International Journal of Environmental Research and Public Health

28 pages, 7585 KiB

Open AccessArticle

Spatiotemporal Characteristics and Influencing Factors of Tourism–Urbanization–Technology–Ecological Environment on the Yunnan–Guizhou–Sichuan Region: An Uncoordinated Coupling Perspective

by Guangming Yang, Guofang Gong, Yao Luo, Yunrui Yang and Qingqing Gui

Int. J. Environ. Res. Public Health 2022, 19(14), 8885; https://doi.org/10.3390/ijerph19148885 - 21 Jul 2022

Cited by 13 | Viewed by 2184

Abstract

The tourism, urbanization, technology, and the ecological environment both promote and restrict each other. Coordinating the relationship between the four is of great significance to the realization of high-quality sustainable regional development. Taking the Yunnan–Guizhou–Sichuan region as an example, this paper constructs an [...] Read more.

The tourism, urbanization, technology, and the ecological environment both promote and restrict each other. Coordinating the relationship between the four is of great significance to the realization of high-quality sustainable regional development. Taking the Yunnan–Guizhou–Sichuan region as an example, this paper constructs an uncoordinated coupling model for the tourism–urbanization–technology–ecological environment system. Using exploratory spatial analysis and geographic information systems, this paper reveals the temporal and spatial evolution law affecting the uncoordinated coupling relationship between tourism, urbanization, technology and the ecological environment in the Yunnan–Guizhou–Sichuan region from 2010 to 2020, before establishing a panel Tobit model that is used to explore the factors affecting the four systems. The research shows the following: (1) The level of comprehensive development for tourism, urbanization, technology, and the ecological environment in Yunnan, Guizhou, and Sichuan has increased rapidly. Of all these, the tourism industry was the most affected by COVID-19 in 2020, while the level of urbanization, technology, and ecological environment developments in the three provinces has become similar over time. (2) Uncoordinated development between cities is a prominent problem; while the uncoordinated coupling spatial agglomeration in various regions is relatively stable, the proportion of cities with no significant agglomeration form amounts to more than 70%, with mostly low–low (L–L) and high–high (H–H) agglomeration types. (3) The degree to which uncoordinated coupling exists among the four systems in the Yunnan–Guizhou–Sichuan region is affected by many factors. Only eco-environmental pressure has a significant positive correlation with the degree of uncoordinated coupling, while the tourism scale, economic urbanization, eco-environmental response, and investment in technology have a significant negative correlation. These results provide a theoretical basis and practical references for strengthening the government’s macro-control and promoting collaborative regional development. Full article

(This article belongs to the Special Issue Environment and Applied Ecology)

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18 pages, 360 KiB

Open AccessArticle

The Impact of Digital Economy on the Efficiency of Green Financial Investment in China’s Provinces

by Xiangyu Tian, Yuanxi Zhang and Guohua Qu

Int. J. Environ. Res. Public Health 2022, 19(14), 8884; https://doi.org/10.3390/ijerph19148884 - 21 Jul 2022

Cited by 30 | Viewed by 3413

Abstract

The global digital operation of finance has accelerated, and the transformation and upgrading of the financial industry has been fully empowered by digital technology, which has promoted the development of traditional financial industry toward green finance. Accelerating the pace of China’s entry into [...] Read more.

The global digital operation of finance has accelerated, and the transformation and upgrading of the financial industry has been fully empowered by digital technology, which has promoted the development of traditional financial industry toward green finance. Accelerating the pace of China’s entry into the digital economy era has given the green financial industry new opportunities in its digital transformation. Therefore, the research reported in this paper selects provincial panel data and discusses the impact efficiency of the digital economy on green financial investment in China by static panel OLS and the threshold model method, and constructs a threshold model with regional industry scale and green financial audit as threshold variables. These steps are used to analyze the nonlinear characteristics of digital economy and green financial efficiency. The results show that the digital economy can improve the overall efficiency of China’s green finance, and there are two threshold effects with regional industry scale as the threshold variable and one threshold effect with green financial audit support as the threshold variable. The results show that the development of a digital economy improved the investment efficiency of green finance in all provinces of China. In addition, through our research, we found that the application of the digital economy in green finance can reduce the imbalance of regional economic development. China should also strengthen the supervision of green auditing to promote the development of new green financial formats. Full article

