International Journal of Environmental Research and Public Health

13 pages, 4781 KiB

Open AccessArticle

Development of a Patient-Oriented Intervention to Support Patient-Provider Conversations about Unnecessary Lower Back Pain Imaging

by Maryam Madani Larijani, Cindy Dumba, Heather Thiessen, Angie Palen, Tracey Carr, Jason R. Vanstone, Daryl R. Fourney, Collin Hartness, Robert Parker and Gary Groot

Int. J. Environ. Res. Public Health 2021, 18(5), 2786; https://doi.org/10.3390/ijerph18052786 - 09 Mar 2021

Cited by 3 | Viewed by 3903

Abstract

Background: despite the efforts of multiple stakeholders to promote appropriate care throughout the healthcare system, studies show that two out of three lower back pain (LBP) patients expect to receive imaging. We used the Choosing Wisely Canada patient-oriented framework, prioritizing patient engagement, to [...] Read more.

Background: despite the efforts of multiple stakeholders to promote appropriate care throughout the healthcare system, studies show that two out of three lower back pain (LBP) patients expect to receive imaging. We used the Choosing Wisely Canada patient-oriented framework, prioritizing patient engagement, to develop an intervention that addresses lower back pain imaging overuse. Methods: to develop this intervention, we collaborated with a multidisciplinary advisory team, including two patient partners with lower back pain, researchers, clinicians, healthcare administrators, and the Choosing Wisely Canada lead for Saskatchewan. For this qualitative study, data were collected through two advisory team meetings, two individual interviews with lower back pain patient partners, and three focus groups with lower back pain patient participants. A lower back pain prescription pad was developed as an outcome of these consultations. Results: participants reported a lack of interactive and informative communication was a significant barrier to receiving appropriate care. The most cited content information for inclusion in this intervention was treatments known to work, including physical activity, useful equipment, and reliable sources of educational material. Participants also suggested it was important that benefits and risks of imaging were explained on the pad. Three key themes derived from the data were also used to guide development of the intervention: (a) the role of imaging in LBP diagnosis; (b) the impact of the patient-physician relationship on LBP diagnosis and treatment; and (c) the lack of patient awareness of Choosing Wisely Canada and their recommendations. Conclusions: the lower back pain patient-developed prescription pad may help patients and clinicians engage in informed conversations and shared decision making that could support reduce unnecessary lower back pain imaging. Full article

(This article belongs to the Special Issue Empowering Patients and Supporting Health Care Providers—New Avenues for High Quality Care and Safety)

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13 pages, 359 KiB

Open AccessArticle

Healthcare-Associated Laboratory-Confirmed Bloodstream Infections—Species Diversity and Resistance Mechanisms, a Four-Year Retrospective Laboratory-Based Study in the South of Poland

by Agnieszka Chmielarczyk, Monika Pomorska-Wesołowska, Dorota Romaniszyn and Jadwiga Wójkowska-Mach

Int. J. Environ. Res. Public Health 2021, 18(5), 2785; https://doi.org/10.3390/ijerph18052785 - 09 Mar 2021

Cited by 7 | Viewed by 2491

Abstract

Introduction: Regardless of the country, advancements in medical care and infection prevention and control of bloodstream infections (BSIs) are an enormous burden of modern medicine. Objectives: The aim of our study was to describe the epidemiology and drug-resistance of laboratory-confirmed BSI (LC-BSIs) among [...] Read more.

Introduction: Regardless of the country, advancements in medical care and infection prevention and control of bloodstream infections (BSIs) are an enormous burden of modern medicine. Objectives: The aim of our study was to describe the epidemiology and drug-resistance of laboratory-confirmed BSI (LC-BSIs) among adult patients of 16 hospitals in the south of Poland. Patients and methods: Data on 4218 LC-BSIs were collected between 2016–2019. The identification of the strains was performed using MALDI-TOF. Resistance mechanisms were investigated according to European Committee on Antimicrobial Susceptibility Testing, EUCAST recommendations. Results: Blood cultures were collected from 8899 patients, and LC-BSIs were confirmed in 47.4%. The prevalence of Gram-positive bacteria was 70.9%, Gram-negative 27.8% and yeast 1.4%. The most frequently isolated genus was Staphylococcus (50% of all LC-BSIs), with a domination of coagulase-negative staphylococci, while Escherichia coli (13.7%) was the most frequent Gram-negative bacterium. Over 4 years, 108 (2.6%) bacteria were isolated only once, including species from the human microbiota as well as environmental and zoonotic microorganisms. The highest methicillin resistant Staphylococcus aureus (MRSA) prevalence was in intensive care units (ICUs) (55.6%) but S. aureus with resistance to macrolides, lincosamides and streptogramins B (MLS_B) in surgery was 66.7%. The highest prevalence of E. faecalis with a high-level aminoglycoside resistance (HLAR) mechanism was in ICUs, (84.6%), while E. faecium-HLAR in surgery was 83.3%. All cocci were fully glycopeptide-sensitive. Carbapenem-resistant Gram-negative bacilli were detected only in non-fermentative bacilli group, with prevalence 70% and more. Conclusions: The BSI microbiology in Polish hospitals was similar to those reported in other studies, but the prevalence of MRSA and enterococci-HLAR was higher than expected, as was the prevalence of carbapenem-resistant non-fermentative bacilli. Modern diagnostic techniques, such as MALDI-TOF, guarantee reliable diagnosis. Full article

(This article belongs to the Special Issue Old and New Epidemiological Alerts: Prevention and Control of COVID-19, Candida auris, Measels, MDR and Other Infectious Diseases)

13 pages, 754 KiB

Open AccessArticle

Health Reporting Characteristics among Journalists in Nepal Utilizing a One Health Framework

by Jessica S. Schwind, Stephanie A. Norman, Munshi Khaledur Rahman, Holly L. Richmond, Sameer M. Dixit, Rajesh M. Rajbhandari, Sarah K. Wagner and Dibesh Karmacharya

Int. J. Environ. Res. Public Health 2021, 18(5), 2784; https://doi.org/10.3390/ijerph18052784 - 09 Mar 2021

Viewed by 3147

Abstract

Journalists play a crucial role in the dissemination of health-related information. In developing countries, such as Nepal, the media are integral in shaping the national agenda and informing the public of important health issues. With an increasing need for a collaborative effort to [...] Read more.

Journalists play a crucial role in the dissemination of health-related information. In developing countries, such as Nepal, the media are integral in shaping the national agenda and informing the public of important health issues. With an increasing need for a collaborative effort to attain optimal health for people, animals, and the environment, the One Health approach was used to characterize health reporting in Nepal. A comprehensive survey was administered to health journalists regarding their public, animal, and environmental health reporting habits. Seventy-one journalists completed the survey across three study sites. Many journalists indicated a history of reporting across all three sectors but did not routinely focus on health reporting in general. The majority of journalists perceived the quality and overall coverage of health-related topics increased over the last five years. However, few journalists reported receiving specialized training in any health sector. Although the overall quality of health reporting in the Nepali media showed improvements, many journalists acknowledged a lack of understanding of common health topics and a desire to learn more skills related to accurate health reporting. One Health provides a conceptual framework for understanding and promoting health communication through mass media to benefit humans, animals, and ecosystems. Full article

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

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15 pages, 570 KiB

Open AccessArticle

Addition of Grape Skin and Stems Extracts in Wines during the Storage to Reduce the Sulfur Dioxide: Impact on Red Wine Quality

by Rocío Casquete, María José Benito, Francisco Pérez-Nevado, Ana Martínez, Alberto Martín and María de Guía Córdoba

Int. J. Environ. Res. Public Health 2021, 18(5), 2783; https://doi.org/10.3390/ijerph18052783 - 09 Mar 2021

Cited by 2 | Viewed by 2600

Abstract

This study aimed to evaluate the usefulness of bioactive extracts obtained from red wine by-products, such as grape skins and stems, for reducing or eliminating the use of SO₂ in red wine production. Special attention was focused on guaranteeing the microbiological stability [...] Read more.

