International Journal of Environmental Research and Public Health

12 pages, 1173 KiB

Open AccessArticle

Temporal Precedence of Physical Literacy and Basic Psychological Needs Satisfaction: A Cross-Lagged Longitudinal Analysis of University Students

by Fong-Jia Wang, Chih-Fu Cheng, Mei-Yen Chen and Kim-Wai Raymond Sum

Int. J. Environ. Res. Public Health 2020, 17(12), 4615; https://doi.org/10.3390/ijerph17124615 - 26 Jun 2020

Cited by 6 | Viewed by 3481

Abstract

Purpose: Building on self-determination theory and extending research in the physical education context in terms of basic psychological needs satisfaction and physical literacy, this study examines the bidirectional effects of basic psychological needs satisfaction and physical literacy over time in a university physical [...] Read more.

Purpose: Building on self-determination theory and extending research in the physical education context in terms of basic psychological needs satisfaction and physical literacy, this study examines the bidirectional effects of basic psychological needs satisfaction and physical literacy over time in a university physical literacy context. Method: Using a two-wave design, data were collected twice with an 18-week time lag from a sample of 549 university students. Utilizing full cross-lagged analyses, we examined the bidirectional effects between basic psychological needs satisfaction and physical literacy. Results: The results provide support for a positive relationship between physical literacy (Time 1) and basic psychological needs satisfaction (Time 2), but we cannot reject the possibility of a bidirectional relation, supporting our expectations. Conclusion: Overall, the study highlights the importance of a reciprocal relationship between physical literacy and basic psychological needs satisfaction. Full article

(This article belongs to the Special Issue Physical Literacy in Children and Youth)

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18 pages, 8000 KiB

Open AccessArticle

The Effects of Long-Term Immunosuppressive Therapies on the Structure of the Rat Prostate

by Marta Grabowska, Maria Laszczyńska, Karolina Kędzierska-Kapuza, Andrzej Kram, Kamil Gill and Małgorzata Piasecka

Int. J. Environ. Res. Public Health 2020, 17(12), 4614; https://doi.org/10.3390/ijerph17124614 - 26 Jun 2020

Cited by 2 | Viewed by 2613

Abstract

Background: Little is known about the overall impact of immunosuppressive drugs on the prostate. The study aimed to determine the impact of different protocols of immunosuppressive treatment on the structure of the rat ventral prostate. Methods: For 6 months, 48 male Wistar [...] Read more.

Background: Little is known about the overall impact of immunosuppressive drugs on the prostate. The study aimed to determine the impact of different protocols of immunosuppressive treatment on the structure of the rat ventral prostate. Methods: For 6 months, 48 male Wistar rats received immunosuppressive drugs: cyclosporin A, tacrolimus, mycophenolate mofetil, rapamycin, and prednisone, according to three-drug protocols. Light and transmission electron microscopic studies, and quantitative evaluation of immunohistochemical expression of selected intermediate filaments, CD117⁺ mast cells, and CD138⁺ plasma cells were performed in the rat ventral prostate. Results: In all experimental groups, acini focal hyperplasia, changes to the ultrastructure of the glandular epithelium, changes in the expression of cytokeratins and desmin, and numerous mast and plasma cells in the prostate stroma were found. In cyclosporine-A-based groups, atrophy and numerous intracellular vacuoles were observed. In groups where a three-drug treatment was replaced with rapamycin, morphological alterations were less severe compared to those without conversion. Conclusions: In the rat ventral prostate, (1) immunosuppressive protocols affect the morphology and immunohistochemical expression of intermediate filaments, (2) morphological alterations, expression, and localization of selected proteins are not connected with adenocarcinoma development, and (3) conversion of the treatment to rapamycin may prevent hyperplastic abnormalities. Full article

(This article belongs to the Special Issue Molecular Toxicology)

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12 pages, 334 KiB

Open AccessArticle

“Too Much to Ask, Too Much to Handle”: Women’s Coping in Times of Zika

by Ana Rosa Linde Arias, Elisa Tristan-Cheever, Grace Furtado and Eduardo Siqueira

Int. J. Environ. Res. Public Health 2020, 17(12), 4613; https://doi.org/10.3390/ijerph17124613 - 26 Jun 2020

Cited by 3 | Viewed by 2410

Abstract

Zika virus infection during pregnancy is a cause of congenital brain abnormalities. Its consequences for pregnancies have made governments and both national and international agencies issue advice and recommendations to women. This study was designed to understand the impacts of Zika on women [...] Read more.

Zika virus infection during pregnancy is a cause of congenital brain abnormalities. Its consequences for pregnancies have made governments and both national and international agencies issue advice and recommendations to women. This study was designed to understand the impacts of Zika on women who were less directly affected and less vulnerable to Zika. Women were recruited from various locations in Brazil, Puerto Rico, and the United States. Data were collected through semi-structured interviews and analyzed using thematic analysis. Women perceived that public health systems placed an unfair responsibility for preventing health complications from Zika onto women who had limited ability to do so. They also stated that the measures recommended to them were invasive, while creating the perception that women were the sole determinant of whether they contracted Zika. The results indicate that women with higher levels of education understood the limitations of the information, government actions, and medical care they received, which ended up producing higher levels of anguish and worry. Gender inequality and discrimination must be recognized and rendered visible in the public health emergency response. The social effects of the epidemic affected women more than had been thought before and at deeper emotional levels. Full article

15 pages, 702 KiB

Open AccessArticle

Toward an Integrative Nursing Curriculum: Combining Team-Based and Problem-Based Learning with Emergency-Care Scenario Simulation

by Cheng-Yi Huang and Ya-huei Wang

Int. J. Environ. Res. Public Health 2020, 17(12), 4612; https://doi.org/10.3390/ijerph17124612 - 26 Jun 2020

Cited by 12 | Viewed by 4364

Abstract

Objective: The study intended to combine team-oriented, problem-based learning (PBL) with emergency-care simulation to investigate whether an integrative intervention could positively impact the core nursing competencies and teacher performance of nursing students. Methods: The study belonged to the domain of action research, which [...] Read more.

Objective: The study intended to combine team-oriented, problem-based learning (PBL) with emergency-care simulation to investigate whether an integrative intervention could positively impact the core nursing competencies and teacher performance of nursing students. Methods: The study belonged to the domain of action research, which aimed to address the weaknesses of traditional teacher-led, lecture-based learning. An 18-week, single-case experimental design, in which 58 senior nursing students at a medical university in central Taiwan participated, was conducted to test the possible benefits of the intervention. The measures included the Scale of Core Nursing Competencies and the Teacher Performance Evaluation Scale. Results: The research results showed that nursing students who received integrative training that combined team-based PBL with emergency-care scenario simulation had stronger mastery over core nursing competencies. At the same time, they also evaluated both the “Emergency Care” course for which the curriculum was used and the teachers’ performance in that course more highly. Conclusions: The findings suggest that an integrative curriculum combining team-based PBL with scenario simulation is worth pursuing. Compared with traditional teacher-led, lecture-based teaching, this curriculum may be more effective in helping nursing students develop core competencies in their field. Full article

(This article belongs to the Collection Nursing Research)

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13 pages, 761 KiB

Open AccessArticle

Effects of Manual Therapy on Fatigue, Pain, and Psychological Aspects in Women with Fibromyalgia

by Yolanda Nadal-Nicolás, Jacobo Ángel Rubio-Arias, María Martínez-Olcina, Cristina Reche-García, María Hernández-García and Alejandro Martínez-Rodríguez

Int. J. Environ. Res. Public Health 2020, 17(12), 4611; https://doi.org/10.3390/ijerph17124611 - 26 Jun 2020

Cited by 24 | Viewed by 10743

Abstract

Fibromyalgia is a condition characterised by chronic widespread muscle pain and fatigue, sleep disturbances, cognitive disorders, and mood disturbance. The purpose of this study was to determine the effectiveness of a manual therapy technique performed with moderate digital pressure in women with fibromyalgia [...] Read more.

