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Int. J. Environ. Res. Public Health, Volume 18, Issue 12 (June-2 2021) – 502 articles

Cover Story (view full-size image): Using social media is an important strategy to communicate research findings and clinical guidelines to the scientific community and general public. There is little empirical evidence about effective strategies related to breastfeeding communication. Additionally, researchers continue to rely on traditional influence metrics, such as number of followers. However, in other fields, such as political sciences, more advanced social network theory (SNT)-based analytical tools are being leveraged to identify influencers, define target audiences, and impact behavior. The authors’ SNT-based research describes the breastfeeding communication landscape on Twitter and helps to inform stakeholders about the best social media practices. In this paper, the authors use Twitter data to share the lessons learned when influencers are identified based on real-time interactions. View this paper.
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17 pages, 3072 KiB  
Article
Nine Months of COVID-19 Pandemic in Europe: A Comparative Time Series Analysis of Cases and Fatalities in 35 Countries
by David Meintrup, Martina Nowak-Machen and Stefan Borgmann
Int. J. Environ. Res. Public Health 2021, 18(12), 6680; https://doi.org/10.3390/ijerph18126680 - 21 Jun 2021
Cited by 13 | Viewed by 2669
Abstract
(1) Background: to describe the dynamic of the pandemic across 35 European countries over a period of 9 months. (2) Methods: a three-phase time series model was fitted for 35 European countries, predicting deaths based on SARS-CoV-2 incidences. Hierarchical clustering resulted in three [...] Read more.
(1) Background: to describe the dynamic of the pandemic across 35 European countries over a period of 9 months. (2) Methods: a three-phase time series model was fitted for 35 European countries, predicting deaths based on SARS-CoV-2 incidences. Hierarchical clustering resulted in three clusters of countries. A multiple regression model was developed predicting thresholds for COVID-19 incidences, coupled to death numbers. (3) Results: The model showed strongly connected deaths and incidences during the waves in spring and fall. The corrected case-fatality rates ranged from 2% to 20.7% in the first wave, and from 0.5% to 4.2% in the second wave. If the incidences stay below a threshold, predicted by the regression model (R2=85.0%), COVID-19 related deaths and incidences were not necessarily coupled. The clusters represented different regions in Europe, and the corrected case-fatality rates in each cluster flipped from high to low or vice versa. Severely and less severely affected countries flipped between the first and second wave. (4) Conclusions: COVID-19 incidences and related deaths were uncoupled during the summer but coupled during two waves. Once a country-specific threshold of infections is reached, death numbers will start to rise, allowing health care systems and countries to prepare. Full article
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10 pages, 455 KiB  
Article
Association between Residence Location and Pre-Hospital Delay in Patients with Heart Failure
by Kyoung Suk Lee, Hyeongsuk Lee and Jae-Hyeong Park
Int. J. Environ. Res. Public Health 2021, 18(12), 6679; https://doi.org/10.3390/ijerph18126679 - 21 Jun 2021
Cited by 1 | Viewed by 1903
Abstract
Rural residents with heart failure (HF) face more challenges than their urban counterparts in taking action when their symptoms worsen due to limited healthcare resources in rural areas. This may contribute to rural residents’ pre-hospital delay in seeking medical care. However, few studies [...] Read more.
Rural residents with heart failure (HF) face more challenges than their urban counterparts in taking action when their symptoms worsen due to limited healthcare resources in rural areas. This may contribute to rural residents’ pre-hospital delay in seeking medical care. However, few studies have investigated the relationship between residence locations and pre-hospital delay among patients with HF. Therefore, this study determined whether living in rural areas is associated with pre-hospital delay in patients with HF. A retrospective electronic medical record review was conducted using the data of patients discharged with worsening HF from an academic medical center. Data on postal codes of the patients’ residences and their experiences before seeking medical care were obtained. Pre-hospital delay was calculated from the onset of HF symptoms to hospital arrival. A multivariate linear regression analysis was performed to determine the relationship between residence location and pre-hospital delay. The median pre-hospital delay time of all patients was 72 h (N = 253). About half of the patients did nothing to relieve their symptoms before seeking medical care. Living in urban areas was associated with a shorter pre-hospital delay. Patients with HF waited several days after first experiencing worsening of symptoms before getting admitted to a hospital, which may be related to inappropriate interpretation and responses to the worsening of symptoms. Furthermore, we found that rural residents were more vulnerable to pre-hospital delay than their urban counterparts. Full article
(This article belongs to the Section Health Behavior, Chronic Disease and Health Promotion)
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20 pages, 3100 KiB  
Article
Music Is Life—Follow-Up Qualitative Study on Parental Experiences of Creative Music Therapy in the Neonatal Period
by Friederike Barbara Haslbeck, Lars Schmidli, Hans Ulrich Bucher and Dirk Bassler
Int. J. Environ. Res. Public Health 2021, 18(12), 6678; https://doi.org/10.3390/ijerph18126678 - 21 Jun 2021
Cited by 8 | Viewed by 4583
Abstract
Developmental problems in extremely preterm (EP) infants and the associated longitudinal burden for their families are major health issues worldwide. Approaches to social-emotional support such as family-integrating Creative Music Therapy (CMT) are warranted. We aimed: (1) to explore parental perspectives on the use [...] Read more.
Developmental problems in extremely preterm (EP) infants and the associated longitudinal burden for their families are major health issues worldwide. Approaches to social-emotional support such as family-integrating Creative Music Therapy (CMT) are warranted. We aimed: (1) to explore parental perspectives on the use of CMT with EP infants in the neonatal hospitalization period and (2) to examine the possible longitudinal influence of CMT. A qualitative design was used to examine the perspective of six families from various backgrounds. Semi-structured interviews were carried out when the infants reached school age. We used an inductive–deductive thematic analysis to identify three main themes, each with three sub-themes: (1) the positive impact of CMT on the infants, the parents, and bonding; (2) the attitude toward CMT, from being open-minded to recommending it as complementary therapy; and (3) the experience of overall healthy infant development despite unique developmental delay issues. The findings elucidate the positive and formative impact of CMT on both infants and parents in the stressful NICU setting and beyond. CMT may empower positive transformation in the parents through individualized early nurturing musical interactions, capacity building, and positive reinforcement. Further research may help to identify and implement potentially modifiable factors for improving health care in this vulnerable group through early family-integrating, resource-based approaches such as CMT. Full article
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11 pages, 1812 KiB  
Review
The Radiologist as a Gatekeeper in Chest Pain
by Silvia Pradella, Giulia Zantonelli, Giulia Grazzini, Diletta Cozzi, Ginevra Danti, Manlio Acquafresca and Vittorio Miele
Int. J. Environ. Res. Public Health 2021, 18(12), 6677; https://doi.org/10.3390/ijerph18126677 - 21 Jun 2021
Cited by 6 | Viewed by 2469
Abstract
Chest pain is a symptom that can be found in life-threatening conditions such as acute coronary syndrome (ACS). Those patients requiring invasive coronary angiography treatment or surgery should be identified. Often the clinical setting and laboratory tests are not sufficient to rule out [...] Read more.