This study aimed to evaluate the usefulness of bioactive extracts obtained from red wine by-products, such as grape skins and stems, for reducing or eliminating the use of SO₂ in red wine production. Special attention was focused on guaranteeing the microbiological stability of the red wines and protecting them against oxidation. Therefore, the antioxidant and antimicrobial activities of the extracts and red wines were studied. Red grape stems and skins, by-products of the wine industry, from six types of monovarietal wines, were used. Extracts obtained from stems displayed higher concentrations of total phenolic compounds and higher in vitro antioxidant activity. Both stem and skin extracts demonstrated higher antimicrobial activity against pathogenic bacteria and lower activity against yeasts. In the wines produced, higher antimicrobial and antioxidant activities were observed, mainly in the skin extract batches. This study highlights that bioactive extracts obtained from by-products of wine making could be used to reduce or eliminate the use of SO₂ in wine production. In this way, healthier red wines could be obtained while guaranteeing their microbiological stability and protecting them from oxidation. Furthermore, the use of these by-products is strongly associated with the circular economy, as they could help to reduce the environmental impact of the wine industry. Full article

(This article belongs to the Special Issue Bioactive Compounds Obtained from Vegetables: Valorizing Agricultural By-Products and Their Use in Healthy and Safety Food Production)

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11 pages, 1592 KiB

Open AccessArticle

Changes in Anthropometric and Performance Parameters in High-Level Endurance Athletes during a Sports Season

by Javier Alves, Gema Barrientos, Víctor Toro, Esther Sánchez, Diego Muñoz and Marcos Maynar

Int. J. Environ. Res. Public Health 2021, 18(5), 2782; https://doi.org/10.3390/ijerph18052782 - 09 Mar 2021

Cited by 2 | Viewed by 2458

Abstract

Several anthropometric and performance parameters related to aerobic metabolism are associated with performance in endurance runners and are modified according to the training performed. The objective of this study was to investigate the ergospirometric and body composition changes in endurance runners during a [...] Read more.

Several anthropometric and performance parameters related to aerobic metabolism are associated with performance in endurance runners and are modified according to the training performed. The objective of this study was to investigate the ergospirometric and body composition changes in endurance runners during a sports season in relation to their training. Twenty highly trained men endurance runners performed an incremental test until exhaustion (initial, and at 3, 6, and 9 months) on a treadmill to determine maximal oxygen consumption (VO₂ max), second ventilatory threshold (VT₂), and their associated running speeds. Skinfolds, perimeters, and weights were measured. No changes were obtained in VO₂ max or VT₂ during the study, although their associated running speeds increased (p < 0.05) after 3 months of the study. Decreases in fat mass (p < 0.05) and muscle mass (p < 0.05) were observed at the end of the season (9 months). Changes occurred in the different skinfolds according to the characteristics of the training performed during the season. In conclusion, vVO₂ max and vVT₂ increase with a greater volume of kilometres trained and can be adversely affected by loss of muscle mass. Full article

(This article belongs to the Special Issue Body Composition in Sports and Health)

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11 pages, 1719 KiB

Open AccessReview

A Meta-Analytical Comparison of the Effects of Small-Sided Games vs. Running-Based High-Intensity Interval Training on Soccer Players’ Repeated-Sprint Ability

by Filipe Manuel Clemente, Rodrigo Ramirez-Campillo, José Afonso, Hugo Sarmento, Thomas Rosemann and Beat Knechtle

Int. J. Environ. Res. Public Health 2021, 18(5), 2781; https://doi.org/10.3390/ijerph18052781 - 09 Mar 2021

Cited by 10 | Viewed by 4603

Abstract

This systematic review with a meta-analysis was conducted to compare the effects of small-sided games (SSGs)-based interventions with the effects of running-based high-intensity interval training (HIIT) interventions on soccer players’ repeated sprint ability (RSA). The data sources utilized were Web of Science, Scopus, [...] Read more.

This systematic review with a meta-analysis was conducted to compare the effects of small-sided games (SSGs)-based interventions with the effects of running-based high-intensity interval training (HIIT) interventions on soccer players’ repeated sprint ability (RSA). The data sources utilized were Web of Science, Scopus, SPORTDiscus, and PubMed. The study eligibility criteria were: (i) parallel studies (SSG-based programs vs. running-based HIIT) conducted in soccer players with no restrictions on age, sex, or competitive level; (ii) isolated intervention programs (i.e., only SSG vs. only running-based HIIT as individual forms) with no restrictions on duration; (iii) a pre–post outcome for RSA; (iv) original, full-text, peer-reviewed articles written in English. An electronic search yielded 513 articles, four of which were included in the present study. There was no significant difference between the effects of SSG-based and HIIT-based training interventions on RSA (effect size (ES) = 0.30; p = 0.181). The within-group analysis revealed no significant effect of SSG-based training interventions (ES = −0.23; p = 0.697) or HIIT-based training interventions (ES = 0.08; p = 0.899) on RSA. The meta-comparison revealed that neither SSGs nor HIIT-based interventions were effective in improving RSA in soccer players, and no differences were found between the two types of training. This suggests that complementary training may be performed to improve the effects of SSGs and HIIT. It also suggests that different forms of HIIT can be used because of the range of opportunities that such training affords. Full article

(This article belongs to the Special Issue Training Load and Performance Monitoring, Recovery, Wellbeing, Illness and Injury Prevention)

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10 pages, 1537 KiB

Open AccessArticle

Reflective Functioning in Patients with Irritable Bowel Syndrome, Non-Affective Psychosis and Affective Disorders—Differences and Similarities

by Larisa Dzirlo, Felix Richter, Dagmar Steinmair and Henriette Löffler-Stastka

Int. J. Environ. Res. Public Health 2021, 18(5), 2780; https://doi.org/10.3390/ijerph18052780 - 09 Mar 2021

Cited by 4 | Viewed by 2409

Abstract

Irritable bowel syndrome (IBS), as part of the functional somatic syndromes, is frequent in the general population. Medical care and morbidity costs are high, and so is the psychological and somatic strain. The etiopathogenesis of IBS is still poorly understood; it is assumed [...] Read more.

Irritable bowel syndrome (IBS), as part of the functional somatic syndromes, is frequent in the general population. Medical care and morbidity costs are high, and so is the psychological and somatic strain. The etiopathogenesis of IBS is still poorly understood; it is assumed to be multifactorial and to include biopsychosocial factors. Links between the intestine, psyche, nervous system (e.g., via the hypothalamic–pituitary–adrenal axis (HPA-Axis/neurotransmitters) and with the microbiome, the immune system have lately been investigated. Factors such as personality traits, mentalization, and early attachment strategies (deactivating and hyperactivating) have been suggested to influence IBS with relevance for treatment regimens. At this time, data on reflective functioning (RF) is lacking. Within a cross-sectional, we examined the mentalizing capacity of a clinical sample (n = 90) consisting of patients with IBS (n = 30), affective disorders (AD; n = 28), and non-affective psychosis (NAP; n = 32). The reflective functioning scale was used based on the brief reflective function interview (BRFI). The results revealed severe impairment in patients with IBS concerning their mentalizing ability, which was comparable to patients with affective disorders. Patients with non-affective-psychosis showed the lowest mentalizing ability. Thus, psychotherapeutic treatment with a focus on mentalization could be a promising approach. Full article

(This article belongs to the Special Issue Individualized Bio- Psycho- Social Interventions for Youth with Mental Disorders)

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12 pages, 349 KiB

Open AccessArticle

Depression, Anxiety and Eating Disorder-Related Impairment: Moderators in Female Adolescents and Young Adults

by Johanna Sander, Markus Moessner and Stephanie Bauer

Int. J. Environ. Res. Public Health 2021, 18(5), 2779; https://doi.org/10.3390/ijerph18052779 - 09 Mar 2021

Cited by 55 | Viewed by 11207

Abstract

Adolescents and young adults, particularly females, are highly vulnerable to the development of anxiety disorders, depression, and eating disorders. Comorbid anxiety disorder or depression in eating disorders are associated with greater symptom severity, poorer prognosis, and burden of illness. Nonetheless, studies on what [...] Read more.

