International Journal of Environmental Research and Public Health

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13 pages, 2747 KiB

Open AccessEditor’s ChoiceArticle

A Geospatial Analysis of the Lung Cancer Burden in Philadelphia, Using Pennsylvania Cancer Registry Data from 2008–2017

by Russell K. McIntire, Katherine Senter, Christine Shusted, Rickisa Yearwood, Julie Barta, Scott W. Keith and Charnita Zeigler-Johnson

Int. J. Environ. Res. Public Health 2025, 22(3), 455; https://doi.org/10.3390/ijerph22030455 - 20 Mar 2025

Viewed by 1247

Abstract

(1) Background: Lung cancer is the deadliest and second most prevalent cancer in Pennsylvania (PA), and African American patients are disproportionately affected. Lung cancer morbidity and mortality in Philadelphia County are among the highest in PA. Geographic information systems (GIS) are useful to [...] Read more.

(1) Background: Lung cancer is the deadliest and second most prevalent cancer in Pennsylvania (PA), and African American patients are disproportionately affected. Lung cancer morbidity and mortality in Philadelphia County are among the highest in PA. Geographic information systems (GIS) are useful to explore geospatial variations in the cancer burden and risk factors. Therefore, we used GIS to analyze the lung cancer burden in Philadelphia to assess which areas of the city have the highest morbidity and mortality, identify potential clusters, and determine which census tract-level characteristics were associated with higher tract-level cancer burden. (2) Methods: Using secondary data from the Pennsylvania Cancer Registry, age-adjusted standardized incidence and mortality ratios (SIR and SMR) were calculated by census tract, and choropleth maps were created to visualize geographic variations in the disease burden. Two geostatistical methods were used to determine the presence of lung cancer clusters. Multivariable regression analyses were performed to identify which census-tract level characteristics correlated with a higher lung cancer burden. (3) Results: Three distinct geographical lung cancer clusters were identified. After controlling for demographics and other covariates, adult smoking prevalence, prevalence of chronic obstructive pulmonary disease, and percentage of residential addresses vacant were positively associated with higher lung cancer SIR and SMR. (4) Conclusions: Our findings may inform cancer control efforts within the region and guide future municipal-level GIS analyses of the lung cancer burden. Full article

(This article belongs to the Special Issue Cancer Causes and Control)

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19 pages, 1474 KiB

Open AccessEditor’s ChoiceArticle

“Understand the Way We Walk Our Life”: Indigenous Patients’ Experiences and Recommendations for Healthcare in the United States

by Melissa E. Lewis, Ivy Blackmore, Martina L. Kamaka, Sky Wildcat, Amber Anderson-Buettner, Elizabeth Modde, Laurelle Myhra, Jamie B. Smith and Antony L. Stately

Int. J. Environ. Res. Public Health 2025, 22(3), 445; https://doi.org/10.3390/ijerph22030445 - 17 Mar 2025

Viewed by 546

Abstract

Background: The quality of healthcare experiences for Indigenous communities is worse when compared to non-Indigenous patients. Bias and discrimination within healthcare systems relate to worsened care and worsened health outcomes for Indigenous patients. The purpose of this study was to learn about the [...] Read more.

Background: The quality of healthcare experiences for Indigenous communities is worse when compared to non-Indigenous patients. Bias and discrimination within healthcare systems relate to worsened care and worsened health outcomes for Indigenous patients. The purpose of this study was to learn about the experiences of Indigenous people within healthcare settings, as well as their viewpoints for improving healthcare delivery to this population. Methods: Indigenous research methods were employed in this study as clinic administrators and staff, elders, and Indigenous researchers collaborated on the study purpose, design, and analysis. Twenty Indigenous patients participated in one of four focus groups regarding their experiences with healthcare systems. Results: Seven main themes emerged, highlighting participants’ experiences during health encounters, in relation to healthcare systems, and Indigenous health beliefs. Participants discussed challenges and barriers in each area and offered recommendations for care delivery to this population. Conclusions: Participants in this study highlighted that biased care results in poor quality of healthcare delivery and that there are actionable steps that providers and systems of healthcare can take to reduce bias within healthcare systems. The provision of culturally congruent care is imperative in improving the health and well-being of Indigenous communities. Full article

(This article belongs to the Special Issue Advances in Indigenous and American Indian and Alaska Native Health and Wellness)

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15 pages, 514 KiB

Open AccessEditor’s ChoiceArticle

Social Inequities in Cardiovascular Disease Risk Factors at Multiple Levels Persist Among Mothers in Texas

by Catherine Cubbin, Quynh Nhu (Natasha) B. La Frinere-Sandoval and Elizabeth M. Widen

Int. J. Environ. Res. Public Health 2025, 22(3), 404; https://doi.org/10.3390/ijerph22030404 - 10 Mar 2025

Viewed by 621

Abstract

The life stage between the ages of 30–45 years for women is critical, given the competing demands of occupational advancement, intimate partner relationships, and childcare responsibilities. Cardiovascular disease (CVD) is the leading cause of death among women in the US, which is experienced [...] Read more.

The life stage between the ages of 30–45 years for women is critical, given the competing demands of occupational advancement, intimate partner relationships, and childcare responsibilities. Cardiovascular disease (CVD) is the leading cause of death among women in the US, which is experienced inequitably by race/ethnicity/nativity and socioeconomic status and is embedded within geographic contexts. The objective of the current study was to examine social inequities in pre-pregnancy risk factors for cardiovascular disease. We analyzed 16 years of geocoded natality data in Texas (N = 2,089,588 births between 2005 and 2020 to mothers aged 30–45 years) linked with census tract- and county-level data. Dependent variables included pre-pregnancy diabetes, hypertension, obesity, and smoking. Independent variables included individual-level race/ethnicity/nativity and educational attainment, tract-level poverty and racial/ethnic concentrations, and county-level urban/rural status, with controls for other sociodemographic characteristics and time trend. Two-level, random intercept hierarchical generalized logistic models were used to estimate associations and model fit. Significant social inequities at the individual-, tract-, and county-levels in each risk factor were found. For example, tract-level variables had substantial and significant association with the four CVD risk factors, ranging from 13% to 72% higher odds in adjusted models. For all four risk factors, the more rural the county of residence was, the higher the odds of having the risk factor (24% to 256% higher odds). Individual-level social inequalities by race/ethnicity/nativity (ORs ranging from 0.04 to 2.12) and education (ORs ranging from 1.25 to 5.20) were also observed. Enhancing our understanding of this important period of life may enable policy and interventions to better support women through this critical life stage. Full article

(This article belongs to the Special Issue Advances in Gender Inequality and Women's Health)

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21 pages, 1352 KiB

Open AccessEditor’s ChoiceArticle

Mapping the Vulnerability of Older-Adult Neighborhoods: An Ecological Study of New York State

by Samantha Friedman, Chunxu Fang, Tse-Chuan Yang, Rui Li, Imran Hossain Mithu, Jennifer A. Manganello, Xiaobo Romeiko and Shao Lin

Int. J. Environ. Res. Public Health 2025, 22(3), 332; https://doi.org/10.3390/ijerph22030332 - 24 Feb 2025

Viewed by 1023

Abstract

We examined neighborhood-level demographic, economic, and social characteristics and food and health-services access to gauge the vulnerability of older-adult neighborhoods in New York State (NYS), which is understudied and is significant given the rapid aging of populations worldwide. We conducted descriptive ecological analyses [...] Read more.

We examined neighborhood-level demographic, economic, and social characteristics and food and health-services access to gauge the vulnerability of older-adult neighborhoods in New York State (NYS), which is understudied and is significant given the rapid aging of populations worldwide. We conducted descriptive ecological analyses using data from the American Community Survey, historical redlining maps, Social Capital Instruments, U.S. Department of Agriculture food access atlas, ESRI businesses, and Social Determinants of Health. We compared census tracts classified as having high and low levels of older-adult population; among those identified as high-older-adult neighborhoods, we then examined tracts with high and low levels of adult population living alone and in poverty. Our results showed that NYS neighborhoods with large shares of the older adult population are generally faring well in terms of their socioeconomic status, social capital, lack of social isolation, and health services access. However, the older-adult neighborhoods with larger shares of the population living alone and in poverty fare worse, living in areas with poorer socioeconomic status, lower social capital, and considered medically underserved. NYS older adult communities are projected to increase by 2030. Resources should be invested in such areas with vulnerable groups so populations may age in equitable and accessible communities. Full article

(This article belongs to the Special Issue Social Inequalities in Later Life: Care Services in the Future)

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15 pages, 495 KiB

Open AccessEditor’s ChoiceArticle

HPV Self-Sampling Promotion Among African American (AA) and Sub-Saharan African (SAI) Immigrant Women: Adaptation and Usability Testing

by Adebola Adegboyega, Gia Mudd-Martin, Nancy E. Schoenberg and Mark Dignan

Int. J. Environ. Res. Public Health 2025, 22(3), 317; https://doi.org/10.3390/ijerph22030317 - 20 Feb 2025

Viewed by 645

Abstract

Background: Cervical cancer (CC) rates have declined nationally but rates remain high in Black women with most cases occurring among unscreened and under-screened women. This paper describes the adaptation, acceptability, and useability of an education intervention, “Health is Wealth: A Cervical Health Intervention”, [...] Read more.