Chest pain is a symptom that can be found in life-threatening conditions such as acute coronary syndrome (ACS). Those patients requiring invasive coronary angiography treatment or surgery should be identified. Often the clinical setting and laboratory tests are not sufficient to rule out a coronary or aortic syndrome. Cardiac radiological imaging has evolved in recent years both in magnetic resonance (MR) and in computed tomography (CT). CT, in particular, due to its temporal and spatial resolution, the quickness of the examination, and the availability of scanners, is suitable for the evaluation of these patients. In particular, the latest-generation CT scanners allow the exclusion of diagnoses such as coronary artery disease and aortic pathology, thereby reducing the patient’s stay in hospital and safely selecting patients by distinguishing those who do not need further treatment from those who will need more- or less-invasive therapies. CT additionally reduces costs by improving long-term patient outcome. The limitations related to patient characteristics and those related to radiation exposure are weakening with the improvement of CT technology. Full article
(This article belongs to the Special Issue The Evolving Role of Diagnostic Imaging Service in Public Health)
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14 pages, 1473 KiB  
Article
Community Engagement Practices at Research Centers in U.S. Minority Institutions: Priority Populations and Innovative Approaches to Advancing Health Disparities Research
by Tabia Henry Akintobi, Payam Sheikhattari, Emma Shaffer, Christina L. Evans, Kathryn L. Braun, Angela U. Sy, Bibiana Mancera, Adriana Campa, Stephania T. Miller, Daniel Sarpong, Rhonda Holliday, Julio Jimenez-Chavez, Shafiq Khan, Cimona Hinton, Kimberly Sellars-Bates, Veronica Ajewole, Nicolette I. Teufel-Shone, Juliet McMullin, Sandra Suther, K. Sean Kimbro, Lorraine Taylor, Carmen M. Velez Vega, Carla Williams, George Perry, Stephan Zuchner, Melissa Marzan Rodriguez and Paul B. Tchounwouadd Show full author list remove Hide full author list
Int. J. Environ. Res. Public Health 2021, 18(12), 6675; https://doi.org/10.3390/ijerph18126675 - 21 Jun 2021
Cited by 6 | Viewed by 3918
Abstract
This paper details U.S. Research Centers in Minority Institutions (RCMI) Community Engagement Cores (CECs): (1) unique and cross-cutting components, focus areas, specific aims, and target populations; and (2) approaches utilized to build or sustain trust towards community participation in research. A mixed-method data [...] Read more.
This paper details U.S. Research Centers in Minority Institutions (RCMI) Community Engagement Cores (CECs): (1) unique and cross-cutting components, focus areas, specific aims, and target populations; and (2) approaches utilized to build or sustain trust towards community participation in research. A mixed-method data collection approach was employed for this cross-sectional study of current or previously funded RCMIs. A total of 18 of the 25 institutions spanning 13 U.S. states and territories participated. CEC specific aims were to support community engaged research (94%); to translate and disseminate research findings (88%); to develop partnerships (82%); and to build capacity around community research (71%). Four open-ended questions, qualitative analysis, and comparison of the categories led to the emergence of two supporting themes: (1) establishing trust between the community-academic collaborators and within the community and (2) building collaborative relationships. An overarching theme, building community together through trust and meaningful collaborations, emerged from the supporting themes and subthemes. The RCMI institutions and their CECs serve as models to circumvent the historical and current challenges to research in communities disproportionately affected by health disparities. Lessons learned from these cores may help other institutions who want to build community trust in and capacities for research that addresses community-related health concerns. Full article
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9 pages, 327 KiB  
Article
Analysis of Digital Literacy in Health through Active University Teaching
by Alejandro De la Hoz, Javier Cubero, Lina Melo, Miguel A. Durán-Vinagre and Susana Sánchez
Int. J. Environ. Res. Public Health 2021, 18(12), 6674; https://doi.org/10.3390/ijerph18126674 - 21 Jun 2021
Cited by 8 | Viewed by 3466
Abstract
As we have seen as a consequence of the COVID-19 global pandemic, our scientific-technological society requires a transformation of knowledge in a global, digital and virtual manner. In light of this, and to improve the public health skills of professionals working to promote [...] Read more.
As we have seen as a consequence of the COVID-19 global pandemic, our scientific-technological society requires a transformation of knowledge in a global, digital and virtual manner. In light of this, and to improve the public health skills of professionals working to promote health education, one of the current priorities is to train pre-service teachers on how to search for health-related scientific knowledge relating to bio-health through digital literacy in health. The objectives of this study were to determine the level of eHealth literacy, scientific knowledge in health and confidence on the part of students, analyzing the degree of improvement following a teaching intervention with students of the Bachelor’s Degree of Education of the University of Extremadura. A quasi-experimental longitudinal study was carried out with pre-test and post-test groups and a mixed data analysis. It involved the application of an active cooperative methodology with tutoring using the jigsaw technique, with the use of four quality digital browsers to enhance scientific rigor. The results show that the initial level of eHealth literacy and confidence was problematic. Following the intervention with the cooperative methodology, both these levels and the level of scientific knowledge in health reached an excellent level. In conclusion, this suggests that university training programs need to be implemented to improve digital and scientific skills in health education as they are currently insufficient. It has been demonstrated that a cooperative active methodology improved these levels and accordingly its use in active and digital higher education should be promoted. Full article
15 pages, 1292 KiB  
Article
Adolescents’ Perceptions of Their Problematic Use of ICT: Relationship with Study Time and Academic Performance
by Adoración Díaz-López, Ana Belén Mirete-Ruiz and Javier Maquilón-Sánchez
Int. J. Environ. Res. Public Health 2021, 18(12), 6673; https://doi.org/10.3390/ijerph18126673 - 21 Jun 2021
Cited by 4 | Viewed by 3288
Abstract
Today, the use of Information and Communication Technologies (ICT) is part of the daily lives of adolescents. However, its widespread use in all areas, the vulnerable condition of adolescents and the imminent consequences of problematic use are awakening a growing social and educational [...] Read more.
Today, the use of Information and Communication Technologies (ICT) is part of the daily lives of adolescents. However, its widespread use in all areas, the vulnerable condition of adolescents and the imminent consequences of problematic use are awakening a growing social and educational concern. With the purpose of looking into this problem, the following research aims are formulated: (1) Analyse the perception of adolescents about their academic performance and the interference of ICT in their development; (2) Describe the frequency of use of ICT and its influence on study time and grades; and (3) Analyse the relationship between family supervision of ICT and academic performance. The representative sample consisted of 1101 adolescents from 10 educational centers in the Southeast of Spain. Descriptive statistics, contingency tables, Chi Square, Cramer’s V and Linear Regression were calculated. The results show that more than 50% of the students believe that they would spend more time studying if they did not have continuous access to technologies. Likewise, 20% of the students identify ICT as responsible for the decline in their academic performance. Statistically significant relationships were found between time limitations for Internet access and academic performance. It is therefore concluded that the problematic use of ICT in adolescence is a phenomenon that demands intervention, and the training of parents and adolescents in the responsible use of ICT is urged. Full article
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18 pages, 536 KiB  
Article
The Effect of Work Safety on Organizational Social Sustainability Improvement in the Healthcare Sector: The Case of a Public Sector Hospital in Pakistan
by Zia Ullah, Mohammed Ali Bait Ali Sulaiman, Syed Babar Ali, Naveed Ahmad, Miklas Scholz and Heesup Han
Int. J. Environ. Res. Public Health 2021, 18(12), 6672; https://doi.org/10.3390/ijerph18126672 - 21 Jun 2021
Cited by 20 | Viewed by 3157
Abstract
Social sustainability is the much emphasized organizational phenomenon in Western literature; however, in emerging economies, its importance has only been realized in the recent past. Social sustainability is the amiability of the relationship between employees and the organizations on a relatively permanent basis. [...] Read more.