Adolescents and young adults, particularly females, are highly vulnerable to the development of anxiety disorders, depression, and eating disorders. Comorbid anxiety disorder or depression in eating disorders are associated with greater symptom severity, poorer prognosis, and burden of illness. Nonetheless, studies on what affects the relationship between anxiety, depression, and eating disorders in female at-risk samples are scarce. Using hierarchical linear modeling, the present study examined potential moderators to explain between-person differences in the association between anxiety, depression, and eating disorder-related impairment within 12- to 25-year-old females (N = 320). High impairment in anxiety/depression was associated with more severe eating disorder symptoms. Older age as well as greater impairment in mood dysregulation, self-esteem, and perfectionism were linked to more severe eating disorder symptomatology. Whereas mood dysregulation, self-esteem, and perfectionism had no statistically significant moderating effects, younger age appeared to augment the association of anxiety/depression and eating disorder symptomatology. Preventive care in particular needs to consider age-related effects as eating disorder symptoms are associated more strongly with symptoms of anxiety and depression in early adolescence. Full article

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

12 pages, 777 KiB

Open AccessArticle

The Impact of Childhood Left-Behind Experience on the Mental Health of Late Adolescents: Evidence from Chinese College Freshmen

by Huajun Wu, Zhiyong Cai, Qing Yan, Yi Yu and Ning Neil Yu

Int. J. Environ. Res. Public Health 2021, 18(5), 2778; https://doi.org/10.3390/ijerph18052778 - 09 Mar 2021

Cited by 14 | Viewed by 3363

Abstract

A paucity of public service afforded to migrant workers often begets a wide range of social problems. In China, hundreds of millions of migrant worker parents have to leave children behind in their hometowns. This paper investigated the long-term effects of the childhood [...] Read more.

A paucity of public service afforded to migrant workers often begets a wide range of social problems. In China, hundreds of millions of migrant worker parents have to leave children behind in their hometowns. This paper investigated the long-term effects of the childhood experience of being left behind on the mental well-being of late adolescents. Mandatory university personality inventory (UPI) surveys (involving psychosomatic problems such as anxiety, depression, and stress) were conducted at a university in Jiangsu, China, during 2014–2017. The study sample consisted of 15,804 first-year college students aged between 15 and 28 years. The PSM method and the OLS regression model were employed. Controlling for the confounding factors (gender, age, single-child status, hometown location, ethnicity, and economic status), our empirical investigation demonstrated that childhood left-behind experience significantly worsened the mental health of the study sample, increasing the measure of mental ill-being by 0.661 standard deviations (p < 0.01). Moreover, the effects were consistently significant in subsamples divided by gender, single-child status, and hometown location; and the effects were greater for females, single-child students, and urban residents. Full article

(This article belongs to the Special Issue University Students' Health and Academic Achievement)

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11 pages, 932 KiB

Open AccessArticle

Repatriations of Ill and Injured Travelers and Emigrants to Switzerland: A Retrospective Analysis at a Tertiary Emergency Department from 2013–2018

by Lara Brockhus, Anne-Sophie Eich, Aristomenis Exadaktylos, Anne Jachmann and Jolanta Klukowska-Rötzler

Int. J. Environ. Res. Public Health 2021, 18(5), 2777; https://doi.org/10.3390/ijerph18052777 - 09 Mar 2021

Viewed by 1950

Abstract

Background: As more and more people are travelling abroad, there are also increasing numbers who fall ill or have accidents in foreign countries. Some patients must be repatriated. While it has been reported that the number of repatriations is rising steadily, little [...] Read more.

Background: As more and more people are travelling abroad, there are also increasing numbers who fall ill or have accidents in foreign countries. Some patients must be repatriated. While it has been reported that the number of repatriations is rising steadily, little is known about patients’ characteristics, calling for in depth investigations of this patient group. Methods: We have conducted a retrospective study including 447 patients repatriated to the Emergency Department at the University Hospital (Inselspital) in Bern, Switzerland from 2013–2018. Results: Between 2013 and 2018, the number of repatriated patients increased by 42.6%, from 54 to 77 cases. In total, 59% of these patients were male and the median age was 60 years. Overall, 79% of patients were repatriated from European countries, with the top five countries being Italy, France, Spain, Germany and Austria. About half the cases (51.9%) were caused by illness, the other half by accidents. In total, 127 patients had to undergo surgical intervention abroad; another 194 patients underwent surgery after repatriation. The hospitalization rate was 81.4%, with a median length of in-hospital stay of 9 days (IQR 5–14) at the Inselspital. The mortality rate of at the Inselspital hospitalized patients was 4.4%, with 16 patients dying within the first 30 days after repatriation. The median cost per case was 12,005.79 CHF (IQR 4717.66–24,462.79). A multiple regression analysis showed a significant association of total costs with hospitalization (p = 0.001), surgical intervention (p = 0.001), as well as treatment in the intensive care unit (p = 0.001). Conclusions: The number of repatriations has been continuously increasing in recent years and reached a mean value of more than one case per week at the Inselspital (77 cases per year in 2018). The 30 day-mortality rate of 4.4% and the median cost per case are relatively high, demonstrating a neglected Public Health concern. These findings may provide impetus—not only for further research into repatriations but also for Public Health Promotion strategies. Full article

(This article belongs to the Section Environmental Health)

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11 pages, 372 KiB

Open AccessArticle

The Role of Adequate Resources, Community and Supportive Leadership in Creating Engaged Academics

by Marit Christensen, Jeremy Dawson and Karina Nielsen

Int. J. Environ. Res. Public Health 2021, 18(5), 2776; https://doi.org/10.3390/ijerph18052776 - 09 Mar 2021

Cited by 6 | Viewed by 3392

Abstract

The vast majority of research in academia focuses on the adverse working conditions and poor wellbeing. The present paper presents a positive view on the factors that may promote work engagement in academia. Based on conservation of resources theory, we suggest that academic [...] Read more.

The vast majority of research in academia focuses on the adverse working conditions and poor wellbeing. The present paper presents a positive view on the factors that may promote work engagement in academia. Based on conservation of resources theory, we suggest that academic resources may be related to a social community at work, which in turn creates work engagement among academics. Having positive leadership in the form of fair leadership may be an important contextual factor ensuring that resources are shared fairly and openly. In a study of 1499 academics in Norwegian universities, we found that sufficient administrative resources to support teaching duties were positively related with work engagement, and that a sense of community mediated the relationship between academic resources for teaching and work engagement. These results propose that building academics’ social resources by providing them with the necessary resources to perform their jobs will buffer the impact of a leadership that is perceived to be unfair and help them to perform their work in a positive way. Our results carry important implications for how positive psychology may be used to support engaged workers in academia. Full article

(This article belongs to the Special Issue Challenges in Positive Organizational Psychology)

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17 pages, 46279 KiB

Open AccessArticle

Grid-Scale Impact of Climate Change and Human Influence on Soil Erosion within East African Highlands (Kagera Basin)

by Chaodong Li, Zhanbin Li, Mingyi Yang, Bo Ma and Baiqun Wang

Int. J. Environ. Res. Public Health 2021, 18(5), 2775; https://doi.org/10.3390/ijerph18052775 - 09 Mar 2021

Cited by 5 | Viewed by 2987

Abstract

Under global climate change and pressure from human activities, soil erosion is becoming a major concern in the quest for regional sustainable development in the Kagera basin (KB). However, few studies in this region have comprehensively considered the impact of climate change and [...] Read more.

