International Journal of Environmental Research and Public Health

Verbal encouragement (VE) is considered as external motivation provided by physical education teacher. For this reason, this study aimed to examine the effects of VE on psychophysiological and affective responses during small-sided games (SSG). Sixteen male school students (age: 17.37 ± 0.48 years) completed four sessions of a 4-a-side SSG. Two sessions occurred with VE (SSGE), and two sessions did not include VE (SSGNE). Heart rate was continuously recorded, and rating of perceived exertion (RPE) and blood lactate concentration ([La]b) were measured after each training session. Physical enjoyment was assessed after each protocol. Mood state was recorded before and after each training session using the profile of mood-state. HR max, [La]b, RPE, Physical enjoyment, and vigor were higher in SSGE compared to SSGNE (all, p < 0.001). The SSGE and SSGNE resulted in a decreased total mood disturbance (TMD) (p = 0.001, ES = 0.60; p = 0.04, ES = 0.33, respectively) and tension (p < 0.001, ES = 0.91; p = 0.004, ES = 0.47, respectively), and the vigor was increased after the SSGE (p < 0.001, ES = 0.76). SSGE and SSGNE induce similar improvement in TMD and tension. However, SSGE induced higher physiological responses, RPE, enjoyment, and positive mood than SSGNE. Physical education teachers could use VE during specific soccer sessions to improve physical aspects, enjoyment, and mood in participants. Full article

Because of fast-paced industrialization, urbanization, and population growth in Indonesia, there are serious health issues in the country resulting from air pollution. This study uses geospatial modelling technologies, namely land-use regression (LUR), geographically weighted regression (GWR), and geographic and temporal weighted regression (GTWR) models, to assess variations in particulate matter (PM₁₀) and nitrogen dioxide (NO₂) concentrations in Surabaya City, Indonesia. This is the first study to implement spatiotemporal variability of air pollution concentrations in Surabaya City, Indonesia. To develop the prediction models, air pollution data collected from seven monitoring stations from 2010 to 2018 were used as dependent variables, while land-use/land cover allocations within a 250 m to 5000 m circular buffer range surrounding the monitoring stations were collected as independent variables. A supervised stepwise variable selection procedure was applied to identify the important predictor variables for developing the LUR, GWR, and GTWR models. The developed models of LUR, GWR, and GTWR accounted for 49%, 50%, and 51% of PM₁₀ variations and 46%, 47%, and 48% of NO₂ variations, respectively. The GTWR model performed better (R² = 0.51 for PM₁₀ and 0.48 for NO₂) than the other two models (R² = 0.49–0.50 for PM₁₀ and 0.46–0.47 for NO₂), LUR and GWR. In the PM₁₀ model four predictor variables, public facility, industry and warehousing, paddy field, and normalized difference vegetation index (NDVI), were selected during the variable selection procedure. Meanwhile, paddy field, residential area, rainfall, and temperature played important roles in explaining NO₂ variations. Because of biomass burning issues in South Asia, the paddy field, which has a positive correlation with PM₁₀ and NO₂, was selected as a predictor. By using long-term monitoring data to establish prediction models, this model may better depict PM₁₀ and NO₂ concentration variations within areas across Asia. Full article

Concerns regarding environmental exposures and the impacts of pharmaceuticals on non-target aquatic organisms continue to increase. The antiepileptic drug carbamazepine (CBZ) is often detected as an aquatic contaminant and can disrupt various behaviors of fishes. However, there are few reports which investigate the mechanism of CBZ action in fish. The aim of the current study was to evaluate the effects of CBZ on embryonic development (i.e., hatching rate, heart rate, and body length) and early spontaneous movement. Moreover, we sought to investigate potential mechanisms by focusing on the gamma-aminobutyric acid (GABA) neurotransmitter system in zebrafish 6 days after of exposure. The results show that CBZ exposure did not cause significant effects on embryo development (hatching rate, heart rate, nor body length) at the test concentrations. However, the early spontaneous movement of embryos was inhibited following 10 μg/L CBZ exposure at 28–29 h post-fertilization (hpf). In addition, acetylcholinesterase (AChE) activity and GABA concentrations were increased with exposure, whereas glutamate (Glu) concentrations were decreased in larval zebrafish. Gene expression analysis revealed that GABA and glutamate metabolic pathways in zebrafish larvae were altered following exposure to CBZ. GABA transaminase (abat) and glutamic acid decarboxylase (gad1b) decreased to 100 µg/L, and glutamate receptor, ionotropic, N-methyl D-aspartate 1b (grin1b) as well as the glutamate receptor, ionotropic, α-amino-3hydroxy-5methylisoxazole-4propionic 2b (gria2b) were down-regulated with exposure to 1 µg/L CBZ. Our study suggests that CBZ, which can act as an agonist of the GABA_A receptor in humans, can also induce alterations in the GABAergic system in fish. Overall, this study improves understanding of the neurotoxicity and behavioral toxicity of zebrafish exposed to CBZ and generates data to be used to understand mechanisms of action that may underlie antiepileptic drug exposures. Full article