Background: Cervical cancer (CC) rates have declined nationally but rates remain high in Black women with most cases occurring among unscreened and under-screened women. This paper describes the adaptation, acceptability, and useability of an education intervention, “Health is Wealth: A Cervical Health Intervention”, to promote cervical screening and reduce perceived barriers to CC screening among two subgroups of Black women: African American (AA) and sub-Saharan African immigrant (SAI) women. Methods: In this paper, we describe the process of adapting the Health is Wealth intervention using the Barrera and Castro adaptation framework. The iterative adaptation process included formative focus groups (n = 30 participants) to gather information, expert feedback (n = 4), and usability testing (n = 7). Results: The systematic process resulted in the modification of educational intervention components. Several aspects of the intervention were modified, and core elements of the original intervention were preserved. The usability testing findings suggest the intervention would support the objective of promoting cervical cancer screening uptake among AA and SAI women. Conclusions: Adaptation of an evidence-based intervention is necessary to ensure contextually and culturally appropriateness for target populations, particularly for minoritized populations. We demonstrated that an evidence-based intervention for Pap screening can be adapted for HPV-self-sampling promotion with target community input. Full article

(This article belongs to the Section Global Health)

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12 pages, 864 KiB

Open AccessEditor’s ChoiceArticle

Healthy Behavior for Preventing Cognitive Disability in Older Persons

by Fulvio Lauretani, Antonio Marcato and Crescenzo Testa

Int. J. Environ. Res. Public Health 2025, 22(2), 262; https://doi.org/10.3390/ijerph22020262 - 12 Feb 2025

Viewed by 935

Abstract

Sufficient levels of physical activity are fundamental for preventing cardiovascular disease, dementia, and ultimately disability in older persons, yet this protective factor is nullified when excessive hours are spent in continuous sitting. Balancing physical activity and sedentary behavior is crucial for influencing metabolic [...] Read more.

Sufficient levels of physical activity are fundamental for preventing cardiovascular disease, dementia, and ultimately disability in older persons, yet this protective factor is nullified when excessive hours are spent in continuous sitting. Balancing physical activity and sedentary behavior is crucial for influencing metabolic parameters and vascular patterns, both central and peripheral, thereby reducing the risk of cardiovascular diseases, vascular dementia, and cognitive impairment. The primary goal of geriatric medicine is to improve quality of life and prevent disability by promptly identifying frail older individuals, thus mitigating both cognitive and motor impairments. Achieving this objective requires not only the optimization of pharmacological treatments but also the active promotion of a healthy lifestyle. In this context, investigating preclinical stages of disability, such as Motoric Cognitive Risk (MCR) Syndrome, which integrates physical and cognitive components of decline, becomes essential. However, despite robust evidence supporting these interventions, greater efforts are needed from the geriatric medical community to bridge the gap between scientific recommendations and everyday clinical practice. Integrating these guidelines into routine care is pivotal for delivering personalized interventions that address both physical inactivity and prolonged sedentary behavior. More research should aim to strengthen this balance, providing clearer, actionable strategies for clinicians to implement, thereby fostering the formation of evidence-based public health guidelines on physical activity specifically tailored for older persons. Full article

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17 pages, 1330 KiB

Open AccessEditor’s ChoiceArticle

Physical and Mental Health of Caregivers and Educators of Preschool-Aged Children: Identifying Benefits and Barriers to Outdoor Time, How Outdoor Time Can Make a Difference for Health Equity, and Why Income Matters

by Amber L. Fyfe-Johnson, Carolyn J. Noonan, Maria B. Butcher and Magdalena K. Haakenstad

Int. J. Environ. Res. Public Health 2025, 22(2), 236; https://doi.org/10.3390/ijerph22020236 - 7 Feb 2025

Viewed by 860

Abstract

Outdoor time is positively associated with improved physical and mental health in adults. Little is known about the specific effects of outdoor time on health outcomes for parents and educators of preschool-aged children. Early childhood is a critical window for growth and development, [...] Read more.

Outdoor time is positively associated with improved physical and mental health in adults. Little is known about the specific effects of outdoor time on health outcomes for parents and educators of preschool-aged children. Early childhood is a critical window for growth and development, as parental and educator stress negatively impacts young children; thus, it is of paramount importance to systematically support parents and educators during these developmental years. The objectives of this research were to use a cross-sectional natural experiment to (1) evaluate the association between outdoor time and physical and mental health in caregivers and educators who engage with preschool-aged children; (2) evaluate the association between income and physical and mental health in caregivers and educators who engage with preschool-aged children; and (3) identify benefits and barriers of outdoor time and the importance, availability, and accessibility of community resources for outdoor time. Participants were recruited from three stakeholder groups: preschool educators, parents of children attending an outdoor preschool, and parents of preschool-aged children in the local community. Participants completed a health needs assessment (n = 46) to assess demographics, mental and physical health outcomes, and benefits, barriers, and resources for outdoor time. Caregivers and educators in the higher income group (≥USD 70,000) were 41% (95% CI: 12%, 70%) more likely to report very good or excellent self-reported health. Mean anxiety, depression, and perceived stress were lower in the higher-income group. Caregivers and educators in the higher outdoor time group had lower body mass index (−5.5 kg/m²; 95% CI: −11.6, 0.7), and outdoor time appeared to be protective for general health independent of income. Thus, outdoor time may be a critical protective factor to enhance biological resilience for caregivers and educators, especially for those facing financial adversity. Full article

(This article belongs to the Special Issue The Impact of Health-Promoting Built Environments on Public Health)

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17 pages, 995 KiB

Open AccessEditor’s ChoiceArticle

Associations Between Traumatic Brain Injury Characteristics and Memory Outcomes: Insights from the Health and Retirement Study

by Eric S. Cerino, Monica R. Lininger, Thomasina J. Seaton, Gillian Porter and Julie A. Baldwin

Int. J. Environ. Res. Public Health 2025, 22(2), 150; https://doi.org/10.3390/ijerph22020150 - 23 Jan 2025

Viewed by 822

Abstract

Traumatic brain injury (TBI) is an established risk factor for accelerated cognitive decline and increased dementia risk. The specific characteristics of TBI (e.g., type of head trauma, presence of a gap in memory, age of onset) that confer the greatest risk to cognitive [...] Read more.

Traumatic brain injury (TBI) is an established risk factor for accelerated cognitive decline and increased dementia risk. The specific characteristics of TBI (e.g., type of head trauma, presence of a gap in memory, age of onset) that confer the greatest risk to cognitive health remain comparatively less clear. Using data from the 2014 Health and Retirement Study (HRS) experimental module, we examined associations between TBI characteristics and memory outcomes in a national adult lifespan sample. We tested whether the age of onset and presence of a memory gap in TBI resulting from a vehicle accident, from a fall or being hit, or from playing sports or playing on a playground were associated with self-rated memory and recall memory performance in a subsample of HRS respondents across the adult lifespan (N = 414, mean age = 66.28, SD = 9.70, 52% female). In cases where participants reported TBI from three different types of injury (vehicle accident, fall, and playing sports or playing on a playground), they shared whether they experienced a gap in their memory and their age when the head trauma occurred. Participants also reported on self-rated memory and performed a recall memory task. Hierarchical linear regression models were adjusted for age, sex, race, ethnicity, education, and self-rated health. Older age of onset for TBI from a fall was associated with worse self-rated memory (Est. = −0.11, SE = 0.04, p = 0.01) and recall performance (Est. = −0.33, SE = 0.15, p = 0.03). Encountering a memory gap from the TBI that resulted from a vehicle accident (Est. = −0.22, SE = 0.10, p = 0.03), a fall (Est. = −0.23, SE = 0.09, p = 0.01), and from playing sports or playing on a playground (Est. = −0.40, SE = −0.13, p < 0.01) were all significantly associated with worse self-rated memory. Links between encountering a memory gap and recall performance were comparatively scant. Results indicate the impact of TBI on memory varies as a function of type of trauma, age of onset, and presence of memory gap from the head trauma. Our study takes a preclinical, preventative approach to inform public health efforts that target the mitigation of specific types of head trauma at different developmental phases of the lifespan. Full article

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20 pages, 3022 KiB

Open AccessEditor’s ChoiceArticle

Sociodemographic and Population Exposure to Upstream Oil and Gas Operations in Canada

by Martin Lavoie, David Risk and Daniel Rainham

Int. J. Environ. Res. Public Health 2024, 21(12), 1692; https://doi.org/10.3390/ijerph21121692 - 19 Dec 2024

Viewed by 4474

Abstract

Canada, as one of the largest oil and gas producer in the world, is responsible for large emissions of methane, a powerful greenhouse gas. At low levels, methane is not a direct threat to human health; however, human health is affected by exposure [...] Read more.