Under global climate change and pressure from human activities, soil erosion is becoming a major concern in the quest for regional sustainable development in the Kagera basin (KB). However, few studies in this region have comprehensively considered the impact of climate change and human influence on soil erosion, and the associated processes are unclear. Based on the premise of quantifying climate change, human influence, and soil erosion, this study undertook a neighborhood analysis as the theoretical support, for a grey relation analysis which was conducted to realize the qualitative assessment of the influence of climate change and human activities on soil erosion. The results show that 90.32% of the KB saw climate change as having a greater influence on soil erosion than human influence, with the remaining area 9.68% seeing human influence having a greater impact than climate change, mainly as a result of the effect of rangeland and farmland. The average soil erosion rate of the KB shows a very low level (10.54 t ha⁻¹ yr⁻¹), with rangeland and farmland being the main land use/land cover (LULC) types that see soil loss, followed by forest, wetland, and built-up areas. The climate change trends of the KB show the most dramatic changes in the northeast and southwest, gradually decreasing towards the line crossing from the Birunga National Park (Rwanda) to the Keza district (Tanzania). The human influence intensity (HII) shows a high level in the KB (21.93), where it is higher in the west and lower in the east of the basin. Full article

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33 pages, 2306 KiB

Open AccessArticle

Time Trend of Persistent Organic Pollutants and Metals in Greenlandic Inuit during 1994–2015

by Manhai Long, Maria Wielsøe and Eva Cecilie Bonefeld-Jørgensen

Int. J. Environ. Res. Public Health 2021, 18(5), 2774; https://doi.org/10.3390/ijerph18052774 - 09 Mar 2021

Cited by 12 | Viewed by 2652

Abstract

Persistent organic pollutants (POPs), including polychlorinated biphenyls (PCBs), organchlorine pesticides and perfluoroalkylated substances (PFASs) and heavy metals bioaccumulate in the marine food chain in the Arctic regions, and thus, the Greenlandic population has a higher body burden due to relatively high intake of [...] Read more.

Persistent organic pollutants (POPs), including polychlorinated biphenyls (PCBs), organchlorine pesticides and perfluoroalkylated substances (PFASs) and heavy metals bioaccumulate in the marine food chain in the Arctic regions, and thus, the Greenlandic population has a higher body burden due to relatively high intake of marine mammals. We assessed the temporal trend for POPs, including PCB 153; 1,1-dichloro−2,2-bis (p-chlorophenyl)-ethylene (p,p’-DDE); oxychlordane; six PFASs; mercury; lead and selenium in Inuit from Ilulissat, Nuuk, and across Greenland (including thirteen towns/districts), from 1994 to 2015. Data showed a significant annual decrease of 6.85–8.61% for PCB153, 6.67–8.61% for p,p’-DDE, 6.11–9.52% for oxychlordane, 5.92–6.76% for mercury and 6.48–9.43% for lead in Inuit women from Nuuk, Ilulissat, and across thirteen Greenlandic districts. The blood selenium level of all Greenlandic women increased 1.01% annually, while the trend direction was negative for Nuuk women. A similar pattern was seen for men across Greenland, with a yearly decrease of 11.3% for PCB 153, 8.61% for p,p’-DDE, 15.6% for oxychlordane, 13.1% for mercury and 12.2% for lead. Perfluorooctane sulfonate, perfluorohexane sulfonate and perfluorooctanoic acid significantly decreased 5.82–11.7% annually for both women and men across Greenland. For perfluorononanoic acid, perfluorodecanoic acid and perfluoroundecanoic acid, we observed an increasing trend for women across Greenland. In conclusion, there was a decreasing trend of the regulated POPs and metals but a potential increasing trend of the nonregulated PFASs in the Greenlandic population between 1994 and 2015. The continuing biomonitoring of contaminants of concern is important to protect the Arctic population heath. Full article

(This article belongs to the Section Environmental Health)

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17 pages, 542 KiB

Open AccessArticle

The Story as a Quality Instrument: Developing an Instrument for Quality Improvement Based on Narratives of Older Adults Receiving Long-Term Care

by Aukelien Scheffelaar, Meriam Janssen and Katrien Luijkx

Int. J. Environ. Res. Public Health 2021, 18(5), 2773; https://doi.org/10.3390/ijerph18052773 - 09 Mar 2021

Cited by 8 | Viewed by 3761

Abstract

The individual experiences of older adults in long-term care are broadly recognized as an important source of information for measuring wellbeing and quality of care. Narrative research is a special type of qualitative research to elicit people’s individual, diverse experiences in the context [...] Read more.

The individual experiences of older adults in long-term care are broadly recognized as an important source of information for measuring wellbeing and quality of care. Narrative research is a special type of qualitative research to elicit people’s individual, diverse experiences in the context of their lifeworld. Narratives are potentially useful for long-term care improvement as they can provide a rich description of an older adult’s life from their own point of view, including the provided care. Little is known about how narratives can best be collected and used to stimulate learning and quality improvement in long-term care for older adults. The current study takes a theoretical approach to developing a narrative quality instrument for care practice in order to discover the experiences of older adults receiving long-term care. The new narrative quality instrument is based on the available literature describing narrative research methodology. The instrument is deemed promising for practice, as it allows care professionals to collect narratives among older adults in a thorough manner for team reflection in order to improve the quality of care. In the future, the feasibility and usability of the instrument will have to be empirically tested. Full article

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

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15 pages, 1964 KiB

Open AccessReview

Approaches to Nutritional Screening in Patients with Coronavirus Disease 2019 (COVID-19)

by Amira Mohammed Ali and Hiroshi Kunugi

Int. J. Environ. Res. Public Health 2021, 18(5), 2772; https://doi.org/10.3390/ijerph18052772 - 09 Mar 2021

Cited by 38 | Viewed by 5394

Abstract

Malnutrition is common among severe patients with coronavirus disease 2019 (COVID-19), mainly elderly adults and patients with comorbidities. It is also associated with atypical presentation of the disease. Despite the possible contribution of malnutrition to the acquisition and severity of COVID-19, it is [...] Read more.

Malnutrition is common among severe patients with coronavirus disease 2019 (COVID-19), mainly elderly adults and patients with comorbidities. It is also associated with atypical presentation of the disease. Despite the possible contribution of malnutrition to the acquisition and severity of COVID-19, it is not clear which nutritional screening measures may best diagnose malnutrition in these patients at early stages. This is of crucial importance given the urgency and rapid progression of the disease in vulnerable groups. Accordingly, this review examines the available literature for different nutritional screening approaches implemented among COVID-19 patients, with a special focus on elderly adults. After a literature search, we selected and scrutinized 14 studies assessing malnutrition among COVID-19 patients. The Nutrition Risk Screening 2002 (NRS-2002) has demonstrated superior sensitivity to other traditional screening measures. The controlling nutritional status (CONUT) score, which comprises serum albumin level, cholesterol level, and lymphocytes count, as well as a combined CONUT-lactate dehydrogenase-C-reactive protein score expressed a predictive capacity even superior to that of NRS-2002 (0.81% and 0.92% vs. 0.79%) in midlife and elder COVID-19 patients. Therefore, simple measures based on routinely conducted laboratory investigations such as the CONUT score may be timely, cheap, and valuable alternatives for identifying COVID-19 patients with high nutritional risk. Mini Nutritional Assessment (MNA) was the only measure used to detect residual malnutrition and high malnutrition risk in remitting patients—MNA scores correlated with hypoalbuminemia, hypercytokinemia, and weight loss. Older males with severe inflammation, gastrointestinal symptoms, and pre-existing comorbidities (diabetes, obesity, or hypertension) are more prone to malnutrition and subsequently poor COVID-19 prognosis both during the acute phase and during convalescence. Thus, they are in need of frequent nutritional monitoring and support while detecting and treating malnutrition in the general public might be necessary to increase resilience against COVID-19. Full article

(This article belongs to the Special Issue A Public Health View on COVID-19: Epidemiology, Implications and Responses)

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13 pages, 19671 KiB

Open AccessArticle

Interest in Sexually Transmitted Infections: Analysis of Web Search Data Terms in Eleven Large German Cities from 2015 to 2019

by Anna Caroline Pilz, Linda Tizek, Melvin Rüth, Peter Seiringer, Tilo Biedermann and Alexander Zink

Int. J. Environ. Res. Public Health 2021, 18(5), 2771; https://doi.org/10.3390/ijerph18052771 - 09 Mar 2021

Cited by 5 | Viewed by 2470

Abstract

Incidence of sexually transmitted infections (STIs) such as chlamydia, gonorrhea, and syphilis has increased in recent years in the US and in European countries. In order to implement effective educational programs, the interests of target populations have to be identified. Since the internet [...] Read more.

