Journal Description

International Journal of Environmental Research and Public Health

International Journal of Environmental Research and Public Health (ISSN 1660-4601; CODEN: IJERGQ; ISSN 1661-7827 for printed edition) is an interdisciplinary peer-reviewed open access journal published semi-monthly online by MDPI. It covers Environmental Sciences and Engineering, Public Health, Environmental Health, Occupational Hygiene, Health Economic and Global Health Research, etc. The International Society Doctors for the Environment (ISDE) and Italian Society of Environmental Medicine (SIMA) are affiliated with IJERPH and their members receive a discount on the article processing charges.

Open Access—free for readers, with article processing charges (APC) paid by authors or their institutions.
High Visibility: indexed by the Science Citation Index Expanded (Web of Science), Social Sciences Citation Index (Web of Science), MEDLINE (PubMed), Scopus (Elsevier) and other databases. Full-text available in PubMed Central.
Rapid Publication: manuscripts are peer-reviewed and a first decision provided to authors approximately 15.3 days after submission; acceptance to publication is undertaken in 2.9 days (median values for papers published in this journal in the first half of 2020).
Recognition of Reviewers: reviewers who provide timely, thorough peer-review reports receive vouchers entitling them to a discount on the APC of their next publication in any MDPI journal, in appreciation of the work done.
Testimonials: See what our authors say about IJERPH
Sections: published in twenty-six topical sections

Impact Factor: 2.849 (2019) ; 5-Year Impact Factor: 3.127 (2019)

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Latest Articles

Open AccessArticle

Alcohol and Road Accidents Involving Pedestrians as Unprotected Road Users

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Int. J. Environ. Res. Public Health 2020, 17(23), 8995; https://doi.org/10.3390/ijerph17238995 (registering DOI) - 02 Dec 2020

Abstract

According to the World Health Organization (WHO), more than half of all road fatalities involve vulnerable road users, i.e., pedestrians, cyclists, and motorcyclists. Poland is classified as one of the European Union (EU) countries marked by low road safety, with a higher frequency of accidents involving pedestrians compared to other EU countries (31% of all fatalities). Among unprotected road users, a significant group of victims are pedestrians, who are often under the influence of alcohol. This study aims to analyze the impact of alcohol on the risk of occurrence and consequences of road accidents among pedestrians. The source of data was the medical documentation of the Department of Forensic Medicine of the Medical University of Warsaw. In more than half of pedestrian deaths, the presence of alcohol was found; regardless of the place of the event and the place of death, among the victims under the influence of alcohol, males dominated; the average age of the victims under the influence of alcohol was significantly lower compared to the average age of sober victims, with younger victims being significantly more likely to die at the scene of the accident, especially in rural areas; significantly higher alcohol concentrations were found in males, in victims who died at the scene of the accident, and with victims of accidents in rural areas. Among pedestrian traffic accident fatalities, the most numerous group comprised young men under the influence of alcohol. In rural areas, a higher percentage of pedestrian victims died at the scene as a result of excessive alcohol consumption. These areas should be subject to intensive preventive measures to increase the safety of pedestrians as unprotected road users. Full article

(This article belongs to the Special Issue Disasters Preparedness and Emergency Response: Prevention, Surveillance and Mitigation Planning)

Open AccessCase Report

Situation of India in the COVID-19 Pandemic: India’s Initial Pandemic Experience

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Int. J. Environ. Res. Public Health 2020, 17(23), 8994; https://doi.org/10.3390/ijerph17238994 (registering DOI) - 02 Dec 2020