Canada, as one of the largest oil and gas producer in the world, is responsible for large emissions of methane, a powerful greenhouse gas. At low levels, methane is not a direct threat to human health; however, human health is affected by exposure to pollutants co-emitted with methane. The objectives of this research were to estimate and map pollutants emitted by the oil and gas industry, to assess the demographic of the population exposed to oil and gas activities, and to characterize the impact of well density on cardiovascular- and respiratory-related outcomes with a focus on Alberta. We estimated that ~13% and 3% people in Alberta reside, respectively, within 1.5 km of an active well and 1.5 km of a flare. Our analysis suggests that racial and socioeconomic disparities exist in residential proximity to active wells, with people of Aboriginal identity and people with less education being more exposed to active wells than the general population. We found increased odds of cardiovascular-related (1.13–1.29 for low active well density) and respiratory-related (1.07–1.19 for low active well density) outcomes with exposure to wells. Close to 100 countries produce oil and gas, making this a global issue. There is an important need for additional studies from other producing jurisdictions outside the United States. Full article

(This article belongs to the Section Environmental Health)

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14 pages, 472 KiB

Open AccessEditor’s ChoiceArticle

Lifestyle Factors and Associations with Individual and Comorbid Cardiometabolic and Pulmonary Disease Among U.S. Adults

by Osayande Agbonlahor, Delvon T. Mattingly, Maggie K. Richardson, Joy L. Hart, Alison C. McLeish and Kandi L. Walker

Int. J. Environ. Res. Public Health 2024, 21(12), 1674; https://doi.org/10.3390/ijerph21121674 - 16 Dec 2024

Viewed by 966

Abstract

Background: Although lifestyle factors have been linked to chronic diseases among adults, their association with diagnosed individual and comorbid cardiometabolic (CMD) and pulmonary disease (PD) is not fully known. This study aimed to examine the associations between lifestyle factors and individual and comorbid [...] Read more.

Background: Although lifestyle factors have been linked to chronic diseases among adults, their association with diagnosed individual and comorbid cardiometabolic (CMD) and pulmonary disease (PD) is not fully known. This study aimed to examine the associations between lifestyle factors and individual and comorbid CMD and PD among U.S. adults. Methods: We used cross-sectional data from the 2017–2020 National Health and Nutrition Examination Survey (n = 7394). Health care provider’s diagnosis of CMD and PD and lifestyle factors (i.e., past 5-day tobacco use, past 12-month alcohol use, diet, sleep troubles, and physical activity) were assessed. Adjusted odds ratios were estimated using logistic and multinomial logistic regression. Results: Trouble sleeping was associated with increased odds of CMD (OR: 2.47) and PD (OR: 2.29) individually, while physical activity was associated with lower odds (OR: 0.75, OR: 0.77). Past 5-day tobacco (OR: 2.36) and past year alcohol (OR: 1.61) use were associated with increased PD odds. Lifestyle factors were associated with increased odds of comorbid CMD and PD. Conclusions: Lifestyle factors were associated with increased odds of individual and comorbid CMD and PD among adults. CMD and PD prevention should involve promoting lifestyle modification and implementation of policies that eliminate structural barriers to healthy lifestyle adoption. Full article

(This article belongs to the Special Issue The 20th Anniversary of IJERPH)

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17 pages, 1254 KiB

Open AccessEditor’s ChoiceArticle

Early Family Conflict and Behavioral Outcomes in Children from Low-Income Families: The Indirect Effects of Parental Depression and Parenting Practices

by Rong Huang, Rachel Chazan-Cohen and Delaina Carlson

Int. J. Environ. Res. Public Health 2024, 21(12), 1664; https://doi.org/10.3390/ijerph21121664 - 13 Dec 2024

Viewed by 1726

Abstract

Family conflict has been demonstrated as a risk factor impacting children’s mental health and behaviors; however, the mechanisms underlying these connections are unclear. Focusing on 1622 children from low-income families (51.4% boys, 38.3% White, 35.5% Hispanic/Latino, 22.1% African American, 4.1% other), the current [...] Read more.

Family conflict has been demonstrated as a risk factor impacting children’s mental health and behaviors; however, the mechanisms underlying these connections are unclear. Focusing on 1622 children from low-income families (51.4% boys, 38.3% White, 35.5% Hispanic/Latino, 22.1% African American, 4.1% other), the current study examines the role that maternal depression and parenting behaviors play in the associations between family conflict in early childhood and children’s internalizing and externalizing behaviors in early adolescence. Family conflict was positively associated with maternal depression at age 3 and detached parenting at age 5; however, maternal depression was linked to increased child internalizing and externalizing behaviors, and detached parenting was associated with decreased behavioral outcomes. Maternal depression at age 3 and intrusive parenting at age 5 successively mediated the association between family conflict and child externalizing. Multi-group analysis indicated different indirect paths of parenting behaviors in boys and girls. Specifically, in boys, the indirect effect of detached parenting on the links between family conflict and externalizing and internalizing behaviors was sustained. In girls, maternal depression and intrusive parenting sequentially explained the link between family conflict and externalizing behaviors. The findings highlighted the importance of addressing family well-being and parenting support, especially for children from low-income families. Full article

(This article belongs to the Special Issue The Influence of Parenting Styles on Children's Mental Health)

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13 pages, 321 KiB

Open AccessEditor’s ChoiceArticle

What’s the Matter? Alcohol Use Risk Among Relatives of People with Mental Illness

by Suzanne A. McKeag, Gordon L. Flett and Joel O. Goldberg

Int. J. Environ. Res. Public Health 2024, 21(12), 1637; https://doi.org/10.3390/ijerph21121637 - 9 Dec 2024

Viewed by 1404

Abstract

Family members who live with relatives with serious mental illness face unique mental health risks, which become worse with alcohol use and without social support. Research has highlighted the damaging effects of harmful substance use among people who feel like they do not [...] Read more.

Family members who live with relatives with serious mental illness face unique mental health risks, which become worse with alcohol use and without social support. Research has highlighted the damaging effects of harmful substance use among people who feel like they do not matter to others, but few studies have assessed links between mattering and alcohol use within marginalized populations. In the present study, a sample of family members who reside with a relative with mental illness completed an online survey. Using the AUDIT alcohol screening measure, participants were classified into a No–Low Risk Alcohol Use (n = 52) or a Hazardous Drinking (n = 28) group. Hazardous alcohol use was alarmingly high, reaching triple the rate of the general population and categorized at the most severe level of harm. Those who drank hazardously felt like they mattered less to others (p < 0.001), felt like they mattered less to their relative with mental illness (p = 0.035), had greater anti-mattering (e.g., they felt invisible and unheard) (p = 0.008), experienced more hopelessness (p < 0.001), felt less supported by significant others (p = 0.003), endorsed having more problems with mental health services (p = 0.017), had higher stigma (p < 0.001), and had lower psychological well-being (p < 0.001). Findings highlight under-recognized public health risks, implications for public health initiatives, and the need for tailored interventions that boost mattering and reduce harmful alcohol use in this vulnerable family member population. Full article

(This article belongs to the Special Issue Alcohol Use in Disadvantaged Populations: Health Equalities and Appropriate Intervention)

17 pages, 376 KiB

Open AccessEditor’s ChoiceArticle

Environmental Health Attitudes, Practices, and Educational Preferences: A National Survey of Reproductive-Aged Women in Canada

by Eric J. Crighton, Erica Phipps, Graeme N. Smith, Rukhsana Ahmed, Jocelynn L. Cook, Jeffrey R. Masuda, Alvaro R. Osornio-Vargas, Margaret Sanborn, Lesley J. Brennan, Karen P. Phillips and on behalf of the PEHE Collaboration

Int. J. Environ. Res. Public Health 2024, 21(11), 1397; https://doi.org/10.3390/ijerph21111397 - 23 Oct 2024

Cited by 1 | Viewed by 1327

Abstract

Prenatal exposures to environmental toxicants can adversely affect fetal and child development and lead to increased risk of chronic disease. While regulatory action is essential to reduce sources of environmental toxicants, prenatal care presents an opportunity to educate, mobilize, and support prospective parents [...] Read more.

