International Journal of Environmental Research and Public Health

9 pages, 319 KiB

Open AccessEditor’s ChoiceArticle

Effect of the COVID-19 Emergency on Physical Function among School-Aged Children

by Tadashi Ito, Hideshi Sugiura, Yuji Ito, Koji Noritake and Nobuhiko Ochi

Int. J. Environ. Res. Public Health 2021, 18(18), 9620; https://doi.org/10.3390/ijerph18189620 - 13 Sep 2021

Cited by 21 | Viewed by 4580

In April 2020, the Japanese government declared a state of emergency due to the novel coronavirus disease (COVID-19). Schools were closed and a stay-at-home order was issued in April and May 2020. This before-and-after study aimed to measure the effects of these COVID-19-related [...] Read more.

In April 2020, the Japanese government declared a state of emergency due to the novel coronavirus disease (COVID-19). Schools were closed and a stay-at-home order was issued in April and May 2020. This before-and-after study aimed to measure the effects of these COVID-19-related restrictions on physical function among Japanese children. The study included children aged 6–7 years, enrolled before and after the emergency declaration. Their body fat percentage, single-leg standing time, Gait Deviation Index score, and history of falls were compared. There were 56 and 54 children in the before and after groups, respectively. Children in the after group had a higher body fat percentage (p = 0.037), shorter single-leg standing time (p = 0.003), and a larger number of falls per month (p < 0.001) than those in the before group. In the logistic regression analysis, children in the after group had a significantly shorter single-leg standing time (odds ratio (OR): 0.985, 95% confidence interval (CI): 0.972−0.997, p = 0.013), a greater number of falls per month (OR: 1.899, 95% CI: 1.123−3.210, p = 0.017), and a higher body fat percentage (OR: 1.111, 95% CI: 1.016−1.215, p = 0.020) than those in the before group. The COVID-19 emergency restrictions had a negative effect on children’s physical function, especially on balance. Full article

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

23 pages, 8912 KiB

Open AccessEditor’s ChoiceArticle

The Driving Influence of Multi-Dimensional Urbanization on PM_2.5 Concentrations in Africa: New Evidence from Multi-Source Remote Sensing Data, 2000–2018

by Guoen Wei, Pingjun Sun, Shengnan Jiang, Yang Shen, Binglin Liu, Zhenke Zhang and Xiao Ouyang

Int. J. Environ. Res. Public Health 2021, 18(17), 9389; https://doi.org/10.3390/ijerph18179389 - 6 Sep 2021

Cited by 26 | Viewed by 4173

Abstract

Africa’s PM_2.5 pollution has become a security hazard, but the understanding of the varying effects of urbanization on driven mechanisms of PM_2.5 concentrations under the rapid urbanization remains largely insufficient. Compared with the direct impact, the spillover effect of urbanization on [...] Read more.

Africa’s PM_2.5 pollution has become a security hazard, but the understanding of the varying effects of urbanization on driven mechanisms of PM_2.5 concentrations under the rapid urbanization remains largely insufficient. Compared with the direct impact, the spillover effect of urbanization on PM_2.5 concentrations in adjacent regions was underestimated. Urbanization is highly multi-dimensional phenomenon and previous studies have rarely distinguished the different driving influence and interactions of multi-dimensional urbanization on PM_2.5 concentrations in Africa. This study combined grid and administrative units to explore the spatio-temporal change, spatial dependence patterns, and evolution trend of PM_2.5 concentrations and multi-dimensional urbanization in Africa. The differential influence and interaction effects of multi-dimensional urbanization on PM_2.5 concentrations under Africa’s rapid urbanization was further analyzed. The results show that the positive spatial dependence of PM_2.5 concentrations gradually increased over the study period 2000–2018. The areas with PM_2.5 concentrations exceeding 35 μg/m³ increased by 2.2%, and 36.78% of the African continent had an increasing trend in Theil–Sen index. Urbanization was found to be the main driving factor causing PM_2.5 concentrations changes, and economic urbanization had a stronger influence on air quality than land urbanization or population urbanization. Compared with the direct effect, the spillover effect of urbanization on PM_2.5 concentrations in two adjacent regions was stronger, particularly in terms of economic urbanization. The spatial distribution of PM_2.5 concentrations resulted from the interaction of multi-dimensional urbanization. The interaction of urbanization of any two different dimensions exhibited a nonlinear enhancement effect on PM_2.5 concentrations. Given the differential impact of multi-dimensional urbanization on PM_2.5 concentrations inside and outside the region, this research provides support for the cross-regional joint control strategies of air pollution in Africa. The findings also indicate that PM_2.5 pollution control should not only focus on urban economic development strategies but should be an optimized integration of multiple mitigation strategies, such as improving residents’ lifestyles, optimizing land spatial structure, and upgrading the industrial structure. Full article

(This article belongs to the Special Issue Air Pollution in Africa and the African Diaspora)

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14 pages, 817 KiB

Open AccessEditor’s ChoiceArticle

School Teachers’ Self-Reported Fear and Risk Perception during the COVID-19 Pandemic—A Nationwide Survey in Germany

by Stefanie Weinert, Anja Thronicke, Maximilian Hinse, Friedemann Schad and Harald Matthes

Int. J. Environ. Res. Public Health 2021, 18(17), 9218; https://doi.org/10.3390/ijerph18179218 - 1 Sep 2021

Cited by 23 | Viewed by 4482

Abstract

With the coronavirus disease 2019 (COVID-19) cases peaking and health systems reaching their limits in winter 2020/21, schools remained closed in many countries. To better understand teachers’ risk perception, we conducted a survey in Germany. Participants were recruited through various associations and invited [...] Read more.

With the coronavirus disease 2019 (COVID-19) cases peaking and health systems reaching their limits in winter 2020/21, schools remained closed in many countries. To better understand teachers’ risk perception, we conducted a survey in Germany. Participants were recruited through various associations and invited to take part in a cross-sectional COVID-19-specific online survey. Descriptive statistical analysis was performed. Factors associated with teachers’ fears of contracting the severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2) were evaluated with an adjusted multivariable regression analysis. The median age of the 6753 participating teachers was 43 years, and 77% were female. Most teachers worked in high schools (29%) and elementary schools (26%). The majority of participants (73%) feared contracting SARS-CoV-2 at school, while 77% intended to receive their COVID-19 vaccination. Ninety-eight percent considered students to pose the greatest risk. Female and younger teachers were significantly more anxious to get infected and teachers who opposed the re-opening of schools had significantly higher odds of being more anxious (p < 0.001). To the authors’ knowledge, this is the first study to describe teachers’ risk perception of COVID-19 and their attitudes towards vaccinations in a nationwide survey. The anxiety correlates with the COVID-19 protection measures demanded and appears to be a driving factor rather than rational logic. Full article

(This article belongs to the Collection Outbreak of a Novel Coronavirus: A Global Health Threat)

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8 pages, 321 KiB

Open AccessFeature PaperEditor’s ChoiceReview

Will Nothing Be the Same Again?: Changes in Lifestyle during COVID-19 Pandemic and Consequences on Mental Health

by Emanuele Caroppo, Marianna Mazza, Alessandra Sannella, Giuseppe Marano, Carla Avallone, Angelo Emilio Claro, Delfina Janiri, Lorenzo Moccia, Luigi Janiri and Gabriele Sani

Int. J. Environ. Res. Public Health 2021, 18(16), 8433; https://doi.org/10.3390/ijerph18168433 - 10 Aug 2021

Cited by 155 | Viewed by 17644

Abstract

Social isolation caused by the COVID-19 pandemic has drastically affected lifestyles: from sedentary behaviors to reduced physical activity, from disrupted sleep patterns to altered dietary habits. As a consequence, serious mental and emotional responses have been registered. There was a significant decline in [...] Read more.

Social isolation caused by the COVID-19 pandemic has drastically affected lifestyles: from sedentary behaviors to reduced physical activity, from disrupted sleep patterns to altered dietary habits. As a consequence, serious mental and emotional responses have been registered. There was a significant decline in physical and other meaningful activities of daily living, leisure, social activity, and education. In children, collateral effects of the pandemic include inadequate nutrition with a risk of both overweight and underweight, addiction to screens, lack of schooling, and psychosocial difficulties. Older adults are frequently unable to adapt to lockdown measures and suffer from depression and cognitive complaints. Recent studies focusing on changes in lifestyle during the Covid-19 pandemic and consequences on mental health have been identified in PubMed/Medline, Scopus, Embase, and ScienceDirect. All the available literature has been retrospectively reviewed. The results of the present narrative review suggest that mental distress caused by social isolation seems to be linked not only to personality characteristics but also to several lifestyle components (sleep disruption, altered eating habits, reduced physical activity). This review aims to explore major changes in the lifestyle and quality of life and the impact of these changes on mental health, and to inform clinicians and policymakers about elements that may reduce the negative psychological effects of the quarantine period imposed during this worldwide crisis. There is an urgent need for tailored preventive, diagnostic, and therapeutic mental health interventions for the general population and for higher risk groups. Full article

(This article belongs to the Special Issue Health Promotion in Relation to Behavioral Nutrition and Physical Activity in the Era of Sars-Cov2 Pandemic)

16 pages, 2916 KiB

Open AccessEditor’s ChoiceArticle

One-Year Lesson: Machine Learning Prediction of COVID-19 Positive Cases with Meteorological Data and Mobility Estimate in Japan

by Essam A. Rashed and Akimasa Hirata

Int. J. Environ. Res. Public Health 2021, 18(11), 5736; https://doi.org/10.3390/ijerph18115736 - 27 May 2021

Cited by 27 | Viewed by 5717

Abstract

With the wide spread of COVID-19 and the corresponding negative impact on different life aspects, it becomes important to understand ways to deal with the pandemic as a part of daily routine. After a year of the COVID-19 pandemic, it has become obvious [...] Read more.

With the wide spread of COVID-19 and the corresponding negative impact on different life aspects, it becomes important to understand ways to deal with the pandemic as a part of daily routine. After a year of the COVID-19 pandemic, it has become obvious that different factors, including meteorological factors, influence the speed at which the disease is spread and the potential fatalities. However, the impact of each factor on the speed at which COVID-19 is spreading remains controversial. Accurate forecasting of potential positive cases may lead to better management of healthcare resources and provide guidelines for government policies in terms of the action required within an effective timeframe. Recently, Google Cloud has provided online COVID-19 forecasting data for the United States and Japan, which would help in predicting future situations on a state/prefecture scale and are updated on a day-by-day basis. In this study, we propose a deep learning architecture to predict the spread of COVID-19 considering various factors, such as meteorological data and public mobility estimates, and applied it to data collected in Japan to demonstrate its effectiveness. The proposed model was constructed using a neural network architecture based on a long short-term memory (LSTM) network. The model consists of multi-path LSTM layers that are trained using time-series meteorological data and public mobility data obtained from open-source data. The model was tested using different time frames, and the results were compared to Google Cloud forecasts. Public mobility is a dominant factor in estimating new positive cases, whereas meteorological data improve their accuracy. The average relative error of the proposed model ranged from 16.1% to 22.6% in major regions, which is a significant improvement compared with Google Cloud forecasting. This model can be used to provide public awareness regarding the morbidity risk of the COVID-19 pandemic in a feasible manner. Full article

(This article belongs to the Special Issue Deep Learning: AI Steps Up in Battle against COVID-19)

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19 pages, 434 KiB

Open AccessEditor’s ChoiceReview

Associations between Nature Exposure and Health: A Review of the Evidence

by Marcia P. Jimenez, Nicole V. DeVille, Elise G. Elliott, Jessica E. Schiff, Grete E. Wilt, Jaime E. Hart and Peter James

Int. J. Environ. Res. Public Health 2021, 18(9), 4790; https://doi.org/10.3390/ijerph18094790 - 30 Apr 2021

Cited by 325 | Viewed by 55308

Abstract

There is extensive empirical literature on the association between exposure to nature and health. In this narrative review, we discuss the strength of evidence from recent (i.e., the last decade) experimental and observational studies on nature exposure and health, highlighting research on children [...] Read more.