Abstract

In this article, we investigate the impact of COVID-19 through screening and surveillance methods adopted in India, as well as the potential health system, social, political, and economic consequences. The research was done in a chronological manner, and data was collected between 30 January 2020 till 12 June 2020. Initial containment measures, including point of entry screenings and testing protocols, appeared insufficient. However, testing capacity was gradually expanded after the commencement of a nation-wide lockdown. Modeling predictions have shown varying results on the emergence of cases depending on the infectiousness of asymptomatic individuals, with a peak predicted in mid-July having over two million cases. The country also faces risks of the economic plunge by losing approximately 4% of its gross domestic product, due to containment measures and reduction in goods importation. The low public health expenditure combined with a lack of infrastructure and low fiscal response implies several challenges to scale up the COVID-19 response and management. Therefore, an emergency preparedness and response plan is essential to integrate into the health system of India. Full article

(This article belongs to the Special Issue COVID-19 Public Policies Around the World: Lessons Learnt from a Series of Case Studies of the First Pandemic Wave)

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Open AccessArticle

Environmental Practices in Firms Located in Underpopulated Rural Areas in Spain: The Case of the Province of Teruel

Luisa Esteban-Salvador

Ana Felicitas Gargallo-Castel

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Javier Pérez-Sanz

Int. J. Environ. Res. Public Health 2020, 17(23), 8993; https://doi.org/10.3390/ijerph17238993 (registering DOI) - 02 Dec 2020

Abstract

This study aims to develop a better understanding of what drives small and medium-sized enterprises (SMEs) to engage in environmental practices in isolated rural areas. Despite a growing literature on environmental behavior in different contexts, the green activities of SMEs in rural areas remains underexposed. This neglect is remarkable, and deserves attention given the serious depopulation problems they have to face, and the economic and social challenges that lie ahead. Using unique data from 141 SMEs in one of the most sparsely populated regions in the European Union, we study the influence of territorial relations on firms’ environmental conduct. Our results suggest that different territorial factors have some impact on the adoption of environmental practices. We report evidence indicative of the role of these factors in shaping environmental decisions. Finally, we offer suggestions for future research that could further develop our understanding of environmental management decisions in rural and underpopulated areas. Full article

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Open AccessReview

Relationship between Land Use/Land-Use Change and Human Health in Australia: A Scoping Study

Tamzyn M Davey

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Linda A Selvey

Int. J. Environ. Res. Public Health 2020, 17(23), 8992; https://doi.org/10.3390/ijerph17238992 (registering DOI) - 02 Dec 2020

Abstract

We undertook a scoping study to map the relevant evidence, summarise the findings, and to help identify gaps in the knowledge base on the relationship between land use/land-use change and human health in Australia. Our systematic search of the scientific literature for relevant articles up to August 2020 identified 37 articles. All 37 articles meeting our inclusion criteria were published after 2003. Zoonotic or vector-borne disease constituted the most common health outcome type studied. Agriculture/grazing was the land use/land-use change type most frequently represented in the literature, followed by coal seam gas extraction and open cut coal mining. The relationship between land use/land use change and human health in Australia, is not conclusive from the existing evidence. This is because of (1) a lack of comprehensive coverage of the topic, (2) a lack of coverage of the geography, (3) a lack of coverage of study types, and (4) conflicting results in the research already undertaken. If we are to protect human health and the ecosystems which support life, more high-quality, specific, end-user driven research is needed to support land management decisions in Australia. Until the health effects of further land use change are better known and understood, caution ought to be practiced in land management and land conversion. Full article

(This article belongs to the Section Environmental Health)

Open AccessArticle

Body Composition in Women after Radical Mastectomy

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Int. J. Environ. Res. Public Health 2020, 17(23), 8991; https://doi.org/10.3390/ijerph17238991 (registering DOI) - 02 Dec 2020