Prenatal exposures to environmental toxicants can adversely affect fetal and child development and lead to increased risk of chronic disease. While regulatory action is essential to reduce sources of environmental toxicants, prenatal care presents an opportunity to educate, mobilize, and support prospective parents to reduce exposures to such hazards. As the first phase of an interdisciplinary research collaboration to inform the development of prenatal environmental health education strategy in Canada, we surveyed reproductive-aged female individuals. The online survey (July–September 2021) yielded a nationally representative sample of 1914 reproductive-aged females living in Canada. The questionnaire topics addressed the respondents’ knowledge and perceptions of environmental health risks, preventive actions and related facilitators and barriers, information sources and preferences, reproductive history, and demographics. The analysis included bivariate and multivariate techniques. Our results suggest broad awareness among reproductive-aged females that exposure to toxicants can be harmful, and that reducing prenatal exposures can benefit child health. However, fewer than half of respondents felt that they had enough knowledge to take protective measures. Despite high levels of preference for prenatal care as an ideal context for learning about environmental health risks and protective measures, fewer than one in four respondents had ever discussed environmental health concerns with a healthcare provider. Our findings reveal a knowledge–action gap and a corresponding opportunity to improve environmental health education and advocacy in prenatal care in the Canadian context. Full article

12 pages, 1880 KiB

Open AccessEditor’s ChoiceArticle

The Impacts of COVID-19 Lockdowns on Road Transport Air Pollution in London: A State-Space Modelling Approach

by Hajar Hajmohammadi and Hamid Salehi

Int. J. Environ. Res. Public Health 2024, 21(9), 1153; https://doi.org/10.3390/ijerph21091153 - 30 Aug 2024

Viewed by 1304

Abstract

The emergence of the COVID-19 pandemic in 2020 led to the implementation of legal restrictions on individual activities, significantly impacting traffic and air pollution levels in urban areas. This study employs a state-space intervention method to investigate the effects of three major COVID-19 [...] Read more.

The emergence of the COVID-19 pandemic in 2020 led to the implementation of legal restrictions on individual activities, significantly impacting traffic and air pollution levels in urban areas. This study employs a state-space intervention method to investigate the effects of three major COVID-19 lockdowns in March 2020, November 2020, and January 2021 on London’s air quality. Data were collected from 20 monitoring stations across London (central, ultra-low emission zone, and greater London), with daily measurements of NO_x, PM₁₀, and PM_2.5 for four years (January 2019–December 2022). Furthermore, the developed model was adjusted for seasonal effects, ambient temperature, and relative humidity. This study found significant reductions in the NO_x levels during the first lockdown: 49% in central London, 33% in the ultra-low emission zone (ULEZ), and 37% in greater London. Although reductions in NO_x were also observed during the second and third lockdowns, they were less than the first lockdown. In contrast, PM₁₀ and PM_2.5 increased by 12% and 1%, respectively, during the first lockdown, possibly due to higher residential energy consumption. However, during the second lockdown, PM₁₀ and PM_2.5 levels decreased by 11% and 13%, respectively, and remained unchanged during the third lockdown. These findings highlight the complex dynamics of urban air quality and underscore the need for targeted interventions to address specific pollution sources, particularly those related to road transport. The study provides valuable insights into the effectiveness of lockdown measures and informs future air quality management strategies. Full article

(This article belongs to the Section Environmental Health)

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14 pages, 1226 KiB

Open AccessEditor’s ChoiceArticle

Quantitative Definition of Low-Health-Interest Populations by Using Regression Trees: A Nationwide Internet Survey in Japan

by Yoko Nishizawa, Takuya Yamada, Kumi Sugimoto, Chie Ozawa, Takahiro Tabuchi, Hirono Ishikawa and Yoshiharu Fukuda

Int. J. Environ. Res. Public Health 2024, 21(8), 1049; https://doi.org/10.3390/ijerph21081049 - 9 Aug 2024

Viewed by 1282

Abstract

Background: Reducing health disparities is a public health issue. Identification of low-health-interest populations is important, but a definition of people with low health interest has not yet been established. We aimed to quantitatively define low-health-interest populations. Methods: A nationwide cross-sectional internet survey was [...] Read more.

Background: Reducing health disparities is a public health issue. Identification of low-health-interest populations is important, but a definition of people with low health interest has not yet been established. We aimed to quantitatively define low-health-interest populations. Methods: A nationwide cross-sectional internet survey was conducted in 2022. We compiled regression tree (RT) analyses with/without adjustment for age, sex, and socioeconomic status with the 12-item Interest in Health Scale (IHS, score range 12–48) as an explanatory variable and the 10 composite health behaviors as a dependent variable. We defined the first IHS branching condition from the root node as a lower-health-interest group and the terminal node with the lowest health behaviors as the lowest-health-interest group. Results: The mean IHS value of 22,263 analyzed participants was 32.1 ± 5.6; it was higher in females and in those who were aged over 45 years, had a high education, a high income, or a spouse. The first branching condition was IHS 31.5, and the terminal node branched at 24.5, before/after adjustment for covariates. Conclusions: We determined the cutoff values of the IHS as <32 for a lower-health-interest group and <25 for the lowest-health-interest group. Using these cutoffs might enable us to reveal the characteristics of low-health-interest populations. Full article

(This article belongs to the Collection Health Behaviors, Risk Factors, NCDs and Health Promotion)

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16 pages, 336 KiB

Open AccessEditor’s ChoiceArticle

Leukemia Incidence by Occupation and Industry: A Cohort Study of 2.3 Million Workers from Ontario, Canada

by Konrad Samsel, Tanya Navaneelan, Nathan DeBono, Louis Everest, Paul A. Demers and Jeavana Sritharan

Int. J. Environ. Res. Public Health 2024, 21(8), 981; https://doi.org/10.3390/ijerph21080981 - 27 Jul 2024

Cited by 1 | Viewed by 2173

Abstract

Although a significant body of evidence has attributed certain occupational exposures with leukemia, such as benzene, formaldehyde, 1,3-butadiene and ionizing radiation, more research is needed to identify work environments at increased risk for this disease. Our study aimed to identify occupational and industry [...] Read more.

Although a significant body of evidence has attributed certain occupational exposures with leukemia, such as benzene, formaldehyde, 1,3-butadiene and ionizing radiation, more research is needed to identify work environments at increased risk for this disease. Our study aimed to identify occupational and industry groups associated with an elevated incidence of leukemia using a diverse cohort of workers’ compensation claimants from Ontario, Canada. A total of 2,363,818 workers in the Occupational Disease Surveillance System (ODSS) cohort, with claims between 1983–2019, were followed for malignant leukemia diagnoses up to 31 December 2019. We used a Cox proportional-hazards model to estimate the relative incidence of leukemia in specific occupation and industry groups. After adjusting for age and birth year, males in protective services (HR = 1.17, 95% CI = 1.02–1.35), metal machining (HR = 1.23, 95% CI = 1.07–1.41), transport (HR = 1.15, 95% CI = 1.06–1.25), and mining occupations (HR = 1.28, 95% CI = 1.02–1.60) had elevated risks of leukemia compared to other workers in the ODSS, with comparable findings by industry. Among female workers, slight risk elevations were observed among product fabricating, assembling, and repairing occupations, with other increased risks seen in furniture and fixture manufacturing, storage, and retail industries. These findings underscore the need for exposure-based studies to better understand occupational hazards in these settings. Full article

(This article belongs to the Special Issue Cancer Causes and Control)

13 pages, 1100 KiB

Open AccessEditor’s ChoiceArticle

Temporal Trends in Air Pollution Exposure across Socioeconomic Groups in The Netherlands

by Niklas Hlubek, Yvonne Koop, Alfred Wagtendonk and Ilonca Vaartjes

Int. J. Environ. Res. Public Health 2024, 21(8), 976; https://doi.org/10.3390/ijerph21080976 - 26 Jul 2024

Cited by 1 | Viewed by 1674

Abstract

Air pollution exposure has been linked to detrimental health outcomes. While cross-sectional studies have demonstrated socioeconomic disparities in air pollution exposure, longitudinal evidence on these disparities remains limited. The current study investigates trends in residential air pollution exposure across socioeconomic groups in the [...] Read more.