Incidence of sexually transmitted infections (STIs) such as chlamydia, gonorrhea, and syphilis has increased in recent years in the US and in European countries. In order to implement effective educational programs, the interests of target populations have to be identified. Since the internet is an important source of information-gathering on health issues, this study investigates web search data in large German cities related to STIs. Google Ads Keyword Planner was used to identify STI-related terms and their search volume in eleven German cities from June 2015 to May 2019. The data obtained were analyzed descriptively with regard to total search volumes, search volumes of specific thematic areas, and search volumes per 100,000 inhabitants. Overall, 741 terms with a total search volume of 5,142,560 queries were identified, with more than 70% of all search queries including a specific disease and “chlamydia” being the overall most often searched term (n = 1,196,160). Time courses of search behavior displayed a continuous interest in STIs with synchronal and national rather than regional peaks. Volumes of search queries lacked periodic patterns. Based on the findings of this study, a more open public discussion about STIs with linkage to increased media coverage and clarification of responsibilities among all STI-treating disciplines concerning management of STIs seem advisable. Full article

(This article belongs to the Special Issue Public Health and Prevention Strategies in Dermatology)

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14 pages, 389 KiB

Open AccessArticle

Emotional Processing in Healthy Ageing, Mild Cognitive Impairment, and Alzheimer’s Disease

by José Cárdenas, María J. Blanca, Fernando Carvajal, Sandra Rubio and Carmen Pedraza

Int. J. Environ. Res. Public Health 2021, 18(5), 2770; https://doi.org/10.3390/ijerph18052770 - 09 Mar 2021

Cited by 10 | Viewed by 2956

Abstract

Emotional processing, particularly facial expression recognition, is essential for social cognition, and dysfunction may be associated with poor cognitive health. In pathological ageing conditions, such as mild cognitive impairment (MCI) and Alzheimer’s disease (AD), in which cognitive impairments are present, disturbed emotional processing [...] Read more.

Emotional processing, particularly facial expression recognition, is essential for social cognition, and dysfunction may be associated with poor cognitive health. In pathological ageing conditions, such as mild cognitive impairment (MCI) and Alzheimer’s disease (AD), in which cognitive impairments are present, disturbed emotional processing and difficulty with social interactions have been documented. However, it is unclear how pathological ageing affects emotional processing and human social behaviour. The aim of this study is to provide insight into how emotional processing is affected in MCI and AD and whether this capacity can constitute a differentiating factor allowing the preclinical diagnosis of both diseases. For this purpose, an ecological emotional battery adapted from five subsets of the Florida Affect Battery was used. Given that emotion may not be separated from cognition, the affect battery was divided into subtests according to cognitive demand, resulting in three blocks. Our results showed that individuals with MCI or AD had poorer performance on the emotional processing tasks, although with different patterns, than that of controls. Cognitive demand may be responsible for the execution patterns of different emotional processing tests. Tasks with moderate cognitive demand are the most sensitive for discriminating between two cognitive impairment entities. In summary, emotional processing tasks may aid in characterising the neurocognitive deficits in MCI or AD. Additionally, identifying these deficits may be useful for developing interventions that specifically target these emotional processing problems. Full article

(This article belongs to the Section Health Behavior, Chronic Disease and Health Promotion)

10 pages, 1033 KiB

Open AccessArticle

The Carbon Footprint of Marathon Runners: Training and Racing

by Laurent Castaignède, Frederic Veny, Johnathan Edwards and Véronique Billat

Int. J. Environ. Res. Public Health 2021, 18(5), 2769; https://doi.org/10.3390/ijerph18052769 - 09 Mar 2021

Cited by 6 | Viewed by 4398

Abstract

Marathon running leaves a significant carbon footprint regarding CO₂ emissions; for example, 37 percent of New York Marathon participants travel internationally to New York. The aim of this study is to estimate the CO₂ footprint of a person training and competing [...] Read more.

Marathon running leaves a significant carbon footprint regarding CO₂ emissions; for example, 37 percent of New York Marathon participants travel internationally to New York. The aim of this study is to estimate the CO₂ footprint of a person training and competing in a marathon; we will also propose methods to minimize the CO₂ footprint because of transportation. In addition, we also examine the influence of food practices and hygiene on training and racing a marathon. Methods: We estimated the annual carbon footprint of one person taking part in a marathon. We considered all training, racing, and travelling (local and international) for one person (we are going to give him the first name of “Henri”), and then compared his CO₂ footprint with his colleagues playing tennis and soccer. The excess CO₂ footprint whilst running and for shoes, clothing, books, magazines, insurance, travel, hygiene, laundry, and resources for electronics and additional food consumed were calculated. For competitions, we estimated and compared the CO₂ emission from transportation to national vs. international marathon (New York). Results: We estimated that our runner emitted 4.3 tons of CO₂ equivalent (CO₂e), including all greenhouse gases. A transatlantic flight to New York corresponded to 3.5 tons CO₂, which is 83% of the annual carbon footprint of an average French citizen which is about 11 tons CO₂e/year. This leads to a sudden 40% increase in Henri’s annual carbon footprint. Conclusions: By focusing on the additional carbon footprint from one year of marathon training and racing, and traveling locally versus internationally, this sport still has a potentially significant carbon footprint that runners and race organizers ought to consider. We wanted to answer a growing question of marathon runners who are wondering about the carbon footprint of their sports practice in following with a new environmentalist trend that considers not traveling anymore to participate in marathons and to stay local. However, the representativeness in the selection of calculation objectives is very low. There is no need for statistics since this study is a theoretical simulation of traditional training and competition practices of marathon runners. Full article

(This article belongs to the Special Issue The Marathon: Environmental and Public Health Aspects)

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19 pages, 778 KiB

Open AccessArticle

Exploring Factors That Could Potentially Have Affected the First 1000 Days of Absent Learners in South Africa: A Qualitative Study

by Carien van Zyl and Carlien van Wyk

Int. J. Environ. Res. Public Health 2021, 18(5), 2768; https://doi.org/10.3390/ijerph18052768 - 09 Mar 2021

Cited by 5 | Viewed by 3057

Abstract

Background: The first 1000 days of life—from conception to the second birthday of children —is widely recognized as the most crucial development phase, which could have long lasting effects on the health and well-being of children throughout their lives. Purpose: The purpose of [...] Read more.