Abstract

The aim of the study was to analyse the body composition among women after radical mastectomy. The body compositions of 30 women after radical mastectomy (study group) were compared with those of 30 healthy females (control group). The method of electrical bioimpedance was used to analyse body composition. The significant differences between the groups, unfavourable for women, following mastectomy concerned body mass (p = 0.021), BMI (p = 0.049), fat mass (%) (p = 0.007), fat mass (kg) (p = 0.005), total body water (%) (p = 0.002), left upper limb fat mass (p = 0.013) as well as right upper limb fat mass (p = 0.022). The body composition of women after radical mastectomy was significantly worse compared to the control group. The majority of subjects were overweight and had high levels of body fat. Abnormal body composition is a modifiable risk factor of breast cancer; therefore, improving lifestyle is important in the prevention and treatment of this disease. There is a need for education, dietary supervision and physical activity in women following radical mastectomy. The innovation of our study was the use of the modern bioelectrical impedance analysis (BIA) method, which does not cause ionisation and is a gold standard in the field of body composition analysis. In future research, we plan to broaden the assessment of lifestyle and the significance of diet and physical activity in the prevention and treatment of breast cancer. Full article

(This article belongs to the Section Women's Health)

Open AccessArticle

Mercury in Pancreatic Cells of People with and Without Pancreatic Cancer

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Int. J. Environ. Res. Public Health 2020, 17(23), 8990; https://doi.org/10.3390/ijerph17238990 (registering DOI) - 02 Dec 2020

Abstract

Toxic metals have been implicated in the pathogenesis of pancreatic cancer. Human exposure to mercury is widespread, but it is not known how often mercury is present in the human pancreas and which cells might contain mercury. We therefore aimed to determine, in people with and without pancreatic cancer, the distribution and prevalence of mercury in pancreatic cells. Paraffin-embedded sections of normal pancreatic tissue were obtained from pancreatectomy samples of 45 people who had pancreatic adenocarcinoma, and from autopsy samples of 38 people without pancreatic cancer. Mercury was identified using two methods of elemental bio-imaging: (1) With autometallography, inorganic mercury was seen in islet cells in 14 of 30 males (47%) with pancreatic cancer compared to two of 17 males (12%) without pancreatic cancer (p = 0.024), and in 10 of 15 females (67%) with pancreatic cancer compared to four of 22 females (19%) without pancreatic cancer (p = 0.006). Autometallographic mercury was present in acinar cells in 24% and in periductal cells in 11% of people with pancreatic cancer, but not in those without pancreatic cancer. (2) Laser ablation-inductively coupled plasma-mass spectrometry confirmed the presence of mercury in islets that stained with autometallography and detected cadmium, lead, chromium, iron, nickel and aluminium in some samples. In conclusion, the genotoxic metal mercury is found in normal pancreatic cells in more people with, than without, pancreatic cancer. These findings support the hypothesis that toxic metals such as mercury contribute to the pathogenesis of pancreatic cancer. Full article

(This article belongs to the Section Toxicology and Public Health)

Open AccessArticle

The Burden of Spinal Muscular Atrophy on Informal Caregivers

Isaac Aranda-Reneo

Luz María Peña-Longobardo

Juan Oliva-Moreno

Svenja Litzkendorf

Isabelle Durand-Zaleski

Eduardo F. Tizzano

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Julio López-Bastida

Int. J. Environ. Res. Public Health 2020, 17(23), 8989; https://doi.org/10.3390/ijerph17238989 (registering DOI) - 02 Dec 2020

Abstract

Spinal muscular atrophy (SMA) is one of the most common severe hereditary diseases of infancy and early childhood. The progression of this illness causes a high degree of disability; hence, a significant burden is experienced by individuals with this disease and their families. We analyzed the time taken to care for patients suffering from SMA in European countries and the burden on their informal caregivers. We designed a cross-sectional study recording data from France, Germany, Spain and the United Kingdom. The primary caregivers completed a self-administered questionnaire that included questions about the time of care, The Zarit Burden Interview, type of SMA and socio-demographic characteristics. Multivariate analyses were used to study the associations between the type of SMA, time of care and burden supported by informal caregivers. The caregivers provided 10.0 h (SD = 6.7) per day of care (the principal caregivers provided 6.9 h, SD = 4.6). The informal caregivers of patients with type I SMA had a 36.3 point higher likelihood (p < 0.05) of providing more than 10 hours of care per day in comparison with caregivers of patients with type III SMA. The severity of the disease was associated with more time of care and a higher burden on the caregivers. Full article