Fibromyalgia is a condition characterised by chronic widespread muscle pain and fatigue, sleep disturbances, cognitive disorders, and mood disturbance. The purpose of this study was to determine the effectiveness of a manual therapy technique performed with moderate digital pressure in women with fibromyalgia (n = 24). In this randomised, controlled trial, the participants were randomly assigned to the experimental group or placebo group. The experimental group was assisted with manual therapy sessions based on connective tissue massage, whereas the placebo group was “treated” with ultrasound sessions performed without conductive gel and with the machine turned off as the placebo. Fatigue severity scale (FSS), visual analogical scale (VAS), Pittsburgh sleep quality index (PSQI), and profile of mood states (POMS-29) were completed before and after the intervention. In the experimental group (manual therapy), significant results were obtained on a VAS scale, referring to the neck pain in patients with fibromyalgia (p < 0.001). Correlations showed a relationship between fatigue and sleep variables (R = 0.411; p = 0.046) and pain variables with the POMS anger-hostility subscale (R = 0.436; p = 0.033). Although the size of the sample could be a limitation, the study concluded that the application of manual therapy in fibromyalgia patients performed with moderate pressure for 15 min on the posterior cervical musculature decreased the perception of pain, muscle fatigue, and the state of tension-anxiety. Full article

(This article belongs to the Special Issue Physical Education and Exercise Prehabilitation)

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8 pages, 303 KiB

Open AccessReview

Impact of Psychotherapy on Psychosocial Functioning in Borderline Personality Disorder Patients

by Soheil Zahediabghari, Philippe Boursiquot and Paul Links

Int. J. Environ. Res. Public Health 2020, 17(12), 4610; https://doi.org/10.3390/ijerph17124610 - 26 Jun 2020

Cited by 5 | Viewed by 3753

Abstract

Borderline Personality Disorder (BPD) significantly impairs functioning. Fortunately, effective treatments are available for borderline symptoms but their effect on functioning should be assessed. The objective of this meta-analysis is to assess the effect of specifically-designed versus non-specifically designed psychotherapies on function in adult [...] Read more.

Borderline Personality Disorder (BPD) significantly impairs functioning. Fortunately, effective treatments are available for borderline symptoms but their effect on functioning should be assessed. The objective of this meta-analysis is to assess the effect of specifically-designed versus non-specifically designed psychotherapies on function in adult patients with BPD. The reference list of Cristea et al. 2017 was used to identify the randomized controlled trials (RCTs) assessing the BPD-specifically-designed psychotherapy versus non-specific psychotherapies in adult BPD patients. Among those, RCTs assessing post-treatment functioning using the Global Assessment of Functioning, Social Adjustment Scale–Self-Report and Inventory of Interpersonal Problems were included. Ten trials (880 participants) were included. Summary effect size was calculated using the measured Hedge’s g. The results indicate the BPD patients in the intervention group had a significantly higher (g = 0.41; 95% CI, 0.09–0.73) level of psychosocial functioning after receiving the specifically-designed psychotherapies in comparison with BPD patients in control groups after receiving non-specific psychotherapies. Specifically-designed psychotherapies can improve psychosocial functioning although improvement in measurement of function (i.e., more objective and universal tools) and improvement in psychotherapies (i.e., more focused on general functioning) will be helpful. Full article

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12 pages, 440 KiB

Open AccessReview

COVID-19 and Dentistry: Prevention in Dental Practice, a Literature Review

by Federico Alcide Villani, Riccardo Aiuto, Luigi Paglia and Dino Re

Int. J. Environ. Res. Public Health 2020, 17(12), 4609; https://doi.org/10.3390/ijerph17124609 - 26 Jun 2020

Cited by 76 | Viewed by 14983

Abstract

SARS-CoV-2 is a member of the family of coronaviruses. The first cases were recorded in Wuhan, China, between December 2019 and January 2020. Italy is one of the most affected countries in Europe. COVID-19 is a new challenge in modern dentistry. New guidelines [...] Read more.

SARS-CoV-2 is a member of the family of coronaviruses. The first cases were recorded in Wuhan, China, between December 2019 and January 2020. Italy is one of the most affected countries in Europe. COVID-19 is a new challenge in modern dentistry. New guidelines are required in dental clinics to avoid contagion caused by cross-infections. A narrative review was performed using both primary sources, such as scientific articles and secondary ones, such as bibliographic indexes, web pages, and databases. The main search engines were PubMed, SciELO, and Google Scholar. Twelve articles were selected to develop the bibliographic review by applying pre-established inclusion and exclusion criteria. Precautionary measures should be applied to control COVID-19 in clinical practice. Several authors have highlighted the importance of telephone triage and/or clinic questionnaires, body temperature measurement, usage of personal protective equipment, surface disinfection with ethanol between 62% and 71%, high-speed instruments equipped with an anti-retraction system, four-handed work, and large-volume cannulas for aspiration. Clinically, the use of a rubber dam is essential. FFP2 (or N95) and FFP3 respirators, if compared to surgical masks, provide greater protection for health workers against viral respiratory infections. Further accurate studies are needed to confirm this. Full article

(This article belongs to the Special Issue COVID-19: A Public Health Approach for Health Professionals)

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19 pages, 1387 KiB

Open AccessArticle

Association between Prenatal Exposure to Household Pesticides and Neonatal Weight and Length Growth in the Japan Environment and Children’s Study

by Taro Matsuki, Takeshi Ebara, Hazuki Tamada, Yuki Ito, Yasuyuki Yamada, Hirohisa Kano, Takahiro Kurihara, Hirotaka Sato, Sayaka Kato, Shinji Saitoh, Mayumi Sugiura-Ogasawara, Michihiro Kamijima and The Japan Environment and Children’s Study (JECS) Group

Int. J. Environ. Res. Public Health 2020, 17(12), 4608; https://doi.org/10.3390/ijerph17124608 - 26 Jun 2020

Cited by 16 | Viewed by 3362

Abstract

The effects of prenatal exposure to household pesticides on fetal and neonatal growth have not been fully clarified. The present study aims to determine the effects of prenatal exposure to pesticides on neonates’ body size and growth during the first month. This study [...] Read more.