There is extensive empirical literature on the association between exposure to nature and health. In this narrative review, we discuss the strength of evidence from recent (i.e., the last decade) experimental and observational studies on nature exposure and health, highlighting research on children and youth where possible. We found evidence for associations between nature exposure and improved cognitive function, brain activity, blood pressure, mental health, physical activity, and sleep. Results from experimental studies provide evidence of protective effects of exposure to natural environments on mental health outcomes and cognitive function. Cross-sectional observational studies provide evidence of positive associations between nature exposure and increased levels of physical activity and decreased risk of cardiovascular disease, and longitudinal observational studies are beginning to assess long-term effects of nature exposure on depression, anxiety, cognitive function, and chronic disease. Limitations of current knowledge include inconsistent measures of exposure to nature, the impacts of the type and quality of green space, and health effects of duration and frequency of exposure. Future directions include incorporation of more rigorous study designs, investigation of the underlying mechanisms of the association between green space and health, advancement of exposure assessment, and evaluation of sensitive periods in the early life-course. Full article

(This article belongs to the Special Issue Greenspaces and Health: Measures and Methods)

12 pages, 630 KiB

Open AccessEditor’s ChoiceArticle

Quality of Life Changes during the COVID-19 Pandemic for Caregivers of Children with ADHD and/or ASD

by Keith W. Pecor, Georgia Barbayannis, Max Yang, Jacklyn Johnson, Sarah Materasso, Mauricio Borda, Disleidy Garcia, Varsha Garla and Xue Ming

Int. J. Environ. Res. Public Health 2021, 18(7), 3667; https://doi.org/10.3390/ijerph18073667 - 1 Apr 2021

Cited by 52 | Viewed by 8842

Abstract

The COVID-19 pandemic has presented many challenges to caregivers of children. Families with children with attention-deficit/hyperactivity disorder (ADHD) and/or autism spectrum disorder (ASD) are an understudied but potentially vulnerable population to changes during the outbreak. As such, the aim of this study was [...] Read more.

The COVID-19 pandemic has presented many challenges to caregivers of children. Families with children with attention-deficit/hyperactivity disorder (ADHD) and/or autism spectrum disorder (ASD) are an understudied but potentially vulnerable population to changes during the outbreak. As such, the aim of this study was to contrast quality of life for caregivers of children with ADHD and/or ASD, before and during the pandemic, compared to caregivers of neurotypical (NT) children. Total, Parent Health-Related Quality of Life, and Family Functioning Summary Scores from the Family Impact Module of the Pediatric Quality of Life Inventory^TM were contrasted among caregivers of children with ADHD, ASD, comorbid ADHD and ASD, and NT development. For all scores, caregivers of ADHD and/or ASD children reported lower quality of life, both before and during the pandemic, in comparison to caregivers of NT children. For all diagnoses, quality of life decreased during the pandemic, but caregivers of children with ADHD and/or ASD reported a greater decrease in quality of life than caregivers for NT children. There are limitations to this study in terms of the composition of the sample and the survey methodology, but we are able to conclude that caregivers of children with ADHD and/or ASD have been disproportionately affected by the pandemic, and it is imperative that these families receive additional resources and support to improve their quality of life. Full article

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

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23 pages, 928 KiB

Open AccessEditor’s ChoiceReview

Green Gentrification and Health: A Scoping Review

by Na’Taki Osborne Jelks, Viniece Jennings and Alessandro Rigolon

Int. J. Environ. Res. Public Health 2021, 18(3), 907; https://doi.org/10.3390/ijerph18030907 - 21 Jan 2021

Cited by 92 | Viewed by 23261

Abstract

Urban greening initiatives are often linked to enhanced human health and wellbeing, but they can also be a driver of gentrification. To date, few studies have focused on how green gentrification shapes health. In this scoping review, we analyzed existing peer-reviewed research on [...] Read more.

Urban greening initiatives are often linked to enhanced human health and wellbeing, but they can also be a driver of gentrification. To date, few studies have focused on how green gentrification shapes health. In this scoping review, we analyzed existing peer-reviewed research on how greening initiatives in gentrifying neighborhoods impact health, well-being, and health pathways (e.g., physical activity, affordable housing). Using a multi-step approach to scoping the literature (including searches in PubMed, JSTOR, and Google Scholar), we identified 15 empirical studies that met our inclusion criteria. We found studies focusing on green space use, physical activity, sense of community, safety, and self-reported health. Overall, longtime, marginalized residents are negatively impacted by green gentrification as they experience a lower sense of community, feel that they do not belong in green space, and, in many studies, use green space less often than newcomers. Overall, the research in this area is limited, and more studies on mental health and cardiovascular health markers could advance this literature. Based on the limited available evidence, we suggest that public health, urban planning, and parks professionals could collaborate to enhance the use of green space for marginalized residents and their feelings of inclusion in gentrifying areas. Full article

(This article belongs to the Special Issue Environmental Health: Feature Review Papers)

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16 pages, 569 KiB

Open AccessEditor’s ChoiceReview

Psychological Wellbeing in Physical Education and School Sports: A Systematic Review

by Javier Piñeiro-Cossio, Antonio Fernández-Martínez, Alberto Nuviala and Raquel Pérez-Ordás

Int. J. Environ. Res. Public Health 2021, 18(3), 864; https://doi.org/10.3390/ijerph18030864 - 20 Jan 2021

Cited by 52 | Viewed by 18686

Abstract

Mental health in children and adolescents has become an increasingly important topic in recent years. It is against this backdrop that physical education and school sports play an important role in promoting psychological wellbeing. The aim of this review was to analyse interventions [...] Read more.

Mental health in children and adolescents has become an increasingly important topic in recent years. It is against this backdrop that physical education and school sports play an important role in promoting psychological wellbeing. The aim of this review was to analyse interventions for improving psychological wellbeing in this area. To this end, a literature review was conducted using four databases (WOS, SPORTDiscus, SCOPUS and ERIC) and the following keywords: psychological wellbeing, physical education, and school sports. Twenty-one articles met the inclusion criteria. The results showed that interventions varied greatly in terms of duration and used a wide range of strategies (conventional and non-conventional sports, physical activity, games, etc.) for promoting psychological wellbeing, primarily among secondary school students. There was a lack of consensus as to the conceptualisation of the construct of psychological wellbeing, resulting in a variety of tools and methods for assessing it. Some studies also suggested a link between psychological wellbeing and other variables, such as basic psychological needs and self-determination. Finally, this study provides a definition of psychological wellbeing through physical activity based on our findings. Full article

(This article belongs to the Special Issue Physical Activity in Children's Health: Management for Leisure, Recreation and Sports)

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24 pages, 2271 KiB

Open AccessEditor’s ChoiceReview

Indoor Exposure to Selected Air Pollutants in the Home Environment: A Systematic Review

by Sotiris Vardoulakis, Evanthia Giagloglou, Susanne Steinle, Alice Davis, Anne Sleeuwenhoek, Karen S. Galea, Ken Dixon and Joanne O. Crawford

Int. J. Environ. Res. Public Health 2020, 17(23), 8972; https://doi.org/10.3390/ijerph17238972 - 2 Dec 2020

Cited by 331 | Viewed by 27416

Abstract

(1) Background: There is increasing awareness that the quality of the indoor environment affects our health and well-being. Indoor air quality (IAQ) in particular has an impact on multiple health outcomes, including respiratory and cardiovascular illness, allergic symptoms, cancers, and premature mortality. (2) [...] Read more.

(1) Background: There is increasing awareness that the quality of the indoor environment affects our health and well-being. Indoor air quality (IAQ) in particular has an impact on multiple health outcomes, including respiratory and cardiovascular illness, allergic symptoms, cancers, and premature mortality. (2) Methods: We carried out a global systematic literature review on indoor exposure to selected air pollutants associated with adverse health effects, and related household characteristics, seasonal influences and occupancy patterns. We screened records from six bibliographic databases: ABI/INFORM, Environment Abstracts, Pollution Abstracts, PubMed, ProQuest Biological and Health Professional, and Scopus. (3) Results: Information on indoor exposure levels and determinants, emission sources, and associated health effects was extracted from 141 studies from 29 countries. The most-studied pollutants were particulate matter (PM_2.5 and PM₁₀); nitrogen dioxide (NO₂); volatile organic compounds (VOCs) including benzene, toluene, xylenes and formaldehyde; and polycyclic aromatic hydrocarbons (PAHs) including naphthalene. Identified indoor PM_2.5 sources include smoking, cooking, heating, use of incense, candles, and insecticides, while cleaning, housework, presence of pets and movement of people were the main sources of coarse particles. Outdoor air is a major PM_2.5 source in rooms with natural ventilation in roadside households. Major sources of NO₂ indoors are unvented gas heaters and cookers. Predictors of indoor NO₂ are ventilation, season, and outdoor NO₂ levels. VOCs are emitted from a wide range of indoor and outdoor sources, including smoking, solvent use, renovations, and household products. Formaldehyde levels are higher in newer houses and in the presence of new furniture, while PAH levels are higher in smoking households. High indoor particulate matter, NO₂ and VOC levels were typically associated with respiratory symptoms, particularly asthma symptoms in children. (4) Conclusions: Household characteristics and occupant activities play a large role in indoor exposure, particularly cigarette smoking for PM_2.5, gas appliances for NO₂, and household products for VOCs and PAHs. Home location near high-traffic-density roads, redecoration, and small house size contribute to high indoor air pollution. In most studies, air exchange rates are negatively associated with indoor air pollution. These findings can inform interventions aiming to improve IAQ in residential properties in a variety of settings. Full article

(This article belongs to the Special Issue Designing Healthy Indoor Air Quality)

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20 pages, 1075 KiB

Open AccessEditor’s ChoiceArticle

Updating the Mediterranean Diet Pyramid towards Sustainability: Focus on Environmental Concerns

by Lluís Serra-Majem, Laura Tomaino, Sandro Dernini, Elliot M. Berry, Denis Lairon, Joy Ngo de la Cruz, Anna Bach-Faig, Lorenzo M. Donini, Francesc-Xavier Medina, Rekia Belahsen, Suzanne Piscopo, Roberto Capone, Javier Aranceta-Bartrina, Carlo La Vecchia and Antonia Trichopoulou

Int. J. Environ. Res. Public Health 2020, 17(23), 8758; https://doi.org/10.3390/ijerph17238758 - 25 Nov 2020

Cited by 252 | Viewed by 33815

Abstract

Background: Nowadays the food production, supply and consumption chain represent a major cause of ecological pressure on the natural environment, and diet links worldwide human health with environmental sustainability. Food policy, dietary guidelines and food security strategies need to evolve from the limited [...] Read more.