Social sustainability is the much emphasized organizational phenomenon in Western literature; however, in emerging economies, its importance has only been realized in the recent past. Social sustainability is the amiability of the relationship between employees and the organizations on a relatively permanent basis. Social sustainability is the key determinant of organizational sustainability and organizational effectiveness. As healthcare organizations are labor-intensive, the role of social sustainability in hospitals is more crucial. The purpose of the present study is to understand the role of work safety in improving social sustainability in public sector hospitals. To this effect, we collected data from 431 healthcare professionals of a large public sector tertiary and teaching hospital in the city of Lahore Pakistan and analyzed the data using structural equation modeling (SEM). The results uncovered certain important facts, which were not expected per se. Job design, coworkers’ behavior towards work safety, and supervisors’ role in ensuring work safety are the key factors that influence social sustainability. However, surprisingly, in the eyes of employees, management practices and safety programs/policies do not contribute to the work safety of the hospital under study. Keeping in view the findings, we suggest that management must participate in work safety affairs directly and formulate indigenous policies and programs according to local needs. Job analysis is needed to redesign job structures to meet workplace safety requirements. Formal and informal training will be beneficial to make workers and supervisors more aware, more sensitive, and more responsible regarding work safety. Full article
(This article belongs to the Special Issue Health Environment and Sustainable Development)
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14 pages, 1217 KiB  
Article
Seafarers’ Perception and Attitudes towards Noise Emission on Board Ships
by Luka Vukić, Vice Mihanović, Luca Fredianelli and Veljko Plazibat
Int. J. Environ. Res. Public Health 2021, 18(12), 6671; https://doi.org/10.3390/ijerph18126671 - 21 Jun 2021
Cited by 46 | Viewed by 3394
Abstract
Noise has long been neglected as an environmental pollutant and impairment health factor in maritime transport. Recently, acoustic pollution indicates the highest growth in transport external cost unit values. In 2020, questionnaires were submitted to seafarers to examine their noise exposure and perception [...] Read more.
Noise has long been neglected as an environmental pollutant and impairment health factor in maritime transport. Recently, acoustic pollution indicates the highest growth in transport external cost unit values. In 2020, questionnaires were submitted to seafarers to examine their noise exposure and perception on board and attitudes towards noise abatement measures. Responses of 189 participants were processed using descriptive statistics and Likert scale valuation, while their consistency was tested with indirect indicators using linear regression and correlation test. Results show that more than 40% of respondents do not consider noise as a significant environmental problem. The negative perception among respondents with ≥10 years of work experience was much lower (23.53%). Most are aware of the onboard noise harmful effects that can influence their health. Despite that, they use personal protection equipment only sometimes. A higher positive perception was recorded in groups of respondents with a university degree (90%), work experience longer than ten years (82.35%), and monthly income higher than 4000 € (70%). Respondents are not strongly motivated to participate in funding noise mitigation measures, and such a viewpoint is not related to their monthly incomes. The low awareness and motivation regarding acoustic pollution generally shown by the surveyed seafarers should be watched as a threat by the company managers. Better education and awareness are likely to be crucial to change the current state of affairs. Full article
(This article belongs to the Special Issue New Indicators for the Assessment and Prevention of Noise Nuisance)
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15 pages, 951 KiB  
Article
Women’s Usage Behavior and Perceived Usefulness with Using a Mobile Health Application for Gestational Diabetes Mellitus: Mixed-Methods Study
by Shilpa Surendran, Chang Siang Lim, Gerald Choon Huat Koh, Tong Wei Yew, E Shyong Tai and Pin Sym Foong
Int. J. Environ. Res. Public Health 2021, 18(12), 6670; https://doi.org/10.3390/ijerph18126670 - 21 Jun 2021
Cited by 10 | Viewed by 3645
Abstract
The prevalence of gestational diabetes mellitus (GDM) is increasing, and only a few mobile health (mHealth) applications are specifically designed to manage GDM. In this mixed-methods study, a follow-up study of a randomized controlled trial (RCT) analyzed a largely automated mHealth application-based lifestyle [...] Read more.
The prevalence of gestational diabetes mellitus (GDM) is increasing, and only a few mobile health (mHealth) applications are specifically designed to manage GDM. In this mixed-methods study, a follow-up study of a randomized controlled trial (RCT) analyzed a largely automated mHealth application-based lifestyle coaching program to (a) measure the application’s usage behavior and (b) explore users’ perceptions of its usefulness in GDM management. Quantitative data were collected from the 170 application users who had participated in the intervention arm of the RCT. Semi-structured interviews (n = 14) captured users’ experiences when using the application. Data were collected from June 2019 to January 2020. Quantitative data were analyzed descriptively, and interviews were analyzed thematically. Only 57/170 users (34%) logged at least one meal, and only 35 meals on average were logged for eight weeks because of the incorrectly worded food items and limited food database. On the contrary, an average of 1.85 (SD = 1.60) weight values were logged per week since the weight tracking component was easy to use. Many users (6/14 (43%)) mentioned that the automatic coach messages created an immediate sense of self-awareness in food choices and motivated behavior. The findings suggest that for GDM management, a largely automated mHealth application has the potential to promote self-awareness of healthy lifestyle choices, reducing the need for intensive human resources. Additionally, several gaps in the application’s design were identified which need to be addressed in future works. Full article
(This article belongs to the Special Issue Digital Health Tools: A Critical Assessment of Long-Term Engagement)
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18 pages, 1365 KiB  
Article
Costs for Statutorily Insured Dental Services in Older Germans 2012–2017
by Aleksander Krasowski, Joachim Krois, Sebastian Paris, Adelheid Kuhlmey, Hendrik Meyer-Lueckel and Falk Schwendicke
Int. J. Environ. Res. Public Health 2021, 18(12), 6669; https://doi.org/10.3390/ijerph18126669 - 21 Jun 2021
Cited by 3 | Viewed by 1664
Abstract
Objectives: We assessed the costs of dental services in statutorily insured, very old (geriatric) Germans. Methods: A comprehensive sample of very old (≥75 years) people insured at a large Northeastern statutory insurer was followed over 6 years (2012–2017). We assessed dental services costs [...] Read more.