(This article belongs to the Special Issue The Economics of Caring)

Open AccessArticle

Influence of Connection Type and Platform Diameter on Titanium Dental Implants Fatigue: Non-Axial Loading Cyclic Test Analysis

Ana I. Nicolas-Silvente

Eugenio Velasco-Ortega

Ivan Ortiz-Garcia

Alvaro Jimenez-Guerra

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Int. J. Environ. Res. Public Health 2020, 17(23), 8988; https://doi.org/10.3390/ijerph17238988 (registering DOI) - 02 Dec 2020

Abstract

Two-pieces dental implants must provide stability of the implant-abutment-interface. The connection type and platform diameter could influence the biomechanical resistance and stress distribution. This study aims to evaluate the fatigue for different types of connections, external and internal, and different platform diameters. Three implant designs with the same length were used: (a) external hexagon/narrow platform; (b) internal double hexagon/narrow platform; (c) internal octagon/regular platform. A fatigue test was developed to establish the number of cycles needed before fracture. A 30º oblique load with a sinusoidal function of fatigue at a frequency of 15 Hz and 10% stress variation was applied to each system. The fatigue load limit (FLL) for design (a) was 190N, being the nominal-curvature-moment (NCM) = 1.045; FLL = 150 N, with a NCM = 0.825 for (b), and FLL = 325 N, with a NCM = 1.788 for (c). The platform diameter affects the FLL, obtaining lower FLL on a narrow platform. The connection type interferes with the implant walls’ width, especially in narrow implants, making internal connections more unstable at this level. Long-term clinical studies to assess the restoration’s success rate and survival are mandatory. Full article

(This article belongs to the Special Issue Impact of Dental Implants on Oral Health)

Open AccessArticle

Associations between COVID-19-Related Digital Health Literacy and Online Information-Seeking Behavior among Portuguese University Students

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Int. J. Environ. Res. Public Health 2020, 17(23), 8987; https://doi.org/10.3390/ijerph17238987 (registering DOI) - 02 Dec 2020

Abstract

We aim to evaluate the associations between digital health literacy (DHL) related to COVID-19 and online information-seeking behavior among university students. Methods: A total of 3.084 students (75.7% women), with an average age of 24.2 (SD = 7.5) participated in this cross-sectional study, most of whom (36.5%) were from social sciences and pursued a bachelor’s degree (50.7%). Data on COVID-19-related DHL and online information-seeking behavior were collected using an online questionnaire. Logistic regression models were performed. Results: As the pandemic progressed, participants showed a lower chance of achieving a sufficient DHL (OR = 0.7; 95% CI = 0.6; 0.9). Using search engines more often (e.g., Google) (OR = 0.7; 95% CI = 0.5; 0.9), Wikipedia (OR = 0.7; 95% CI = 0.6; 0.9) and social media (e.g., Facebook) (OR = 0.7; 95% CI = 0.6; 0.9) decreased the likelihood of achieving sufficient DHL related to COVID-19. More frequent use of websites of public bodies (OR = 1.7; 95% CI = 1.1; 2.5) increased the odds of reporting sufficient DHL. Conclusion: DHL is associated with university students’ online information-seeking behavior in the time of COVID-19. From a community and public health perspective, programs aiming at improving DHL should be highlighted. Full article

(This article belongs to the collection Global Health Literacy)

Open AccessArticle

Sensation Seeking and Gambling Behavior in Adolescence: Can Externalizing Problems Moderate This Relationship?