(This article belongs to the Special Issue Green Development and Carbon Neutralization)

28 pages, 2777 KiB

Open AccessReview

Illicit Substance Use and the COVID-19 Pandemic in the United States: A Scoping Review and Characterization of Research Evidence in Unprecedented Times

by Anh Truc Vo, Thomas Patton, Amy Peacock, Sarah Larney and Annick Borquez

Int. J. Environ. Res. Public Health 2022, 19(14), 8883; https://doi.org/10.3390/ijerph19148883 - 21 Jul 2022

Cited by 6 | Viewed by 2875

Abstract

We carried out a scoping review to characterize the primary quantitative evidence addressing changes in key individual/structural determinants of substance use risks and health outcomes over the first two waves of the COVID-19 pandemic in the United States (US). We systematically queried the [...] Read more.

We carried out a scoping review to characterize the primary quantitative evidence addressing changes in key individual/structural determinants of substance use risks and health outcomes over the first two waves of the COVID-19 pandemic in the United States (US). We systematically queried the LitCovid database for US-only studies without date restrictions (up to 6 August 2021). We extracted quantitative data from articles addressing changes in: (a) illicit substance use frequency/contexts/behaviors, (b) illicit drug market dynamics, (c) access to treatment and harm reduction services, and (d) illicit substance use-related health outcomes/harms. The majority of 37 selected articles were conducted within metropolitan locations and leveraged historical timeseries medical records data. Limited available evidence supported changes in frequency/behaviors/contexts of substance use. Few studies point to increases in fentanyl and reductions in heroin availability. Policy-driven interventions to lower drug use treatment thresholds conferred increased access within localized settings but did not seem to significantly prevent broader disruptions nationwide. Substance use-related emergency medical services’ presentations and fatal overdose data showed a worsening situation. Improved study designs/data sources, backed by enhanced routine monitoring of illicit substance use trends, are needed to characterize substance use-related risks and inform effective responses during public health emergencies. Full article

(This article belongs to the Special Issue Substance Use, Treatment, and Harms during COVID-19)

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12 pages, 464 KiB

Open AccessArticle

The Identification of Subphenotypes and Associations with Health Outcomes in Patients with Opioid-Related Emergency Department Encounters Using Latent Class Analysis

by Neeraj Chhabra, Dale L. Smith, Caitlin M. Maloney, Joseph Archer, Brihat Sharma, Hale M. Thompson, Majid Afshar and Niranjan S. Karnik

Int. J. Environ. Res. Public Health 2022, 19(14), 8882; https://doi.org/10.3390/ijerph19148882 - 21 Jul 2022

Cited by 2 | Viewed by 2036

Abstract

The emergency department (ED) is a critical setting for the treatment of patients with opioid misuse. Detecting relevant clinical profiles allows for tailored treatment approaches. We sought to identify and characterize subphenotypes of ED patients with opioid-related encounters. A latent class analysis was [...] Read more.

The emergency department (ED) is a critical setting for the treatment of patients with opioid misuse. Detecting relevant clinical profiles allows for tailored treatment approaches. We sought to identify and characterize subphenotypes of ED patients with opioid-related encounters. A latent class analysis was conducted using 14,057,302 opioid-related encounters from 2016 through 2017 using the National Emergency Department Sample (NEDS), the largest all-payer ED database in the United States. The optimal model was determined by face validity and information criteria-based metrics. A three-step approach assessed class structure, assigned individuals to classes, and examined characteristics between classes. Class associations were determined for hospitalization, in-hospital death, and ED charges. The final five-class model consisted of the following subphenotypes: Chronic pain (class 1); Alcohol use (class 2); Depression and pain (class 3); Psychosis, liver disease, and polysubstance use (class 4); and Pregnancy (class 5). Using class 1 as the reference, the greatest odds for hospitalization occurred in classes 3 and 4 (Ors 5.24 and 5.33, p < 0.001) and for in-hospital death in class 4 (OR 3.44, p < 0.001). Median ED charges ranged from USD 2177 (class 1) to USD 2881 (class 4). These subphenotypes provide a basis for examining patient-tailored approaches for this patient population. Full article