Objectives: We assessed the costs of dental services in statutorily insured, very old (geriatric) Germans. Methods: A comprehensive sample of very old (≥75 years) people insured at a large Northeastern statutory insurer was followed over 6 years (2012–2017). We assessed dental services costs for: (1) examination, assessments and advice, (2) operative, (3) surgical, (4) prosthetic, (5) periodontal, (6) preventive and (7) outreach services. Association of utilization with: (1) sex, (2) age, (3) region, (4) social hardship status, (5) International Disease Classification (ICD-10) diagnoses and (6) Diagnoses Related Groups (DRGs) was explored. Results: 404,610 individuals with a mean (standard deviation, SD) age 81.9 (5.4 years) were followed, 173,733 did not survive follow-up. Total mean costs were 129.61 (310.97) euro per capita; the highest costs were for prosthetic (54.40, SD 242.89 euro) and operative services (28.40, SD 68.38 euro), examination/advice (21.15, SD 28.77 euro), prevention (13.31, SD 49.79 euro), surgery (5.91, SD 23.91 euro), outreach (4.81, SD 28.56 euro) and periodontal services (1.64, SD 7.39 euro). The introduction of new fee items for outreach and preventive services between 2012 and 2017 was reflected in costs. Total costs decreased with increasing age, and this was also found for all service blocks except outreach and preventive services. Costs were higher in those with social hardship status, and in Berlin than Brandenburg and Mecklenburg-Western Pomerania. Certain general health conditions were associated with increased or decreased costs. Conclusions: Costs were associated with sex, social hardship status, place of living and general health conditions. Clinical significance: Dental services costs for the elderly in Germany are unequally distributed and, up to a certain age or health status, generated by invasive interventions mainly. Policy makers should incentivize preventive services earlier on and aim to distribute expenses more equally. Full article
(This article belongs to the Section Oral Health)
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17 pages, 356 KiB  
Article
To Volunteer or Not? Perspectives towards Pre-Registered Nursing Students Volunteering Frontline during COVID-19 Pandemic to Ease Healthcare Workforce: A Qualitative Study
by Betsy Seah, Ben Ho, Sok Ying Liaw, Emily Neo Kim Ang and Siew Tiang Lau
Int. J. Environ. Res. Public Health 2021, 18(12), 6668; https://doi.org/10.3390/ijerph18126668 - 21 Jun 2021
Cited by 22 | Viewed by 5104
Abstract
COVID-19 has caused a shortage of healthcare workers and has strained healthcare systems globally. Pre-registered healthcare students with training have a duty of care and can support the healthcare workforce. This study explored factors influencing the willingness of final-year nursing students to volunteer [...] Read more.
COVID-19 has caused a shortage of healthcare workers and has strained healthcare systems globally. Pre-registered healthcare students with training have a duty of care and can support the healthcare workforce. This study explored factors influencing the willingness of final-year nursing students to volunteer during the COVID-19 pandemic, the role of professional identity in volunteering as healthcare workers, and strategies to improve future volunteering uptakes and processes. A qualitative study using focus-group discussions was conducted. Final-year nursing students who volunteered, students who did not volunteer, and lecturers who supervised student volunteers were recruited. Interviews were conducted online, video-recorded, and transcribed verbatim. A thematic analysis was used. The themes were “wavering thoughts on volunteering”, “bringing out ‘the nurse’ in students through volunteering” and “gearing up to volunteer”. Findings suggested the need to look beyond the simplicity of altruism to the role of professional identity, operational, and motivational factors to explain nursing students’ decision to volunteer and their volunteer behavior. Providing accommodation, monetary and academic-related incentives, supporting the transitionary phase from students to “professional volunteers”, promoting cohesive and positive staff–student volunteer relationships, and establishing a volunteer management team are strategies identified to improve volunteering uptake and operational processes. Our findings advocate strategic partnerships between hospitals/communities and academic institutions in providing various healthcare services during pandemics. Full article
(This article belongs to the Special Issue Nursing and COVID-19 )
10 pages, 514 KiB  
Brief Report
Profile Pictures in the Digital World: Self-Photographs Predict Better Life Satisfaction
by Kalai Hung, Naomi A. Lee, Kaiping Peng and Jie Sui
Int. J. Environ. Res. Public Health 2021, 18(12), 6667; https://doi.org/10.3390/ijerph18126667 - 21 Jun 2021
Cited by 2 | Viewed by 2751
Abstract
Profiles pictures as online identities represent an extension of the user’s self in the digital world. Changes in self-representation are responsible for reduced well-being in individuals in the offline world. However, whether profile picture selection predicts the well-being of internet users is unknown. [...] Read more.
Profiles pictures as online identities represent an extension of the user’s self in the digital world. Changes in self-representation are responsible for reduced well-being in individuals in the offline world. However, whether profile picture selection predicts the well-being of internet users is unknown. To address this question, we tested the relationship between the type of profile picture (e.g., self-photographs or other pictures) used on social media and the life satisfaction of internet users, accounting for gender and personality traits that have been thought to relate to the selection of profile pictures. The results showed that individuals using self-photographs as profiles reported a higher level of life satisfaction compared to individuals using other pictures as profiles. This effect was influenced by gender, openness, and extraversion. Hierarchical regression and moderation analyses revealed that openness and profile type interacted to predict life satisfaction in women, while openness and profile picture independently predicted life satisfaction in men. Furthermore, extraversion directly predicted life satisfaction in both men and women. These results indicate that the consistency between one’s online and offline self-representation may characterize internet users’ well-being, with potential implications for digital wellness. Full article
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12 pages, 600 KiB  
Article
Relationship between Oral Hypofunction and Sarcopenia in Community-Dwelling Older Adults: The Otassha Study
by Yoshihiro Kugimiya, Masanori Iwasaki, Yuki Ohara, Keiko Motokawa, Ayako Edahiro, Maki Shirobe, Yutaka Watanabe, Shuichi Obuchi, Hisashi Kawai, Yoshinori Fujiwara, Kazushige Ihara, Hunkyung Kim, Takayuki Ueda and Hirohiko Hirano
Int. J. Environ. Res. Public Health 2021, 18(12), 6666; https://doi.org/10.3390/ijerph18126666 - 21 Jun 2021
Cited by 28 | Viewed by 3433
Abstract
Oral hypofunction, resulting from a combined decrease in multiple oral functions, may affect systemic-condition deterioration; however, few studies have examined the association between oral hypofunction and general health among older adults. In this cross-sectional study, we examined the relationship between oral hypofunction and [...] Read more.
Oral hypofunction, resulting from a combined decrease in multiple oral functions, may affect systemic-condition deterioration; however, few studies have examined the association between oral hypofunction and general health among older adults. In this cross-sectional study, we examined the relationship between oral hypofunction and sarcopenia in community-dwelling older adults. We included 878 adults (268 men and 610 women, mean age 76.5 ± 8.3 years). Tongue coating index, oral moisture, occlusal force, oral diadochokinesis (/pa/,/ta/,/ka/), tongue pressure, mas-ticatory function, and swallowing function were evaluated as indicators of oral hypofunction. Grip strength, gait speed, and skeletal muscle mass index were measured as diagnostic sarcopenia parameters. The association between oral hypofunction and sarcopenia was examined via logistic regression using sarcopenia as the dependent variable. Oral hypofunction prevalence was 50.5% overall, 40.3% in men, and 54.9% in women. The prevalence of sarcopenia was 18.6% overall, 9.7% in men, and 22.5% in women. A logistic regression showed oral hypofunction, age, body mass index, higher-level functional capacity, and serum albumin level were significantly associated with sarcopenia. Sarcopenia occurred at an increased frequency in patients diagnosed with oral hypofunction (odds ratio: 1.59, 95% confidence interval: 1.02–2.47); accordingly, oral hypofunction appears to be significantly associated with sarcopenia. Full article
(This article belongs to the Special Issue Oral Health and Connections to Mental and Physical Health)
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20 pages, 3568 KiB  
Review
The Effect of Ambient Environmental Conditions on COVID-19 Mortality: A Systematic Review
by Karla Romero Starke, René Mauer, Ethel Karskens, Anna Pretzsch, David Reissig, Albert Nienhaus, Anna Lene Seidler and Andreas Seidler
Int. J. Environ. Res. Public Health 2021, 18(12), 6665; https://doi.org/10.3390/ijerph18126665 - 21 Jun 2021
Cited by 17 | Viewed by 2728
Abstract
Weather conditions may have an impact on SARS-CoV-2 virus transmission, as has been shown for seasonal influenza. Virus transmission most likely favors low temperature and low humidity conditions. This systematic review aimed to collect evidence on the impact of temperature and humidity on [...] Read more.