The current study examined the relationships among work support, role stress, work-family conflict, and life satisfaction, with a sample of social workers in China’s Pearl River Delta (N = 1414). Using structure equation modelling, the study revealed that social workers’ life satisfaction reduced because of role conflict and work-family conflicts. Work-family conflict partially mediated the negative effects of role ambiguity and conflict on social workers’ life satisfaction. Work support from their director, manager, supervisor, and co-workers protectively reduced role stress and work-family conflict. The findings emphasize the significance of managing the interference between work and family for social workers’ well-being. Full article

Virtual reality programs are being actively utilized in various education fields, but not many have been developed/used in nursing. This study aimed to explore the essential components and improvements needed in an adult nursing VR-based simulation training program for nursing students through focus group interviews (FGIs). This was a qualitative study. Fourteen nursing students from three cities in Korea who had experienced clinical practice and simulation training participated. They were divided into three FGIs. Data were collected from February–March 2020. We analyzed the data from the FGIs using Colaizzi’s phenomenological methodology. In total, 40 themes emerged, divided into 13 theme clusters and the following four categories. When developing an adult nursing VR-based simulation training program, the development should focus on addressing the limitations of conventional clinical practice, and these should be analyzed; it should also reflect students’ needs, including the following: provide an array of scenarios/skills to be trained; difficulty-specific learning scenarios; immediate feedback (e.g., those in computerized games); simulate emergency situations; simulate clinical cases that are difficult to experience in clinical practice; and allow for the training of patient–nurse communication skills. Full article

The aims of this study were to analyse the effects of unstable and stable bodyweight neuromuscular training on dynamic balance control and to analyse the between-group differences after the training period. Seventy-seven physically active young adults (48 males, 29 females, 19.1 ± 1.1 years, 170.2 ± 9.2 cm, 64.1 ± 10.7 kg) were distributed into an unstable training group (UTG), a stable training group (STG), and a control group (CG). Training was conducted three times a week for nine weeks. Pre-intervention and post-intervention measures included dynamic balance control using a Y Balance Test (YBT), anterior (A), posteromedial (PM), and posterolateral (PL) reach direction. A mixed ANOVA was executed to test the within-subjects factor and the between-subjects factor. Statistically significant differences were found for all YBT measures within groups (p = 0.01) and between groups (p = 0.01). After the intervention, UTG and STG presented meaningfully improved results in all YBT measures (A: 7%, p = 0.01; 4%, p = 0.02, PM: 8%, p = 0.01; 5%, p = 0.01, PL: 8%, p = 0.01; 4%, p = 0.04, respectively). No statistical changes were found for any of the measures in the CG. After the intervention, significant differences were observed between the UTG and CG for the YBTA and PM (p = 0.03; p = 0.01). The results suggest that neuromuscular training using an unstable surface had similar effects on dynamic balance control as training using a stable surface. When compared to CG, UTG showed better performance in YBTA and PM. Full article

A growing number of studies have revealed the association between health-related lifestyle habits and purpose in life. However, the mechanism linking the two has not been adequately understood. This study aims to examine the effect of changes in health-related lifestyle habits on purpose in life. A retrospective cohort study was conducted on certified professional specialists of health management. We analyzed the cohort’s demographic information, health-related lifestyle behaviors, reported changes in health-related lifestyle habits (exercise, diet, sleep, and other habits), and purpose in life using a validated tool (Ikigai-9). The cohort was divided into four groups based on the number of reported changes in health-related lifestyles. The purpose in life score was compared among the four groups with and without adjusting for lifestyle. In total, there were 4820 participants. The means (and SD) of the Ikigai-9 score for groups 1, 2, 3, and 4 were 31.4 (6.6), 32.2 (5.6), 32.8 (5.8), and 34.9 (5.4), respectively. There was a statistically significant difference in the Ikigai-9 score among the groups. Healthier changes in lifestyle habits increased perceptions of purpose in life. Both purpose in life and health-related lifestyle habits might be the target factors for disease prevention and health promotion. Full article