Franca Tani

Lucia Ponti

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Simon Ghinassi

Int. J. Environ. Res. Public Health 2020, 17(23), 8986; https://doi.org/10.3390/ijerph17238986 (registering DOI) - 02 Dec 2020

Abstract

Gambling is a widespread phenomenon during adolescence. Among different risk factors involved in the onset of adolescent gambling behaviors, one factor that is studied is the sensation seeking personality trait. However, the literature is heterogeneous and a direct relationship between sensation seeking and gaming behaviors has not always been highlighted. This suggests that the relationship can be influenced by other factors. In particular, we explored the moderating role of externalizing problems in this relationship. A total of 363 adolescents (232 males and 131 females) aged 14 to 20 (M = 16.35, SD = 1.36) completed a battery of questionnaires aimed to assess their gambling behaviors, as well as the levels of externalizing problems and sensation seeking. The results showed that sensation seeking was associated with gambling severity, but this relationship was significant when externalizing problems were high and medium. On the contrary, when externalizing problems were low, the relationship between sensation seeking and gambling severity was not significant. Overall, sensation seeking in adolescence can favor the implementation of risk behaviors, such as gambling, but only in association with the presence of externalizing problems. Limitations, strengths, and social and clinical implications of the present study are discussed. Full article

(This article belongs to the Special Issue Risk and Protective Factors in the Development of Pathological Gambling among Adolescents and Young Adults)

Open AccessArticle

The Influence of Social Isolation on the Preventive Behaviors for Non-Communicable Diseases in Community-Dwelling Older Adults in Japan

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Int. J. Environ. Res. Public Health 2020, 17(23), 8985; https://doi.org/10.3390/ijerph17238985 (registering DOI) - 02 Dec 2020

Abstract

This study aimed to examine the relationship between one’s physical status related to non-communicable diseases (NCDs) and social isolation, and to identify lifestyle behaviors for the prevention of NCDs associated with social isolation among community-dwelling older adults in Japan. A cross-sectional study was conducted to investigate lifestyle behaviors for NCD prevention associated with social isolation in Japanese adults aged 60 years and above in a community setting. Out of 57 participants, 17.5% were not socially participative, 66.7% hardly ever, 29.8% sometimes, and 3.5% often felt loneliness. Non-social participation and loneliness were negatively related to the frequency of vegetable and fruit intake. Additionally, loneliness was positively associated with one’s duration of smoking and current smoking habits, and negatively associated with the frequency of moderate-intensity activities, with marginal significance. Those with non-social participation or loneliness were less likely to eat a healthy diet and live a smoke-free lifestyle. The findings of this study suggest that a mutual health support system in the community and the development of community-based approaches for the prevention of NCDs among Japanese older adults are needed. Full article

(This article belongs to the Special Issue Assessment and Management of Lifestyle-Related Risk Factors for the Prevention and Management of Non-communicable Disease in Primary and Community Care)

Open AccessReview

Cold Water Swimming—Benefits and Risks: A Narrative Review

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Pantelis T. Nikolaidis

Int. J. Environ. Res. Public Health 2020, 17(23), 8984; https://doi.org/10.3390/ijerph17238984 (registering DOI) - 02 Dec 2020

Abstract

Cold water swimming (winter or ice swimming) has a long tradition in northern countries. Until a few years ago, ice swimming was practiced by very few extreme athletes. For some years now, ice swimming has been held as competitions in ice-cold water (colder than 5 °C). The aim of this overview is to present the current status of benefits and risks for swimming in cold water. When cold water swimming is practiced by experienced people with good health in a regular, graded and adjusted mode, it appears to bring health benefits. However, there is a risk of death in unfamiliar people, either due to the initial neurogenic cold shock response or due to a progressive decrease in swimming efficiency or hypothermia. Full article

(This article belongs to the Special Issue Exercise and Sport in Stressful Conditions and Environments)

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Open AccessArticle

Influence of Psychosocial Variables on the Health of People Living in Housing Exclusion

Fernando Fajardo-Bullón

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Int. J. Environ. Res. Public Health 2020, 17(23), 8983; https://doi.org/10.3390/ijerph17238983 (registering DOI) - 02 Dec 2020