Weather conditions may have an impact on SARS-CoV-2 virus transmission, as has been shown for seasonal influenza. Virus transmission most likely favors low temperature and low humidity conditions. This systematic review aimed to collect evidence on the impact of temperature and humidity on COVID-19 mortality. This review was registered with PROSPERO (registration no. CRD42020196055). We searched the Pubmed, Embase, and Cochrane COVID-19 databases for observational epidemiological studies. Two independent reviewers screened the title/abstracts and full texts of the studies. Two reviewers also performed data extraction and quality assessment. From 5051 identified studies, 11 were included in the review. Although the results were inconsistent, most studies imply that a decrease in temperature and humidity contributes to an increase in mortality. To establish the association with greater certainty, future studies should consider accurate exposure measurements and important covariates, such as government lockdowns and population density, sufficient lag times, and non-linear associations. Full article
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20 pages, 6457 KiB  
Article
Characterization and Analysis of the Carbonation Process of a Lime Mortar Obtained from Phosphogypsum Waste
by María Isabel Romero-Hermida, Antonio María Borrero-López, Vicente Flores-Alés, Francisco Javier Alejandre, José María Franco, Alberto Santos and Luis Esquivias
Int. J. Environ. Res. Public Health 2021, 18(12), 6664; https://doi.org/10.3390/ijerph18126664 - 21 Jun 2021
Cited by 7 | Viewed by 2356
Abstract
This work addresses the reuse of waste products as a raw material for lime putties, which are one of the components of mortar. 1:3 Lime/sand mortars very similar to conventional construction mortars were prepared using a lime putty obtained from the treatment of [...] Read more.
This work addresses the reuse of waste products as a raw material for lime putties, which are one of the components of mortar. 1:3 Lime/sand mortars very similar to conventional construction mortars were prepared using a lime putty obtained from the treatment of phosphogypsum with sodium hydroxide. The physical, rheological and mechanical properties of this phosphogypsum-derived mortar have been studied, as well as the mineralogical composition, microstructure by scanning electron microscope (SEM) and curing process by monitoring carbonation and ultrasonic propagation velocity. Considering the negative influence of sulphates on the hardened material, the behaviour of the material after sulphates precipitation by adding barium sulphate was additionally tested. Carbonation progressed from the outside to the inside of the specimen through the porous system by Liesegang rings patterns for mortars with soluble sulphates, while the carbonation with precipitated sulphates was controlled by diffusion-precipitation. Overall, the negative influence of low-sulphate contents on the mechanical properties of mortars was verified. It must be highlighted the importance of their precipitation to obtain adequate performance. Full article
(This article belongs to the Special Issue Environmental Waste Recycling)
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10 pages, 341 KiB  
Article
Oral Health Related Quality of Life and Prosthetic Status among Institutionalized Elderly from the Bucharest Area: A Pilot Study
by Laura Iosif, Cristina Teodora Preoteasa, Elena Preoteasa, Ana Ispas, Radu Ilinca, Cǎtǎlina Murariu-Mǎgureanu and Oana Elena Amza
Int. J. Environ. Res. Public Health 2021, 18(12), 6663; https://doi.org/10.3390/ijerph18126663 - 21 Jun 2021
Cited by 8 | Viewed by 2531
Abstract
The aim of the study was to assess the oral health related quality of life (OHRQoL) of elderly in care homes, one of Romania’s most vulnerable social categories, to correlate it to sociodemographic, oral health parameters, and prosthodontic status. Therefore, a cross-sectional study [...] Read more.
The aim of the study was to assess the oral health related quality of life (OHRQoL) of elderly in care homes, one of Romania’s most vulnerable social categories, to correlate it to sociodemographic, oral health parameters, and prosthodontic status. Therefore, a cross-sectional study was performed on 58 geriatrics divided into 3 age groups, who were clinically examined and answered the oral health impact profile (OHIP-14) questionnaire. Very high rates of complete edentulism in the oldest-old subgroup (bimaxillary in 64.3%; mandibular in 64.3%; maxillary in 85.7%), and alarming frequencies in the other subgroups (middle-old and youngest-old), statistically significant differences between age groups being determined. The OHIP-14 mean score was 14.5. Although not statistically significant, females had higher OHIP-14 scores, also middle-old with single maxillary arch, single mandibular arch, and bimaxillary complete edentulism, whether they wore dentures or not, but especially those without dental prosthetic treatment in the maxilla. A worse OHRQoL was also observed in wearers of bimaxillary complete dentures, in correlation with periodontal disease-related edentulism, in those with tertiary education degree, and those who came from rural areas. There were no statistically significant correlations of OHRQoL with age, total number of edentulous spaces or edentulous spaces with no prosthetic treatment. In conclusion, despite poor oral health and prosthetic status of the institutionalized elderly around Bucharest, the impact on their wellbeing is comparatively moderate. Full article
(This article belongs to the Special Issue Dental Care for Elderly and Special Groups)
9 pages, 347 KiB  
Article
Exploring Sexting and Online Sexual Victimization during the COVID-19 Pandemic Lockdown
by Aina M. Gassó, Katrin Mueller-Johnson, José R. Agustina and Esperanza L. Gómez-Durán
Int. J. Environ. Res. Public Health 2021, 18(12), 6662; https://doi.org/10.3390/ijerph18126662 - 21 Jun 2021
Cited by 10 | Viewed by 3713
Abstract
The COVID-19 pandemic lockdown has impacted daily routines, forcing people to stop socializing in person and changing the way people express their feelings and their romantic or sexual interactions. Social distancing has changed the way people behave online, and we expect that engagement [...] Read more.
The COVID-19 pandemic lockdown has impacted daily routines, forcing people to stop socializing in person and changing the way people express their feelings and their romantic or sexual interactions. Social distancing has changed the way people behave online, and we expect that engagement in sexting and online sexual victimization behaviors have increased during lockdown. The aim of this paper is to study the prevalence of sexting and online sexual victimization behaviors during the COVID-19 lockdown in Spanish adults in order to explore how social distancing has affected these behaviors. The sample comprised 293 Spanish adults (mean age = 30.3; 66.2% female) who took part in an online survey about their engagement in sexting behaviors and online sexual victimization experiences. Overall results were apparently not supportive of our main hypothesis, showing that both sexting engagement and online sexual victimization decreased during lockdown despite the increase in internet use. Apart from differences in time period of reference, some alternative hypotheses relate to the increased presence of capable guardians according to the routine activities theory and to forced distance as a demotivation to sext. Possible explanations and hypotheses for these results are discussed further in the paper. Full article
(This article belongs to the Special Issue Intersections of Public Health, Sexuality, and Communication)
16 pages, 1473 KiB  
Article
Constructing Well-Being in Organizations: First Empirical Results on Job Crafting, Personality Traits, and Insight
by Alessio Gori, Alessandro Arcioni, Eleonora Topino, Letizia Palazzeschi and Annamaria Di Fabio
Int. J. Environ. Res. Public Health 2021, 18(12), 6661; https://doi.org/10.3390/ijerph18126661 - 21 Jun 2021
Cited by 16 | Viewed by 3349
Abstract
The construct of job crafting is gaining increasing attention in the research and practice of work psychology in light of the positive effects it has on workers and the organizational context. On this basis, the present study aimed to explore the associations between [...] Read more.