Diabetes mellitus (DM) is a major global public health problem with an increasing prevalence. DM increases the risk of infections caused by bacteria, fungi, viruses, and parasites. We examined the prevalence, subtypes, and risk factors of Blastocystis infection in patients with and without DM in central Thailand. Stool samples and questionnaires were obtained from 130 people in the DM group and 100 people in the non-DM group. Blastocystis infection was identified via a nested polymerase chain reaction and subtyped via sequencing of the partial small-subunit ribosomal RNA (SSU rRNA) gene. Analysis of potential risk factors was conducted via binary logistic regression. The overall prevalence of Blastocystis infection was 10.8%, including rates of 9% and 12.3% in the non-DM and DM groups, respectively. The most prevalent subtype was ST3, followed by ST1, and ST4. Factors that potentially increased the risk of Blastocystis infection include patients being >65 years old, the presence of DM, a DM duration of ≥10 years, a low level of education, and animal ownership. In conclusion, this is the first study of Blastocystis infection in DM, and a high prevalence was found among this population. Therefore, health education promoting sanitation and hygiene is necessary to reduce and prevent infection in the community. Full article

This study analyses broadcasted advertising spots during the COVID-19 isolation period in Spain. It aims to identify the narrative communicative resources and messages spread by companies/brands under the background of a global pandemic, where a common pattern highlighting the social function of brands is supposed, specifically regarding stress and resilience. We propose a mixed method based on the combination of qualitative analysis of the content of a compendium of 71 commercials and statistical analysis to group and test the correlations between some key variables, thus incorporating multivariate analysis with a quantitative method. Our main finding is the collective trend and communicative behaviour in the advertising of companies/brands during isolation, in which a change in the traditional role of advertising communication has occurred, where advertisers have become a key support in combatting the disease and a key support for health and psychological management in the Spanish population. In fact, they act as guardians of resilience and promoters for alleviating stress. Full article

The migrant population has increased in recent years and, as a result, so has cultural diversity. Universities are incorporating specific modules addressing cultural diversity. However, the native population has negative attitudes towards immigrants, as they believe that immigrants receive more social benefits and abuse healthcare services. Nurses may have these attitudes too, which may affect the way they treat patients. The objective of this study was to determine nursing students’ attitudes towards the rights of the migrant population. This is a descriptive ex post facto study using a cross-sectional design, with 821 nursing students in Melilla, Ceuta, and Almeria, Spain. An anonymous questionnaire was used for data collection. Students recognize the same rights for both the immigrant and native populations. More than 80% of the sample upholds the right of undocumented immigrants and their families to access publicly funded healthcare. Attitudes were more positive among students with a Berber background and first-year students. Students approved of the right of immigrants and their families to healthcare and education. The students’ negative attitudes towards the social rights of immigrants need to be addressed with intercultural training to reduce their prejudices as future professionals in a multicultural society. Full article

Social engagement and networking deter depression among older adults. During the COVID-19 pandemic, older adults are especially at risk of isolation from face-to-face and non-face-to-face interactions. We developed the National Center for Geriatrics and Gerontology Social Network Scale (NCGG-SNS) to assess frequency of, and satisfaction with, social interactions. The NCGG-SNS consists of four domains: face-to-face/non-face-to-face interactions with family/friends. Each domain score is obtained by multiplying frequency ratings by satisfaction ratings for each item; all scores were summed to obtain a total NCGG-SNS score (range: 0–64). Additionally, face-to-face and non-face-to-face subscores were calculated. Higher scores indicated satisfactory social networking. A cohort of 2445 older Japanese adults completed the NCGG-SNS and the Geriatrics Depression Scale-Short form. Receiver Operating Characteristic (ROC) analysis and logistic regression determined predictive validity for depressive symptoms. Depressive symptoms were reported by 284 participants (11.6%). The optimal NCGG-SNS cut-off value to identify depressive symptoms was 26.5 points. In logistic regression analysis adjusted for potential confounders, lower NCGG-SNS values were significantly associated with greater prevalence of depressive symptoms. Face-to-face and non-face-to-face subscores were associated with depressive symptoms. The NCGG-SNS is a valid and useful indicator of multidimensional social networking enabling identification of depressive symptoms in older adults. Full article