The effects of prenatal exposure to household pesticides on fetal and neonatal growth have not been fully clarified. The present study aims to determine the effects of prenatal exposure to pesticides on neonates’ body size and growth during the first month. This study included 93,718 pairs of pregnant women and their children from the Japan Environment and Children’s Study. Participants completed self-reporting questionnaires during their second or third trimesters on their demographic characteristics and frequency of pesticide use during pregnancy. Child weight, length, and sex were obtained from medical record transcripts. Birth weight and length, as well as weight and length changes over the first month, were estimated using an analysis of covariance. Frequency of exposure to almost all pesticides had no effects on birth weight and length. However, we found small but significant associations (i) between the use of fumigation insecticides and decreased birth weight, and (ii) between frequencies of exposure to pyrethroid pesticides, especially mosquito coils/mats, and suppression of neonatal length growth. Prenatal exposure to household pesticides, especially those containing pyrethroids, might adversely influence fetal and postnatal growth trajectories. Full article

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

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13 pages, 4969 KiB

Open AccessArticle

Implant Placement in Patients under Treatment with Rivaroxaban: A Retrospective Clinical Study

by Guido Galletti, Fortunato Alfonsi, Angelo Raffaele, Nicola Alberto Valente, Sibylle Chatelain, Roni Kolerman, Chiara Cinquini, Stefano Romeggio, Giovanna Iezzi and Antonio Barone

Int. J. Environ. Res. Public Health 2020, 17(12), 4607; https://doi.org/10.3390/ijerph17124607 - 26 Jun 2020

Cited by 11 | Viewed by 3805

Abstract

The management of patients under treatment with Direct Oral Anticoagulants (DOACs) has led clinicians to deal with two clinical issues, such as the hemorrhagic risk in case of non-interruption or the risk of thromboembolism in case of suspension of the treatment. The primary [...] Read more.

The management of patients under treatment with Direct Oral Anticoagulants (DOACs) has led clinicians to deal with two clinical issues, such as the hemorrhagic risk in case of non-interruption or the risk of thromboembolism in case of suspension of the treatment. The primary aim of this retrospective study was to evaluate the incidence of perioperative bleeding events and healing complications in patients who were under treatment with Rivaroxaban and who received dental implants and immediate prosthetic restoration. Patients treated with Rivaroxaban (Xarelto 20 mg daily) and who needed implant rehabilitation were selected. Four to six implants were placed in mandibular healed sites or fresh extraction sockets. All patients, in agreement with their physicians, interrupted the medication for 24 h and received implants and immediate restorations. Twelve patients and 57 implants were analyzed in the study. No major postoperative bleeding events were reported. Three patients (25%) presented slight immediate postoperative bleeding controlled with compression only. The implant and prosthetic survival rate were both 100% after 1 year. Within the limitations of this study, multiple implant placement with an immediate loading can be performed without any significant complication with a 24 h discontinuation of Rivaroxaban, in conjunction with the patient’s physician. Full article

(This article belongs to the Collection Modern Patient-Centered Dental Care)

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13 pages, 325 KiB

Open AccessArticle

The Effect of Socioeconomic Status on All-Cause Maternal Mortality: A Nationwide Population-Based Cohort Study

by Wonjeong Jeong, Sung-In Jang, Eun-Cheol Park and Jin Young Nam

Int. J. Environ. Res. Public Health 2020, 17(12), 4606; https://doi.org/10.3390/ijerph17124606 - 26 Jun 2020

Cited by 12 | Viewed by 4425

Abstract

Improving maternal health is one of the 13 targets of Sustainable Development Goal 3; consequently, preventing maternal death, which usually occurs in women’s prime productive years, is an important issue that needs to be addressed immediately. This study examines the association between socioeconomic [...] Read more.

Improving maternal health is one of the 13 targets of Sustainable Development Goal 3; consequently, preventing maternal death, which usually occurs in women’s prime productive years, is an important issue that needs to be addressed immediately. This study examines the association between socioeconomic status and all-cause maternal mortality in South Korea and provides evidence of preventable risk factors for maternal death. For this population-based retrospective cohort study, data on 3,334,663 nulliparous women were extracted from the Korean National Health Insurance Service database between 2003 and 2018. The outcome variables were all-cause maternal mortality within six weeks and a year after childbirth. A log-binomial regression model determined the association between maternal mortality and income-level adjusted covariates. Women with lower income levels had higher risk of maternal death within six weeks (risk ratio (RR) = 2.42, 95% confidence interval (CI) = 1.65–3.53) and within one year (RR = 1.83, 95% CI = 1.47–2.28), especially those who were aged 35–39 years, lived in rural areas, delivered via cesarean section, and had maternal comorbidities. The study identifies a significant relationship between South Korean primiparas’ socioeconomic status and maternal death within six weeks or one year after childbirth, suggesting interventions to alleviate the risk of maternal death. Full article

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

10 pages, 321 KiB

Open AccessArticle

by Salvatore Cocuzza, Antonino Maniaci, Calogero Grillo, Salvatore Ferlito, Giacomo Spinato, Salvatore Coco, Federico Merlino, Giovanna Stilo, Giovanni Paolo Santoro, Giannicola Iannella, Claudio Vicini and Ignazio La Mantia

Int. J. Environ. Res. Public Health 2020, 17(12), 4605; https://doi.org/10.3390/ijerph17124605 - 26 Jun 2020

Cited by 15 | Viewed by 3151

Abstract

(1) Introduction: Laryngeal cancer is one of the most common types of cancer affecting the upper aerodigestive tract. Despite ensuring good oncological outcome in many locoregionally advanced cases, total laryngectomy is associated with relevant physical and psychological sequelae. Treatment through tracheo-esophageal speech, if [...] Read more.

(1) Introduction: Laryngeal cancer is one of the most common types of cancer affecting the upper aerodigestive tract. Despite ensuring good oncological outcome in many locoregionally advanced cases, total laryngectomy is associated with relevant physical and psychological sequelae. Treatment through tracheo-esophageal speech, if promising, can lead to very variable outcomes. Not all laryngectomee patients with vocal prosthesis benefit from the same level of rehabilitation mainly due to the development of prosthetic or fistula related problems. The relating sequelae in some cases are even more decisive in the patient quality of life, having a higher impact than communicational or verbal skills. (2) Material and Methods: A retrospective study was conducted on 63 patients initially enrolled with a history of total laryngectomy and voice rehabilitation, treated at the University Hospital of Catania from 1 January 2010 to 31 December 2018. Quality of life (QoL) evaluation through validated self-administrated questionnaires was performed. (3) Results: The Voice-Related Quality of Life questionnaire revealed significantly better outcomes in both socio-emotional and functional domains of the tracheoesophageal patient group compared to the esophageal group (p = 0.01; p = 0.01, respectively), whereas in the Voice Handicap Index assessment, statistically significant scores were not achieved (p = 0.33). (4) Discussion: The significant differences reported through the V-RQOL and Voice Handicap Index scales in the presence of fistula related problems and device lifetime reduction when compared to the oesophageal speech group have demonstrated, as supported by the literature, a crucial role in the rehabilitative prognosis. (5) Conclusions: The criteria of low resistance to airflow, optimal tracheoesophageal retention, prolonged device life, simple patient maintenance, and comfortable outpatient surgery are the reference standard for obtaining good QoL results, especially over time. Furthermore, the correct phenotyping of the patient based on the main outcomes achieved at clinical follow-up guarantees the primary objective of the identification of a better quality of life. Full article

(This article belongs to the Special Issue The Impact of ENT Diseases in Social Life)

16 pages, 1535 KiB

Open AccessArticle

Associations between Particulate Matter and Otitis Media in Children: A Meta-Analysis

by Sang-Youp Lee, Myoung-jin Jang, Seung Ha Oh, Jun Ho Lee, Myung-Whan Suh and Moo Kyun Park

Int. J. Environ. Res. Public Health 2020, 17(12), 4604; https://doi.org/10.3390/ijerph17124604 - 26 Jun 2020

Cited by 10 | Viewed by 2428

Abstract

Particulate matter (PM), a primary component of air pollution, is a suspected risk factor for the development of otitis media (OM). However, the results of studies on the potential correlation between an increase in the concentration of PM and risk of developing OM [...] Read more.