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16 pages, 10070 KiB

Open AccessArticle

Nicotine Exerts Cytotoxic Effects in a Panel of Healthy Cell Lines and Strong Irritating Potential on Blood Vessels

by Doina Chioran, Adrian Sitaru, Ioana Macasoi, Iulia Pinzaru, Cristian Andrei Sarau, Cristina Dehelean, Stefania Dinu, Camelia Szuhanek, Irina Nicoleta Zetu, Andra Cristine Serafin, Mircea Rivis, Marioara Poenaru and Razvan Dragoi

Int. J. Environ. Res. Public Health 2022, 19(14), 8881; https://doi.org/10.3390/ijerph19148881 - 21 Jul 2022

Cited by 3 | Viewed by 4089

Abstract

The use of tobacco products is a major global public health issue, as it is the leading cause of preventable death worldwide. In addition, nicotine (NIC) is a key component of electronic and conventional cigarettes. Although nicotine’s addictive potential is well known, its [...] Read more.

The use of tobacco products is a major global public health issue, as it is the leading cause of preventable death worldwide. In addition, nicotine (NIC) is a key component of electronic and conventional cigarettes. Although nicotine’s addictive potential is well known, its health effects are not entirely understood. Thus, the main objective of the present study was to evaluate its toxicological profile both in vitro, at the level of three healthy cell lines, and in ovo, at the level of the chorioallantoic membrane. Five different concentrations of nicotine were used in keratinocytes, cardiomyocytes, and hepatocytes for the purpose of evaluating cell viability, cell morphology, and its impact on nuclei. Additionally, the hen’s egg test on the chorioallantoic membrane (HET-CAM) method was used to assess the biocompatibility and irritant potential of the chorioallantoic membrane. Across all cell lines studied, nicotine was proven to be significantly damaging to cell viability, with the highest concentration tested resulting in less than 2% viable cells. Moreover, the morphology of cells changed dramatically, with alterations in their shape and confluence. Nicotine-induced cell death appears to be apoptotic, based on its impact on the nucleus. In addition, nicotine was also found to have a very strong irritating effect on the chorioallantoic membrane. In conclusion, nicotine has an extremely strong toxicological profile, as demonstrated by the drastic reduction of cell viability and the induction of morphological changes and nuclear alterations associated with cellular apoptosis. Additionally, the HET-CAM method led to the observation of a strong irritating effect associated with nicotine. Full article

(This article belongs to the Special Issue Tobacco Smoke Exposure and Tobacco Product Use)

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12 pages, 673 KiB

Open AccessArticle

Assessing Relationships between Physically Demanding Work and Late-Life Disability in Italian Nonagenarian Women Living in a Rural Area

by Gemma Lombardi, Silvia Pancani, Francesca Lorenzini, Federica Vannetti, Guido Pasquini, Roberta Frandi, Nona Turcan, Lorenzo Razzolini, Raffaello Molino Lova, Francesca Cecchi and Claudio Macchi

Int. J. Environ. Res. Public Health 2022, 19(14), 8880; https://doi.org/10.3390/ijerph19148880 - 21 Jul 2022

Cited by 1 | Viewed by 1276

Abstract

As more and more persons live into their 90s and beyond, investigating causes of disability in the oldest-old population is relevant for public health implications to plan preventive strategies and rehabilitation interventions. A negative association between physically demanding work and midlife physical function [...] Read more.

As more and more persons live into their 90s and beyond, investigating causes of disability in the oldest-old population is relevant for public health implications to plan preventive strategies and rehabilitation interventions. A negative association between physically demanding work and midlife physical function has been shown, but there is a paucity of longitudinal studies investigating possible work-related long-term effects in the oldest old. This study investigates the relationship between physically demanding work exposure and late-life physical performances, disability, general health status, and quality of life in a sample of women aged 90 years and over inside the Mugello Study. Sociodemographic data, cognitive and functional status, lifestyle, medical history, drug use, and work history were collected from 236 participants. Farmers had a lower percentage of individuals with preserved independence in basic activities of daily living compared to other occupations. However, in the multivariate analysis, only a higher cognitive function remained associated with functional independence. While confirming the well-known association between cognitive and functional decline in very old age, our results do not support the hypothesis that the negative effects of physical work exposure observed in midlife are relevant to predict disability in nonagenarian women. Full article