This research analyzes the presence of advertising and radio mentions of alcoholic beverages and sports betting, two products that represent harmful behaviors for the audiences’ health. To do this, a quantitative content analysis was undertaken for all of the programming of the three most listened radio stations in Spain (Cadena Ser, COPE, and Onda Cero) throughout 2017, obtaining a total corpus of 2848 radio messages distributed as follows: 266 radio spots and 2582 radio mentions. The messages were also analyzed according to the broadcasting schedules (protected time-slot or non-protected time-slot). The results showed that advertising and sports betting mentions were more present in the regular programming of the three stations (n = 2304), with mentions (n = 2582) being more numerous than advertising spots (n = 544). Moreover, it is evident that in practice, none of the radio stations respected the protected time slots since the majority of the mentions and spots of high alcoholic beverages and sports bets were verified between 6:00–21:59 (n = 2522). These results show the prevailing need for greater control over this type of content by public entities, demonstrating a significant lack of regulation by the media’s self-control mechanisms. Full article

Promoting patient safety culture (PSC) is a critical issue for healthcare providers. Quality control circles program (QCCP) can be used as an effective tool to foster long-lasting improvements on the quality of medical institution. The effect of QCCP on PSC is still unknown. This was a retrospective study conducted with matching data. A safety attitudes questionnaire (SAQ) was used for the evaluation of PSC. The association between all scores of six subscales of SAQ and the participation QCCP were analyzed with both the Mann–Whitney and Kruskal–Wallis tests. A total of 2718 valid questionnaires were collected. Most participants of QCCP were females (78.9%), nurses (52.6%), non-supervisors (92.2%), aged <40 years old (64.8%), degree of specialist or university graduates (78%), and with work experience of <10 years (61.6%). Of all participants, the highest scores were in the dimension of safety climate (74.11 ± 17.91) and the lowest scores in the dimension of working conditions (68.90 ± 18.84). The participation of QCCP was associated with higher scores in four dimensions, namely: teamwork climate (p = 0.006), safety climate (p = 0.037), perception of management (p = 0.009), and working conditions (p = 0.015). The participation or not of QCCP had similar results in the dimension of job satisfaction and stress recognition. QCCP was associated with SAQ in subjects with the following characteristics: female, nurse, non-supervisor, aged >50 years old, higher education degrees and with longer working experiences in the hospital. In this first study on the association between each dimension of SAQ and the implementation of QCCP, we found that QCCP interventions were associated with better PSC. QCCP had no benefits in the dimensions of job satisfaction and stress recognition. Full article

This study used a cross-sectional design and a person-centered approach in order to test the addictive and interactive strain hypotheses of Job Demands–Control Model to explain burnout. A large sample (n = 6357) of Portuguese workers (nurses, bank employees, retail traders, and contact center agents) was used. Through latent profile analysis (LPA), first latent profiles of demands and control were identified and then it was examined how these profiles differed in workplace well-being (engagement and burnout) through an ANCOVA. The four hypothesized profiles (i.e., “high-strain”, “low-Strain”, “passive”, and “active”) and one more profile denominated “moderate active”, emerged from LPA analysis. The hypotheses were supported in both addictive effects and interactive effects (buffer hypothesis), suggesting that the difficulty in finding consistent support for the buffer hypothesis might be related to the use of variable-centered approaches. Moreover, this reinforces that, in organizational practice, job control is a crucial characteristic to face job demands, as job control will buffer job demands’ harmful effects on workplace well-being. Full article

Venting range hoods can control indoor air pollutants emitted during residential cooktop and oven cooking. To quantify their potential benefits, it is important to know how frequently and under what conditions range hoods are operated during cooking. We analyzed data from 54 single family houses and 17 low-income apartments in California in which cooking activities, range hood use, and fine particulate matter (PM_2.5) were monitored for one week per home. Range hoods were used for 36% of cooking events in houses and 28% in apartments. The frequency of hood use increased with cooking frequency across homes. In both houses and apartments, the likelihood of hood use during a cooking event increased with the duration of cooktop burner use, but not with the duration of oven use. Actual hood use rates were higher in the homes of participants who self-reported more frequent use in a pre-study survey, but actual use was far lower than self-reported frequency. Residents in single family houses used range hoods more often when cooking caused a discernible increase in PM_2.5. In apartments, residents used their range hood more often only when high concentrations of PM_2.5 were generated during cooking. Full article