Background: Nowadays the food production, supply and consumption chain represent a major cause of ecological pressure on the natural environment, and diet links worldwide human health with environmental sustainability. Food policy, dietary guidelines and food security strategies need to evolve from the limited historical approach, mainly focused on nutrients and health, to a new one considering the environmental, socio-economic and cultural impact—and thus the sustainability—of diets. Objective: To present an updated version of the Mediterranean Diet Pyramid (MDP) to reflect multiple environmental concerns. Methods: We performed a revision and restructuring of the MDP to incorporate more recent findings on the sustainability and environmental impact of the Mediterranean Diet pattern, as well as its associations with nutrition and health. For each level of the MDP we provided a third dimension featuring the corresponding environmental aspects related to it. Conclusions: The new environmental dimension of the MDP enhances food intake recommendations addressing both health and environmental issues. Compared to the previous 2011 version, it emphasizes more strongly a lower consumption of red meat and bovine dairy products, and a higher consumption of legumes and locally grown eco-friendly plant foods as much as possible. Full article

(This article belongs to the Special Issue Food Safety, Security, Sustainability and Nutrition as Priority Objectives of the Food Sector)

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12 pages, 2000 KiB

Open AccessEditor’s ChoiceArticle

Severe Housing Insecurity during Pregnancy: Association with Adverse Birth and Infant Outcomes

by Kathryn M. Leifheit, Gabriel L. Schwartz, Craig E. Pollack, Kathryn J. Edin, Maureen M. Black, Jacky M. Jennings and Keri N. Althoff

Int. J. Environ. Res. Public Health 2020, 17(22), 8659; https://doi.org/10.3390/ijerph17228659 - 21 Nov 2020

Cited by 54 | Viewed by 8895

Abstract

Introduction: Housing insecurity is increasingly commonplace among disadvantaged women and children. We measured the individual- and population-level impact of severe housing insecurity during pregnancy on adverse birth and infant outcomes. Methods: We analyzed data from 3428 mother–infant dyads enrolled in the Fragile Families [...] Read more.

Introduction: Housing insecurity is increasingly commonplace among disadvantaged women and children. We measured the individual- and population-level impact of severe housing insecurity during pregnancy on adverse birth and infant outcomes. Methods: We analyzed data from 3428 mother–infant dyads enrolled in the Fragile Families and Child Wellbeing Study, a prospective cohort study representing births in 20 large U.S. cities from 1998 to 2000. Severe housing insecurity was defined as threatened eviction or homelessness during pregnancy. Outcomes included low birth weight and/or preterm birth, admission to a neonatal intensive care unit (NICU) or stepdown facility, extended hospitalization after delivery, and infant health and temperament. We estimated exposure–outcome associations with risk ratios adjusted for pre-pregnancy maternal sociodemographic and heath factors and calculated a population attributable fraction (PAF) of outcomes attributable to severe housing insecurity. Results: We found statistically significant associations between severe housing insecurity during pregnancy and low birth weight and/or preterm birth (risk ratio (RR] 1.73, 95% confidence interval (CI) 1.28, 2.32), NICU or stepdown stay (RR 1.64, CI 1.17, 2.31), and extended hospitalization (RR 1.66, CI 1.28, 2.16). Associations between housing insecurity and infant fair or poor health (RR 2.62, CI 0.91, 7.48) and poor temperament (RR 1.52, CI 0.98, 2.34) were not statistically significant. PAF estimates ranged from 0.9–2.7%, suggesting that up to three percent of adverse birth and infant outcomes could be avoided by eliminating severe housing insecurity among low-income, pregnant women in US cities. Conclusions: Results suggest that housing insecurity during pregnancy shapes neonatal and infant health in disadvantaged urban families. Full article

(This article belongs to the Special Issue Social, Structural, and Policy Determinants of Maternal and Child Health and Health Inequities)

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18 pages, 7611 KiB

Open AccessEditor’s ChoiceArticle

Facing a Second Wave from a Regional View: Spatial Patterns of COVID-19 as a Key Determinant for Public Health and Geoprevention Plans

by Olga De Cos, Valentín Castillo and David Cantarero

Int. J. Environ. Res. Public Health 2020, 17(22), 8468; https://doi.org/10.3390/ijerph17228468 - 16 Nov 2020

Cited by 22 | Viewed by 5017

Abstract

Several studies on spatial patterns of COVID-19 show huge differences depending on the country or region under study, although there is some agreement that socioeconomic factors affect these phenomena. The aim of this paper is to increase the knowledge of the socio-spatial behavior [...] Read more.

Several studies on spatial patterns of COVID-19 show huge differences depending on the country or region under study, although there is some agreement that socioeconomic factors affect these phenomena. The aim of this paper is to increase the knowledge of the socio-spatial behavior of coronavirus and implementing a geospatial methodology and digital system called SITAR (Fast Action Territorial Information System, by its Spanish acronym). We analyze as a study case a region of Spain called Cantabria, geocoding a daily series of microdata coronavirus records provided by the health authorities (Government of Cantabria—Spain) with the permission of Medicines Ethics Committee from Cantabria (CEIm, June 2020). Geocoding allows us to provide a new point layer based on the microdata table that includes cases with a positive result in a COVID-19 test. Regarding general methodology, our research is based on Geographical Information Technologies using Environmental Systems Research Institute (ESRI) Technologies. This tool is a global reference for spatial COVID-19 research, probably due to the world-renowned COVID-19 dashboard implemented by the Johns Hopkins University team. In our analysis, we found that the spatial distribution of COVID-19 in urban locations presents a not random distribution with clustered patterns and density matters in the spread of the COVID-19 pandemic. As a result, large metropolitan areas or districts with a higher number of persons tightly linked together through economic, social, and commuting relationships are the most vulnerable to pandemic outbreaks, particularly in our case study. Furthermore, public health and geoprevention plans should avoid the idea of economic or territorial stigmatizations. We hold the idea that SITAR in particular and Geographic Information Technologies in general contribute to strategic spatial information and relevant results with a necessary multi-scalar perspective to control the pandemic. Full article

(This article belongs to the Section Public Health Statistics and Risk Assessment)

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15 pages, 350 KiB

Open AccessEditor’s ChoiceArticle

Vaccine Hesitancy in the Age of Coronavirus and Fake News: Analysis of Journalistic Sources in the Spanish Quality Press

by Daniel Catalan-Matamoros and Carlos Elías

Int. J. Environ. Res. Public Health 2020, 17(21), 8136; https://doi.org/10.3390/ijerph17218136 - 4 Nov 2020

Cited by 47 | Viewed by 8353

Abstract

The study of the quality press and the use of sources is relevant to understand the role of journalists in scientific controversies. The objective was to examine media sourcing patterns, using the case of vaccines as a backdrop. Articles were retrieved from the [...] Read more.

The study of the quality press and the use of sources is relevant to understand the role of journalists in scientific controversies. The objective was to examine media sourcing patterns, using the case of vaccines as a backdrop. Articles were retrieved from the national quality press in Spain. Content analysis was undertaken on the sources and on other variables such as tone, frames and journalistic genre. The software myNews and NVivo were used for data collection and coding, while SPSS and Excel were used for statistical analysis. Findings indicate that sources related to the government, professional associations and scientific companies are the most frequently used, confirming the central role of government institutions as journalistic sources. These were followed by university scientists, scientific journals and clinicians. On the other hand, NGOs and patients groups were included in fewer than 5% of the articles. More than 30% included none or just one source expressing unbalanced perspectives. Frequent use of certain source types, particularly governmental, may indicate state structures of power. The study provides a better understanding of journalistic routines in the coverage of vaccines, including fresh perspectives in the current COVID-19 pandemic. Full article

(This article belongs to the Special Issue Mass Communication, Digital Media, and Public Health)

11 pages, 281 KiB

Open AccessEditor’s ChoiceReview

Consideration of the Psychological and Mental Health of the Elderly during COVID-19: A Theoretical Review

by Kunho Lee, Goo-Churl Jeong and JongEun Yim

Int. J. Environ. Res. Public Health 2020, 17(21), 8098; https://doi.org/10.3390/ijerph17218098 - 3 Nov 2020

Cited by 112 | Viewed by 25136

Abstract

COVID-19 has spread worldwide causing an unprecedented public health crisis. After the World Health Organization declared a pandemic in March 2020, the number of confirmed cases and deaths has continued to increase. This situation may be prolonged until an effective, tested, and safe [...] Read more.

COVID-19 has spread worldwide causing an unprecedented public health crisis. After the World Health Organization declared a pandemic in March 2020, the number of confirmed cases and deaths has continued to increase. This situation may be prolonged until an effective, tested, and safe treatment is available. COVID-19 can occur at any age. However, the maximum confirmed cases and deaths have occurred among the elderly. Particularly, the mental and physical health of the elderly aged above 60 and classified as high-risk groups is more vulnerable than other age groups, requiring more attention. Strong social restraint, social distancing, and quarantine measures to prevent the COVID-19 spread have raised concerns about their mental health. Therefore, it is crucial to analyze and identify the psychological concepts and protective factors that support and constitute these guidelines and strategies and prepare practical suggestions and guidelines to protect the mental health of the elderly during COVID-19. These discussions will facilitate a deeper understanding and expansion of these guidelines and strategies. Therefore, this study explores factors—including pandemic-induced stress, self-integration, self-efficacy, and resilience—in order to prepare practical and detailed suggestions and guidelines using studies that considered these factors, including coping with COVID-19-induced stress, social support, and physical activity. Full article

(This article belongs to the Section Mental Health)

45 pages, 5305 KiB

Open AccessEditor’s ChoiceReview

PFAS Environmental Pollution and Antioxidant Responses: An Overview of the Impact on Human Field

by Marco Bonato, Francesca Corrà, Marta Bellio, Laura Guidolin, Laura Tallandini, Paola Irato and Gianfranco Santovito

Int. J. Environ. Res. Public Health 2020, 17(21), 8020; https://doi.org/10.3390/ijerph17218020 - 30 Oct 2020

Cited by 122 | Viewed by 17267

Abstract

Due to their unique properties, perfluorinated substances (PFAS) are widely used in multiple industrial and commercial applications, but they are toxic for animals, humans included. This review presents some available data on the PFAS environmental distribution in the world, and in particular in [...] Read more.

Due to their unique properties, perfluorinated substances (PFAS) are widely used in multiple industrial and commercial applications, but they are toxic for animals, humans included. This review presents some available data on the PFAS environmental distribution in the world, and in particular in Europe and in the Veneto region of Italy, where it has become a serious problem for human health. The consumption of contaminated food and drinking water is considered one of the major source of exposure for humans. Worldwide epidemiological studies report the negative effects that PFAS have on human health, due to environmental pollution, including infertility, steroid hormone perturbation, thyroid, liver and kidney disorders, and metabolic disfunctions. In vitro and in vivo researches correlated PFAS exposure to oxidative stress effects (in mammals as well as in other vertebrates of human interest), produced by a PFAS-induced increase of reactive oxygen species formation. The cellular antioxidant defense system is activated by PFAS, but it is only partially able to avoid the oxidative damage to biomolecules. Full article

(This article belongs to the Special Issue Environmental Pollution and Oxidative Status)

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24 pages, 361 KiB

Open AccessEditor’s ChoiceArticle

The Use of New Digital Information and Communication Technologies in Psychological Counseling during the COVID-19 Pandemic

by Artemisa R. Dores, Andreia Geraldo, Irene P. Carvalho and Fernando Barbosa

Int. J. Environ. Res. Public Health 2020, 17(20), 7663; https://doi.org/10.3390/ijerph17207663 - 21 Oct 2020

Cited by 63 | Viewed by 11914

Abstract

The use of digital information and communication technologies (ICTs) has enabled many professionals to continue to provide their services during the COVID-19 pandemic. However, little is known about the adoption of ICTs by psychologists and the impact of such technologies on their practice. [...] Read more.

The use of digital information and communication technologies (ICTs) has enabled many professionals to continue to provide their services during the COVID-19 pandemic. However, little is known about the adoption of ICTs by psychologists and the impact of such technologies on their practice. This study aimed to explore psychologists’ practices related with the use of ICTs before and during the COVID-19 lockdown, to identify the main changes that the pandemic has brought and the impact that such changes have had on their practice with clients, and also identify the factors that potentially have affected such changes. The Portuguese Psychologists Association announced the study, and 108 psychologists responded to an online survey during the mandatory lockdown. The results showed that these professionals continued to provide their services due to having adopted ICTs. Comparing with face-to-face interventions, psychologists recognized that additional precautions/knowledge were needed to use such technologies. Despite the challenges identified, they described the experience with the use of ICTs as positive, meeting clients’ adherence, and yielding positive results. Psychologists with the most years of professional experience maintained their services the most, but those with average experience showed the most favorable attitudes toward the use of technologies and web-based interventions. Full article

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

13 pages, 338 KiB

Open AccessEditor’s ChoiceArticle

Interference and Impact of Dysmenorrhea on the Life of Spanish Nursing Students

by Ana Abreu-Sánchez, Javier Ruiz-Castillo, María Dolores Onieva-Zafra, María Laura Parra-Fernández and Elia Fernández-Martínez

Int. J. Environ. Res. Public Health 2020, 17(18), 6473; https://doi.org/10.3390/ijerph17186473 - 5 Sep 2020

Cited by 25 | Viewed by 5317

Abstract

Dysmenorrhea is a cause of absenteeism in universities which, in the context of nursing studies, may affect mandatory attendance. Moreover, presenteeism is associated with medication errors, patient falls, and a reduced quality of patient care. This study sought to identify the degree of

[...] Read more.