Particulate matter (PM), a primary component of air pollution, is a suspected risk factor for the development of otitis media (OM). However, the results of studies on the potential correlation between an increase in the concentration of PM and risk of developing OM are inconsistent. To better characterize this potential association, a meta-analysis of studies indexed in three global databases (PubMed, EMBASE, and The Cochrane Library) was conducted. These databases were systematically screened for observational studies of PM concentration and the development of OM from the time of their inception to 31 March 2020. Following these searches, 12 articles were analyzed using pooled odds ratios generated from random-effects models to test for an association between an increased concentration of PM and the risk of developing OM. The data were analyzed separately according to the size of particulate matter as PM_2.5 and PM₁₀. The pooled odds ratios for each 10 μg/m³ increase in PM_2.5 and PM₁₀ concentration were 1.032 (95% confidence interval (CI), 1.005–1.060) and 1.010 (95% CI, 1.008–1.012), respectively. Specifically, the pooled odds ratios were significant within the short-term studies (PM measured within 1 week of the development of OM), as 1.024 (95% CI, 1.008–1.040) for PM_2.5 concentration and 1.010 (95% CI, 1.008–1.012) for PM₁₀ concentration. They were significant for children under 2 years of age with pooled odds ratios of 1.426 (95% CI, 1.278–1.519) for an increase in the concentration of PM_2.5. The incidence of OM was not correlated with the concentration of PM, but was correlated with an increase in the concentration of PM. In conclusion, an increase in the concentration of PM_2.5 is more closely associated with the development of OM compared with an increase in the concentration of PM₁₀; this influence is more substantial in shorter-term studies and for younger children. Full article

(This article belongs to the Special Issue Air Pollution and Climate Change-Mediated Health Impacts)

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14 pages, 425 KiB

Open AccessArticle

Obesity in Young Adulthood: The Role of Physical Activity Level, Musculoskeletal Pain, and Psychological Distress in Adolescence (The HUNT-Study)

by Maren Hjelle Guddal, Synne Øien Stensland, Milada Cvancarova Småstuen, Marianne Bakke Johnsen, Ingrid Heuch, John-Anker Zwart and Kjersti Storheim

Int. J. Environ. Res. Public Health 2020, 17(12), 4603; https://doi.org/10.3390/ijerph17124603 - 26 Jun 2020

Cited by 4 | Viewed by 3199

Abstract

The global obesity epidemic raises long-term health concerns which underline the importance of preventive efforts. We aimed to investigate individual and combined effects of common health problems in adolescence on the probability of obesity in young adulthood. This prospective population-based study included data [...] Read more.

The global obesity epidemic raises long-term health concerns which underline the importance of preventive efforts. We aimed to investigate individual and combined effects of common health problems in adolescence on the probability of obesity in young adulthood. This prospective population-based study included data from participants in the Nord-Trøndelag Health Study in Norway (Young-HUNT1 (1995–1997), age 13–19, baseline) who participated in HUNT3 as young adults 11 years later (age 23–31). Exposure variables at baseline included self-reported physical activity, musculoskeletal pain, and psychological distress. We examined associations between exposure variables and the main outcome of obesity in young adulthood (BMI ≥ 30 kg/m²) using univariate and multiple logistic regression, stratified by sex. Probabilities of obesity for given combinations of the exposure variables were visualized in risk matrixes. The study sample consisted of 1859 participants (43.6% boys). Higher probabilities of obesity in young adulthood were found across combinations of lower physical activity levels and presence of musculoskeletal pain in adolescence. Additional adverse effects of psychological distress were low. Proactive intervention strategies to promote physical activity and facilitate sports participation for all adolescents, whilst addressing musculoskeletal pain and its potential individual causes, could prove helpful to prevent development of obesity in young adulthood. Full article

(This article belongs to the Special Issue Risk and Maintenance of Obesity and Eating Disorders in Adolescents)

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11 pages, 1016 KiB

Open AccessArticle

Resilience Scale Psychometric Study. Adaptation to the Spanish Population in Nursing Students

by Ana M. Tur Porcar, Noemí Cuartero Monteagudo, Vicente Gea-Caballero and Raúl Juárez-Vela

Int. J. Environ. Res. Public Health 2020, 17(12), 4602; https://doi.org/10.3390/ijerph17124602 - 26 Jun 2020

Cited by 7 | Viewed by 2878

Abstract

Nursing students and professionals are exposed to highly stressful clinical situations. However, when confronted with stress, which is exacerbated by academic and professional situations, there is a great disparity between those who do not know how to respond suitably to the demands from [...] Read more.

Nursing students and professionals are exposed to highly stressful clinical situations. However, when confronted with stress, which is exacerbated by academic and professional situations, there is a great disparity between those who do not know how to respond suitably to the demands from patients or teachers due to a lack of competence and personal resistance, and those who are more resilient and develop a greater range of strengths. This research aims to analyse the validity and psychometric characteristics of a questionnaire on resilience adapted to Spanish nursing bachelor’s degree students. The participants were 434 undergraduate nursing students from the province of Valencia (Spain) between 17 and 54 years of age (Mean, M = 21; Standard Deviation, SD = 0.320), 104 of whom were men (24%) and 330 women (76%). A cross-sectional group evaluation was carried out in the university itself, adhering to the ethical standards of the Declaration of Helsinki. Based on the descriptive, factorial, exploratory and confirmatory analyses, it was possible to confirm the suitability of the questionnaire and its adaptation to nursing students. The model is thus suitable for evaluating the population under study. Furthermore, there are statistically significant differences depending on age and gender. The results show that the questionnaire analysed is suited to evaluating resilience among Spanish nursing students, thereby justifying the adaptation of a scale of this nature to foster resilience among nursing students and nurses in professional life, who are exposed to critical situations with patients’ suffering, deterioration or death. Our study highlights important practical implications: Spanish nursing studies involve theory and practice, but students and nurses in professional life have to confront critical situations of patients’ suffering, deterioration, or death. These situations cause stress and feelings of impotence that may lead to chronic stress and even suicidal thoughts. Full article

(This article belongs to the Collection Nursing Research)

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18 pages, 964 KiB

Open AccessArticle

Perceived Discrimination, Psychological Distress and Cardiovascular Risk in Migrants in Spain

by María José Martos-Méndez, Alba García-Cid, Luis Gómez-Jacinto and Isabel Hombrados-Mendieta

Int. J. Environ. Res. Public Health 2020, 17(12), 4601; https://doi.org/10.3390/ijerph17124601 - 26 Jun 2020

Cited by 7 | Viewed by 3109

Abstract

The aim of the present study is to determine the effect of discrimination and psychological distress on the cardiovascular health of immigrants, as well as to analyse potential differences based on age, gender, length of residence in host country and geographic origin. The [...] Read more.