Air pollution exposure has been linked to detrimental health outcomes. While cross-sectional studies have demonstrated socioeconomic disparities in air pollution exposure, longitudinal evidence on these disparities remains limited. The current study investigates trends in residential air pollution exposure across socioeconomic groups in the Netherlands from 2014 to 2019. Our dataset includes over 12.5 million individuals, aged 18 years and above, who resided in the Netherlands between 2014 and 2019, using Statistics Netherlands data. The address-level air pollution concentrations were estimated by dispersion models of the National Institute of Public Health and the Environment. We linked the exposure estimations of particulate matter < 10 or <2.5 μm (PM₁₀, PM_2.5) and nitrogen dioxide (NO₂) to household-level socioeconomic data. In highly urbanized areas, individuals from both the lowest and highest socioeconomic groups were exposed to higher air pollution concentrations. Individuals from the lowest socioeconomic group were disproportionally located in highly urbanized and more polluted areas. The air pollution concentrations of PM₁₀, PM_2.5, and NO₂ decreased between 2014 and 2019 for all the socioeconomic groups. The decrease in the annual average air pollution concentrations was the strongest for the lowest socioeconomic group, although differences in exposure between the socioeconomic groups remain. Further research is needed to define the health and equity implications. Full article

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12 pages, 353 KiB

Open AccessEditor’s ChoiceArticle

Prevalence and Determinants of Changes in Physical Activity and Sedentary Behavior during and after the COVID-19 Pandemic: A Swedish Repeated Cross-Sectional Study

by Birgitta Kerstis, Maria Elvén, Kent W. Nilsson, Petra von Heideken Wågert, Jonas Stier, Micael Dahlen and Daniel Lindberg

Int. J. Environ. Res. Public Health 2024, 21(8), 960; https://doi.org/10.3390/ijerph21080960 - 23 Jul 2024

Viewed by 1437

Abstract

Physical activity (PA) and sedentary behavior (SB) changed during the COVID-19 pandemic; hence, this study examined PA and SB at four time points between December 2019 and December 2022. The participants’ PA decreased during the pandemic and did not recover afterwards. Among women, [...] Read more.

Physical activity (PA) and sedentary behavior (SB) changed during the COVID-19 pandemic; hence, this study examined PA and SB at four time points between December 2019 and December 2022. The participants’ PA decreased during the pandemic and did not recover afterwards. Among women, PA increased slightly in 2022 but not at all in men. From 2019 to 2020, SB increased and then decreased to near the pre-pandemic level in both sexes. Regarding age, PA decreased in the oldest age group (65–79 years) across all time points, while SB increased in all age groups during 2019–2020 and then returned close to pre-pandemic levels among the two middle age groups (30–64 years), but not among the youngest and oldest groups. Considering occupation, PA decreased from 2020 to December 2022 among retired and “other” participants, while SB decreased among nonmanual workers and retired participants. The regression models associated better self-reported health, male sex, and those born overseas with higher PA. Higher age, better self-reported health, poor education, and later survey time points were associated with lower SB. These findings highlight the need to return PA and SB to at least pre-pandemic levels and that subgroups may need different interventions. Full article

13 pages, 312 KiB

Open AccessEditor’s ChoiceArticle

Mental Health, Declining Physical Activity and Social Connection during Transitions into Fatherhood in the UK

by Emily Lovett and Andy Smith

Int. J. Environ. Res. Public Health 2024, 21(7), 890; https://doi.org/10.3390/ijerph21070890 - 9 Jul 2024

Cited by 1 | Viewed by 2036

Abstract

This paper addresses an under-explored area of sociologically oriented health research, namely, the mental health and physical activity (PA) experiences of new fathers. Drawing upon responses to an online qualitative survey from 32 fathers, aged 18 or over, and living in the UK, [...] Read more.

This paper addresses an under-explored area of sociologically oriented health research, namely, the mental health and physical activity (PA) experiences of new fathers. Drawing upon responses to an online qualitative survey from 32 fathers, aged 18 or over, and living in the UK, we show how the decline in these fathers’ overall PA was associated with poor mental health and the changing constraints that characterised their increasingly complex networks of interdependence. These constraints corresponded with shifts in fathers’ PA engagement from team sports towards individualised, flexible, and more recreationally oriented lifestyle activities like running and the gym. Fathers’ engagement in these activities appeared to exacerbate the complex feelings of guilt and isolation that they already encountered as new fathers. These experiences were simultaneously associated with feelings of shame associated with being insufficiently active and fearing judgement about their engagement in fathering responsibilities. The paper has important policy implications, highlighting the need for tailored support for new fathers in the perinatal period, and implications for practice, suggesting that co-produced community-based PA programmes are potentially effective settings for engaging new fathers in PA and promoting their mental health. Full article

(This article belongs to the Section Behavioral and Mental Health)

21 pages, 3940 KiB

Open AccessEditor’s ChoiceArticle

Random Forest and Feature Importance Measures for Discriminating the Most Influential Environmental Factors in Predicting Cardiovascular and Respiratory Diseases

by Francesco Cappelli, Gianfranco Castronuovo, Salvatore Grimaldi and Vito Telesca

Int. J. Environ. Res. Public Health 2024, 21(7), 867; https://doi.org/10.3390/ijerph21070867 - 2 Jul 2024

Cited by 9 | Viewed by 2852

Abstract

Background: Several studies suggest that environmental and climatic factors are linked to the risk of mortality due to cardiovascular and respiratory diseases; however, it is still unclear which are the most influential ones. This study sheds light on the potentiality of a data-driven [...] Read more.

Background: Several studies suggest that environmental and climatic factors are linked to the risk of mortality due to cardiovascular and respiratory diseases; however, it is still unclear which are the most influential ones. This study sheds light on the potentiality of a data-driven statistical approach by providing a case study analysis. Methods: Daily admissions to the emergency room for cardiovascular and respiratory diseases are jointly analyzed with daily environmental and climatic parameter values (temperature, atmospheric pressure, relative humidity, carbon monoxide, ozone, particulate matter, and nitrogen dioxide). The Random Forest (RF) model and feature importance measure (FMI) techniques (permutation feature importance (PFI), Shapley Additive exPlanations (SHAP) feature importance, and the derivative-based importance measure (

κ^{A L E}

)) are applied for discriminating the role of each environmental and climatic parameter. Data are pre-processed to remove trend and seasonal behavior using the Seasonal Trend Decomposition (STL) method and preliminary analyzed to avoid redundancy of information. Results: The RF performance is encouraging, being able to predict cardiovascular and respiratory disease admissions with a mean absolute relative error of 0.04 and 0.05 cases per day, respectively. Feature importance measures discriminate parameter behaviors providing importance rankings. Indeed, only three parameters (temperature, atmospheric pressure, and carbon monoxide) were responsible for most of the total prediction accuracy. Conclusions: Data-driven and statistical tools, like the feature importance measure, are promising for discriminating the role of environmental and climatic factors in predicting the risk related to cardiovascular and respiratory diseases. Our results reveal the potential of employing these tools in public health policy applications for the development of early warning systems that address health risks associated with climate change, and improving disease prevention strategies. Full article

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15 pages, 3622 KiB

Open AccessEditor’s ChoiceArticle

Towards Resilient Healthcare Systems: A Framework for Crisis Management

by Seyedeh Gelareh Emami, Valentina Lorenzoni and Giuseppe Turchetti

Int. J. Environ. Res. Public Health 2024, 21(3), 286; https://doi.org/10.3390/ijerph21030286 - 29 Feb 2024

Cited by 9 | Viewed by 8656

Abstract

This study addresses the crucial need for resilient healthcare systems, highlighted by recent global health emergencies such as the Ebola and COVID-19 crises. It identifies a significant gap in the current literature: a lack of practical, actionable frameworks for healthcare resilience. To bridge [...] Read more.

This study addresses the crucial need for resilient healthcare systems, highlighted by recent global health emergencies such as the Ebola and COVID-19 crises. It identifies a significant gap in the current literature: a lack of practical, actionable frameworks for healthcare resilience. To bridge this gap, the research introduces an innovative framework that blends theoretical resilience concepts with heuristic approaches. This framework, rooted in the principles of monitoring, anticipation, recognition, and learning, is designed to enhance the crisis management capabilities of healthcare systems. The methodology involves a comprehensive literature review, combined with heuristic methods, culminating in a framework that is both academically sound and practically applicable. This framework guides healthcare systems through various stages of crisis management, including data collection, situation analysis, risk anticipation, and response evaluation. It provides a holistic approach to enhancing resilience in healthcare settings. Overall, this paper makes a significant contribution to the field of healthcare system resilience, offering a strategic blueprint for improved crisis response and recovery. It marks an important advancement in aligning theoretical resilience concepts with practical implementation strategies, essential for tackling current and future healthcare challenges. Full article

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18 pages, 1292 KiB

Open AccessEditor’s ChoiceArticle

Sibling Violence and Bullying Behaviors in Peers: The Mediational Role of Self-Esteem

by Catarina Pinheiro Mota, Joana Rita Sousa and Inês Carvalho Relva

Int. J. Environ. Res. Public Health 2024, 21(2), 227; https://doi.org/10.3390/ijerph21020227 - 15 Feb 2024

Cited by 1 | Viewed by 3380

Abstract

In the context of the existing research on families, sibling violence is a less explored area. However, it has seemingly received more attention recently, and it can assume a relevant role in understanding the maladaptive behavior of youngsters and bullying. Additionally, adolescents involved [...] Read more.