Dysmenorrhea is a cause of absenteeism in universities which, in the context of nursing studies, may affect mandatory attendance. Moreover, presenteeism is associated with medication errors, patient falls, and a reduced quality of patient care. This study sought to identify the degree of interference of dysmenorrhea on daily life and its impact on academic performance among Spanish nursing students, and to explore the reasons for presenteeism. A cross-sectional descriptive study was conducted on 261 nursing students. Data were collected using a self-administered questionnaire. The chi square tests, chi-square linear trend, Student’s t-test, one-way analysis of variance of polynomial contrasts, and post hoc tests for the bi-variate analysis were used to compare the participants’ responses regarding their type of dysmenorrhea and pain intensity. In addition, a multivariate regression was performed to predict absenteeism. The answers to the open questions were analyzed using thematic content analysis techniques. We observed 62.8% of absenteeism and 92.7% of presenteeism due to dysmenorrhea. Absenteeism was observed to be 3.079 (confidence interval (CI): 95%1.724–5.499; p < 0.001) times more likely among women with severe menstrual pain, 2.513 (CI 95%1.314–4.807; p = 0.005) times more in those suffering from menstrual nausea and 1.936 (CI 95%1.098–3.411; p = 0.022) times more frequent in those suffering from diarrhea. The reasons for presenteeism were grouped into five categories: the pain was bearable, it is not a reason to be absent, others don’t consider it a reason to be absent, responsibility and guilt, and academic consequences. Dysmenorrhea can have a significant impact on academic performance. The concern among students about the academic repercussions and even feelings of guilt and incomprehension from others leads to high rates of presenteeism with potentially negative consequences for patient care.

Full article

(This article belongs to the Special Issue Assessment of Health-Related Quality of Life (HRQoL) in Public Health)

29 pages, 772 KiB

Open AccessEditor’s ChoiceReview

Stigma and Discrimination (SAD) at the Time of the SARS-CoV-2 Pandemic

by Antonio Baldassarre, Gabriele Giorgi, Federico Alessio, Lucrezia Ginevra Lulli, Giulio Arcangeli and Nicola Mucci

Int. J. Environ. Res. Public Health 2020, 17(17), 6341; https://doi.org/10.3390/ijerph17176341 - 31 Aug 2020

Cited by 111 | Viewed by 13012

Abstract

Infectious disease control is a crucial public health issue. Although it is important to urgently perform public health measures in order to reduce the risk of spread, it could end up stigmatizing entire groups of people rather than offering control measures based on [...] Read more.

Infectious disease control is a crucial public health issue. Although it is important to urgently perform public health measures in order to reduce the risk of spread, it could end up stigmatizing entire groups of people rather than offering control measures based on sound scientific principles. This “us” versus “them” dynamic is common in stigmatization, in general, and indicates a way in which disease stigma can be viewed as a proxy for other types of fears, especially xenophobia and general fear of outsiders. The pandemic risk associated with SARS-CoV-2 infection led us to consider, among other related issues, how stigma and discrimination remain serious barriers to care for people suspected of being infected, even more if they are assisting professions, such as health workers, employed in emergency response. The purpose of this review is to evaluate and promote the importance of psychological aspects of the stigma and social discrimination (SAD) in pandemic realities and, more specifically, nowadays, in the context of SARS-CoV-2/COVID-19. Just as it happened with HIV, HCV, tuberculosis, and Zika, stigma and discrimination undermine the social fabric compromising the ethics and principles of civilization to which each individual in entitled. Recognizing disease stigma history can give us insight into how, exactly, stigmatizing attitudes are formed, and how they are disbanded. Instead of simply blaming the ignorance of people espousing stigmatizing attitudes about certain diseases, we should try to understand precisely how these attitudes are formed so that we can intervene in their dissemination. We should also look at history to see what sorts of interventions against stigma may have worked in the past. Ongoing research into stigma should evaluate what has worked in the past, as above-mentioned, providing us with some clues as to what might work in the current pandemic emergency, to reduce devastating discrimination that keeps people from getting the care they need. We propose a systematic and historical review, in order to create a scientific and solid base for the following SAD analysis. The aim is to propose a coping strategy to face stigma and discrimination (SAD) related to SARS-CoV-2/COVID-19 pandemic outbreak, borrowing coping strategy tools and solutions from other common contagious diseases. Furthermore, our study observes how knowledge, education level, and socioeconomic status (SES) can influence perception of SARS-CoV-2/ COVID-19 risk in a digital world, based on previous research, best practices, and evidence-based research. Full article

(This article belongs to the Special Issue The Dark Side and the Light Side of Technology Related Stress and Stress related to Workplace Innovations. From Artificial Intelligence to Business Transformations)

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14 pages, 355 KiB

Open AccessEditor’s ChoiceReview

Key Guidelines in Developing a Pre-Emptive COVID-19 Vaccination Uptake Promotion Strategy

by Jeff French, Sameer Deshpande, William Evans and Rafael Obregon

Int. J. Environ. Res. Public Health 2020, 17(16), 5893; https://doi.org/10.3390/ijerph17165893 - 13 Aug 2020

Cited by 152 | Viewed by 32414

Abstract

This paper makes the case for immediate planning for a COVID-19 vaccination uptake strategy in advance of vaccine availability for two reasons: first, the need to build a consensus about the order in which groups of the population will get access to the [...] Read more.

This paper makes the case for immediate planning for a COVID-19 vaccination uptake strategy in advance of vaccine availability for two reasons: first, the need to build a consensus about the order in which groups of the population will get access to the vaccine; second, to reduce any fear and concerns that exist in relation to vaccination and to create demand for vaccines. A key part of this strategy is to counter the anti-vaccination movement that is already promoting hesitancy and resistance. Since the beginning of the COVID-19 pandemic there has been a tsunami of misinformation and conspiracy theories that have the potential to reduce vaccine uptake. To make matters worse, sections of populations in many countries display low trust in governments and official information about the pandemic and how the officials are tackling it. This paper aims to set out in short form critical guidelines that governments and regional bodies should take to enhance the impact of a COVID-19 vaccination strategy. We base our recommendations on a review of existing best practice guidance. This paper aims to assist those responsible for promoting COVID-19 vaccine uptake to digest the mass of guidance that exists and formulate an effective locally relevant strategy. A summary of key guidelines is presented based on best practice guidance. Full article

(This article belongs to the Section Health Communication and Informatics)

17 pages, 623 KiB

Open AccessEditor’s ChoiceReview

Secular Trends in Physical Fitness of Children and Adolescents: A Review of Large-Scale Epidemiological Studies Published after 2006

by Tanja Eberhardt, Claudia Niessner, Doris Oriwol, Lydia Buchal, Annette Worth and Klaus Bös

Int. J. Environ. Res. Public Health 2020, 17(16), 5671; https://doi.org/10.3390/ijerph17165671 - 5 Aug 2020

Cited by 69 | Viewed by 5453

Abstract

Physical fitness (PF) of children and adolescents is an important resource for their future health. Population-based studies, however, rarely report secular changes of PF, although monitoring of these is crucial to deriving information for adequate interventions. This review aims to report trends in [...] Read more.

Physical fitness (PF) of children and adolescents is an important resource for their future health. Population-based studies, however, rarely report secular changes of PF, although monitoring of these is crucial to deriving information for adequate interventions. This review aims to report trends in PF of children and adolescents. A literature search was conducted in PubMed in July 2019. Cohort studies published in English allowing statements to be made on trends in PF by comparing youth between the ages of four and 18 years were included. The review identified 24 studies from 16 countries meeting the inclusion criteria, with an overall sample size of more than 860,000 children and adolescents. Through a standardized quality assessment tool, we classified two studies as strong, 21 as moderate, and only one as weak. We analyzed specific secular trends separately for the five different dimensions: endurance, strength, speed, flexibility, and coordination. The majority of studies report a decline of PF over time; however, a few studies report conflicting results. Performance in endurance, strength, and flexibility decreased over time, whereas there was no consistent trend reported for speed and coordination. Overall, there is no international standard on examining and reporting changes or secular trends in PF of children and adolescents, and comparability of studies is limited due to heterogeneous conditions of conducting and analyzing PF tests. Consequently, standardized and consistent international monitoring should be implemented. Full article

(This article belongs to the Special Issue Motor Competence and Physical Fitness in the Promotion of an Active and Healthy Lifestyle in Children and Adolescents)

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20 pages, 2492 KiB

Open AccessEditor’s ChoiceArticle

BCG Vaccination and Mortality of COVID-19 across 173 Countries: An Ecological Study

by Mitsuyoshi Urashima, Katharina Otani, Yasutaka Hasegawa and Taisuke Akutsu

Int. J. Environ. Res. Public Health 2020, 17(15), 5589; https://doi.org/10.3390/ijerph17155589 - 3 Aug 2020

Cited by 42 | Viewed by 14906

Abstract

Ecological studies have suggested fewer COVID-19 morbidities and mortalities in Bacillus Calmette–Guérin (BCG)-vaccinated countries than BCG-non-vaccinated countries. However, these studies obtained data during the early phase of the pandemic and did not adjust for potential confounders, including PCR-test numbers per population (PCR-tests). Currently—more [...] Read more.

Ecological studies have suggested fewer COVID-19 morbidities and mortalities in Bacillus Calmette–Guérin (BCG)-vaccinated countries than BCG-non-vaccinated countries. However, these studies obtained data during the early phase of the pandemic and did not adjust for potential confounders, including PCR-test numbers per population (PCR-tests). Currently—more than four months after declaration of the pandemic—the BCG-hypothesis needs reexamining. An ecological study was conducted by obtaining data of 61 factors in 173 countries, including BCG vaccine coverage (%), using morbidity and mortality as outcomes, obtained from open resources. ‘Urban population (%)’ and ‘insufficient physical activity (%)’ in each country was positively associated with morbidity, but not mortality, after adjustment for PCR-tests. On the other hand, recent BCG vaccine coverage (%) was negatively associated with mortality, but not morbidity, even with adjustment for percentage of the population ≥ 60 years of age, morbidity, PCR-tests and other factors. The results of this study generated a hypothesis that a national BCG vaccination program seems to be associated with reduced mortality of COVID-19, although this needs to be further examined and proved by randomized clinical trials. Full article

(This article belongs to the Special Issue COVID-19: Prevention, Diagnosis, Therapy and Follow Up)

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13 pages, 1526 KiB

Open AccessEditor’s ChoiceArticle

Genome-Wide DNA Methylation Profiles in Community Members Exposed to the World Trade Center Disaster

by Alan A. Arslan, Stephanie Tuminello, Lei Yang, Yian Zhang, Nedim Durmus, Matija Snuderl, Adriana Heguy, Anne Zeleniuch-Jacquotte, Yongzhao Shao and Joan Reibman

Int. J. Environ. Res. Public Health 2020, 17(15), 5493; https://doi.org/10.3390/ijerph17155493 - 30 Jul 2020

Cited by 18 | Viewed by 4387

Abstract

The primary goal of this pilot study was to assess feasibility of studies among local community members to address the hypothesis that complex exposures to the World Trade Center (WTC) dust and fumes resulted in long-term epigenetic changes. We enrolled 18 WTC-exposed cancer-free [...] Read more.