The construct of job crafting is gaining increasing attention in the research and practice of work psychology in light of the positive effects it has on workers and the organizational context. On this basis, the present study aimed to explore the associations between the Big Five personality traits and job crafting (and its subdimensions, individual job crafting and collaborative job crafting), as well as investigating the role of insight in mediating these relationships. A sample of 159 Italian workers took part in the study and completed the self-report measures. Results showed a positive association between extraversion, agreeableness and conscientiousness and job crafting (total), individual job crafting, and collaborative job crafting, with significant mediations of insight orientation. Openness was positively associated with job crafting (total) and individual job crafting, but not with the collaborative subdimension, with insight orientation that mediated existing relationships. Emotional stability and job crafting (total) or its subdimensions were found to have no significant relationships. These findings suggest that insight orientation could represent a promising resource for job crafting, both in terms of primary prevention, strength-based prevention, and healthy organizations. Full article
(This article belongs to the Special Issue Social, Group, and Identity Determinants of Well-Being and Health)
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4 pages, 247 KiB  
Editorial
Special Issue on “Qualitative Inquiry in Mental Health Research with Young People”
by Katherine M. Boydell and Michael Hodgins
Int. J. Environ. Res. Public Health 2021, 18(12), 6660; https://doi.org/10.3390/ijerph18126660 - 21 Jun 2021
Viewed by 2287
Abstract
This editorial to the Special Issue on Qualitative Inquiry in Mental Health Research with Young People provides an overview of the importance of qualitative inquiry to the field of child and youth mental health. The issue highlights research using qualitative methods to depict [...] Read more.
This editorial to the Special Issue on Qualitative Inquiry in Mental Health Research with Young People provides an overview of the importance of qualitative inquiry to the field of child and youth mental health. The issue highlights research using qualitative methods to depict the lived experiences and contribution of young people in areas that reflect important mental health concerns, ranging from anxiety, non-suicidal self-injury, positive resilience in young people in times of crisis, and drug and alcohol treatment. Full article
(This article belongs to the Special Issue Qualitative Inquiry in Mental Health Research with Young People)
17 pages, 1239 KiB  
Article
Lessons Learned during a Naturalistic Study of Online Treatment for Pediatric Rehabilitation
by Naomi Gefen, Shoshana Steinhart, Maurit Beeri and Patrice L. Weiss
Int. J. Environ. Res. Public Health 2021, 18(12), 6659; https://doi.org/10.3390/ijerph18126659 - 21 Jun 2021
Cited by 11 | Viewed by 3345
Abstract
The COVID-19 pandemic forced many health care providers to modify their service model by adopting telehealth and tele-rehabilitation with minimal time to plan for its execution. ALYN—Pediatric Rehabilitation Hospital in Jerusalem, Israel, responded with alacrity by providing a broad range of rehabilitation services [...] Read more.
The COVID-19 pandemic forced many health care providers to modify their service model by adopting telehealth and tele-rehabilitation with minimal time to plan for its execution. ALYN—Pediatric Rehabilitation Hospital in Jerusalem, Israel, responded with alacrity by providing a broad range of rehabilitation services to young people via online therapy during the first 5 months of the pandemic. The objectives of this naturalistic study were: (1) to monitor usage and user experience of online rehabilitation provided to young people receiving out-patient sessions of physical therapy, occupational therapy, speech and language therapy and psychology and (2) to consider the advantages and disadvantages of retaining this model of online treatment in full or in part post-COVID-19. The online rehabilitation treatment program was provided to 147 young people, aged 3 months to 20 years (mean 8.5 y; SD 5.3), and monitored and evaluated via data from the medical records as well as interviews, questionnaires and focus groups. The results use descriptive and inferential statistics to analyze data on the types and frequencies of therapy provided to 147 young people. Over a five month-period, 2392 therapy sessions were provided, 61 therapists from four disciplines were involved and 56.4% of the young people received two or more types of therapies via online rehabilitation. A repeated measures ANOVA showed significant differences over time per therapy. Feedback and recommendations about the process from therapists, parents and young people were collected during two focus groups of the professional staff (n = 12), parents and young people (parents n = 5, young people n = 3). Tele-rehabilitation services were perceived to be beneficial and effective by the great majority of young people, their parents and the healthcare professionals. The results are discussed within the context of conventional therapy as well as in comparison to reports of other online services for similar populations. We conclude that a hybrid approach in which in-person therapy sessions are coordinated with synchronous, online sessions, will provide a best-case fit for young people with chronic disabilities. Full article
(This article belongs to the Special Issue Evaluating Telerehabilitation for Patients across the Lifespan)
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15 pages, 4437 KiB  
Article
Green Investment Changes in China: A Shift-Share Analysis
by Ruxu Sheng, Rong Zhou, Ying Zhang and Zidi Wang
Int. J. Environ. Res. Public Health 2021, 18(12), 6658; https://doi.org/10.3390/ijerph18126658 - 21 Jun 2021
Cited by 6 | Viewed by 2317
Abstract
As China’s economic development has entered a new phase, China needs to seek a new path of green transformation development to coordinate the economic growth with environmental mitigation. From 2002 to 2017, green investment in China grew from 118.56 billion Chinese yuan to [...] Read more.
As China’s economic development has entered a new phase, China needs to seek a new path of green transformation development to coordinate the economic growth with environmental mitigation. From 2002 to 2017, green investment in China grew from 118.56 billion Chinese yuan to 950.86 billion Chinese yuan, increasing more than seven times. In this study, a homothetic shift-share analysis (HSSA) is used to understand how green investment changed and was used to decompose the change of provincial green investment in China from 2002 to 2017 into four driving factors: the national economic growth effect (NEG), national green investment structure effect (NIS), homothetic regional green investment competition effect (HRIC), and regional green investment allocation effect (RIA). The results indicate that these four factors had various regional and temporal characteristics, although green investment increased in all provinces during this period. More specifically, the NEG was more significant in the east than in other regions. The regional differences of NEG were relatively large in the first two periods (2002–2007 and 2007–2012) and began to shrink in the third period (2012–2017). The NIS shared the same characteristics as the NEG. In terms of HRIC, the central region was ahead of the eastern and western regions, and relatively many eastern provinces were with negative HRIC. The HRIC of most provinces showed a trend of “low/medium-medium/high-low”. The RIA inhibited green investment growth in most provinces and showed a “high-low-high” trend regarding the change from 2002 to 2017. Our study suggests that it is necessary to coordinate the growth of green investment across different regions and establish an ecological compensation mechanism. Full article
(This article belongs to the Section Environmental Science and Engineering)
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15 pages, 384 KiB  
Article
Slut Shaming in Adolescence: A Violence against Girls and Its Impact on Their Health
by Margot Goblet and Fabienne Glowacz
Int. J. Environ. Res. Public Health 2021, 18(12), 6657; https://doi.org/10.3390/ijerph18126657 - 21 Jun 2021
Cited by 11 | Viewed by 10784
Abstract
Slut shaming is defined as the stigmatization of an individual based on his or her appearance, sexual availability, and actual or perceived sexual behavior. It can take place in physical or virtual spaces. The present study questions the impact of this form of [...] Read more.