The aim of the present study is to determine the effect of discrimination and psychological distress on the cardiovascular health of immigrants, as well as to analyse potential differences based on age, gender, length of residence in host country and geographic origin. The sample was formed by 1714 immigrants from Africa, Eastern Europe and Latin America. Of the sample, 48.7% were men and 51.3% were women. Most relevant results show that discrimination (t = 4.27; p = 0.000) and psychological distress (t = 4.35; p = 0.000) experienced by immigrants predict their cardiovascular risk. Furthermore, psychological distress mediates the relation between discrimination and risk (t = 4.03; p = 0.000). Significant differences between men and women were found, as well as differences based on ethnicity, although to a lesser extent. Age affects the relation between discrimination, psychological distress and arterial hypertension and hypercholesterolemia. Results are notably relevant for the design of preventive health programmes for immigrants and intervention strategies in order to prevent diseases that may imply cardiovascular risks and seriously affect immigrants’ health. Full article

(This article belongs to the Special Issue Social Inequities in Cardiovascular Health: Unexplored Immigrant and Mobility Effects)

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10 pages, 477 KiB

Open AccessArticle

The Status of First Aid and Its Associations with Health Outcomes among Patients with Traffic Accidents in Urban Areas of Vietnam

by Hue Thi Mai, Hai Minh Vu, Tam Thi Ngo, Giang Thu Vu, Huong Lan Thi Nguyen, Men Thi Hoang, Bach Xuan Tran, Carl A. Latkin, Cyrus S. H. Ho and Roger C. M. Ho

Int. J. Environ. Res. Public Health 2020, 17(12), 4600; https://doi.org/10.3390/ijerph17124600 - 26 Jun 2020

Cited by 3 | Viewed by 3824

Abstract

While it is well-evident that proper first aid would significantly promote survival and later treatment outcomes, little attention has been paid to improving its capacity in Vietnam. Thus, we conducted this study to assess the status of first aid and its associations with [...] Read more.

While it is well-evident that proper first aid would significantly promote survival and later treatment outcomes, little attention has been paid to improving its capacity in Vietnam. Thus, we conducted this study to assess the status of first aid and its associations with health outcomes among patients in traffic accidents in urban areas of Vietnam. We conducted a cross-sectional study on 413 patients in traffic accidents from October to December 2018 at six hospitals in Thai Binh province. Socio-demographics, first aid characteristics, and health outcomes were collected via face-to-face interviews using a structured questionnaire. We used a chi-square test to determine the differences in health outcomes among those who received first aid and those without. In addition, a multivariable regression was performed to determine the factors associated with first aid. The results indicated that less than half of the patients received first aid (48.1%), and only one fourth received first aid within 10 min after an accident. The proportions of having problems with mobility, self-care, usual activities, and pain/discomfort were significantly lower among those who received first aid compared to those without it. The regression model showed that those with multiple injuries were less likely to receive first aid. Full article

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13 pages, 3573 KiB

Open AccessArticle

Chemical Characterization of Seasonal PM_2.5 Samples and Their Cytotoxicity in Human Lung Epithelial Cells (A549)

by Ao Di, Yun Wu, Mindong Chen, Dongyang Nie and Xinlei Ge

Int. J. Environ. Res. Public Health 2020, 17(12), 4599; https://doi.org/10.3390/ijerph17124599 - 26 Jun 2020

Cited by 17 | Viewed by 2576

Abstract

In order to study the toxicity of fine particulate matter (PM_2.5) sourced from different seasons on human health, we collected PM_2.5 samples quarterly from March 2016 to February 2017 in Nanjing, China. The component analysis results showed that high proportions [...] Read more.

In order to study the toxicity of fine particulate matter (PM_2.5) sourced from different seasons on human health, we collected PM_2.5 samples quarterly from March 2016 to February 2017 in Nanjing, China. The component analysis results showed that high proportions of water-soluble organic carbon (WSOC), SO₄²⁻, Ca²⁺ and Mg²⁺ were found in the summer samples, while high proportions of NO₃⁻, NH₄⁺ and heavy metals were observed in the spring and winter samples. Then human lung epithelial cells (A549) were exposed to the PM_2.5 samples. The toxicological results indicated that reactive oxygen species (ROS) production in the spring and winter samples was higher than that in the summer and fall samples, which was related to the contribution of some heavy metals and inorganic ions (e.g., Pb and NO₃⁻). However, the apoptosis rates of the cells showed the opposite seasonal changes as what the ROS did, which might be caused by the higher WSOC content in the summer. In addition, regression analysis also showed the importance of the PM_2.5 components in ROS production and apoptosis. Particularly, Zn had the strongest correlation with ROS production (R = 0.863) and cell apoptosis (R = 0.675); thus, the specific toxicity of Zn in PM_2.5 deserves further investigation. Our results could be beneficial for assessing the health risks and controlling the toxic components of PM_2.5 in Nanjing. Full article

(This article belongs to the Special Issue The Effects of Air Pollution and Traffic Exposure in the General Population)

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23 pages, 427 KiB

Open AccessArticle

Psychological Risk Factors that Predict Social Networking and Internet Addiction in Adolescents

by Montserrat Peris, Usue de la Barrera, Konstanze Schoeps and Inmaculada Montoya-Castilla

Int. J. Environ. Res. Public Health 2020, 17(12), 4598; https://doi.org/10.3390/ijerph17124598 - 26 Jun 2020

Cited by 57 | Viewed by 12763

Abstract

Adolescents’ addictive use of social media and the internet is an increasing concern among parents, teachers, researchers and society. The purpose was to examine the contribution of body self-esteem, personality traits, and demographic factors in the prediction of adolescents’ addictive use of social [...] Read more.

Adolescents’ addictive use of social media and the internet is an increasing concern among parents, teachers, researchers and society. The purpose was to examine the contribution of body self-esteem, personality traits, and demographic factors in the prediction of adolescents’ addictive use of social media and the internet. The participants were 447 Spanish adolescents aged 13−16 years (M = 14.90, SD = 0.81, 56.2% women). We measured gender, age, body self-esteem (body satisfaction and physical attractiveness), personality traits (extraversion, neuroticism, disinhibition and narcissism) and social networking and internet addiction (internet addiction symptoms, social media use, geek behaviour, and nomophobia). The effects of gender, age, body self-esteem and personality on the different dimensions of internet addiction were estimated, conducting hierarchical linear multiple regression analysis and a fuzzy-set qualitative comparative analysis (fsQCA). The results evidenced different pathways explaining four types of adolescents’ internet addiction: gender and disinhibition were the most relevant predictors of addiction symptoms; gender combined with physical attractiveness best explained social media use; narcissism and neuroticism appear to be the most relevant predictors of geek behaviour; and narcissism was the variable that best explained nomophobia. Furthermore, the advantages and differences between both methodologies (regressions vs. QCA) were discussed. Full article

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

13 pages, 866 KiB

Open AccessArticle

Impact of Medical Debt on the Financial Welfare of Middle- and Low-Income Families across China

by Jiajing Li, Chen Jiao, Stephen Nicholas, Jian Wang, Gong Chen and Jinghua Chang

Int. J. Environ. Res. Public Health 2020, 17(12), 4597; https://doi.org/10.3390/ijerph17124597 - 26 Jun 2020

Cited by 4 | Viewed by 3103

Abstract

Background: Medical debt is a persistent global issue and a crucial and effective indicator of long-term family medical financial burden. This paper fills a research gap on the incidence and causes of medical debt in Chinese low- and middle-income households. Method: Data were [...] Read more.