The primary goal of this pilot study was to assess feasibility of studies among local community members to address the hypothesis that complex exposures to the World Trade Center (WTC) dust and fumes resulted in long-term epigenetic changes. We enrolled 18 WTC-exposed cancer-free women from the WTC Environmental Health Center (WTC EHC) who agreed to donate blood samples during their standard clinical visits. As a reference WTC unexposed group, we randomly selected 24 age-matched cancer-free women from an existing prospective cohort who donated blood samples before 11 September 2001. The global DNA methylation analyses were performed using Illumina Infinium MethylationEpic arrays. Statistical analyses were performed using R Bioconductor package. Functional genomic analyses were done by mapping the top 5000 differentially expressed CpG sites to the Kyoto Encyclopedia of Genes and Genomes (KEGG) Pathway database. Among cancer-free subjects, we observed substantial methylation differences between WTC-exposed and unexposed women. The top 15 differentially methylated gene probes included BCAS2, OSGIN1, BMI1, EEF1A2, SPTBN5, CHD8, CDCA7L, AIDA, DDN, SNORD45C, ZFAND6, ARHGEF7, UBXN8, USF1, and USP12. Several cancer-related pathways were enriched in the WTC-exposed subjects, including endocytosis, mitogen-activated protein kinase (MAPK), viral carcinogenesis, as well as Ras-associated protein-1 (Rap1) and mammalian target of rapamycin (mTOR) signaling. The study provides preliminary data on substantial differences in DNA methylation between WTC-exposed and unexposed populations that require validation in further studies. Full article

(This article belongs to the Special Issue Environmental Factors, Epigenetics, and Cancer)

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22 pages, 3568 KiB

Open AccessEditor’s ChoiceReview

Air Pollution and COVID-19: The Role of Particulate Matter in the Spread and Increase of COVID-19’s Morbidity and Mortality

by Silvia Comunian, Dario Dongo, Chiara Milani and Paola Palestini

Int. J. Environ. Res. Public Health 2020, 17(12), 4487; https://doi.org/10.3390/ijerph17124487 - 22 Jun 2020

Cited by 348 | Viewed by 25424

Abstract

Sars-Cov-2 virus (COVID-19) is a member of the coronavirus family and is responsible for the pandemic recently declared by the World Health Organization. A positive correlation has been observed between the spread of the virus and air pollution, one of the greatest challenges [...] Read more.

Sars-Cov-2 virus (COVID-19) is a member of the coronavirus family and is responsible for the pandemic recently declared by the World Health Organization. A positive correlation has been observed between the spread of the virus and air pollution, one of the greatest challenges of our millennium. COVID-19 could have an air transmission and atmospheric particulate matter (PM) could create a suitable environment for transporting the virus at greater distances than those considered for close contact. Moreover, PM induces inflammation in lung cells and exposure to PM could increase the susceptibility and severity of the COVID-19 patient symptoms. The new coronavirus has been shown to trigger an inflammatory storm that would be sustained in the case of pre-exposure to polluting agents. In this review, we highlight the potential role of PM in the spread of COVID-19, focusing on Italian cities whose PM daily concentrations were found to be higher than the annual average allowed during the months preceding the epidemic. Furthermore, we analyze the positive correlation between the virus spread, PM, and angiotensin-converting enzyme 2 (ACE2), a receptor involved in the entry of the virus into pulmonary cells and inflammation. Full article

(This article belongs to the Section Environmental Health)

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14 pages, 361 KiB

Open AccessEditor’s ChoiceArticle

Bone Mineral Density of Femur and Lumbar and the Relation between Fat Mass and Lean Mass of Adolescents: Based on Korea National Health and Nutrition Examination Survey (KNHNES) from 2008 to 2011

by Aram Kim, Seunghui Baek, Seyeon Park and Jieun Shin

Int. J. Environ. Res. Public Health 2020, 17(12), 4471; https://doi.org/10.3390/ijerph17124471 - 22 Jun 2020

Cited by 14 | Viewed by 4021

Abstract

It is most important to reach the maximum bone density in the childhood period to prevent developing osteoporosis; it is widely known that increased body weight has a positive correlation with bone density and that even though both the fat mass and lean [...] Read more.

It is most important to reach the maximum bone density in the childhood period to prevent developing osteoporosis; it is widely known that increased body weight has a positive correlation with bone density and that even though both the fat mass and lean mass have a significant impact on bone density, the latter mass has more importance for adults. Therefore, the study analyzed to identify the relationship between bone density and both fat mass and lean mass of Korean adolescents. Subjects were chosen among 21,303 people from the Korea National Health and Nutrition Examination Survey (KNHNES) between 2008 and 2011 that took a bone density checkup; as a result, 1454 teenagers aged between 12 and 18 were selected. Data analysis was performed in SAS ver. 9.4 (SAS Institute Inc., Cary, NC, USA) following the KNHNES and the weighted complex sample analysis was conducted; body fat mass and lean mass were divided into quintile groups, and to figure out the differences in bone density that were analyzed in six models adjusted by body weight (kg) and walking (yes/no), muscle strengthening exercises (yes/no), nutrition (intake of ca (g), and serum vitamin D (ng/mL)). Then, the generalized linear model (GLM) and trend test were conducted for each gender with a significance level of 0.05. The bone density differences of fat mass and lean mass were analyzed. The result of Model 6 considering all correction variables is as follows; in the case of male adolescents, the total femur and lumbar spine showed a significant difference (F = 13.120, p < 0.001; F = 12.900, p < 0.001) for fat mass, and the trend test showed that the figures significantly decreased (β = −0.030, p < 0.001; −0.035, p < 0.001). Meanwhile, for lean mass, the total femur and lumbar spine had a significant difference (F = 16.740, p < 0.001; F = 20.590, p < 0.001) too, but the trend test showed a significant increase (β = 0.054, p < 0.001; 0.057, p < 0.001). In the case of female adolescents, the lumbar spine (F = 3.600, p < 0.05) for lean mass showed a significant difference, and it also significantly rose in the trend test too (β = 0.020, p < 0.01). To sum up the results, for male adolescents, the bone density differences for fat mass (FM) and lean mass (LM) all had significant differences, but for female adolescents, only the lumbar spine for LM showed such a result. Meanwhile, both genders showed that LM had a more positive impact on bone density than FM. Full article

(This article belongs to the Special Issue Big Data, Decision Models, and Public Health)

14 pages, 370 KiB

Open AccessEditor’s ChoiceReview

The Need for the Right Socio-Economic and Cultural Fit in the COVID-19 Response in Sub-Saharan Africa: Examining Demographic, Economic Political, Health, and Socio-Cultural Differentials in COVID-19 Morbidity and Mortality

by Andre M. N. Renzaho

Int. J. Environ. Res. Public Health 2020, 17(10), 3445; https://doi.org/10.3390/ijerph17103445 - 15 May 2020

Cited by 75 | Viewed by 13771

Abstract

The coronavirus disease (COVID-19) has spread quickly across the globe with devastating effects on the global economy as well as the regional and societies’ socio-economic fabrics and the way of life for vast populations. The nonhomogeneous continent faces local contextual complexities that require [...] Read more.

The coronavirus disease (COVID-19) has spread quickly across the globe with devastating effects on the global economy as well as the regional and societies’ socio-economic fabrics and the way of life for vast populations. The nonhomogeneous continent faces local contextual complexities that require locally relevant and culturally appropriate COVID-19 interventions. This paper examines demographic, economic, political, health, and socio-cultural differentials in COVID-19 morbidity and mortality. The health systems need to be strengthened through extending the health workforce by mobilizing and engaging the diaspora, and implementing the International Health Regulations (2005) core capacities. In the absence of adequate social protection and welfare programs targeting the poor during the pandemic, sub-Saharan African countries need to put in place flexible but effective policies and legislation approaches that harness and formalise the informal trade and remove supply chain barriers. This could include strengthening cross-border trade facilities such as adequate pro-poor, gender-sensitive, and streamlined cross-border customs, tax regimes, and information flow. The emphasis should be on cross-border infrastructure that not only facilitates trade through efficient border administration but can also effectively manage cross-border health threats. There is an urgent need to strengthen social protection systems to make them responsive to crises, and embed them within human rights-based approaches to better support vulnerable populations and enact health and social security benefits. The COVI-19 response needs to adhere to the well-established ‘do no harm’ principle to prevent further damage or suffering as a result of the pandemic and examined through local lenses to inform peace-building initiatives that may yield long-term gains in the post-COVID-19 recovery efforts. Full article

(This article belongs to the Collection Outbreak of a Novel Coronavirus: A Global Health Threat)

13 pages, 925 KiB

Open AccessEditor’s ChoiceArticle

Sensitivity of Nutrition Indicators to Measure the Impact of a Multi-Sectoral Intervention: Cross-Sectional, Household, and Individual Level Analysis

by Anastasia Marshak, Helen Young, Anne Radday and Elena N. Naumova

Int. J. Environ. Res. Public Health 2020, 17(9), 3121; https://doi.org/10.3390/ijerph17093121 - 30 Apr 2020

Cited by 3 | Viewed by 6133

Abstract

Interventions tackling multiple drivers of child malnutrition have potential, yet the evidence is limited and draws on different analysis and nutrition outcomes, reducing comparability. To better understand the advantages and disadvantages of three different analytical approaches on seven common nutrition indicators, we use [...] Read more.

Interventions tackling multiple drivers of child malnutrition have potential, yet the evidence is limited and draws on different analysis and nutrition outcomes, reducing comparability. To better understand the advantages and disadvantages of three different analytical approaches on seven common nutrition indicators, we use panel data (2012, 2014, 2015) on 1420 households from a randomized control study of a multi-sectoral intervention in Chad. We compare program impact using three types of analysis: a cross-sectional analysis of non-matched children; a panel analysis on longitudinal outcomes following the worst-off child in the household; and a panel analysis on longitudinal outcomes of matched children. We find that the sensitivity of the nutrition outcomes to program impact increases with each subsequent analytical approach, despite the reduction in sample size, as the analysis is able to control for more non-measured child and household characteristics. In the matched child panel analysis, the odds of a child being severely wasted were 76% lower (CI: 0.59–0.86, p = 0.001), the odds of being underweight were 33% lower (CI: 0.15–0.48, p = 0.012), and weight-for-height z-score was 0.19 standard deviations higher (CI: 0.09–0.28, p = 0.022) in the treatment versus control group. The study provides evidence for multi-sectoral interventions to tackle acute malnutrition and recommends the best practice analytical approach. Full article

(This article belongs to the Special Issue Early Influences on Child Health and Wellbeing)

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13 pages, 516 KiB

Open AccessEditor’s ChoiceReview

Five Challenges When Managing Mass Casualty or Disaster Situations: A Review Study

by Karin Hugelius, Julia Becker and Annsofie Adolfsson

Int. J. Environ. Res. Public Health 2020, 17(9), 3068; https://doi.org/10.3390/ijerph17093068 - 28 Apr 2020

Cited by 44 | Viewed by 10196

Abstract

Background: Managing mass casualty or disaster incidents is challenging to any person or organisation. Therefore, this paper identifies and describes common challenges to managing such situations, using case and lessons learned reports. It focuses on sudden onset, man-made or technologically caused mass [...] Read more.