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18 pages, 1005 KiB

Open AccessArticle

Epidemiology and Clinical Characteristics of Older Patients Transferred from Long-Term-Care Hospitals (LTCHs) to Emergency Departments by a Comparison with Non-LTCHs in South Korea: A Cross-Sectional Observational Study

by Soon Young Yun, Ji Yeon Lim, Eun Kim, Jongseok Oh and Duk Hee Lee

Int. J. Environ. Res. Public Health 2022, 19(14), 8879; https://doi.org/10.3390/ijerph19148879 - 21 Jul 2022

Cited by 2 | Viewed by 1308

Abstract

The South Korean population is rapidly aging, and the number of older patients in long-term-care hospitals (LTCHs) continues to increase. This study aims to investigate the epidemiologic data, characteristics, and clinical outcomes of patients aged 65 years and older transferred from LTCHs to [...] Read more.

The South Korean population is rapidly aging, and the number of older patients in long-term-care hospitals (LTCHs) continues to increase. This study aims to investigate the epidemiologic data, characteristics, and clinical outcomes of patients aged 65 years and older transferred from LTCHs to emergency departments (EDs). This is a retrospective study based on National Emergency Department Information System data from 2014 to 2019. Of the 6,209,695 older patients visiting EDs for disease treatment, 211,141 (3.4%) were transferred from LTCHs. Among patients from LTCHs (211,141), 24.2% were discharged from EDs, 43.0% were admitted to general wards, 20.7% were hospitalized in intensive care units, 3.1% were transferred to another hospital, 6.1% returned to LTCHs, and 2.1% died in EDs. ED stays were the longest for those returning to LTCHs (710.49 ± 1127.43 min). Foley catheterization (40.3%) was most frequently performed in preventable ED visits. In South Korea, older patients being discharged from the ED or returning to LTCHs, after being transferred from LTCHs to EDs, increased. ED stays among older LTCH patients were longer than among non-LTCH older patients, contributing to congestion. To reduce avoidable transfer to EDs from LTCHs, it is necessary to discuss policies, such as expanding appropriate medical personnel and transitional treatment. Full article

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16 pages, 1512 KiB

Open AccessArticle

Initial Surgical Strategy for the Treatment of Type A Acute Aortic Dissection: Does Proximal or Distal Extension of the Aortic Resection Influence the Outcomes?

by Carlo Bassano, Marta Pugliese, Charles Mve Mvondo, Calogera Pisano, Paolo Nardi, Dario Buioni, Fabio Bertoldo, Mattia Scognamiglio, Alessandro C. Salvati, Claudia Altieri and Giovanni Ruvolo

Int. J. Environ. Res. Public Health 2022, 19(14), 8878; https://doi.org/10.3390/ijerph19148878 - 21 Jul 2022

Cited by 3 | Viewed by 1315

Abstract

(1) Background: We sought to analyze and compare the outcomes in terms of early and late mortality and freedom from a redo operation in patients undergoing surgical treatment for a type A acute aortic dissection in relation to the initial surgical treatment strategy, [...] Read more.