Background: The first 1000 days of life—from conception to the second birthday of children —is widely recognized as the most crucial development phase, which could have long lasting effects on the health and well-being of children throughout their lives. Purpose: The purpose of this study was to qualitatively explore and describe factors that could potentially have affected the first 1000 days of absent learners in the Foundation Phase within the Paarl-East community in the Western Cape of South Africa. Methods: The data for this qualitative descriptive study were collected through semi-structured interviews with 18 biological mothers of absent learners in the Foundation Phase, who resided in Paarl East. The transcribed texts were analyzed by making use of a thematic data analysis. Results: The findings revealed six predominant themes that played a role during the first 1000 days of the lives of these absent learners. Conclusion: It was concluded from the findings in this study that factors, such as health and nutrition of both the mothers and their children, substance use/abuse during pregnancy, toxic stress, support received by the mothers and their children, attachment, attentive care, and stimulation and play, could have affected the first 1000 days of the absent learners in this study. Since this study did not aim to confirm a correlation between the first 1000 days and absenteeism, but solely to explore factors affecting the first 1000 days, conclusions regarding cause and effect was not possible. Full article

(This article belongs to the Special Issue Early Child Development: From Measurement to Optimal Functioning and Evidence-based Policy)

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12 pages, 837 KiB

Open AccessArticle

Structure and Distribution of Health Care Costs across Age Groups of Patients with Multimorbidity in Lithuania

by Laura Nedzinskienė, Elena Jurevičienė, Žydrūnė Visockienė, Agnė Ulytė, Roma Puronaitė, Vytautas Kasiulevičius, Edita Kazėnaitė, Greta Burneikaitė and Rokas Navickas

Int. J. Environ. Res. Public Health 2021, 18(5), 2767; https://doi.org/10.3390/ijerph18052767 - 09 Mar 2021

Cited by 6 | Viewed by 2509

Abstract

Background. Patients with multimorbidity account for ever-increasing healthcare resource usage and are often summarised as big spenders. Comprehensive analysis of health care resource usage in different age groups in patients with at least two non-communicable diseases is still scarce, limiting the quality of [...] Read more.

Background. Patients with multimorbidity account for ever-increasing healthcare resource usage and are often summarised as big spenders. Comprehensive analysis of health care resource usage in different age groups in patients with at least two non-communicable diseases is still scarce, limiting the quality of health care management decisions, which are often backed by limited, small-scale database analysis. The health care system in Lithuania is based on mandatory social health insurance and is covered by the National Health Insurance Fund. Based on a national Health Insurance database. The study aimed to explore the distribution, change, and interrelationships of health care costs across the age groups of patients with multimorbidity, suggesting different priorities at different age groups. Method. The study identified all adults with at least one chronic disease when any health care services were used over a three-year period between 2012 and 2014. Further data analysis excluded patients with single chronic conditions and further analysed patients with multimorbidity, accounting for increasing resource usage. The costs of primary, outpatient health care services; hospitalizations; reimbursed and paid out-of-pocket medications were analysed in eight age groups starting at 18 and up to 85 years and over. Results. The study identified a total of 428,430 adults in Lithuania with at least two different chronic diseases from the 32 chronic disease list. Out of the total expenditure within the group, 51.54% of the expenses were consumed for inpatient treatment, 30.90% for reimbursed medications. Across different age groups of patients with multimorbidity in Lithuania, 60% of the total cost is attributed to the age group of 65–84 years. The share in the total spending was the highest in the 75–84 years age group amounting to 29.53% of the overall expenditure, with an increase in hospitalization and a decrease in outpatient services. A decrease in health care expenses per capita in patients with multimorbidity after 85 years of age was observed. Conclusions. The highest proportion of health care expenses in patients with multimorbidity relates to hospitalization and reimbursed medications, increasing with age, but varies through different services. The study identifies the need to personalise the care of patients with multimorbidity in the primary-outpatient setting, aiming to reduce hospitalizations with proactive disease management. Full article

(This article belongs to the Special Issue Population Health and Health Services)

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19 pages, 2349 KiB

Open AccessReview

Pandemics and Burden of Stroke and Epilepsy in Sub-Saharan Africa: Experience from a Longstanding Health Programme

by Massimo Leone, Fausto Ciccacci, Stefano Orlando, Sandro Petrolati, Giovanni Guidotti, Noorjehan Abdul Majid, Victor Tamba Tolno, JeanBaptiste Sagno, Darlington Thole, Fabio Massimo Corsi, Michelangelo Bartolo and Maria Cristina Marazzi

Int. J. Environ. Res. Public Health 2021, 18(5), 2766; https://doi.org/10.3390/ijerph18052766 - 09 Mar 2021

Cited by 12 | Viewed by 4436

Abstract

Eighty percent of people with stroke live in low- to middle-income nations, particularly in sub-Saharan Africa (SSA) where stroke has increased by more than 100% in the last decades. More than one-third of all epilepsy−related deaths occur in SSA. HIV infection is a [...] Read more.

Eighty percent of people with stroke live in low- to middle-income nations, particularly in sub-Saharan Africa (SSA) where stroke has increased by more than 100% in the last decades. More than one-third of all epilepsy−related deaths occur in SSA. HIV infection is a risk factor for neurological disorders, including stroke and epilepsy. The vast majority of the 38 million people living with HIV/AIDS are in SSA, and the burden of neurological disorders in SSA parallels that of HIV/AIDS. Local healthcare systems are weak. Many standalone HIV health centres have become a platform with combined treatment for both HIV and noncommunicable diseases (NCDs), as advised by the United Nations. The COVID-19 pandemic is overwhelming the fragile health systems in SSA, and it is feared it will provoke an upsurge of excess deaths due to the disruption of care for chronic diseases such as HIV, TB, hypertension, diabetes, and cerebrovascular disorders. Disease Relief through Excellent and Advanced Means (DREAM) is a health programme active since 2002 to prevent and treat HIV/AIDS and related disorders in 10 SSA countries. DREAM is scaling up management of NCDs, including neurologic disorders such as stroke and epilepsy. We described challenges and solutions to address disruption and excess deaths from these diseases during the ongoing COVID-19 pandemic. Full article

(This article belongs to the Section Global Health)

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26 pages, 32651 KiB

Open AccessArticle

Evaluation of Social Values for Ecosystem Services in Urban Riverfront Space Based on the SolVES Model: A Case Study of the Fenghe River, Xi’an, China

by Zhicheng Zhang, Hongjuan Zhang, Juan Feng, Yirong Wang and Kang Liu

Int. J. Environ. Res. Public Health 2021, 18(5), 2765; https://doi.org/10.3390/ijerph18052765 - 09 Mar 2021

Cited by 21 | Viewed by 3547

Abstract

Urban riverfront space has diversified ecosystem services, but due to excessive changes in the geographical environment, such as drastic changes in land use, people gain social value at a great ecological cost. Obtaining benefits from the ecosystem in this way is not sustainable. [...] Read more.

Urban riverfront space has diversified ecosystem services, but due to excessive changes in the geographical environment, such as drastic changes in land use, people gain social value at a great ecological cost. Obtaining benefits from the ecosystem in this way is not sustainable. Therefore, this paper uses the SolVES model to evaluate the social value of ecosystem services on the east bank of the Fenghe River, while also studying the contribution of different environmental variables to social value. The main results are as follows. (1) Environmental variables affect the spatial distribution characteristics of social value. The distance to water (DTW) means the social value was distributed in strips, and the distance to road (DTR) concentrated the social value along the road. The landscape type (LT) means the social value was concentrated in the landscape space. (2) When DTW, DTR, and LT were collectively used as environmental variables, the distribution characteristics of various social values were similar to when LT was used as the only environmental variable. (3) The results of MaxEnt show that LT made a greater contribution to the aesthetic, recreation, therapeutic, and historic values, and was the largest contribution factor to the aesthetic, therapeutic, and historic values, with contribution rates of 47.6, 50.5, and 80.0%, respectively. DTW is the factor that contributed the most to recreation, with a contribution rate of 43.1%. Improving social value based on the influence and contribution of environmental variables can reduce the damage to the ecological environment caused by changes in geographic factors. This is sustainable for both the ecosystem and the services it provides to mankind. Full article

(This article belongs to the Special Issue Engineering for Sustainable Environment)

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10 pages, 338 KiB

Open AccessArticle

Maternal Prenatal Hair Cortisol Is Associated with Child Wheeze among Mothers and Infants with Tobacco Smoke Exposure and Who Face High Socioeconomic Adversity

by Ashley Scherman, Eliot R. Spindel, Byung Park, Robert Tepper, David W. Erikson, Cynthia Morris and Cindy T. McEvoy

Int. J. Environ. Res. Public Health 2021, 18(5), 2764; https://doi.org/10.3390/ijerph18052764 - 09 Mar 2021

Cited by 3 | Viewed by 2395

Abstract

The association of co-occurring prenatal stress and tobacco exposures on childhood wheezing and asthma are not well established. In this study, we compared maternal prenatal hair cortisol concentration (HCC) to the maternal report of infant wheezing (y/n) in the first year of life [...] Read more.