Background: Managing mass casualty or disaster incidents is challenging to any person or organisation. Therefore, this paper identifies and describes common challenges to managing such situations, using case and lessons learned reports. It focuses on sudden onset, man-made or technologically caused mass casualty or disaster situations. Methods: A management review was conducted based on a structured search in the PubMed and Web of Science databases. Results: The review included 20 case—and lessons learned reports covering natural disasters, man-made events, and accidents across Europe, the United States of Amerika (USA), Asia and the Middle East. Five common challenges were identified: (1) to identify the situation and deal with uncertainty, (2) to balance the mismatch between the contingency plan and the reality, (3) to establish a functional crisis organization, (4) to adapt the medical response to the actual and overall situation and (5) to ensure a resilient response. Conclusions: The challenges when managing mass casualty or disaster events involved were mainly related to the ability to manage uncertainty and surprising situations, using structured processes to respond. The ability to change mind set, organization and procedures, both from an organizational- and individual perspective, was essential. Non-medical factors and internal factors influenced the medical management. In order to respond in an effective, timely and resilient way, all these factors should be taken into consideration. Full article

(This article belongs to the Special Issue Prehospital and Disaster Medicine and Crises Management)

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16 pages, 3841 KiB

Open AccessEditor’s ChoiceReview

Internet Addiction in the Web of Science Database: A Review of the Literature with Scientific Mapping

by Antonio-José Moreno-Guerrero, Gerardo Gómez-García, Jesús López-Belmonte and Carmen Rodríguez-Jiménez

Int. J. Environ. Res. Public Health 2020, 17(8), 2753; https://doi.org/10.3390/ijerph17082753 - 16 Apr 2020

Cited by 58 | Viewed by 9108

Abstract

Information and communication technologies (ICT) is a major element of today’s society with great potential that can offer both advantages and disadvantages. Addiction to the Internet and social networks is a growing problem in all age groups. Education is the context in which [...] Read more.

Information and communication technologies (ICT) is a major element of today’s society with great potential that can offer both advantages and disadvantages. Addiction to the Internet and social networks is a growing problem in all age groups. Education is the context in which to work and train in the correct use of these media. The objective of the study focuses on knowing the scientific production and the performance of the concepts “addiction” and “internet” (ADIN). A bibliometric methodology complemented with the scientific mapping technique was followed. Different processes related to the quantification, analysis, evaluation, and estimation of scientific documents were carried out. The literature was analyzed by specific programs such as SciMAT, Analyze Results, and Creation Citation Report. The unit of analysis was specified in 5644 scientific publications extracted from Web of Science (WoS), belonging to the period of years between 1996 and 2019. The results showed that the evolution in the study of the addiction to the Internet is constant and continuous, with articles in English being the most used means to present the information on the part of the investigators. In addition, the subject of study was based on time, given that the coincidence of key words between the periods analyzed was high. In conclusion, the importance of promoting healthy living habits that include responsible use of the Internet are discussed. Full article

(This article belongs to the Special Issue Internet and Smartphone Use-Related Addiction Health Problems: Treatment, Education and Research)

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15 pages, 352 KiB

Open AccessEditor’s ChoiceArticle

A New Application of Social Impact in Social Media for Overcoming Fake News in Health

by Cristina M. Pulido, Laura Ruiz-Eugenio, Gisela Redondo-Sama and Beatriz Villarejo-Carballido

Int. J. Environ. Res. Public Health 2020, 17(7), 2430; https://doi.org/10.3390/ijerph17072430 - 3 Apr 2020

Cited by 158 | Viewed by 38795

Abstract

One of the challenges today is to face fake news (false information) in health due to its potential impact on people’s lives. This article contributes to a new application of social impact in social media (SISM) methodology. This study focuses on the social [...] Read more.

One of the challenges today is to face fake news (false information) in health due to its potential impact on people’s lives. This article contributes to a new application of social impact in social media (SISM) methodology. This study focuses on the social impact of the research to identify what type of health information is false and what type of information is evidence of the social impact shared in social media. The analysis of social media includes Reddit, Facebook, and Twitter. This analysis contributes to identifying how interactions in these forms of social media depend on the type of information shared. The results indicate that messages focused on fake health information are mostly aggressive, those based on evidence of social impact are respectful and transformative, and finally, deliberation contexts promoted in social media overcome false information about health. These results contribute to advancing knowledge in overcoming fake health-related news shared in social media. Full article

(This article belongs to the Special Issue Social Media Intelligence for Public Health Surveillance)

11 pages, 313 KiB

Open AccessEditor’s ChoiceArticle

Longitudinal Patterns of Social Problem-Solving Skills in an Ethnically Diverse Sample of Pediatric Patients with Cancer and their Caregivers

by Evrosina I. Isaac, Urmila Sivagnanalingam, Andrea R. Meisman, Crista Wetherington Donewar, Linda J. Ewing, Ernest R. Katz, Anna C. Muriel and Jennifer M. Rohan

Int. J. Environ. Res. Public Health 2020, 17(5), 1581; https://doi.org/10.3390/ijerph17051581 - 29 Feb 2020

Cited by 3 | Viewed by 3385

Abstract

Pediatric patients with acute lymphoblastic leukemia and lymphoblastic lymphoma are prescribed a daily oral chemotherapy medication named 6-mercaptopurine. Adherence to this medication is vital for survival and decreased risk for disease relapse. Adaptive problem-solving strategies are important for adhering to this complex regimen. [...] Read more.

Pediatric patients with acute lymphoblastic leukemia and lymphoblastic lymphoma are prescribed a daily oral chemotherapy medication named 6-mercaptopurine. Adherence to this medication is vital for survival and decreased risk for disease relapse. Adaptive problem-solving strategies are important for adhering to this complex regimen. This manuscript examined ethnic and racial differences in social problem-solving domains (Social Problem-Solving Inventory) among patients aged 7–19 years old who were diagnosed with cancer; and, their caregivers (N = 139). This was a 15-month longitudinal study. We also examined differences in medication adherence based on behavioral adherence measures. Our study found significant differences between minority and non-minority reporters across multiple social problem-solving domains (p < 0.05). However, there were no significant differences observed for medication adherence. Our findings underscore the importance of implementing culturally sensitive interventions in clinical care that could ultimately positively impact health behaviors, interactions with healthcare providers, and long-term health outcomes. Full article

(This article belongs to the Special Issue Child-Parent Dynamics, Psychosocial Factors, and Health Outcomes)

13 pages, 539 KiB

Open AccessEditor’s ChoiceArticle

Internet Gaming Disorder Clustering Based on Personality Traits in Adolescents, and Its Relation with Comorbid Psychological Symptoms

by Vega González-Bueso, Juan José Santamaría, Ignasi Oliveras, Daniel Fernández, Elena Montero, Marta Baño, Susana Jiménez-Murcia, Amparo del Pino-Gutiérrez and Joan Ribas

Int. J. Environ. Res. Public Health 2020, 17(5), 1516; https://doi.org/10.3390/ijerph17051516 - 26 Feb 2020

Cited by 30 | Viewed by 7854

Abstract

In recent years, the evidence regarding Internet Gaming Disorder (IGD) suggests that some personality traits are important risk factors for developing this problem. The heterogeneity involved in problematic online gaming and differences found in the literature regarding the comorbid psychopathology associated with the [...] Read more.

In recent years, the evidence regarding Internet Gaming Disorder (IGD) suggests that some personality traits are important risk factors for developing this problem. The heterogeneity involved in problematic online gaming and differences found in the literature regarding the comorbid psychopathology associated with the problem could be explained through different types of gamers. Clustering analysis can allow organization of a collection of personality traits into clusters based on similarity. The objectives of this study were: (1) to obtain an empirical classification of IGD patients according to personality variables and (2) to describe the resultant groups in terms of clinical and sociodemographic variables. The sample included 66 IGD adolescent patients who were consecutive referrals at a mental health center in Barcelona, Spain. A Gaussian mixture model cluster analysis was used in order to classify the subjects based on their personality. Two clusters based on personality traits were detected: type I “higher comorbid symptoms” (n = 24), and type II “lower comorbid symptoms” (n = 42). The type I included higher scores in introversive, inhibited, doleful, unruly, forceful, oppositional, self-demeaning and borderline tendency traits, and lower scores in histrionic, egotistic and conforming traits. The type I obtained higher scores on all the Symptom Check List-90 items-Revised, all the State-Trait Anxiety Index scales, and on the DSM-5 IGD criteria. Differences in personality can be useful in determining clusters with different types of dysfunctionality. Full article

(This article belongs to the Special Issue Internet and Smartphone Use-Related Addiction Health Problems: Treatment, Education and Research)

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12 pages, 362 KiB

Open AccessEditor’s ChoiceArticle

Geographical Disparities in Screening and Cancer-Related Health Behaviour

by Belinda C. Goodwin, Arlen K. Rowe, Fiona Crawford-Williams, Peter Baade, Suzanne K. Chambers, Nicholas Ralph and Joanne F. Aitken

Int. J. Environ. Res. Public Health 2020, 17(4), 1246; https://doi.org/10.3390/ijerph17041246 - 14 Feb 2020

Cited by 20 | Viewed by 5641

Abstract

This study aimed to identify whether cancer-related health behaviours including participation in cancer screening vary by geographic location in Australia. Data were obtained from the 2014–2015 Australian National Health Survey, a computer-assisted telephone interview that measured a range of health-related issues in a [...] Read more.

This study aimed to identify whether cancer-related health behaviours including participation in cancer screening vary by geographic location in Australia. Data were obtained from the 2014–2015 Australian National Health Survey, a computer-assisted telephone interview that measured a range of health-related issues in a sample of randomly selected households. Chi-square tests and adjusted odds ratios from logistic regression models were computed to assess the association between residential location and cancer-related health behaviours including cancer screening participation, alcohol consumption, smoking, exercise, and fruit and vegetable intake, controlling for age, socio-economic status (SES), education, and place of birth. The findings show insufficient exercise, risky alcohol intake, meeting vegetable intake guidelines, and participation in cervical screening are more likely for those living in inner regional areas and in outer regional/remote areas compared with those living in major cities. Daily smoking and participation in prostate cancer screening were significantly higher for those living in outer regional/remote areas. While participation in cancer screening in Australia does not appear to be negatively impacted by regional or remote living, lifestyle behaviours associated with cancer incidence and mortality are poorer in regional and remote areas. Population-based interventions targeting health behaviour change may be an appropriate target for reducing geographical disparities in cancer outcomes. Full article

(This article belongs to the Section Global Health)

11 pages, 347 KiB

Open AccessEditor’s ChoiceArticle

Predictors Associated with Health-Related Heat Risk Perception of Urban Citizens in Germany

by Sabrina K. Beckmann and Michael Hiete

Int. J. Environ. Res. Public Health 2020, 17(3), 874; https://doi.org/10.3390/ijerph17030874 - 30 Jan 2020

Cited by 33 | Viewed by 6391

Abstract

The rising probability of extremely high temperatures and an increasing number of consecutive hot days caused by climate change—combined with the impact of these high temperatures on human health—is widely discussed in the literature. There are calls for the development of heatwave adaptation [...] Read more.

The rising probability of extremely high temperatures and an increasing number of consecutive hot days caused by climate change—combined with the impact of these high temperatures on human health—is widely discussed in the literature. There are calls for the development of heatwave adaptation measures by governmental and scientific institutions. In this research, the predictors of health-related heat risk perception of urban citizens in Augsburg, Germany, were investigated. An online survey was conducted with 468 citizens, asking about their heat risk perception, knowledge about heat risks, and demographic data and health information. Statistical methods (Spearman correlation, unpaired t-test, ANOVA and multiple regression) were used to determine which factors were significant and relevant. The results show that the knowledge of heat risks, heat risk sensitivity and an external locus of control are the most important factors for heat risk perception. The health implication score and chronic disease show significant effects in descriptive statistics. Furthermore, younger people showed the highest heat risk perception of all age groups. Surprisingly, income, education, living alone and gender did not play a role in heat risk perception. The findings imply a need for better and intensified heat risk communication in urban areas—especially among elderly people—and thus are important for creating acceptance towards heat wave risks, which is a prerequisite of willingness to adapt. Full article

(This article belongs to the Special Issue Climate Change Adaptation and Risk Reduction)

16 pages, 360 KiB

Open AccessEditor’s ChoiceArticle

Associations of Socioeconomic Status, Parental Smoking and Parental E-Cigarette Use with 10–11-Year-Old Children’s Perceptions of Tobacco Cigarettes and E-Cigarettes: Cross Sectional Analysis of the CHETS Wales 3 Survey

by Graham F. Moore, Lianna Angel, Linsay Gray, Lauren Copeland, Jordan Van Godwin, Jeremy Segrott and Britt Hallingberg

Int. J. Environ. Res. Public Health 2020, 17(3), 683; https://doi.org/10.3390/ijerph17030683 - 21 Jan 2020

Cited by 13 | Viewed by 7312

Abstract

Background: This study examines primary schoolchildren’s perceptions of e-cigarettes and tobacco cigarettes, and associations with parental smoking, vaping and socioeconomic status. Methods: Survey of 2218 10–11-year-old children in 73 schools in Wales. Results: Overall, 36% reported that a parent figure smoked compared to [...] Read more.

