressway in Xi’an as the research object to explore the accident characteristics of SSI. Firstly, the expressway is divided into four sections. Furthermore, their safety can be evaluated by the number of accidents per unit distance of 100 million vehicles (NAP). Subsequently, eight indexes, such as mean spacing distance (MSD), are selected to explain the cause affecting expressway safety by developing the least square support vector machine (LSSVM). Secondly, the difference between SSI and normal-spacing interchanges (NSI) is clarified by statistical analysis. Finally, LSSVM, random forest, and logistic regression models are built using 12 indicators, such as the time spent exploring the causes of serious accidents. The results show that the inner ring NAP in Sections I and II with SSI is 27.2 and 33.7, higher than in other sections. The density, annual average daily traffic, and MSD adversely affect expressway traffic safety. The road condition mainly influences the serious traffic accidents in the SSI. This study can provide the theoretical basis for traffic management and accident prevention in the SSI of the expressway. Full article

The periodontal inflamed surface area (PISA) is a useful indicator of periodontal status. However, its formula was based on a meta-analysis involving five countries, and racial differences in tooth root morphology could have affected the calculations. This study aimed to develop a Japanese version of the PISA and compare it with the original version. The formulas reported by a previous Japanese study calculating the amount of remaining periodontal ligament from clinical attachment measurements were used to calculate the PISA. A simulation was performed to compare the Japanese version with the original version by inputting probing pocket depth (PPD) from 1 to10 mm and by using clinical data. The PISA values in the Japanese version were larger and smaller than those in the original version for PPDs of 1–5 mm and 6–10 mm, respectively. The PISA values for the clinical data from the Japanese version were significantly higher than those from the original version. Both versions of the PISA values correlated equally well with body mass index. The Japanese version of the PISA can be used to assess the amount of inflamed periodontal tissue resulting from periodontitis in Japanese populations, taking into account racial heterogeneity in root morphologies. Full article

This study investigated the association between a healthy lifestyle with all-cause, cause-specific mortality, and cancer incidence among individuals with metabolic syndrome (MetS). Healthy lifestyle scores were created based on MetS management guidelines, including never/quitting smoking, moderate drinking, good sleep, healthy diet, sufficient exercise, social support, and less sedentary behaviour. Weighted healthy lifestyle scores were further constructed and classified into three groups: unfavourable (lowest quintile), intermediate (quintiles 2–4), and favourable (highest quintile) lifestyles. We included 87,342 MetS participants from the UK Biobank. Hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated using multivariate-adjusted Cox proportional hazards regression. During a median follow-up of 12.54 years, 6739 deaths were reported; during a median follow-up of 10.69 years, 10,802 new cancer cases were documented. We found a favourable lifestyle was inversely associated with all-cause mortality (HR: 0.57; 95%CI: 0.53–0.62), cause-specific mortality from respiratory disease, cancer, digestive disease, cardiovascular disease (HR < 1; p-trend < 0.001), and overall cancer incidence (HR: 0.84; 95% CI: 0.79–0.90). Our results indicate that adherence to healthy lifestyles is associated with lower overall cancer incidence and all-cause mortality risk among MetS individuals. However, causality cannot be made due to the nature of observational studies. Full article

Background: Non-alcoholic fatty liver disease (NAFLD) is the most common chronic liver disease globally in tandem with the growing obesity epidemic. However, there is a lack of data on the relationship between historical weight changes 10 years ago and at present on NAFLD prevalence at the population level. Therefore, we sought to evaluate the relationship between weight classes and the prevalence of NAFLD. Methods: Data were used from the United States National Health and Nutrition Examination Survey (NHANES) from 1999 to 2018. Univariate and multivariate general linear model analyses were used to obtain risk ratio (RR) estimations of NAFLD events. Results: In total, 34,486 individuals were analysed, with those who were lean at both time points as the control group. Overweight (RR: 14.73, 95%CI: 11.94 to 18.18, p < 0.01) or obese (RR: 31.51, 95%CI: 25.30 to 39.25, p < 0.01) individuals at both timepoints were more likely to develop NAFLD. Residual risk exists where previously obese individuals became overweight (RR: 14.72, 95%CI: 12.36 to 17.52, p < 0.01) or lean (RR: 2.46, 95%CI: 1.40 to 4.31, p = 0.02), and previously overweight individuals who became lean (RR 2.24, 95%CI 1.42 to 3.54, p = 0.01) had persistent elevated risk of developing NAFLD despite weight regression. Sensitivity analysis identified that a higher proportion of individuals with regression in weight class were diabetics and Mexican Americans, while fewer African Americans saw weight-class regression. Conclusions: Residual risk exists in patients who lost weight despite the smaller magnitude of effect, and targeted weight reductions should still be used to mitigate the risk of NAFLD at the population level. Full article