Slut shaming is defined as the stigmatization of an individual based on his or her appearance, sexual availability, and actual or perceived sexual behavior. It can take place in physical or virtual spaces. The present study questions the impact of this form of sexism in virtual spaces on girls and interrogates the interaction between the values that girls integrate through their life experiences, especially in the family sphere, and slut shaming victimization. We conducted a paper-pencil questionnaire with 605 girls between the ages of 10 and 18 (average age: 15.18 years). Our data confirm the impact of slut shaming on the physical and psychological well-being of young girls as early as adolescence. Second, mediation analyses provide insights into the revictimization and Poly-victimization processes, from childhood adverse experiences to sexist victimization in virtual spaces and their combined impact on the physical and psychic health of girls. Finally, we address prevention strategies and the involvement of socializing institutions in the deconstruction of gender stereotypes. Full article
12 pages, 495 KiB  
Article
An Early Collaborative Intervention Focusing on Parent-Infant Interaction in the Neonatal Period. A Descriptive Study of the Developmental Framework
by Charlotte Sahlén Helmer, Ulrika Birberg Thornberg and Evalotte Mörelius
Int. J. Environ. Res. Public Health 2021, 18(12), 6656; https://doi.org/10.3390/ijerph18126656 - 21 Jun 2021
Cited by 5 | Viewed by 4147
Abstract
Moderate to late preterm infants are at risk of developing problems later in life. To support attachment and infants’ development, high quality parent-infant interaction is important. Parent-infant interaction is known to improve through intervention programs but since no such intervention program is addressed [...] Read more.
Moderate to late preterm infants are at risk of developing problems later in life. To support attachment and infants’ development, high quality parent-infant interaction is important. Parent-infant interaction is known to improve through intervention programs but since no such intervention program is addressed directly to moderate to late preterm infants, a tailor-made intervention was developed. The aim was to describe the rationale, development, framework and practical provision of a new early collaborative intervention program. This study has a descriptive design and the intervention is described using the Template for Intervention Description and Replication. During an intervention-session, the preterm infant’s cues are made visible to the parents as they perform an everyday care-taking procedure. Instant feedback is delivered to give the parents the opportunity to notice, interpret and respond to cues immediately. The infant’s response to the parent’s action is discussed in a dialogue to instantly guide parents´ awareness of the preterm infant’s subtle cues. This study describes a new early collaborative intervention, developed to support interaction between parents and their moderate to late preterm infants starting in the neonatal intensive care unit. Clinical studies evaluating parental experiences as well as the effects of the early intervention are ongoing, ClinicalTrials.gov NCT02034617. Full article
(This article belongs to the Special Issue Interventions to Improve Parent-Child Attachment)
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10 pages, 735 KiB  
Article
Association between Health-Related Physical Fitness and Respiratory Diseases in Adolescents: An Age- and Gender-Matched Study
by Jeong-Hui Park, Myong-Won Seo, Hyun Chul Jung, Jong-Kook Song and Jung-Min Lee
Int. J. Environ. Res. Public Health 2021, 18(12), 6655; https://doi.org/10.3390/ijerph18126655 - 21 Jun 2021
Cited by 3 | Viewed by 2041
Abstract
The current study examined the differences in health-related physical fitness (HRPF), physical activity (PA), and sedentary behavior (SB) between adolescents with and without ongoing respiratory diseases (RD). This study’s participants were from 12 to 15 years old (7th–10th grade) in South Korea. Adolescents [...] Read more.
The current study examined the differences in health-related physical fitness (HRPF), physical activity (PA), and sedentary behavior (SB) between adolescents with and without ongoing respiratory diseases (RD). This study’s participants were from 12 to 15 years old (7th–10th grade) in South Korea. Adolescents with RD were selected through RD-related questions (i.e., asthma, rhinitis, sinusitis, and bronchitis) (n = 139); in contrast, adolescents without RD, randomly selected from the general group, responded to any health problem-related questions as “No” (n = 139). HRPF was measured based on the FITNESSGRAM and EURO FIT test batteries and the measurements of HRPF included cardiovascular endurance, muscular strength, muscular endurance, flexibility, and body composition. All statistical analyses were conducted by SPSS 25.0, and the independent t-test was used to compare the HRPF and PA between the two groups. Moreover, the measured HRPF was compared with a series of analyses of three-way ANOVAs (age × gender × group). Adolescents with RD had a positive association with less participation in PA (p < 0.05; RD: 3081.81 ± 4793.37; general: 2073.64 ± 3123.47) and with more time spent on SB (above 12 h per week: RD group (38.85%) and general group (33.09%)). Furthermore, adolescents in the RD group showed significant effects on all components of HRPF (p < 0.05). Our study confirmed that HRPF is an essential predictor of adolescents’ health outcomes, especially for those with RD. We suggest that increased HRPF can be an effective treatment for respiratory diseases in adolescents, and health practitioners should pay more attention to helping adolescents with RD to gain or maintain high HRPF. Full article
(This article belongs to the Special Issue Physical Activity and Health Behaviors in Children and Adolescents)
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12 pages, 2018 KiB  
Article
Clinical and Therapeutic Characteristics of Cancer Patients in the Southern Region of Saudi Arabia: A Cross-Sectional Study
by Hamad S. Alyami, Abdallah Y. Naser, Eman Zmaily Dahmash, Mohammad H. Alyami, Osamah M. Belali, Ahmad M. Assiri, Amjad Rehman, Abdulrhman M. Alsaleh, Hind A. Alsaleh, Shahad H. Hussein, Shahad M. Amer, Sara A. Asiri and Amjad I. Almuadi
Int. J. Environ. Res. Public Health 2021, 18(12), 6654; https://doi.org/10.3390/ijerph18126654 - 21 Jun 2021
Cited by 2 | Viewed by 2389
Abstract
Aims: Due to the continuous changes in modern lifestyle and the need to explore the effect of these changes on the risk of developing cancer, ongoing research on the epidemiology and characteristics of cancer patients is requested. This study explored the epidemiology of [...] Read more.
Aims: Due to the continuous changes in modern lifestyle and the need to explore the effect of these changes on the risk of developing cancer, ongoing research on the epidemiology and characteristics of cancer patients is requested. This study explored the epidemiology of cancer, its characteristics, treatment patterns, and risk factors in the southern region of Saudi Arabia. Methods: A retrospective cross-sectional study was conducted using cancer patients’ medical records at Asir Central Hospital in the southern region of Saudi Arabia. Active patients’ records were extracted between January 2013 and December 2019. Results: A total of 2038 patients were identified during the study period, with a mean age of 60.9 (SD: 19.0) years. The patients had survived with their cancer for a median duration of 4 years (IQR: 2–6). Around 4.6% of the patients required ICU admission with a median period of 9 days (IQR: 5–14.75). The death rate during the study period was 10.9%. Around 20.8% of the cases were metastatic, of which 77.8% were at stage four of metastasis, and 19.7% of the patients were receiving chemotherapy for their disease. The most common types of cancer were malignant neoplasms of digestive organs, comprising 40.8% of the sample. Older age (60 years and above) and using specific chronic disease medications were predictors associated with a higher risk of death due to cancer (p < 0.05). Smoking history, using specific chronic disease medications, and having previous surgery were predictors associated with a higher risk of ICU admission (p < 0.05). Conclusion: Breast, colon, and liver cancers were the most prevalent in the southern region of Saudi Arabia. Several modifiable cancer risk factors were identified. The results of this study should support decision-makers in the initiation of programs for key modifiable risk factors that enhance lifestyle changes and reduce cancer risks. Full article
(This article belongs to the Section Global Health)
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9 pages, 790 KiB  
Article
PM2.5 and Diabetes in the Japanese Population
by Mihye Lee and Sachiko Ohde
Int. J. Environ. Res. Public Health 2021, 18(12), 6653; https://doi.org/10.3390/ijerph18126653 - 21 Jun 2021
Cited by 11 | Viewed by 2151
Abstract
Growing evidence suggests that PM2.5 is associated with diabetes mellitus (DM). Although DM is a major public health concern, there has not yet been a study of this association in Japan. We used health examination data from 66,885 individuals in Tokyo, Japan [...] Read more.