Background: Medical debt is a persistent global issue and a crucial and effective indicator of long-term family medical financial burden. This paper fills a research gap on the incidence and causes of medical debt in Chinese low- and middle-income households. Method: Data were obtained from the 2015 China Household Finance Survey, with medical debt measured as borrowings from families, friends and third parties. Tobit regression models were used to analyze the data. The concentration index was employed to measure the extent of socioeconomic inequality in medical debt incidence. Results: We found that 2.42% of middle-income families had medical debt, averaging US$6278.25, or 0.56 times average household yearly income and 3.92% of low-income families had medical debts averaging US$5419.88, which was equivalent to 2.49 times average household yearly income. The concentration index for low and middle-income families’ medical debt was significantly pro-poor. Medical debt impoverished about 10% of all non-poverty households and pushed poverty households deeper into poverty. While catastrophic health expenditure (CHE) was the single most important factor in medical debt, age, education, and health status of householder, hospitalization and types of medical insurance were also significant factors determining medical debt. Conclusions: Using a narrow definition of medical debt, the incidence of medical debt in Chinese low- and middle-income households was relatively low. But, once medical debt happened, it imposed a long-term financial burden on medical indebted families, tipping many low and middle-income households into poverty and imposing on households several years of debt repayments. Further studies need to use broader definitions of medical debt to better assess the long-term financial impact of medical debt on Chinese families. Policy makers need to modify China’s basic medical insurance schemes to manage out-of-pocket, medical debt and CHE and to take account of pre-existing medical debt. Full article

(This article belongs to the Section Health Care Sciences & Services)

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15 pages, 5238 KiB

Open AccessArticle

Determination of Selenium in Common and Selenium-Rich Rice from Different Areas in China and Assessment of Their Dietary Intake

by Liuquan Zhang, Yanbin Guo, Kehong Liang, Zhongqiu Hu, Xiangdong Sun, Yong Fang, Xiaohong Mei, Hongqing Yin, Xianjin Liu and Baiyi Lu

Int. J. Environ. Res. Public Health 2020, 17(12), 4596; https://doi.org/10.3390/ijerph17124596 - 26 Jun 2020

Cited by 9 | Viewed by 2975

Abstract

In this study, 41 common rice varieties and 211 selenium-rich rice varieties from ten representative areas in China were collected in 2017–2019. The selenium contents of rice were analyzed with optimized inductively coupled plasma mass spectrometry (ICP-MS). Selenium concentrations of common rice and [...] Read more.

In this study, 41 common rice varieties and 211 selenium-rich rice varieties from ten representative areas in China were collected in 2017–2019. The selenium contents of rice were analyzed with optimized inductively coupled plasma mass spectrometry (ICP-MS). Selenium concentrations of common rice and selenium-rich rice ranges were 0.81–7.26 and 0.76–180.73 µg/100 g, respectively. The selenium contents in selenium-rich rice from different areas were significantly different (p < 0.001) while those in common rice from different areas were not. The selenium-rich rice in Harbin and Keshan showed the lowest selenium level and those from selenium-rich areas (Enshi and Ankang) were highest. Based on the estimation of the risk assessment software @risk7.0 (Palisade Corporation, New York, NY, USA), the consumption of selenium-rich rice can effectively increase dietary selenium intake for the population. However, the risk index of P95 (Percentile 95) selenium exposure at the tolerable upper intake level for children at 2–14 years old exceeded 100%, with potential risk currently. Therefore, the consumption of selenium-rich rice should be properly monitored for young children and adolescents. Full article

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

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27 pages, 686 KiB

Open AccessArticle

Supervised Machine Learning Algorithms for Bioelectromagnetics: Prediction Models and Feature Selection Techniques Using Data from Weak Radiofrequency Radiation Effect on Human and Animals Cells

by Malka N. Halgamuge

Int. J. Environ. Res. Public Health 2020, 17(12), 4595; https://doi.org/10.3390/ijerph17124595 - 26 Jun 2020

Cited by 9 | Viewed by 5086

Abstract

The emergence of new technologies to incorporate and analyze data with high-performance computing has expanded our capability to accurately predict any incident. Supervised Machine learning (ML) can be utilized for a fast and consistent prediction, and to obtain the underlying pattern of the [...] Read more.

The emergence of new technologies to incorporate and analyze data with high-performance computing has expanded our capability to accurately predict any incident. Supervised Machine learning (ML) can be utilized for a fast and consistent prediction, and to obtain the underlying pattern of the data better. We develop a prediction strategy, for the first time, using supervised ML to observe the possible impact of weak radiofrequency electromagnetic field (RF-EMF) on human and animal cells without performing in-vitro laboratory experiments. We extracted laboratory experimental data from 300 peer-reviewed scientific publications (1990–2015) describing 1127 experimental case studies of human and animal cells response to RF-EMF. We used domain knowledge, Principal Component Analysis (PCA), and the Chi-squared feature selection techniques to select six optimal features for computation and cost-efficiency. We then develop grouping or clustering strategies to allocate these selected features into five different laboratory experiment scenarios. The dataset has been tested with ten different classifiers, and the outputs are estimated using the k-fold cross-validation method. The assessment of a classifier’s prediction performance is critical for assessing its suitability. Hence, a detailed comparison of the percentage of the model accuracy (PCC), Root Mean Squared Error (RMSE), precision, sensitivity (recall), 1 − specificity, Area under the ROC Curve (AUC), and precision-recall (PRC Area) for each classification method were observed. Our findings suggest that the Random Forest algorithm exceeds in all groups in terms of all performance measures and shows AUC = 0.903 where k-fold = 60. A robust correlation was observed in the specific absorption rate (SAR) with frequency and cumulative effect or exposure time with SAR×time (impact of accumulated SAR within the exposure time) of RF-EMF. In contrast, the relationship between frequency and exposure time was not significant. In future, with more experimental data, the sample size can be increased, leading to more accurate work. Full article

(This article belongs to the Special Issue Machine Learning, Stochastic Modelling and Applied Statistics for EMF Exposure Assessment)

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15 pages, 648 KiB

Open AccessArticle

Development and Evaluation of a Gatekeeper Training Program Regarding Anxiety about Radiation Health Effects Following a Nuclear Power Plant Accident: A Single-Arm Intervention Pilot Trial

by Masatsugu Orui, Maiko Fukasawa, Naoko Horikoshi, Yuriko Suzuki and Norito Kawakami

Int. J. Environ. Res. Public Health 2020, 17(12), 4594; https://doi.org/10.3390/ijerph17124594 - 26 Jun 2020

Cited by 15 | Viewed by 2439

Abstract

After the Fukushima Daiichi Nuclear Power Plant accident in March 2011, residents perceived a radiation exposure risk. To address the concerns about radiation exposure and the subsequent effects on their health, we developed the gatekeeper training program for radiation health anxiety and mental [...] Read more.

After the Fukushima Daiichi Nuclear Power Plant accident in March 2011, residents perceived a radiation exposure risk. To address the concerns about radiation exposure and the subsequent effects on their health, we developed the gatekeeper training program for radiation health anxiety and mental health issues. The program consisted of a presentation and roleplay, with educational objectives to the increase knowledge and understanding around radiation health anxiety, alcoholism, depression, and suicide. Twenty-six counselors participated in the program as a single-arm intervention. To measure the outcomes, the subjects reported self-confidence when they counselled with residents with radiation health anxiety and other mental health issues. Comparing the answers to pre- and 2-month follow-up surveys, the confidence levels were higher after 2 months than at baseline, especially for the question “How confident are you at supporting a resident with mental health issues?”, which showed the largest increase (p < 0.001). Regarding radiation health anxiety the questions “Can you communicate coping skills to a resident with radiation health anxiety?” (p = 0.007) and “Can you refer a resident with radiation health anxiety to professionals who can cope appropriately?” (p = 0.016) showed significant increases in their confidence levels. This program could be useful for on-going health activities and future nuclear disasters. Full article

(This article belongs to the Special Issue Disaster Mental Health Risk Reduction)

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17 pages, 1986 KiB

Open AccessReview

Bibliometric Analysis of Research on Telomere Length in Children: A Review of Scientific Literature

by Desirée Valera-Gran, Daniel Prieto-Botella, Paula Peral-Gómez, Miriam Hurtado-Pomares, Alicia Sánchez-Pérez and Eva-María Navarrete-Muñoz

Int. J. Environ. Res. Public Health 2020, 17(12), 4593; https://doi.org/10.3390/ijerph17124593 - 26 Jun 2020

Cited by 13 | Viewed by 3256

Abstract

Telomere length in early life has been recently associated with biological aging and development of negative consequences in later adult life. A relevant area of research has emerged to understand the factors that impact telomere length in children. We conducted a bibliometric analysis [...] Read more.