The association of co-occurring prenatal stress and tobacco exposures on childhood wheezing and asthma are not well established. In this study, we compared maternal prenatal hair cortisol concentration (HCC) to the maternal report of infant wheezing (y/n) in the first year of life among mother–infant dyads exposed to tobacco smoke and socioeconomic adversity. Data were obtained from the Vitamin C to Decrease Effects of Smoking in Pregnancy on Infant Lung Function study. Maternal adversity was defined by the level of education, household income, and health insurance provider. Hair was collected at delivery, representing average circulating third-trimester cortisol levels. HCC was log transformed and dichotomized into high/low cortisol groups that were placed into a multivariate model predicting wheeze. Subjects (n = 132) were primarily White with ≤high school education and receiving government-provided health insurance. Forty-five percent of infants wheezed. Average HCC was 3.39 pg/mg hair. Women with HCC > 3.55 pg/mg were more than twice as likely to report having a child who wheezed (odds ratio 2.56, 95% confidence interval 1.22–5.40; p = 0.01), adjusting for insurance provider and maternal asthma. Among this sample of dyads with prenatal smoke exposure, elevated maternal HCC was associated with child wheeze that was not diminished after consideration of covariates. Full article

(This article belongs to the Special Issue Women's Health throughout Life Stages)

12 pages, 473 KiB

Open AccessArticle

Effects of Season of Birth and Meteorological Parameters on Serum Bilirubin Levels during the Early Neonatal Period: A Retrospective Chart Review

by Shigeo Iijima, Toru Baba, Miyuki Kondo, Tomoka Fujita and Akira Ohishi

Int. J. Environ. Res. Public Health 2021, 18(5), 2763; https://doi.org/10.3390/ijerph18052763 - 09 Mar 2021

Cited by 2 | Viewed by 2345

Abstract

To establish whether serum bilirubin levels vary in healthy term neonates according to seasonal variations and meteorological factors, we retrospectively studied 3344 healthy term neonates born between 2013 and 2018. Total serum bilirubin (TSB) levels were measured on the fourth day after birth. [...] Read more.

To establish whether serum bilirubin levels vary in healthy term neonates according to seasonal variations and meteorological factors, we retrospectively studied 3344 healthy term neonates born between 2013 and 2018. Total serum bilirubin (TSB) levels were measured on the fourth day after birth. The monthly and seasonal variations in TSB levels and clinical and meteorological effects on TSB levels were assessed. In the enrolled neonates, the median TSB level was 195 µmol/L. The TSB level peaked in December and was the lowest in July, but the variation was not statistically significant. The TSB level was significantly higher in the cold (October to March) than in the warm season (April to September; p = 0.01). The comparison between seasonal differences according to sex showed TSB levels were significantly higher in the cold than in the warm season in male infants (p = 0.001), whereas no significant difference was observed in female infants. A weakly negative but significant association existed between TSB levels and the mean daily air temperature (r = −0.07, p = 0.007) in only the male population; the female population showed no significant correlation between TSB levels and meteorological parameters. The season of birth is an etiological factor in neonatal jaundice, with an additional influence from sex. Full article

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16 pages, 1990 KiB

Open AccessArticle

Does Lung Ultrasound Have a Role in the Clinical Management of Pregnant Women with SARS COV2 Infection?

by Maria Grazia Porpora, Lucia Merlino, Luisa Masciullo, Rossella D’Alisa, Gabriella Brandolino, Cecilia Galli, Casimiro De Luca, Francesco Pecorini, Giovanni Battista Fonsi, Andrea Mingoli, Cristiana Franchi, Alessandra Oliva, Lucia Manganaro, Claudio Maria Mastroianni and Maria Grazia Piccioni

Int. J. Environ. Res. Public Health 2021, 18(5), 2762; https://doi.org/10.3390/ijerph18052762 - 09 Mar 2021

Cited by 8 | Viewed by 3483

Abstract

Severe Acute Respiratory Syndrome coronavirus 2 (SARS-CoV-2) infection is a major health threat. Pregnancy can lead to an increased susceptibility to viral infections. Although chest computed tomography (CT) represents the gold standard for the diagnosis of SARS-CoV-2 pneumonia, lung ultrasound (LUS) could be [...] Read more.

Severe Acute Respiratory Syndrome coronavirus 2 (SARS-CoV-2) infection is a major health threat. Pregnancy can lead to an increased susceptibility to viral infections. Although chest computed tomography (CT) represents the gold standard for the diagnosis of SARS-CoV-2 pneumonia, lung ultrasound (LUS) could be a valid alternative in pregnancy. The objectives of this prospective study were to assess the role of LUS in the diagnosis of lung involvement and in helping the physicians in the management of affected patients. Thirty pregnant women with SARS-CoV-2 infection were admitted at the obstetrical ward of our Hospital. Mean age was 31.2 years, mean gestational age 33.8 weeks. Several LUS were performed during hospitalization. The management of the patients was decided according to the LUS score and the clinical conditions. Mean gestational age at delivery was at 37.7 weeks, preterm birth was induced in 20% of cases for a worsening of the clinical conditions. No neonatal complications occurred. In 9 cases with a high LUS score, a chest CT was performed after delivery. CT confirmed the results of LUS, showing a significant positive correlation between the two techniques. LUS seems a safe alternative to CT in pregnancy and may help in the management of these patients. Full article

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

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8 pages, 2853 KiB

Open AccessArticle

Adaptive Health Coaching Technology for Tailored Interventions

by Holly Jimison, Michael Shapiro and Misha Pavel

Int. J. Environ. Res. Public Health 2021, 18(5), 2761; https://doi.org/10.3390/ijerph18052761 - 09 Mar 2021

Cited by 3 | Viewed by 2179

Abstract

Recent advances in sensor and communications technology have enabled scalable methods for providing continuity of care to the home for patients with chronic conditions and older adults wanting to age in place. In this article we describe our framework for a health coaching [...] Read more.

Recent advances in sensor and communications technology have enabled scalable methods for providing continuity of care to the home for patients with chronic conditions and older adults wanting to age in place. In this article we describe our framework for a health coaching platform with a dynamic user model that enables tailored health coaching messages. We have shown that this can improve coach efficiency without a loss of message quality. We also discovered many lessons for coaching technology, most demonstrating the need for more coach input on sample message content, perhaps even requiring that individual coaches be able to modify the message database directly. Overall, coaches felt that the structure of the automated message generation was useful in remembering what to say, easy to edit if necessary and especially helpful for training new health coaches. Full article

(This article belongs to the Special Issue Mobile Health and Mobile Rehabilitation for People with Disabilities)

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7 pages, 304 KiB

Open AccessArticle

Multiple Forms of Sexting and Associations with Psychosocial Health in Early Adolescents

by Yu Lu, Elizabeth Baumler and Jeff R. Temple

Int. J. Environ. Res. Public Health 2021, 18(5), 2760; https://doi.org/10.3390/ijerph18052760 - 09 Mar 2021

Cited by 19 | Viewed by 3341

Abstract

Despite the recent surge of sexting research, the link between sexting and psychosocial health remains inconclusive. To address this gap in the literature, we examined the link between multiple forms of sexting and a range of psychosocial health problems. Data were from a [...] Read more.