Abstract

The aim of this study was to analyze the influence of some personal characteristics, health variables, and social support on the self-rated health of people in housing exclusion in Spain. For that purpose, we used the FOESSA Survey of Social Integration and Needs database, with a final sample of 1574 households. Being more educated and reporting a good life satisfaction stood out as the main factors preventing worse health status. Furthermore, results showed that being female, experiencing poverty-related food insecurity, not having health insurance, experiencing widowhood or partner bereavement, and having caring responsibilities for others or having a disabled person in the household are associated with increased reporting of regular or poor health. On the other hand, being young, having a diagnosed/long-term illness, and a big household size are preventive factors for good health. These results allowed identifying risk and prevention factors to inform interventions to improve the health of those living in housing exclusion. Promoting better education levels, social support, and overall life satisfaction could be important to improve health in this population. Developing social support policies for caring responsibilities and food insecurity must be a priority to improve the health of people living in housing exclusion. Full article

(This article belongs to the Special Issue Health, Housing and Homelessness)

Open AccessArticle

Public Awareness of and Action towards Heart Attack Symptoms: An Exploratory Study

Abdullah Abdulmajid Abdo Ahmed

Abdulkareem Mohammed Al-Shami

Shazia Jamshed

Abdul Rahman Fata Nahas

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Mohamed Izham Mohamed Ibrahim

Int. J. Environ. Res. Public Health 2020, 17(23), 8982; https://doi.org/10.3390/ijerph17238982 (registering DOI) - 02 Dec 2020

Abstract

Background: Cardiovascular disease (CVD) is still the leading cause of mortality worldwide, and Malaysia is not an exception in this regard. The current research is an attempt to explore symptom awareness of and necessary actions in response to heart attack (HA) among lay public. Methods: This is a cross-sectional study design, and a survey was conducted from May to July 2018 among general public in Kuantan, Pahang state, Malaysia. Results: A total of 393 respondents recruited. Slightly more than one-fourth of the respondents (26.35%) were aware of HA symptoms like pain and/or discomfort in the jaw, neck, or back, while 71.65% showed awareness only of chest pain or discomfort as symptoms. Only 35.6% reported to call an ambulance if they experience someone suffering from HA symptoms, while 82% recognized ≥1 symptom, and only 11.5% recognized all five HA symptoms. Very few respondents, i.e., 1.3% reported awareness about correct recognition of all five HA symptoms. Respondents who had diabetes and hypercholesteremia were more likely to recognize all five HA symptoms. For those who had excellent awareness of all five HA symptoms, the odds ratio (OR) were significantly higher among single respondents (OR 0.023; 95% CI 0.001–0.594), Malay (OR 0.376; 95% CI 0.193–0.733), and those who received information associated with HA (OR 7.540; 95% CI 2.037–27.914). However, those who were aware that HA requires quick treatment had significantly low odds ratio (OR 0.176; 95% CI 0.044–0.710). Conclusions: The awareness of and action towards the signs and symptoms of HA among the public were poor. Full article

(This article belongs to the Section Health Behavior, Chronic Disease and Health Promotion)

Open AccessArticle

The Effect of Balance and Sand Training on Postural Control in Elite Beach Volleyball Players

Sergio Sebastia-Amat

Luca Paolo Ardigò

Jose Manuel Jimenez-Olmedo

Basilio Pueo

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Alfonso Penichet-Tomas

Int. J. Environ. Res. Public Health 2020, 17(23), 8981; https://doi.org/10.3390/ijerph17238981 (registering DOI) - 02 Dec 2020

Abstract

The aim of this work was to evaluate the effectiveness of a 12-week-long balance training program on the postural control of elite male beach volleyball players and the effect on balance when swapping to specific sports training in the sand in the following 12 weeks. Six elite players were tested before and after the balance training program and also 12 weeks after the balance training had finished. To this aim, a pressure platform was used to collect the following center of pressure parameters: path length, speed, mean position, and root-mean-square amplitude in the medial-lateral and anteroposterior planes. Romberg quotients for the center of pressure parameters were also calculated. The results of the present study showed better static postural control after specific balance training: smaller path length and speed under open eyes condition in dominant (p = 0.015; p = 0.009, respectively) and non-dominant monopedal stances (p = 0.005; p = 0.004, respectively). Contrastingly, 12 weeks after the balance training program, the path length and speed values under open eyes condition in bipedal stance increased significantly (p = 0.045; p = 0.004, respectively) for sand training. According to our results, balance training is effective to achieve positive balance test scores. It is speculated, and yet to be proven, that sand training could be effective to improve dynamic and open eyes postural control during beach volleyball practice. In beach volleyball players, a balance training program is effective to develop static balance but the effect of ecological sand training on dynamic performance deserves specific investigation. Full article