In the context of the existing research on families, sibling violence is a less explored area. However, it has seemingly received more attention recently, and it can assume a relevant role in understanding the maladaptive behavior of youngsters and bullying. Additionally, adolescents involved in bullying and self-esteem are associated with disruptive violence inside the family context. This study’s sample consisted of 286 students, aged between 12 and 17 years, from both sexes. This study intends to explore the association between sibling violence and bullying behavior in peers and the mediator effect of self-esteem. The measures for data collection were a demographic questionnaire, the Social Exclusion and School Violence Questionnaire, The Revised Conflict Tactics Scales (Portuguese version for siblings), and the Rosenberg Self-Esteem Scale. The results show a negative effect between negotiation in the sibling relationship (victimization) and social exclusion and verbal aggression related to bullying behavior. Self-esteem represents a total and negative mediator in this connection. Our results also show a variety of indirect outcomes amongst the negotiation dimension, psychological aggression and injury between siblings, and the social exclusion and verbal aggression dimensions (on the aggression and victimization scales). The results will be discussed according to the attachment theory but considering the importance of affective bonds with siblings as a predisposing factor to an adaptive development course. Full article

(This article belongs to the Section Adolescents)

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14 pages, 590 KiB

Open AccessEditor’s ChoiceArticle

Trends in Mental Wellbeing of US Children, 2019–2022: Erosion of Mental Health Continued in 2022

by Neeraj Bhandari and Shivani Gupta

Int. J. Environ. Res. Public Health 2024, 21(2), 132; https://doi.org/10.3390/ijerph21020132 - 25 Jan 2024

Cited by 3 | Viewed by 4104

Abstract

We provide fresh estimates of a change in the nationwide prevalence of mental health symptoms among US children during the COVID-19 pandemic using National Health Interview Survey data (2019–22) on children aged 2–17 years (n = 27,378; age subgroups 2–5, 6–11, and 12–17) [...] Read more.

We provide fresh estimates of a change in the nationwide prevalence of mental health symptoms among US children during the COVID-19 pandemic using National Health Interview Survey data (2019–22) on children aged 2–17 years (n = 27,378; age subgroups 2–5, 6–11, and 12–17) to assess overall mental distress and 19 specific outcomes related to developmental, communicative, cognitive, affective, and behavioral domains. Raw and adjusted (for socio-demographics) linear regressions estimated the change in prevalence for each outcome between 2019 (baseline year) and three succeeding years (2020–2022). Summary scores for mental distress rose between 2019 and 2020 (1.01 to 1.18 points, range of 0–15), declined slightly in 2021 (1.09), and climbed sharply again in 2022 (1.25). The declines primarily affected adolescents (1.11 at baseline, 1.24 in 2020, 1.30 in 2021, and 1.49 in 2022). Specific outcomes belonging to all domains of mental health showed similar increases in prevalence. US children suffered significant erosion of mental health during the COVID-19 pandemic that continued into 2022. Expansion of mental health programs aimed at school-going children will likely be needed to respond effectively to the ongoing crisis. Full article

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23 pages, 1279 KiB

Open AccessEditor’s ChoiceArticle

Palliative Care in the Ageing European Population: A Cross-Country Comparison

by Giovanni Cerullo, Teodora Figueiredo, Constantino Coelho, Cláudia Silva Campos, António Videira-Silva, Joana Carrilho, Luís Midão and Elísio Costa

Int. J. Environ. Res. Public Health 2024, 21(1), 113; https://doi.org/10.3390/ijerph21010113 - 19 Jan 2024

Cited by 2 | Viewed by 3594

Abstract

With Europe’s ageing population and rising demand for palliative care, it is crucial to examine the use of palliative care among older adults during their last years of life and understand the factors influencing their access and end-of-life circumstances. This study employed a [...] Read more.

With Europe’s ageing population and rising demand for palliative care, it is crucial to examine the use of palliative care among older adults during their last years of life and understand the factors influencing their access and end-of-life circumstances. This study employed a cohort of SHARE participants aged 65 years or older who had passed away between Wave 6 (2015) and Wave 7 (2017). Information on death circumstances, palliative care utilization, and associated variables were analysed. The study revealed that nearly 13.0% of individuals across these countries died under palliative care, with Slovenia having the lowest rate (0.3%) and France the highest (30.4%). Palliative care utilization in the last 30 days before death was observed in over 24.0% of participants, with the Czech Republic having the lowest rate (5.0%) and Greece the highest (48.8%). A higher risk of using or dying in palliative care was significantly associated with cognitive impairment (low verbal fluency), physical inactivity, and good to excellent self-perceived health. This work highlights the urgent need for enhanced global access to palliative care and advocates for the cross-country comparison of effective practices within Europe, tailored to the unique healthcare needs of older adults. Full article

(This article belongs to the Special Issue New Advances in Palliative Care)

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28 pages, 2890 KiB

Open AccessEditor’s ChoiceArticle

Geochemical Modeling Source Provenance, Public Health Exposure, and Evaluating Potentially Harmful Elements in Groundwater: Statistical and Human Health Risk Assessment (HHRA)

by Abdur Rashid, Muhammad Ayub, Zahid Ullah, Asmat Ali, Seema Anjum Khattak, Liaqat Ali, Xubo Gao, Chengcheng Li, Sardar Khan, Hamed A. El-Serehy and Prashant Kaushik

Int. J. Environ. Res. Public Health 2022, 19(11), 6472; https://doi.org/10.3390/ijerph19116472 - 26 May 2022

Cited by 25 | Viewed by 3570

Abstract

Groundwater contamination by potentially harmful elements (PHEs) originating from the weathering of granitic and gneissic rock dissolution poses a public health concern worldwide. This study investigated physicochemical variables and PHEs in the groundwater system and mine water of the Adenzai flood plain region, [...] Read more.

Groundwater contamination by potentially harmful elements (PHEs) originating from the weathering of granitic and gneissic rock dissolution poses a public health concern worldwide. This study investigated physicochemical variables and PHEs in the groundwater system and mine water of the Adenzai flood plain region, in Pakistan, emphasizing the fate distribution, source provenance, chemical speciation, and health hazard using the human health risk assessment HHRA-model. The average concentrations of the PHEs, viz., Ni, Mn, Cr, Cu, Cd, Pb, Co, Fe, and Zn 0.23, were 0.27, 0.07, 0.30, 0.07, 0.06, 0.08, 0.68, and 0.23 mg/L, respectively. The average values of chemical species in the groundwater system, viz., H⁺, OH⁻, Ni²⁺, Mn²⁺, Mn³⁺, Cr³⁺, Cr⁶⁺, Cu⁺, Cu²⁺, Cd²⁺, Pb²⁺, Pb⁴⁺, Co²⁺, Co³⁺, Fe²⁺, Fe³⁺, and Zn²⁺, were 1.0 × 10⁻⁴ ± 1.0 × 10⁻⁶, 1.0 × 10⁻⁴ ± 9.0 × 10⁻⁷, 2.0 × 10⁻¹ ± 1.0 × 10⁻³, 3.0 × 10⁻¹ ± 1.0 × 10⁻³, 1.0 × 10⁻²² ± 1.0 × 10⁻²³, 4.0 × 10⁻⁶ ± 2.0 × 10⁻⁶, 4.0 × 10⁻¹¹ ± 2.0 × 10⁻¹¹, 9.0 × 10⁻³ ± 1.0 × 10⁻², 2.0 × 10⁻¹ ± 2.0 × 10⁻³, 7.0 × 10⁻² ± 6.0 × 10⁻², 5.0 × 10⁻² ± 5.0 × 10⁻², 2.0 × 10⁻² ± 1.5 × 10⁻², 6.0 × 10⁻² ± 4.0 × 10⁻², 8.0 × 10⁻³¹ ± 6.0 × 10⁻³¹, 3.0 × 10⁻¹ ± 2.0 × 10⁻⁴, 4.0 × 10⁻¹⁰ ± 3.0 × 10⁻¹⁰, and 2.0 × 10⁻¹ ± 1.0 × 10⁻¹. The mineral compositions of PHEs, viz. Ni, were bunsenite, Ni(OH)₂, and trevorite; Mn viz., birnessite, bixbyite, hausmannite, manganite, manganosite, pyrolusite, and todorokite; Cr viz., chromite and eskolaite; Cu viz., CuCr₂O₄, cuprite, delafossite, ferrite-Cu, and tenorite; Cd viz., monteponite; Pb viz, crocoite, litharge, massicot, minium, plattnerite, Co viz., spinel-Co; Fe viz., goethite, hematite, magnetite, wustite, and ferrite-Zn; and Zn viz., zincite, and ZnCr₂O₄ demarcated undersaturation and supersaturation. However, EC, Ca²⁺, K⁺, Na⁺, HCO₃⁻, Cr, Cd, Pb, Co, and Fe had exceeded the WHO guideline. The Nemerow’s pollution index (NPI) showed that EC, Ca²⁺, K⁺, Na⁺, HCO₃⁻, Mn, Cd, Pb, Co, and Fe had worse water quality. Principal component analysis multilinear regression (PCAMLR) and cluster analysis (CA) revealed that 75% of the groundwater contamination originated from geogenic inputs and 18% mixed geogenic-anthropogenic and 7% anthropogenic sources. The HHRA-model suggested potential non-carcinogenic risks, except for Fe, and substantial carcinogenic risks for evaluated PHEs. The women and infants are extremely exposed to PHEs hazards. The non-carcinogenic and carcinogenic risks in children, males, and females had exceeded their desired level. The HHRA values of PHEs exhibited the following increasing pattern: Co > Cu > Mn > Zn > Fe, and Cd > Pb > Ni > Cr. The higher THI values of PHEs in children and adults suggested that the groundwater consumption in the entire region is unfit for drinking, domestic, and agricultural purposes. Thus, all groundwater sources need immediate remedial measures to secure health safety and public health concerns. Full article