(1) The aim of this study was to identify the association between post-materialism and health care use (in terms of the frequency of doctor visits and the reason for doctor visits). (2) Data were taken from the German General Social Survey (a representative sample of individuals aged 18 years and over, n = 3338). The Inglehart’s post-materialist index was used to quantify post-materialism. The doctor visits (self-reported) in the past three months served as an outcome measure. The reasons for seeing a doctor served as an additional outcome measure (acute illness; chronic illness; feeling unwell; requesting advice; visit to the doctor’s office without consulting the doctor (e.g., need to get a prescription); preventive medical check-up/vaccination). (3) After adjusting for several covariates, negative binomial regressions revealed that compared with materialism, post-materialism was associated with decreased doctor visits (total sample; women). Moreover, the likelihood of visiting the doctor for reasons of chronic illnesses was lower in post-materialistic women, whereas the likelihood of visiting the doctor for reasons of preventive medical check-up/vaccination was higher in post-materialistic women. (4) Study findings identify an unexplored link between post-materialism and doctor visits in women. One may conclude that in the long-term, the increased likelihood of preventive medical check-ups in post-materialistic women will be beneficial in decreasing the need for doctor visits for reasons of chronic illnesses. However, future research is required to elucidate the underlying mechanisms. Full article

Subcutaneous masses smaller than 5 cm can be malignant, in contrast with the international guidelines. Ultrasound (US) and magnetic resonance imaging (MRI) are useful to distinguish a potentially malignant mass from the numerous benign soft tissue (ST) lesions. Contrast-enhanced ultrasound (CEUS) was applied in ST tumors, without distinguishing the subcutaneous from the deep lesions. We evaluated CEUS and MRI accuracy in comparison to histology in differentiating malignant from nonmalignant superficial ST masses, 50% smaller than 5 cm. Sensitivity, specificity, and positive and negative predictive values (PPV, NPV) with their 95% confidence intervals (CI) were calculated. Of malignant cases, 44.4% measured ≤ 5 cm. At univariate analysis, no statistically significant differences emerged between benign and malignant tumors in relation with clinical characteristics, except for relationship with the deep fascia (p = 0.048). MRI accuracy: sensitivity 52.8% (CI 37.0, 68.0), specificity 74.1% (CI 55.3, 86.8), PPV 73.1% (CI 53.9, 86.3), and NPV 54.1% (CI 38.4, 69.0). CEUS accuracy: sensitivity 75% (CI 58.9, 86.3), specificity 37% (CI 21.5, 55.8), PPV 61.4% (CI 46.6, 74.3), and NPV 52.6% (CI 31.7, 72.7). CEUS showed a sensitivity higher than MRI, whereas PPV and NPV were comparable. Also, masses measuring less than 5 cm can be malignant and referral criteria for centralization could be revised. Full article

The 2019 Coronavirus (COVID-19) outbreak caused home confinement, as well as training and sport competitions withdrawals. The prolonged inactivity impact, and lack of in-person interactions among teammates-coaches, could negatively affect athletes. Total of 1508 self-selected Italian athletes, 338 children (aged 10.52 ± 1.31), 499 adolescents (aged 14.17 ± 1.13), and 671 adults (aged 27.59 ± 10.73), completed the Impact of Event Scale (IES-8, IES-15, and IES-R, respectively). Differences by gender, type of sport (individual vs. team), and competitive level (elite vs. amateur) were examined. One-way ANOVAs showed, in adults, significant differences between genders for perceived stress impact total score (TS; p = 0.017) and avoidance behavior, with higher scores in women (p = 0.045). Between individual and team sport, significant differences were found in TS (p = 0.038) and hyperarousal (p = 0.030), with higher results in individual. Adult elite athletes showed significantly higher scores in hyperarousal (p = 0.020) than amateurs. Significant differences were found between gender in adolescents for avoidance (p = 0.011), and between competitive levels in children, for intrusion (p = 0.020). These evidences may raise awareness on distress effects of COVID-19 lockdown among athletes and suggested applying specific well-being protocols during the activity resumption, considering gender, type of sport, and competitive level. Full article

Advances generated in medicine, science, and technology have contributed to a better quality of life in recent years; however, antimicrobial resistance has also benefited from these advances, creating various environmental and health problems. Several determinants may explain the problem of antimicrobial resistance, such as wastewater treatment plants that represent a powerful agent for the promotion of antibiotic-resistant bacteria (ARB) and antibiotic resistance genes (ARG), and are an important factor in mitigating the problem. This article focuses on reviewing current technologies for ARB and ARG removal treatments, which include disinfection, constructed wetlands, advanced oxidation processes (AOP), anaerobic, aerobic, or combined treatments, and nanomaterial-based treatments. Some of these technologies are highly intensive, such as AOP; however, other technologies require long treatment times or high doses of oxidizing agents. From this review, it can be concluded that treatment technologies must be significantly enhanced before the environmental and heath problems associated with antimicrobial resistance can be effectively solved. In either case, it is necessary to achieve total removal of bacteria and genes to avoid the possibility of regrowth given by the favorable environmental conditions at treatment plant facilities. Full article