Telomere length in early life has been recently associated with biological aging and development of negative consequences in later adult life. A relevant area of research has emerged to understand the factors that impact telomere length in children. We conducted a bibliometric analysis to track research output and identify global trends and gaps in the knowledge of telomere length in children. Bibliographic data were retrieved from the Web of Science database and then analyzed by using Bibliometrix R package. A total of 840 publications were yielded from 1991 to 2019. The references were prominently published in journals, with 20 high ranked journals contributing to 30% of literature on telomere length in children. The USA was the most productive country (35.7%), followed by Europe (12.1%), and Asia (11.9%). A knowledge map of telomere length in children through keyword analyses revealed that there were two potential main lines of research based on two different approaches: genomic research and epidemiological research. This study shows that telomere length in children is a topic of research that has gained significant relevance in the last decade. This bibliometric study may be helpful in identifying research trends and finding research hot spots and gaps in this research field. Full article

(This article belongs to the Special Issue Research in Physical, Social and Intellectual Development in Childhood and Adolescence)

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14 pages, 313 KiB

Open AccessArticle

Gender Inequality and the Sexual and Reproductive Health Status of Young and Older Women in the Afar Region of Ethiopia

by Muluken Dessalegn, Mhiret Ayele, Yeshitila Hailu, Genetu Addisu, Sintayehu Abebe, Haset Solomon, Geteneh Mogess and Virginia Stulz

Int. J. Environ. Res. Public Health 2020, 17(12), 4592; https://doi.org/10.3390/ijerph17124592 - 26 Jun 2020

Cited by 19 | Viewed by 7095

Abstract

The main purpose of this research was to analyze gender context in the Afar region of Ethiopia and propose a set of strategies or actions to improve adolescent and youth health. Using a pre-established gender analysis framework, an explorative qualitative study was conducted [...] Read more.

The main purpose of this research was to analyze gender context in the Afar region of Ethiopia and propose a set of strategies or actions to improve adolescent and youth health. Using a pre-established gender analysis framework, an explorative qualitative study was conducted in five districts. Sixteen key informants and eight focus group discussions were conducted among adult women and men of young adolescents and youth. The study revealed that younger and older women are the most disadvantaged groups of the society. This is due to the high workload on women and girls (housekeeping, building a house and taking care of cattle and children), they also are less valued, have no control over resources and have no part in decision making, including their personal life choices. As a result, they rarely access school and health facilities. They are forced get married according to arranged marriage called “absuma.” As such, they suffer from multiple reproductive health problems. Women have poor decision-making autonomy, lack control over resources, have limited participation in socio-economic practices, and experience child and early forced marriage, and this poor service utilization has exposed them to the worst sexual and reproductive health outcomes. Full article

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

12 pages, 1340 KiB

Open AccessArticle

Using Electronic Medical Record Data to Better Understand Obesity in Hispanic Neighborhoods in El Paso, Texas

by Jennifer J. Salinas, Jon Sheen, Malcolm Carlyle, Navkiran K. Shokar, Gerardo Vazquez, Daniel Murphy and Ogechika Alozie

Int. J. Environ. Res. Public Health 2020, 17(12), 4591; https://doi.org/10.3390/ijerph17124591 - 26 Jun 2020

Cited by 2 | Viewed by 2960

Abstract

The prevalence of obesity has been persistent amongst Hispanics over the last 20 years. Socioeconomic inequities have led to delayed diagnosis and treatment of chronic medical conditions related to obesity. Factors contributing include lack of insurance and insufficient health education. It is well-documented [...] Read more.

The prevalence of obesity has been persistent amongst Hispanics over the last 20 years. Socioeconomic inequities have led to delayed diagnosis and treatment of chronic medical conditions related to obesity. Factors contributing include lack of insurance and insufficient health education. It is well-documented that obesity amongst Hispanics is higher in comparison to non-Hispanics, but it is not well-understood how the socioeconomic context along with Hispanic ethnic concentration impact the prevalence of obesity within a community. Specifically studying obesity within Hispanic dominant regions of the United States, along the Texas–Mexico border will aid in understanding this relationship. El Paso, Texas is predominantly Mexican-origin Hispanic, making up 83% of the county’s total population. Through the use of electronic medical records, BMI averages along with obesity prevalence were analyzed for 161 census tracts in the El Paso County. Geographic weighted regression and Hot Spot technology were used to analyze the data. This study did identify a positive association between Hispanic ethnic concentration and obesity prevalence within the El Paso County. Median income did have a direct effect on obesity prevalence while evidence demonstrates that higher education is protective for health. Full article

(This article belongs to the Special Issue Physical Activity and Nutrition Among Border and Other Marginalized Populations)

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20 pages, 5716 KiB

Open AccessArticle

Impact of Apartment Tightness on Temperature Variability during a Fire

by Jerzy Gałaj and Damian Saleta

Int. J. Environ. Res. Public Health 2020, 17(12), 4590; https://doi.org/10.3390/ijerph17124590 - 26 Jun 2020

Cited by 1 | Viewed by 2326

Abstract

Along with the thermal modernization process of old residential buildings, there has been a significant increase in the air tightness of apartments, which may contribute to the deterioration of the safety of users and rescue teams in a fire. The main goal of [...] Read more.

Along with the thermal modernization process of old residential buildings, there has been a significant increase in the air tightness of apartments, which may contribute to the deterioration of the safety of users and rescue teams in a fire. The main goal of this study was to investigate the impact of the air tightness of an apartment on fire growth and temperature variability. In the work, an experimental method was applied. Two full-scale fire tests were carried out, one in a sealed apartment and the other in unsealed one. The temperature was measured by thirty-two thermocouples. Two thermal imaging and video cameras were also used to evaluate a temperature field as well as flame and smoke height. Based on the analysis, conclusions have been formulated. It is noteworthy that the highest temperatures and significant increase in pressure were obtained in a sealed apartment, but dangerous and critical conditions regarding firefighters’ safety were achieved faster and persisted much longer in an unsealed one. Full article

(This article belongs to the Special Issue Environmental and Health Impacts of Fire: Primary and Secondary Effects in Local and Global Scale)

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22 pages, 401 KiB

Open AccessReview

Validity of Tier 1 Modelling Tools and Impacts on Exposure Assessments within REACH Registrations—ETEAM Project, Validation Studies and Consequences

by Urs Schlueter and Martin Tischer

Int. J. Environ. Res. Public Health 2020, 17(12), 4589; https://doi.org/10.3390/ijerph17124589 - 26 Jun 2020

Cited by 8 | Viewed by 2572

Abstract

In the last years, the evaluation and validation of exposure modelling tools for inhalation exposure assessment at workplaces received new and highly increased attention by different stakeholders. One important study in this regard is the ETEAM (Evaluation of Tier 1 [...] Read more.