(This article belongs to the Special Issue Water Pollution: Human Health and Ecological Risks)

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22 pages, 3845 KiB

Open AccessEditor’s ChoiceArticle

Effects of Environmental Features in Small Public Urban Green Spaces on Older Adults’ Mental Restoration: Evidence from Tokyo

by Shan Lu, Wonseok Oh, Ryozo Ooka and Lijun Wang

Int. J. Environ. Res. Public Health 2022, 19(9), 5477; https://doi.org/10.3390/ijerph19095477 - 30 Apr 2022

Cited by 27 | Viewed by 5586

Abstract

Exposure to small public urban green spaces (SPUGS) has been demonstrated to have mental benefits for older adults. However, studies on identifying the objective environmental features of SPUGS and their effects on mental restoration for older adults remain limited. This study employed a [...] Read more.

Exposure to small public urban green spaces (SPUGS) has been demonstrated to have mental benefits for older adults. However, studies on identifying the objective environmental features of SPUGS and their effects on mental restoration for older adults remain limited. This study employed a multilevel regression model to investigate the restorative and vitalizing effects of the environmental features of 11 SPUGS in Tokyo. Onsite measurements were conducted in Kita-Ku, and 202 older adults were surveyed. The results showed that: (1) The fitting curve of the green view index and Restoration Outcome Scale (ROS) score showed an inverted U shape—both green view index and boundary enclosure had a strong impact on the mental restoration of older adults; (2) The colorfulness index showed the strongest relationship with the vitalizing effect. (3) The sky view factor and number of seats only influenced the ROS score, while the results of revitalization suggest that large areas of water should be avoided. (4) Physiological Equivalent Temperature (PET) was also confirmed to have negative effects on the mental restoration of older adults in autumn. These empirical findings can be used as a resource to promote the mental health of older adults in the design of SPUGS in high-density Asian countries. Full article

(This article belongs to the Special Issue Urban Spaces, Environmental Exposures, Public Health, and Human Wellbeing)

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18 pages, 648 KiB

Open AccessEditor’s ChoiceArticle

Quality of Life and Mental Health in Children and Adolescents after the First Year of the COVID-19 Pandemic: A Large Population-Based Survey in South Tyrol, Italy

by Verena Barbieri, Christian Josef Wiedermann, Anne Kaman, Michael Erhart, Giuliano Piccoliori, Barbara Plagg, Angelika Mahlknecht, Dietmar Ausserhofer, Adolf Engl and Ulrike Ravens-Sieberer

Int. J. Environ. Res. Public Health 2022, 19(9), 5220; https://doi.org/10.3390/ijerph19095220 - 25 Apr 2022

Cited by 44 | Viewed by 6156

Abstract

Background: Methodological heterogeneity of studies and geographical variation limit conclusions about the impact of the COVID-19 pandemic on the mental health of youth. This study aimed to explore the health-related quality of life and mental health of children and adolescents in the second [...] Read more.

Background: Methodological heterogeneity of studies and geographical variation limit conclusions about the impact of the COVID-19 pandemic on the mental health of youth. This study aimed to explore the health-related quality of life and mental health of children and adolescents in the second year of the pandemic in South Tyrol, Italy. Methods: An online survey representative for the age and gender of the children and adolescents in South Tyrol was conducted among 5159 families with children and adolescents aged 7–19 years, between 28 May and 16 June 2021. The survey collecting parental ratings and self-rated questionnaires from children and adolescents aged 11–19 years included instruments to measure health-related quality of life (KIDSCREEN-10), mental health problems (SDQ), anxiety (SCARED), and depression (CES-DC). The results were compared with data from corresponding studies conducted in Germany. Results: Decreased health-related quality of life and increased conduct problems, peer-related mental health problems, anxiety, and depressive and psychosomatic symptoms in children and adolescents observed in the second year of the pandemic in Germany were confirmed in the second year in South Tyrol. Children and adolescents with low socioeconomic status, a migration background, and limited living space were significantly affected. Female sex and older age were associated with increased psychosocial problems and a positive family climate supported the mental health of children and adolescents during the pandemic. Conclusions: Confirmation of findings of decreased health-related quality of life and increased emotional problems after the first year of the pandemic supports the ongoing call for low-threshold health promotion, prevention, and early intervention programs to support children and adolescents who have been severely affected by the pandemic. Full article

(This article belongs to the Special Issue Advances in Child and Adolescent Mental Health)

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14 pages, 1782 KiB

Open AccessEditor’s ChoiceArticle

Increased Physical Activity at School Benefits Arterial Blood Pressure in Children—A Prospective Follow-Up Cohort Study

by Wojciech Kolanowski, Katarzyna Ługowska and Joanna Trafialek

Int. J. Environ. Res. Public Health 2022, 19(8), 4662; https://doi.org/10.3390/ijerph19084662 - 12 Apr 2022

Cited by 9 | Viewed by 3784

Abstract

(1) Background: A sedentary lifestyle and low physical activity (PA) increase the risk of hypertension in children. The aim of this study was to assess the impact of increased PA at school by elevation of the number of compulsory physical education (PE) lessons [...] Read more.

(1) Background: A sedentary lifestyle and low physical activity (PA) increase the risk of hypertension in children. The aim of this study was to assess the impact of increased PA at school by elevation of the number of compulsory physical education (PE) lessons on arterial blood pressure in children during a two-year follow-up. (2) Methods: Children (n = 245) born in 2007 attending a standard or elevated number of PE lessons in the school timetable (4 and 10 h a week, respectively) took part in the study. Blood pressure was measured starting from age approx. 10 to 12. (3) Results: Starting from a similar level, after 2 years, the percentage of children with normal blood pressure decreased in the standard-PE children from 83.25% to 78.03% but increased in the elevated-PE ones from 83.15% to 86.13%. The prevalence of both prehypertension and hypertension increased by one-third in the standard-PE children from 16.74% to 21.97% but decreased by one-sixth in the elevated-PE ones from 16.85% to 13.87%. The prevalence of hypertension itself increased by one-third in the standard-PE children from 9.82% to 13.12% but decreased in the elevated-PE ones by one-fifth from 9.60% to 7.75% (4) Conclusions: An increase in PA at school by the elevation of the number of PE lessons benefits children’s arterial blood pressure. Early prevention of hypertension in children can be supported by an adequate number of PE lessons in the school timetable. Full article

(This article belongs to the Special Issue Child Physical Activity and Health)

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15 pages, 350 KiB

Open AccessEditor’s ChoiceArticle

Tocolytic Treatment for the Prevention of Preterm Birth from a Taiwanese Perspective: A Survey of Taiwanese Obstetric Specialists

by Howard Hao Lee, Chang-Ching Yeh, Szu-Ting Yang, Chia-Hao Liu, Yi-Jen Chen and Peng-Hui Wang

Int. J. Environ. Res. Public Health 2022, 19(7), 4222; https://doi.org/10.3390/ijerph19074222 - 1 Apr 2022

Cited by 11 | Viewed by 4435

Abstract

Preterm birth represents a great burden to the healthcare system, resulting in the consideration for the use of tocolytic therapy to provide a “better time” for delivery in order to buy time to accelerate fetal lung maturity, thereby minimizing prematurity-related morbidity and mortality. [...] Read more.