Despite the recent surge of sexting research, the link between sexting and psychosocial health remains inconclusive. To address this gap in the literature, we examined the link between multiple forms of sexting and a range of psychosocial health problems. Data were from a randomized controlled trial of a school-based dating violence prevention program. Participants were 2199 early adolescents (49.8% female) aged 14 years and under (mean age = 13.53, SD = 0.50) enrolled in middle-schools in southeast Texas. Participants self-reported to be 35.4% Hispanic, 7.9% Non-Hispanic White, 26.2% Non-Hispanic Black, 18.6% Asian, and 11.9% other. Multilevel multivariate regressions found that pressured sexting was associated with hostility and aggressive temperament. Receiving unsolicited sexts was associated with depression, impulsivity, hostility, emotion dysregulation, and aggressive temperament. Forwarding sexts without permission was linked to hostility. Asking someone for sexts was linked to impulsivity and aggressive temperament, while being asked to send a sext was associated with depression, anxiety, impulsivity, hostility, emotion dysregulation, and aggressive temperament. Finally, consensual sexting was not significantly associated with poor psychosocial health of any type. Interventions should focus on preventing pressured sexting and teaching early adolescents on how to respond to being pressured to sext. Full article

(This article belongs to the Special Issue Advances in Sexting: Links and Answers)

14 pages, 654 KiB

Open AccessArticle

The Impact of Financial and Non-Financial Work Incentives on the Safety Behavior of Heavy Truck Drivers

by Sebastjan Škerlič and Vanja Erčulj

Int. J. Environ. Res. Public Health 2021, 18(5), 2759; https://doi.org/10.3390/ijerph18052759 - 09 Mar 2021

Cited by 2 | Viewed by 2808

Abstract

The goal of the research is to determine how compensation affects the safety behavior of truck drivers and consequently the frequency of traffic accidents. For this purpose, a survey was conducted on a sample of 220 truck drivers in international road transport in [...] Read more.

The goal of the research is to determine how compensation affects the safety behavior of truck drivers and consequently the frequency of traffic accidents. For this purpose, a survey was conducted on a sample of 220 truck drivers in international road transport in the EU, where the results of the Structural Equation Model (SEM) show that in the current state of the transport sector, financial and non-financial incentives have a positive impact on the work and safety behavior of drivers. Financial incentives also have an impact on drivers’ increased perception of their driving ability, while moving violations continue to have a major impact on the number of accidents. The proposed improvements enable decision-makers at the highest level to adopt legal solutions to help manage the issues that have been affecting the industry from a work, social and safety point of view for the past several years. The results of the research therefore represent an important guideline for improvements to the legislature as well as in the systematization of truck driver compensation within companies. Full article

(This article belongs to the Special Issue Industrial Safety and Risk Management)

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17 pages, 1382 KiB

Open AccessArticle

Mobile-Health Technologies for a Child Neuropsychiatry Service: Development and Usability of the Assioma Digital Platform

by Elisa Fucà, Floriana Costanzo, Dimitri Bonutto, Annarita Moretti, Andrea Fini, Alberto Ferraiuolo, Stefano Vicari and Alberto Eugenio Tozzi

Int. J. Environ. Res. Public Health 2021, 18(5), 2758; https://doi.org/10.3390/ijerph18052758 - 09 Mar 2021

Cited by 2 | Viewed by 2550

Abstract

We developed an m-Health platform to support clinical pathways in a child and adolescent neuropsychiatry unit. The Assioma platform was created for tablets, smartphones and PCs, to support data collection and clinical workflow, to promote constant communication between patients, caregivers and clinicians, and [...] Read more.

We developed an m-Health platform to support clinical pathways in a child and adolescent neuropsychiatry unit. The Assioma platform was created for tablets, smartphones and PCs, to support data collection and clinical workflow, to promote constant communication between patients, caregivers and clinicians, and to promote active family involvement in day hospital (DH) procedures. Through the Assioma application for tablets, caregivers filled out an anamnestic questionnaire and explored contents on the DH procedures and neurodevelopmental conditions. The application for smartphones included an agenda function for the DH pathways. Through the application for desktops, clinicians could export anamnestic information in text and Excel formats, send real-time notifications, and push relative contents to families’ account. We tested the usability and satisfaction of the Assioma platform in a group of children, caregivers (N = 24) and clinicians (N = 6). Both families and clinicians gave high scores to almost all usability items. The overall satisfaction reached the highest levels at 50% satisfied for families and at 33% for clinicians. Our results indicate that the Assioma platform has the potential to optimize clinical pathways, increasing compliance and clinical efficiency, and to reduce in-person contacts supporting social distancing for clinical pathways, a crucial need during the COVID-19 pandemic. Full article

(This article belongs to the Special Issue Mobile Health and Mobile Rehabilitation for People with Disabilities)

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21 pages, 3446 KiB

Open AccessArticle

Time for ‘Green’ during COVID-19? Inequities in Green and Blue Space Access, Visitation and Felt Benefits

by Thomas Astell-Burt and Xiaoqi Feng

Int. J. Environ. Res. Public Health 2021, 18(5), 2757; https://doi.org/10.3390/ijerph18052757 - 09 Mar 2021

Cited by 74 | Viewed by 9842

Abstract

We hypothesized that visits to green and blue spaces may have enabled respite, connection and exercise during the COVID-19 pandemic, but such benefits might have been inequitably distributed due to differences in financial difficulties, opportunities to work from home, and localized restrictions in [...] Read more.

We hypothesized that visits to green and blue spaces may have enabled respite, connection and exercise during the COVID-19 pandemic, but such benefits might have been inequitably distributed due to differences in financial difficulties, opportunities to work from home, and localized restrictions in spatial mobility generated by ‘lockdowns’. A nationally representative online and telephone survey conducted in 12–26 October on the Social Research Centre’s Life in Australia^TM panel (aged ≥ 18 y, 78.8% response, N = 3043) asked about access, visitation, and felt benefits from green and/or blue spaces. Increasing financial difficulty was associated with less time in and fewer visits to green and/or blue spaces, as well as fewer different types visited. Financial difficulty was also associated with feelings that visits to green and/or blue space had less benefit for maintaining social connection. Working from home was associated with more frequent and longer visitation to green and/or blue spaces, as well as discovery of ones previously unvisited. Working from home was also associated with increased levels of exercise and respite resulting from visits to green and/or blue spaces. Residents of Melbourne, a city of 4.9 million who were in ‘lockdown’ at the time of the survey, appeared more likely to benefit from visits to green and/or blue spaces than residents of Sydney, Australia’s largest city at 5.2 million, who were not in lockdown. Residents of Melbourne compared with Sydney reported consistently increased visitation of, discovery of, and greater levels of various felt benefits derived from green and/or blue spaces, including more respite, connection, and exercise. Comparatively shorter distances to preferred green and/or blue spaces and closure of alternative settings at the time of the survey completion in Melbourne compared with Sydney may provide partial explanation, though more acute responses to experiencing green and/or blue spaces within highly cognitively demanding antecedent conditions posed by lockdown are also plausible and warrant further investigation with other health indicators. These results were robust to adjustment for a range of covariates including preferences for natural settings, which were consistently associated with greater levels of green and/or blue space visitation and felt benefits. Collectively, these results indicate that parallel efforts to generate (or renew) felt connection to natural settings, to increase working from home opportunities, and to mitigate financial difficulties may be important to help maximize the population health benefits of urban planning strategies intended to improve the availability of, and to reduce inequities in access to, green and blue spaces. Benefits felt more commonly by people living through lockdown underlines the role previous investments in green and blue space have played in enabling coping during the COVID-19 pandemic. Full article

(This article belongs to the Section Environmental Health)

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