In the last years, the evaluation and validation of exposure modelling tools for inhalation exposure assessment at workplaces received new and highly increased attention by different stakeholders. One important study in this regard is the ETEAM (Evaluation of Tier 1 Exposure Assessment Models) project that evaluated exposure assessment tools under the European REACH regulation (Registration, Evaluation, Authorisation and Restriction of Chemicals), (but next to the ETEAM project—as a project publicly funded by the German Federal Institute for Occupational Safety and Health (BAuA)—it is a rather new development that research groups from universities in Europe, but also internationally, investigated this issue. These other studies focused not only on REACH tier 1 tools but also investigated other tools and aspects of tool validity. This paper tries to summarise the major findings of studies that explored the different issues of tool validity by focusing on the scientific outcomes and the exposure on the science community. On the other hand, this publication aims to provide guidance on the choice and use of tools, addressing the needs of tool users. The consequences of different stakeholders under REACH are discussed from the results of the validation studies. The major stakeholders are: (1) REACH registrants or applicants for REACH authorisations, meaning those companies, consortia or associations who are subject to REACH; (2) Evaluating authorities within the scope of REACH, meaning the ECHA (European Chemicals Agency) secretariat and committees, but also the competent authorities of the member states or the European Union; (3) Developers of the different models and tools; (4) Users of the different models and tools. Full article

(This article belongs to the Special Issue Modeling Tools for Occupational Exposure Assessment)

14 pages, 2352 KiB

Open AccessArticle

Neurodevelopmental Trajectories of Preterm Infants of Italian Native-Born and Migrant Mothers and Role of Neonatal Feeding

by Dino Gibertoni, Alessandra Sansavini, Silvia Savini, Chiara Locatelli, Gina Ancora, Enrica Perrone, Magda Ialonardi, Paola Rucci, Maria Pia Fantini, Giacomo Faldella and Luigi Corvaglia

Int. J. Environ. Res. Public Health 2020, 17(12), 4588; https://doi.org/10.3390/ijerph17124588 - 25 Jun 2020

Cited by 7 | Viewed by 2798

Abstract

There is evidence that preterm infants of migrant mothers are at a higher risk of adverse perinatal outcomes than those of native-born mothers, and that human milk feeding is beneficial to infants’ neurodevelopment. Using the United Nations Human Development Index (HDI) to classify [...] Read more.

There is evidence that preterm infants of migrant mothers are at a higher risk of adverse perinatal outcomes than those of native-born mothers, and that human milk feeding is beneficial to infants’ neurodevelopment. Using the United Nations Human Development Index (HDI) to classify mother’s country of origin, we investigated whether type of neonatal feeding (human milk vs. mixed milk vs. exclusive formula milk) affected preterm newborn neurodevelopment varying across different HDI categories (Italian native-born vs. high HDI migrant vs. low HDI migrant) up to 2 years of age. Neurodevelopment of 530 infants born in Italy at ≤32 weeks of gestational age and/or weighing <1500 g was measured at 3-, 6-, 9-, 12-, 18-, and 24-months corrected age (CA) using the revised Griffiths Mental Development Scale 0–2 years. The trajectories of the general developmental quotient and its five subscales were estimated using mixed models. At 24-months CA only preterm infants of low HDI migrant mothers and fed exclusive formula milk showed moderate neurodevelopment impairment, with lower developmental trajectories of eye-hand coordination, performance, and personal-social abilities. Migrant mothers from low HDI countries and their preterm infants should be targeted by specific programs supporting maternal environment, infant development, and human or mixed milk neonatal feeding. Future research should focus on a deeper understanding of the mechanisms through which type of feeding and mother migrant conditions interact in influencing preterm infants’ neurodevelopment. Full article

(This article belongs to the Special Issue Preterm Birth: Research, Intervention and Developmental Outcomes)

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10 pages, 555 KiB

Open AccessArticle

Interpersonal Violence and Psychotic-Like Experiences: The Mediation of Ideas of Reference, Childhood Memories, and Dissociation

by Sandra Fernández-León, Juan F. Rodríguez-Testal, María L. Gutiérrez-López and Cristina Senín-Calderón

Int. J. Environ. Res. Public Health 2020, 17(12), 4587; https://doi.org/10.3390/ijerph17124587 - 25 Jun 2020

Cited by 4 | Viewed by 2350

Abstract

Previous studies have demonstrated the relationship between the accumulation of situations involving interpersonal violence (IV) and psychotic-like experiences. This study explored whether IV is related to aberrant salience (AS), using a sequential mediation model that included memories of relationship with parents (submission, devaluation, [...] Read more.

Previous studies have demonstrated the relationship between the accumulation of situations involving interpersonal violence (IV) and psychotic-like experiences. This study explored whether IV is related to aberrant salience (AS), using a sequential mediation model that included memories of relationship with parents (submission, devaluation, and threat; Early Life Experiences Scale (ELES)), ideas of reference (IR), and dissociative symptoms (absorption and depersonalization), and whether the patient/nonpatient condition moderated this effect. The sample was made of 401 participants (including 43 patients with psychotic disorders) aged 18 to 71 years (Mage = 30.43; SD = 11.19). Analysis of a serial multiple mediator model revealed that IR, ELES, absorption, and depersonalization fully mediated the effect of IV on AS, explaining 39% of the variance, regardless of the patient/nonpatient condition. The indirect paths, which place IR and dissociation (especially absorption, the variable to which the IR and ELES lead) in a primordial position for being related to AS, are discussed. This continuum model could be useful for understanding processes related to the onset of psychosis unmoderated by the patient/nonpatient condition. Full article

(This article belongs to the Section Mental Health)

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13 pages, 344 KiB

Open AccessPerspective

Molecular Decolonization: An Indigenous Microcosm Perspective of Planetary Health

by Nicole Redvers, Michael Yellow Bird, Diana Quinn, Tyson Yunkaporta and Kerry Arabena

Int. J. Environ. Res. Public Health 2020, 17(12), 4586; https://doi.org/10.3390/ijerph17124586 - 25 Jun 2020

Cited by 26 | Viewed by 10619

Abstract

Indigenous peoples are resilient peoples with deep traditional knowledge and scientific thought spanning millennia. Global discourse on climate change however has identified Indigenous populations as being a highly vulnerable group due to the habitation in regions undergoing rapid change, and the disproportionate burden [...] Read more.

Indigenous peoples are resilient peoples with deep traditional knowledge and scientific thought spanning millennia. Global discourse on climate change however has identified Indigenous populations as being a highly vulnerable group due to the habitation in regions undergoing rapid change, and the disproportionate burden of morbidity and mortality already faced by this population. Therefore, the need for Indigenous self-determination and the formal recognition of Indigenous knowledges, including micro-level molecular and microbial knowledges, as a critical foundation for planetary health is in urgent need. Through the process of Indigenous decolonization, even at the smallest molecular scale, we define a method back to our original selves and therefore to our planetary origin story. Our health and well-being is directly reflected at the planetary scale, and we suggest, can be rooted through the concept of molecular decolonization, which through the English language emerged from the ‘First 1000 Days Australia’ and otherwise collectively synthesized globally. It is through our evolving understanding of decolonization at a molecular level, which many of our Indigenous cultural and healing practices subtly embody, that we are better able to translate the intricacies within the current Indigenous scientific worldview through Western forms of discourse. Full article

(This article belongs to the Special Issue Planetary Health: From Challenges to Opportunities for People, Place, Purpose and Planet)

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Int. J. Environ. Res. Public Health, Volume 17, Issue 12 (June-2 2020) – 435 articles

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