Background: This study examines primary schoolchildren’s perceptions of e-cigarettes and tobacco cigarettes, and associations with parental smoking, vaping and socioeconomic status. Methods: Survey of 2218 10–11-year-old children in 73 schools in Wales. Results: Overall, 36% reported that a parent figure smoked compared to 21% for vaping, with parental smoking lower in affluent families (OR = 0.72; 95% CI = 0.68 to 0.76). Overall, 1% had tried a cigarette, while 5% had tried an e-cigarette. Most said they would not smoke or vape in 2 years’ time; susceptibility to vaping (20%) was higher than smoking (12%). Exposure to and perceptions of tobacco cigarettes were more positive for children of smokers. Having a parent who vaped was associated with exposure to and positive perceptions of e-cigarettes, but not smoking. Most children perceived e-cigarettes as used by adults to stop smoking (64%). Susceptibility to smoking (OR = 0.57; 95% CI = 0.41 to 0.79) and vaping (OR = 0.78; 95% CI = 0.62 to 0.99) were lower among children who perceived e-cigarettes as cessation aids. Conclusions: Parental smoking continues to be concentrated in poorer families. This study provides no evidence that parental vaping in the absence of smoking is associated with more positive perceptions of tobacco cigarettes. Communicating to children the role of e-cigarettes as cessation devices for smokers may help to limit their appeal to young people. Full article

(This article belongs to the Collection Feature Papers in Children's Health)

7 pages, 812 KiB

Open AccessEditor’s ChoiceArticle

Effect of Information Disclosure Policy on Control of Infectious Disease: MERS-CoV Outbreak in South Korea

by Jin-Won Noh, Ki-Bong Yoo, Young Dae Kwon, Jin Hyuk Hong, Yejin Lee and Kisoo Park

Int. J. Environ. Res. Public Health 2020, 17(1), 305; https://doi.org/10.3390/ijerph17010305 - 1 Jan 2020

Cited by 15 | Viewed by 9656

Abstract

This study examined the effect of disclosing a list of hospitals with Middle East respiratory syndrome coronavirus (MERS-CoV) patients on the number of laboratory-confirmed MERS-CoV cases in South Korea. MERS-CoV data from 20 May 2015 to 5 July 2015 were from the Korean [...] Read more.

This study examined the effect of disclosing a list of hospitals with Middle East respiratory syndrome coronavirus (MERS-CoV) patients on the number of laboratory-confirmed MERS-CoV cases in South Korea. MERS-CoV data from 20 May 2015 to 5 July 2015 were from the Korean Ministry of Health & Welfare website and analyzed using segmented linear autoregressive error models for interrupted time series. This study showed that the number of laboratory-confirmed cases was increased by 9.632 on 5 June (p < 0.001). However, this number was significantly decreased following disclosure of a list of hospitals with MERS-CoV cases (Estimate = −0.699; p < 0.001). Disclosing the list of hospitals exposed to MERS-CoV was critical to the prevention of further infection. It reduced the number of confirmed MERS-CoV cases. Thus, providing accurate and timely information is a key to critical care response. Full article

(This article belongs to the Section Public Health Statistics and Risk Assessment)

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15 pages, 3062 KiB

Open AccessEditor’s ChoiceArticle

Reliability of a Virtual Prosthodontic Project Realized through a 2D and 3D Photographic Acquisition: An Experimental Study on the Accuracy of Different Digital Systems

by Luca Lavorgna, Gabriele Cervino, Luca Fiorillo, Giovanni Di Leo, Giuseppe Troiano, Marco Ortensi, Luigi Galantucci and Marco Cicciù

Int. J. Environ. Res. Public Health 2019, 16(24), 5139; https://doi.org/10.3390/ijerph16245139 - 16 Dec 2019

Cited by 59 | Viewed by 4750

Abstract

Aims: The study aims to assess the accuracy of digital planning in dentistry, evaluating the characteristics of different intraoral 3D scanners and comparing it with traditional imaging 2D recording methods. Specifically, using computer aided design (CAD) software and measuring inside CAD software, authors [...] Read more.

Aims: The study aims to assess the accuracy of digital planning in dentistry, evaluating the characteristics of different intraoral 3D scanners and comparing it with traditional imaging 2D recording methods. Specifically, using computer aided design (CAD) software and measuring inside CAD software, authors want to verify the reliability of different models obtained with different techniques and machines. Methods: 12 patients that needed aesthetic restorative treatment were enrolled in the study. All the patients underwent recording data of the height and width dental elements 1.1, 1.2, and 1.3 size using different technologies and comparing 2D with 3D methods. A T test was then applied in order to verify whether there was a statistically significant difference between the measurements obtained, comparing the different tools data (Emerald, TRIOS, Photogrammetry and DSS (Digital Smile System)) with the reference values. Results: No significant differences emerged in the measurements made with the different scanners (Trios 3Shape ^®, Planmeca Emerald ^®) and photogrammetry. Therefore, what should be underlined regarding the 2D measurements is the speed and simplicity compared to all 3D techniques, so this work can help to better define the field of application and the limits connected to 2D techniques, giving a good window of the technique. Conclusions: The low number of patients is not sufficient to provide statistically significant results, but the digital planning future prospects seem to be promising. This study results highlighted how a photogrammetric scanner for dental arches would only have a much smaller shooting field size and greater accuracy. Despite these considerations, the photogrammetric facial scanner provided excellent results for the measurement of individual teeth, showing a great versatility of use. Full article

(This article belongs to the Special Issue Digital Dentistry for Oral Health)

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7 pages, 867 KiB

Open AccessEditor’s ChoiceArticle

Impact of a Telemedicine Program on the Reduction in the Emission of Atmospheric Pollutants and Journeys by Road

by Josep Vidal-Alaball, Jordi Franch-Parella, Francesc Lopez Seguí, Francesc Garcia Cuyàs and Jacobo Mendioroz Peña

Int. J. Environ. Res. Public Health 2019, 16(22), 4366; https://doi.org/10.3390/ijerph16224366 - 8 Nov 2019

Cited by 61 | Viewed by 8660

Abstract

This retrospective study evaluates the effect of a telemedicine program developed in the central Catalan region in lowering the environmental footprint by reducing the emission of atmospheric pollutants, thanks to a reduction in the number of hospital visits involving journeys by road. Between [...] Read more.

This retrospective study evaluates the effect of a telemedicine program developed in the central Catalan region in lowering the environmental footprint by reducing the emission of atmospheric pollutants, thanks to a reduction in the number of hospital visits involving journeys by road. Between January 2018 and June 2019, a total of 12,322 referrals were made to telemedicine services in the primary care centers, avoiding a total of 9034 face-to-face visits. In total, the distance saved was 192,682 km, with a total travel time saving of 3779 h and a total fuel reduction of 11,754 L with an associated cost of €15,664. This represents an average reduction of 3248.3 g of carbon dioxide, 4.05 g of carbon monoxide, 4.86 g of nitric oxide and 3.2 g of sulphur dioxide. This study confirms that telemedicine reduces the environmental impact of atmospheric pollutants emitted by vehicles by reducing the number of journeys made for face-to-face visits, and thus contributing to environmental sustainability. Full article

(This article belongs to the Special Issue Social Media and Public Health: Opportunities and Challenges)

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15 pages, 360 KiB

Open AccessEditor’s ChoiceArticle

Stability of Differences in Weight-Related Characteristics of Mothers across Economic, Cultural, Social, and Environmental-Health Indicators of Socioeconomic Status

by Virginia Quick, Kaitlyn M. Eck, Colleen Delaney, Ryan Lewis and Carol Byrd-Bredbenner

Int. J. Environ. Res. Public Health 2019, 16(20), 3866; https://doi.org/10.3390/ijerph16203866 - 12 Oct 2019

Cited by 5 | Viewed by 3999

Abstract

This study explored the differences in weight-related characteristics when socioeconomic status (SES) was assessed by economic, cultural, social, and environmental-health capital individually and as a composite with the goal of determining the stability of differences across types of capital and to ascertain whether [...] Read more.

This study explored the differences in weight-related characteristics when socioeconomic status (SES) was assessed by economic, cultural, social, and environmental-health capital individually and as a composite with the goal of determining the stability of differences across types of capital and to ascertain whether single or a combination of capital indicators of SES should be used in nutrition and public health studies. Mothers (n = 557) of young children completed a survey assessing capital and weight-related characteristics. Mothers with higher economic, cultural, and social capital and composite SES had fewer sugar-sweetened beverage servings, fewer meals in front of the TV, more food security, and greater neighborhood space/supports for physical activity than comparators. Few differences occurred among environmental-health capital groups. Composite SES performed similarly to individual economic, cultural, and social capital measures. Findings suggest single SES indicators may be sufficiently stable to capture differences in weight-related characteristics. Each capital type captures a unique aspect of SES; thus, assessing an array of capital types could advance understanding of SES aspects on weight-related characteristics. Full article

(This article belongs to the Special Issue Social and Environmental Determinants of Health and Health Disparities)

17 pages, 481 KiB

Open AccessEditor’s ChoiceArticle

Facebook Groups on Chronic Obstructive Pulmonary Disease: Social Media Content Analysis

by Avery Apperson, Michael Stellefson, Samantha R. Paige, Beth H. Chaney, J. Don Chaney, Min Qi Wang and Arjun Mohan

Int. J. Environ. Res. Public Health 2019, 16(20), 3789; https://doi.org/10.3390/ijerph16203789 - 9 Oct 2019

Cited by 31 | Viewed by 6997

Abstract

Facebook Groups facilitate information exchange and engagement for patients with chronic conditions, including those living with Chronic Obstructive Pulmonary Disease (COPD); however, little is known about how knowledge is diffused throughout these communities. This study aimed to evaluate the content that is available [...] Read more.

Facebook Groups facilitate information exchange and engagement for patients with chronic conditions, including those living with Chronic Obstructive Pulmonary Disease (COPD); however, little is known about how knowledge is diffused throughout these communities. This study aimed to evaluate the content that is available on COPD-related Facebook Groups, as well as the communication (self-disclosures, social support) and engagement (agreement, emotional reaction) strategies used by members to facilitate these resources. Two researchers independently searched the “Groups” category using the terms “COPD”, “emphysema”, and “chronic bronchitis”. Twenty-six closed (n = 23) and public (n = 3) COPD Facebook Groups were identified with 87,082 total members. The vast majority of Group members belonged to closed (n = 84,684; 97.25%) as compared to open (n = 2398; 2.75%) groups. Medications were the most commonly addressed self-management topic (n = 48; 26.7%). While overall engagement with wall posts was low, the number of “likes” (an indicator of agreement) was significantly greater for wall posts that demonstrated social support as compared to posts that did not (p < 0.001). Findings from this study showed that COPD Facebook group members share specific disease-related experiences and request information about select self-management topics. This information can be used to improve the quality of self-management support provided to members of popular COPD Facebook groups. Full article

(This article belongs to the Special Issue Exploring the Role of Social Media in Health Promotion)

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17 pages, 363 KiB

Open AccessEditor’s ChoiceReview

Regulatory Policies for Alcohol, other Psychoactive Substances and Addictive Behaviours: The Role of Level of Use and Potency. A Systematic Review

by Jürgen Rehm, Jean-François Crépault, Omer S.M. Hasan, Dirk W. Lachenmeier, Robin Room and Bundit Sornpaisarn

Int. J. Environ. Res. Public Health 2019, 16(19), 3749; https://doi.org/10.3390/ijerph16193749 - 4 Oct 2019

Cited by 19 | Viewed by 7099

Abstract

The object of this contribution based on a systematic review of the literature is to examine to what degree the level of use and potency play a role in regulatory policies for alcohol, other psychoactive substances and gambling, and whether there is an [...] Read more.