(This article belongs to the Special Issue Stress and Training Load Effects on Recovery, Well-Being and Sports Performance)

Open AccessArticle

Serum Gamma Glutamyltransferase Is Associated with 25-Hydroxyvitamin D Status in Elderly Patients with Stable Coronary Artery Disease

Aleksander Danikiewicz

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Barbara Zubelewicz-Szkodzinska

Int. J. Environ. Res. Public Health 2020, 17(23), 8980; https://doi.org/10.3390/ijerph17238980 (registering DOI) - 02 Dec 2020

Abstract

Background: No previous study has investigated the association between gamma glutamyltransferase (GGT) and vitamin D in patients with stable coronary artery disease (CAD). We investigated the cross-sectional associations between vitamin D status as assessed by serum 25(OH)D and GGT. Methods: 169 patients were enrolled. Study population was divided into three groups: 1: 25(OH)D < 10 ng/mL (n = 59); 2: 25(OH)D 10–20 ng/mL (n = 82), and 3: 25(OH)D > 20 ng/mL (n = 28). Based on a cut-off GGT value identified in ROC analysis, we also divided the study population to compare the following groups: GGT ≤19 (n = 66) and GGT >19 (n = 103). Results: GGT activity was the highest in vitamin D severely deficient patients and the lowest in vitamin D insufficient patients. GGT was inversely correlated with 25(OH)D concentrations (R = −0.23; p = 0.002). The receiver operating characteristics curve identified the discrimination threshold of GGT of >19 U/L in predicting vitamin D deficiency. Higher leukocyte and neutrophil counts and lower 25(OH)D concentration were found in patients with GGT > 19 U/L. Conclusions: We identified an interaction between declining 25(OH)D levels and rising GGT levels with increasing age, which resulted in an unfavorable 25(OH)D-to-GGT ratio in stable CAD patients. These results suggest that these changes might further contribute to a high cardiovascular risk in the elderly. Full article

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Open AccessArticle

An Examination of Subway Sex Offense Modus Operandi: A Case of Seoul, South Korea

Taeyoung Kim

Seung Yeop Paek

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Julak Lee

Int. J. Environ. Res. Public Health 2020, 17(23), 8979; https://doi.org/10.3390/ijerph17238979 (registering DOI) - 02 Dec 2020

Abstract

Subway sex offenses are a serious issue in the nations around world, but existing research has failed to explore the offense types or patterns systematically. In order to fill this gap, the authors employed Crime Script Analysis (CSA) to examine the two most common subway sex offenses in Seoul, South Korea. Specifically, the authors assessed the reasoning behind the steps taken to prepare for, carry out, and complete harassment and surreptitious recording. The offenses committed in the subway stations around the city of Seoul were analyzed based on the interviews with the subway police, official crime reports, and crime case files. Drawing from the findings, theoretical and practical implications are discussed. Full article

(This article belongs to the Special Issue Psycho-criminology, Crime, and the Law)

Open AccessArticle

Minding the Gatekeepers: Referral and Recruitment of Postpartum Mothers with Depression into a Randomized Controlled Trial of a Mobile Internet Parenting Intervention to Improve Mood and Optimize Infant Social Communication Outcomes

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Int. J. Environ. Res. Public Health 2020, 17(23), 8978; https://doi.org/10.3390/ijerph17238978 (registering DOI) - 02 Dec 2020