Introduction: The COVID-19 pandemic has affected the mental health of the population. This study aims to assess the prevalence of subjective depressive and anxiety symptoms as well as assess the quality of life in different waves of the COVID-19 pandemic based on an online survey. Methods: The study was conducted based on an original and anonymous questionnaire, consisting of a section assessing sociodemographic status and psychometric tools: Beck Depression Inventory (BDI), Generalised Anxiety Disorder Assessment (GAD-7) and Manchester Short Assessment of Quality of Life (MANSA). A total of 6739 people participated in the survey, with the largest number from the first wave of the pandemic (2467—36.6%), followed by 1627 (24.1%) for the second wave, 1696 (25.2%) for wave three and 949 (14.1%) for wave four. The mean age of the study group was 28.19 ± 9.94. Results: There was an initial, gradual increase in depressive and anxiety symptoms over the three waves. There were no significant differences in the quality-of-life scores, except for the second and third waves (−0.0846; p = 0.013. It was found that women, residents of big cities and people with psychiatric history showed higher BDI and GAD-7 scores. Conclusions: The impact of the pandemic on mental health was not homogeneous, with the first three waves of the COVID-19 pandemic having more of an impact compared to the fourth wave. Female respondents’ sex, history of mental disease and reduced earning capacity exacerbated psychiatric symptoms. Full article

Plant-based ecological protection is one of the effective methods to improve the stability of slope soils. However, plants need a stable growth environment and water supply. Although it has been demonstrated that polymer materials can effectively enhance the stability and water retention of soils, their improvement mechanism and long-term effects are yet to be clear. In this paper, we use a new polymer composite material (ADNB), an optimized compound of nano-aqueous binder (NAB) and super absorption resin (SAR), to conduct outdoor model tests to study the effects of different ADNB ratios on soil compactness, biochemical properties, and plant growth at longer time scales, and to explore its action law and mechanism of enhancing the ecological self-repairing ability of surface slope soil. The results show that ADNB can effectively improve the soil structure, increase the compactness of the soil, increase the organic matter content, microbial population and available nutrient content in the soil, thus promoting plant growth. The adsorption and agglomeration effect of the NAB in ADNB on soil particles and its degradation in natural environment can be observed by SEM. In summary, ADNB can not only effectively enhance the ecological self-repairing ability of surface slope soil, but also has good environmental friendliness and can be completely degraded under natural conditions without additional adverse effects on soil and environment. Full article

Young carers are children and adolescents who provide care to other family members or friends, taking over responsibilities that are usually associated with adulthood. There is emerging but still scarce knowledge worldwide about the phenomenon of young carers and the impact of a caring role on their health, social and personal development spheres. This paper provides an overview of the main results from the ME-WE project, which is the first European research and innovation project dedicated to adolescent young carers (AYCs) (15–17 years). The project methods relied on three main activities: (1) a systematization of knowledge (by means of a survey to AYCs, country case studies, Delphi study, literature review); (2) the co-design, implementation and evaluation of a primary prevention intervention addressing AYCs’ mental health (by means of Blended Learning Networks and a clinical trial in six European countries); (3) the implementation of knowledge translation actions for dissemination, awareness, advocacy and lobbying (by means of national and international stakeholder networks, as well as traditional and new media). Project results substantially contributed to a better understanding of AYCs’ conditions, needs and preferences, defined tailored support intervention (resilient to COVID-19 related restrictions), and significant improvements in national and European policies for AYCs. Full article