The object of this contribution based on a systematic review of the literature is to examine to what degree the level of use and potency play a role in regulatory policies for alcohol, other psychoactive substances and gambling, and whether there is an evidence base for this role. Level of use is usually defined around a behavioural pattern of the user (for example, cigarettes smoked per day, or average ethanol use in grams per day), while potency is defined as a property or characteristic of the substance. For all substances examined (alcohol, tobacco, opioids, cannabis) and gambling, both dimensions were taken into consideration in the formulation of most regulatory policies. However, the associations between both dimensions and regulatory policies were not systematic, and not always based on evidence. Future improvements are suggested. Full article

(This article belongs to the Special Issue Alcohol Control Policy and Health in Europe)

16 pages, 1107 KiB

Open AccessEditor’s ChoiceArticle

Impact of Wildfire Smoke on Adverse Pregnancy Outcomes in Colorado, 2007–2015

by Mona Abdo, Isabella Ward, Katelyn O’Dell, Bonne Ford, Jeffrey R. Pierce, Emily V. Fischer and James L. Crooks

Int. J. Environ. Res. Public Health 2019, 16(19), 3720; https://doi.org/10.3390/ijerph16193720 - 2 Oct 2019

Cited by 144 | Viewed by 18527

Abstract

Colorado is regularly impacted by long-range transport of wildfire smoke from upwind regions. This smoke is a major source of ambient PM_2.5. Maternal exposure to total PM_2.5 during pregnancy has been linked to decreased birth weight and other adverse outcomes, [...] Read more.

Colorado is regularly impacted by long-range transport of wildfire smoke from upwind regions. This smoke is a major source of ambient PM_2.5. Maternal exposure to total PM_2.5 during pregnancy has been linked to decreased birth weight and other adverse outcomes, although the impact of wildfire smoke contribution has only recently been investigated. The objective of this study was to estimate associations between adverse pregnancy outcomes and ambient wildfire smoke PM_2.5. Wildfire smoke PM_2.5 exposures were estimated using a previously published method incorporating ground-based monitors and remote sensing data. Logistic regression models stratified by ZIP code and mixed models with random intercept by ZIP code were used to test for associations. The primary outcomes of interest were preterm birth and birth weight. Secondary outcomes included gestational hypertension, gestational diabetes, neonatal intensive care unit admission, assisted ventilation, small for gestational age, and low birth weight. Exposure to wildfire smoke PM_2.5 over the full gestation and during the second trimester were positively associated with pre-term birth (OR = 1.076 (μg/m³)⁻¹ [95% CI = 1.016, 1.139; p = 0.013] and 1.132 (μg/m³)⁻¹ [95% CI = 1.088, 1.178]; p < 0.0001, respectively), while exposure during the first trimester was associated with decreased birth weight (−5.7 g/(μg/m³) [95% CI: −11.1, −0.4; p = 0.036]). Secondary outcomes were mixed. Full article

(This article belongs to the Special Issue Impacts of Climate Change on Women's Health)

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21 pages, 1301 KiB

Open AccessEditor’s ChoiceArticle

Use of Wearable Technology and Social Media to Improve Physical Activity and Dietary Behaviors among College Students: A 12-Week Randomized Pilot Study

by Zachary C. Pope, Daheia J. Barr-Anderson, Beth A. Lewis, Mark A. Pereira and Zan Gao

Int. J. Environ. Res. Public Health 2019, 16(19), 3579; https://doi.org/10.3390/ijerph16193579 - 25 Sep 2019

Cited by 74 | Viewed by 16452

Abstract

College students demonstrate poor physical activity (PA) and dietary behaviors. We evaluated the feasibility of a combined smartwatch and theoretically based, social media-delivered health education intervention versus a comparison on improving college students’ health behaviors/outcomes. Thirty-eight students (28 female; X_age = 21.5 [...] Read more.

College students demonstrate poor physical activity (PA) and dietary behaviors. We evaluated the feasibility of a combined smartwatch and theoretically based, social media-delivered health education intervention versus a comparison on improving college students’ health behaviors/outcomes. Thirty-eight students (28 female; X_age = 21.5 ± 3.4 years) participated in this two-arm, randomized 12-week pilot trial (2017–2018). Participants were randomized into: (a) experimental: Polar M400 use and twice-weekly social cognitive theory- and self-determination theory-based Facebook-delivered health education intervention; or (b) comparison: enrollment only in separate, but content-identical, Facebook intervention. Primary outcomes pertained to intervention feasibility. Secondary outcomes included accelerometer-estimated PA, physiological/psychosocial outcomes, and dietary behaviors. Intervention adherence was high (~86%), with a retention of 92.1%. Participants implemented health education tips 1–3 times per week. We observed experimental and comparison groups to have 4.2- and 1.6-min/day increases in moderate-to-vigorous PA (MVPA), respectively, at six weeks—partially maintained at 12 weeks. In both groups, similarly decreased body weight (experimental = −0.6 kg; comparison = −0.5 kg) and increased self-efficacy, social support, and intrinsic motivation were observed pre- and post-intervention. Finally, we observed small decreases in daily caloric consumption over time (experimental = −41.0 calories; comparison = −143.3). Both interventions were feasible/of interest to college students and demonstrated initial effectiveness at improving health behaviors/outcomes. However, smartwatch provision may not result in an additional benefit. Full article

(This article belongs to the Special Issue Physical Activity, Sedentary Behavior, and Dietary Interventions and Tracking Using Technology)

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12 pages, 349 KiB

Open AccessEditor’s ChoiceArticle

Flood- and Weather-Damaged Homes and Mental Health: An Analysis Using England’s Mental Health Survey

by Hilary Graham, Piran White, Jacqui Cotton and Sally McManus

Int. J. Environ. Res. Public Health 2019, 16(18), 3256; https://doi.org/10.3390/ijerph16183256 - 5 Sep 2019

Cited by 44 | Viewed by 12958

Abstract

There is increasing evidence that exposure to weather-related hazards like storms and floods adversely affects mental health. However, evidence of treated and untreated mental disorders based on diagnostic criteria for the general population is limited. We analysed the Adult Psychiatric Morbidity Survey, a [...] Read more.

There is increasing evidence that exposure to weather-related hazards like storms and floods adversely affects mental health. However, evidence of treated and untreated mental disorders based on diagnostic criteria for the general population is limited. We analysed the Adult Psychiatric Morbidity Survey, a large probability sample survey of adults in England (n = 7525), that provides the only national data on the prevalence of mental disorders assessed to diagnostic criteria. The most recent survey (2014–2015) asked participants if they had experienced damage to their home (due to wind, rain, snow or flood) in the six months prior to interview, a period that included months of unprecedented population exposure to flooding, particularly in Southern England. One in twenty (4.5%) reported living in a storm- or flood-damaged home in the previous six months. Social advantage (home ownership, higher household income) increased the odds of exposure to storm or flood damage. Exposure predicted having a common mental disorder over and above the effects of other known predictors of poor mental health. With climate change increasing the frequency and severity of storms and flooding, improving community resilience and disaster preparedness is a priority. Evidence on the mental health of exposed populations is key to building this capacity. Full article

(This article belongs to the Section Climate Change)

13 pages, 289 KiB

Open AccessEditor’s ChoiceArticle

Adolescent Smoking in Secondary Schools that Have Implemented Smoke-Free Policies: In-Depth Exploration of Shared Smoking Patterns

by Michael Schreuders, Loekie Klompmaker, Bas van den Putte and Anton E Kunst

Int. J. Environ. Res. Public Health 2019, 16(12), 2100; https://doi.org/10.3390/ijerph16122100 - 13 Jun 2019

Cited by 18 | Viewed by 6630

Abstract

Large numbers of adolescents smoke during school hours, despite the implementation of smoke-free school policies (SFSPs). Studies about SFSPs predominantly analyse smoking as individual behaviour, yet there is increasing recognition that smoking should be understood as social behaviour. We explored shared smoking patterns [...] Read more.

Large numbers of adolescents smoke during school hours, despite the implementation of smoke-free school policies (SFSPs). Studies about SFSPs predominantly analyse smoking as individual behaviour, yet there is increasing recognition that smoking should be understood as social behaviour. We explored shared smoking patterns specifying where, when, and with whom, and social meanings about why groups of adolescents smoke in two Dutch schools that have implemented SFSPs. Surveys among adolescents were held to obtain contextual information about the schools. Four focus group discussions and fourteen individual interviews were held with adolescents to identify shared smoking patterns in each school. Two shared patterns were identified at a school where 17% of students smoked daily: Dependent smoking and Rebellious smoking. Both built on pro-smoking norms and underscored the benefits of smoking. Three shared patterns were identified at a school where 3% of students smoked daily: Social bonding smoking, Low-profile smoking and Smoking-friendly event smoking. These built on anti-smoking norms and helped smokers cope with negative social judgements related to smoking. We conclude that adolescent smoking during school hours is embedded in diverse shared smoking patterns. Future studies should develop more understanding about how to deal with adolescents’ shared smoking patterns that decrease the effectiveness of tobacco policies. Full article

(This article belongs to the Special Issue School Health and Wellbeing)

49 pages, 889 KiB

Open AccessEditor’s ChoiceReview

A Scoping Review Mapping Research on Green Space and Associated Mental Health Benefits

by Charlotte Wendelboe-Nelson, Sarah Kelly, Marion Kennedy and John W. Cherrie

Int. J. Environ. Res. Public Health 2019, 16(12), 2081; https://doi.org/10.3390/ijerph16122081 - 12 Jun 2019

Cited by 121 | Viewed by 17418

Abstract

Background: There is a growing interest in research investigating the association between green space (GS) and mental health and wellbeing (HWB), in order to understand the underlying mechanisms. Accordingly, there is a need to map the literature and create an overview of the [...] Read more.

Background: There is a growing interest in research investigating the association between green space (GS) and mental health and wellbeing (HWB), in order to understand the underlying mechanisms. Accordingly, there is a need to map the literature and create an overview of the research. Methods: A scoping review approach was used to map literature on GS, including context and co-exposures (the GS exposome), and their associations with mental HWB. The review considers mental HWB definitions and measurements and how GS is characterized. Furthermore, the review aims to identify knowledge gaps and make recommendations for future research. Results: We identified a great diversity in study designs, definitions, outcome measures, consideration of the totality of the GS exposome, and reporting of results. Around 70% of the 263 reviewed studies reported a positive association between some aspect of GS and HWB. However, there is a limited amount of research using randomized controlled crossover trails (RCTs) and mixed methods and an abundance of qualitative subjective research. Conclusions: The discords between study designs, definitions, and the reporting of results makes it difficult to aggregate the evidence and identify any potential causal mechanisms. We propose key points to consider when defining and quantifying GS and make recommendations for reporting on research investigating GS and mental HWB. This review highlights a need for large well-designed RCTs that reliably measure the GS exposome in relation to mental HWB. Full article

(This article belongs to the Section Environmental Health)

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