Growing evidence suggests that PM2.5 is associated with diabetes mellitus (DM). Although DM is a major public health concern, there has not yet been a study of this association in Japan. We used health examination data from 66,885 individuals in Tokyo, Japan 2005–2019. Cox proportional hazards models were used to evaluate an association between annual exposure to PM2.5 and glycated hemoglobin A1c (HbA1c), or fasting plasma glucose (FPG). An increase of 1 μg/m3 in the annual average of PM2.5 concentration was associated (HR = 1.029; 95% CI = 1.004–1.055) with an increase in diabetes (incident + prevalent). For incident DM, a greater PM2.5 level was associated with more DM (HR = 1.029; 95% CI, 1.003–1.055). Compared to HbA1c, FPG showed a stronger association with the annual exposure to PM2.5 (HR = 1.065; 95% CI, 1.040–1.091). We found that greater exposure to PM2.5 in the long-term was associated with an increased risk of diabetes, and that the magnitude of association became stronger as the exposure duration increased. Omorogieva Ojo Full article
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12 pages, 778 KiB  
Article
Health Education as a Means of Addressing Death in the Elderly
by Nazaret Martínez-Heredia, Andrés Soriano Díaz, Ana Amaro Agudo and Gracia González-Gijón
Int. J. Environ. Res. Public Health 2021, 18(12), 6652; https://doi.org/10.3390/ijerph18126652 - 21 Jun 2021
Cited by 7 | Viewed by 2826
Abstract
Education for death is an emerging field of study in which health education research and proposals are increasingly being made with the aim of acquiring knowledge and skills to promote positive attitudes towards health and preparation for the end of life. The aim [...] Read more.
Education for death is an emerging field of study in which health education research and proposals are increasingly being made with the aim of acquiring knowledge and skills to promote positive attitudes towards health and preparation for the end of life. The aim of this study is to find out what experience older people have had with death education and the importance they give to health education. A qualitative methodological design was selected using a semi-structured interview. The survey consisted of interviews with 28 participants from the city of Granada (Spain) aged 61 to 78. This qualitative-descriptive study is based on an analysis of older people’s experience of education and preparation for death throughout their lives. The results show that, in most cases, the only information received was in childhood and always from a religious perspective. Death and health are closely related, so working on death education helps to improve the quality of life of elderly people. Health education offers ways of coping with the end of life through the transmission of values and practices that make it possible to anticipate and resolve situations of instability or anxiety. Facing death naturally and as just another part of life will help to make healthy ageing possible, through educational proposals related to the integral health of elderly people. Full article
(This article belongs to the Special Issue Well-Being and Quality of Life in the Elderly)
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18 pages, 374 KiB  
Review
Exposure to Heated Tobacco Products and Adverse Health Effects, a Systematic Review
by Małgorzata Znyk, Joanna Jurewicz and Dorota Kaleta
Int. J. Environ. Res. Public Health 2021, 18(12), 6651; https://doi.org/10.3390/ijerph18126651 - 21 Jun 2021
Cited by 61 | Viewed by 10894
Abstract
Heated tobacco products (HTP) are a form of nicotine delivery intended to be an alternative to traditional cigarettes. HTP tobacco products are sold to consumers as a less harmful alternative to traditional cigarettes, both for users and bystanders. The actual impact of HTP [...] Read more.
Heated tobacco products (HTP) are a form of nicotine delivery intended to be an alternative to traditional cigarettes. HTP tobacco products are sold to consumers as a less harmful alternative to traditional cigarettes, both for users and bystanders. The actual impact of HTP on the health of users and its overall impact on public health is still not fully known. A systematic search of the literature was carried out to identify relevant studies published in English from 2015 to February 2021. The following databases were used: PubMed, Scopus, Elsevier and ClinicalKey. 25 studies (independent and sponsored by the tobacco industry) were considered. The analysis of exposure biomarkers and cardiovascular and respiratory biomarkers showed differences between smokers and people using heated tobacco products. Improvements in clinically relevant risk markers, especially cholesterol, sICAM-1, 8-epi-PGF2α, 11-DTX-B2, HDL and FEV1, were observed compared to persistent cigarette smokers. On the other hand, exposure to IQOS has been reported to alter mitochondrial function, which may further exaggerate airway inflammation, airway remodeling and lung cancer. These products have the potential to increase oxidative stress and increase respiratory tract infections by increasing microbial adherence to the respiratory tract. Our review suggests that HTP products may be products with a reduced risk of chronic diseases, including respiratory and cardiovascular diseases and cancer compared to traditional smoking, although in the case of non-smokers so far, they may pose a risk of their occurrence. Research seems to be necessary to assess the frequency of HTP use and its potential negative health effects. Full article
(This article belongs to the Special Issue New Perspectives in Nicotine Use)
10 pages, 1044 KiB  
Article
Perception of Threat and Psychological Impact of COVID-19 among Expatriates in Makkah Region, Saudi Arabia
by Majed A. Algarni, Mohammad S. Alzahrani, Yasser Alatawi, Raghad A. Alasmari, Hashem O. Alsaab, Atiah H. Almalki, Abdullah A. Alhifany and Yusuf S. Althobaiti
Int. J. Environ. Res. Public Health 2021, 18(12), 6650; https://doi.org/10.3390/ijerph18126650 - 21 Jun 2021
Cited by 13 | Viewed by 3102
Abstract
In the first few months of the pandemic, Makkah region reported the highest number of COVID-19 cases among all regions in Saudi Arabia. More than 80% of these reported cases were non-Saudi residents. In this study, we evaluated the perceived threat from and [...] Read more.
In the first few months of the pandemic, Makkah region reported the highest number of COVID-19 cases among all regions in Saudi Arabia. More than 80% of these reported cases were non-Saudi residents. In this study, we evaluated the perceived threat from and psychological impact of COVID-19 among non-Saudi residents of Makkah region. This was a cross-sectional analysis of data collected using a standardized self-report questionnaire. A total of 292 expatriates were included in the study, the majority of whom were non-Arabic speakers. The prevalence of self-reported depression was nearly 40%, anxiety was 32%, and stress was 43%. The findings indicated variability in the prevalence of psychological symptoms among expatriates from different ethnic backgrounds. Additionally, work environment and perceived threat were strong predictors of psychological disorders. This suggested that the perceived threat from and psychological burden of COVID-19 among non-Saudis in Makkah region is substantial. Future research should investigate the reasons behind these variations in the psychological impact of the pandemic among different ethnic groups. Full article
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