Abstract

Mothers in the United States (U.S.) who are of non-dominant culture and socioeconomically disadvantaged experience depression during postpartum at a rate 3 to 4 times higher than mothers in the general population, but these mothers are least likely to receive services for improving mood. Little research has focused on recruiting these mothers into clinical intervention trials. The purpose of this article is to report on a study that provided a unique context within which to view the differential success of three referral approaches (i.e., community agency staff referral, research staff referral, and maternal self-referral). It also enabled a preliminary examination of whether the different strategies yielded samples that differed with regard to risk factors for adverse maternal and child outcomes. The examination took place within a clinical trial of a mobile intervention for improving maternal mood and increasing parent practices that promote infant social communication development. The sample was recruited within the urban core of a large southern city in the U.S. and was comprised primarily of mothers of non-dominant culture, who were experiencing severe socioeconomic disadvantage. Results showed that mothers self-referred at more than 3.5 times the rate that they were referred by either community agency staff or research staff. Moreover, compared to women referred by research staff, women who self-referred and those who were referred by community gatekeepers were as likely to eventually consent to study participation and initiate the intervention. Results are discussed with regard to implications for optimizing referral into clinical intervention trials. Full article

(This article belongs to the Special Issue Using Information and Communication Technologies (ICT) for Mental Health Prevention and Treatment)

Open AccessArticle

Engaging Older People in Age-Friendly Cities through Participatory Video Design

Margaret von Faber

Zsuzsu Tavy

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Suzan van der Pas

Int. J. Environ. Res. Public Health 2020, 17(23), 8977; https://doi.org/10.3390/ijerph17238977 (registering DOI) - 02 Dec 2020

Abstract

Participatory video design is a novel approach to collect experiences and perceptions of older people about the age-friendliness of their city or neighborhood. In this article, we describe how this co-creative method can add to specific knowledge about the preferences and needs of older people about the improvement or preservation of their environment. We describe two examples of this approach in the cities of The Hague and Leiden, the Netherlands. Persons of 60 years and older were invited to participate in a “workshop” on filmmaking focusing on age-friendly cities. A professional filmmaker and a researcher of the University of Applied Sciences worked in co-creation with older people, to produce short films on the topics that were perceived as important from the perspective of the participants. The older people worked in couples to produce their short films about the city or their neighborhood. Topics of the films included communication and information, outdoor spaces, social relations, and community support. The use of participatory video design can foster empowerment and social interaction among older participants, and insight into the preferences and needs of older people regarding age-friendly cities. Full article

(This article belongs to the Special Issue Feature Papers "Age-Friendly Cities & Communities: State of the Art and Future Perspectives")

Open AccessArticle

Transformation of a Ferry Ship into a Ship Hospital for COVID-19 Patients

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Int. J. Environ. Res. Public Health 2020, 17(23), 8976; https://doi.org/10.3390/ijerph17238976 (registering DOI) - 02 Dec 2020

Abstract

Liguria is a northwestern region of Italy that, since the WHO has declared COVID-19 as a pandemic (11 March 2020), presented 108 patients hospitalized, 34 of which were in the intensive care unit. Due to this serious epidemiological emergency, the transformation of a long-distance ferry ship into a hospital ship for COVID-19 patients who were still positive after the acute phase of the illness was carried out to free up hospital beds for patients in the acute phase. The ship was moored in the port of Genoa, the capital of Liguria. The conversion was localized to a single deck, where designated healthcare areas were identified. From 23 March to 18 June 2020, 191 patients were admitted onto the ship; they were provided with high-level healthcare guaranteed by the multi-disciplinary nature of clinical competencies available. Patients had a favorable outcome in all cases, confirmed by their recovery and negative swab results. Moreover, no cases of voluntary discharge were recorded. To the best of our knowledge, this is the only example in the world in which a passenger ship was transformed into a ship hospital for COVID patients. Full article

(This article belongs to the Special Issue Responding to COVID-19 from Local, Regional and Global Perspectives: Challenges and Solutions)

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