Preterm birth represents a great burden to the healthcare system, resulting in the consideration for the use of tocolytic therapy to provide a “better time” for delivery in order to buy time to accelerate fetal lung maturity, thereby minimizing prematurity-related morbidity and mortality. However, the benefits and potential side effects and risks of tocolytic treatment for preterm birth should be carefully balanced. Although many countries and societies provide guidelines or consensuses for the management for preterm birth, there is no standardized national guideline or consensus in Taiwan. As such, great heterogeneity is suspected in preterm labor management, contributing to the uncertainty of attitudes and practice patterns of obstetric specialists in Taiwan. This study attempts to understand the attitudes and practice patterns regarding tocolytic therapy in Taiwan. A paper-based survey was conducted at the 2020 Taiwan Society of Perinatology Conference on 8 December 2020, exploring how obstetric specialists would use tocolytics under nine different clinical scenarios, such as a short cervix, preterm labor, maintenance tocolysis, preterm premature rupture of membranes, etc. Three hundred ten specialists attended the conference, and 77 responded to the survey with a response rate of 24.8%. According to the survey, many of these specialists would prescribe tocolytics for less evidence-based indications, including 22% for abdominal tightness, 46% for a short cervix, 60% for maintenance tocolysis, and 89% for repeat tocolysis, with the preferred first line medication being ritodrine and nifedipine. We concluded that tocolysis is widely accepted and practiced in Taiwan. More research is needed to include Taiwan-specific economic and cultural factors as well as associated adverse effects and patients’ outcomes. Full article

(This article belongs to the Special Issue Emerging Research in Maternal and Child Healthcare)

14 pages, 2382 KiB

Open AccessEditor’s ChoiceArticle

Association between Asthma Control and Exposure to Greenness and Other Outdoor and Indoor Environmental Factors: A Longitudinal Study on a Cohort of Asthmatic Children

by Giovanna Cilluffo, Giuliana Ferrante, Salvatore Fasola, Velia Malizia, Laura Montalbano, Andrea Ranzi, Chiara Badaloni, Giovanni Viegi and Stefania La Grutta

Int. J. Environ. Res. Public Health 2022, 19(1), 512; https://doi.org/10.3390/ijerph19010512 - 4 Jan 2022

Cited by 19 | Viewed by 3712

Abstract

Achieving and maintaining asthma control (AC) is the main goal of asthma management. Indoor and outdoor environmental factors may play an important role on AC. The aim of this longitudinal study was to evaluate the association between AC and exposure to greenness and [...] Read more.

Achieving and maintaining asthma control (AC) is the main goal of asthma management. Indoor and outdoor environmental factors may play an important role on AC. The aim of this longitudinal study was to evaluate the association between AC and exposure to greenness and other outdoor or indoor environmental factors in a cohort of asthmatic children. This study involved 179 asthmatic children (5–16 years). Parents were interviewed through a modified version of the SIDRIA questionnaire. AC was assessed at each visit. Exposure to greenness was measured using the normalized difference vegetation index (NDVI). A logistic regression model was applied for assessing risk factors for uncontrolled asthma (UA). Low NDVI exposure was a risk factor for UA (OR: 2.662, 95% CI (1.043–6.799)); children exposed to passive smoke during pregnancy had a higher risk of UA than those non-exposed to passive smoke during pregnancy (OR: 3.816, 95% CI (1.114–13.064)); and a unit increase in the crowding index was associated with an increased risk of UA (OR: 3.376, 95% CI (1.294–8.808)). In conclusion, the current study provided a comprehensive assessment of urban-related environmental exposures on asthma control in children, using multiple indicators of greenness and other outdoor or indoor environmental factors. Full article

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

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12 pages, 684 KiB

Open AccessEditor’s ChoiceArticle

Differential Effects of Multiple Dimensions of Poverty on Child Behavioral Problems: Results from the A-CHILD Study

by Yui Yamaoka, Aya Isumi, Satomi Doi, Manami Ochi and Takeo Fujiwara

Int. J. Environ. Res. Public Health 2021, 18(22), 11821; https://doi.org/10.3390/ijerph182211821 - 11 Nov 2021

Cited by 13 | Viewed by 3516

Abstract

The differential effects of low income and material deprivation—in particular, deprivation related to child educational needs—have not been well examined. This study aimed to examine the effects of low income and life-related and child-related deprivation on child behavioral problems. This study used data [...] Read more.

The differential effects of low income and material deprivation—in particular, deprivation related to child educational needs—have not been well examined. This study aimed to examine the effects of low income and life-related and child-related deprivation on child behavioral problems. This study used data from first-grade students who participated in the Adachi Child Health Impact of Living Difficulty (A-CHILD) study in 2015, 2017, and 2019 (N = 12,367) in Japan. Material deprivation was divided into life-related deprivation (i.e., lack of items for a living) and child-related deprivation (i.e., lack of children’s books, etc.), and low income was assessed via annual household income. We assessed child behavioral problems and prosocial behavior using the Strengths and Difficulties Questionnaire. One in ten children belonged to low-income families, 15.4% of children experienced life-related deprivation, and 5.4% of children experienced child-related deprivation. While life- and child-related deprivation had significant adverse effects on behavioral problems, they had no association with prosocial behavior. The effects of low income were mediated by parental psychological distress (45.0% of the total effect) and the number of consulting sources (20.8%) on behavioral problems. The effects of life-related and child-related deprivation were mediated by parental psychological distress (29.2–35.0%) and the number of consulting sources (6.4–6.9%) on behavioral problems. Life-related and child-related deprivation, but not low income, are important for child mental health. Full article

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

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6 pages, 454 KiB

Open AccessEditor’s ChoiceCommunication

Why Does the SARS-CoV-2 Delta VOC Spread So Rapidly? Universal Conditions for the Rapid Spread of Respiratory Viruses, Minimum Viral Loads for Viral Aerosol Generation, Effects of Vaccination on Viral Aerosol Generation, and Viral Aerosol Clouds

by Byung Uk Lee

Int. J. Environ. Res. Public Health 2021, 18(18), 9804; https://doi.org/10.3390/ijerph18189804 - 17 Sep 2021

Cited by 23 | Viewed by 5770

Abstract

This study analyzes the reasons the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) Delta variant of concern (VOC) spreads so rapidly. Novel topics such as universal conditions for the rapid spread of respiratory viruses, minimum viral loads for viral aerosol generation, effects of [...] Read more.

This study analyzes the reasons the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) Delta variant of concern (VOC) spreads so rapidly. Novel topics such as universal conditions for the rapid spread of respiratory viruses, minimum viral loads for viral aerosol generation, effects of vaccination on viral aerosol generation, and viral aerosol clouds were studied. The analyses were based on experimental results and analytic model studies. Four universal conditions, namely asymptomatic host, high viral load, stability of viruses in air, and binding affinity of viruses to human cells, need to be satisfied for the rapid spread of respiratory viruses. SARS-CoV-2 and its variants such as the Alpha VOC and Delta VOC satisfy the four fundamental conditions. In addition, there is an original principle of aerosol generation of respiratory viruses. Assuming that the aerosol–droplet cutoff particle diameter for distinguishing potential aerosols from earthbound respiratory particles is 100 μm, the minimum viral load required in respiratory fluids to generate viral aerosols is ~10⁶ copies mL⁻¹, which is within the range of the reported viral loads in the Alpha VOC cases and the Delta VOC cases. The daily average viral loads of the Delta VOC in hosts have been reported to be between ~10⁹ copies mL⁻¹ and ~10¹⁰ copies mL⁻¹ during the four days after symptom onset in 1848 cases of the Delta VOC infection. Owing to the high viral load, the SARS-CoV-2 Delta VOC has the potential to effectively spread through aerosols. COVID-19 vaccination can decrease aerosol transmission of the SARS-CoV-2 Alpha VOC by reducing the viral load. The viral load can explain the conundrum of viral aerosol spreading. The SARS-CoV-2 Delta VOC aerosol clouds have been assumed to be formed in restricted environments, resulting in a massive numbers of infected people in a very short period with a high spreading speed. Strong control methods against bioaerosols should be considered in this SARS-CoV-2 Delta VOC pandemic. Large-scale environmental monitoring campaigns of SARS-CoV-2 Delta VOC aerosols in public places in many countries are necessary, and these activities could contribute to controlling the coronavirus disease pandemic. Full article

(This article belongs to the Section Environmental Health)

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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 4597

Abstract

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 4198

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 4513

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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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 5740

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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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 53 | Viewed by 8877

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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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 254 | Viewed by 34064

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 8931

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 5031

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 8378

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)

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 11967

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 5363

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)

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 14939

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 4418

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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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 15 | Viewed by 4045

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)

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 6147

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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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 157 | Viewed by 38927

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 3395

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 7902

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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