(1) Background: We sought to analyze and compare the outcomes in terms of early and late mortality and freedom from a redo operation in patients undergoing surgical treatment for a type A acute aortic dissection in relation to the initial surgical treatment strategy, i.e., proximal or distal extension of the aortic segment resection, compared with isolated resection of the supracoronary ascending aorta. (2) Methods: This is a retrospective study in which we included 269 patients who underwent operations for a type A acute aortic dissection in the Department of Cardiac Surgery of Tor Vergata University from May 2006 to May 2016. The patients were grouped according to the extent of the performed surgical treatment: isolated replacement of the supracoronary ascending aorta (NE, no extension), replacement of the aortic root (PE, proximal extension), replacement of the aortic arch (DE, distal extension), and both (BE, bilateral extension). The analyzed variables were in-hospital mortality, postoperative complications (incidence of neurological damage, renal failure and need for prolonged intubation), late mortality and need for a redo operation. (3) Results: Unilateral cerebral perfusion was performed in 49.3% of the patients, and bilateral perfusion—in 50.6%. The overall in-hospital mortality was 31.97%. In the multivariate analysis, advanced age, cardiopulmonary bypass time and preoperative orotracheal intubation were independent predictors of in-hospital mortality. In the population of patients who survived the surgery, the probability of survival at 92 months was 70 ± 5%, the probability of freedom from a redo operation was 71.5 ± 5%, the probability of freedom from the combined end-point death and a redo operation was 50 ± 5%. The re-intervention rate in the general population was 16.9%. The overall probability of freedom from re-intervention was higher in patients undergoing aortic root replacement, although not reaching a level of statistical significance. Patients who underwent aortic arch treatment showed reduced survival. (4) Conclusions: In the treatment of type A acute aortic dissection, all the surgical strategies adopted were associated with satisfactory long-term survival. In the group of patients in which the aortic root had not been replaced, we observed reduced event-free survival. Full article

(This article belongs to the Special Issue Myocardial Infarction: Prevention and Treatment)

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16 pages, 852 KiB

Open AccessArticle

Occurrence of Banned and Currently Used Herbicides, in Groundwater of Northern Greece: A Human Health Risk Assessment Approach

by Paraskevas Parlakidis, Maria Soledad Rodriguez, Georgios D. Gikas, Christos Alexoudis, Greivin Perez-Rojas, Marta Perez-Villanueva, Alejo Perez Carrera, Alicia Fernández-Cirelli and Zisis Vryzas

Int. J. Environ. Res. Public Health 2022, 19(14), 8877; https://doi.org/10.3390/ijerph19148877 - 21 Jul 2022

Cited by 9 | Viewed by 1946

Abstract

The presence of pesticide residues in groundwater, many years after their phase out in European Union verifies that the persistence in aquifer is much higher than in other environmental compartments. Currently used and banned pesticides were monitored in Northern Greece aquifers and a [...] Read more.

The presence of pesticide residues in groundwater, many years after their phase out in European Union verifies that the persistence in aquifer is much higher than in other environmental compartments. Currently used and banned pesticides were monitored in Northern Greece aquifers and a human health risk assessment was conducted. The target compounds were the herbicides metolachlor (MET), terbuthylazine (TER), atrazine (ATR) and its metabolites deisopropylatrazine (DIA), deethylatrazine (DEA) and hydroxyatrazine (HA). Eleven sampling sites were selected to have representatives of different types of wells. Pesticides were extracted by solid-phase extraction and analyzed by liquid chromatography. MET was detected in 100% of water samples followed by ATR (96.4%), DEA and HA (88.6%), DIA (78.2%) and TER (67.5%). ATR, DIA, DEA, HA, MET and TER mean concentrations detected were 0.18, 0.29, 0.14, 0.09, 0.16 and 0.15 μg/L, respectively. Obtained results were compared with historical data from previous monitoring studies and temporal trends were assessed. Preferential flow was the major factor facilitating pesticide leaching within the month of herbicide application. Moreover, apparent age of groundwater and the reduced pesticide dissipation rates on aquifers resulted of long-term detection of legacy pesticides. Although atrazine had been banned more than 18 years ago, it was detected frequently and their concentrations in some cases were over the maximum permissible limit. Furthermore, human health risk assessment of pesticides was calculated for two different age groups though drinking water consumption. In all examined wells, the sum of the HQ values were lower than the unity. As a result, the analyzed drinking water wells are considered safe according to the acute risk assessment process. However, the presence of atrazine residues causes concerns related with chronic toxicity, since ATR R values were greater than the parametric one of 1 × 10⁻⁶ advised by USEPA, for both age groups. Full article

(This article belongs to the Topic Organic Pollution in Soil and Groundwater)

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19 pages, 1818 KiB

Open AccessArticle

Examining the Influence of Housing Conditions and Daily Greenspace Exposure on People’s Perceived COVID-19 Risk and Distress

by Jianwei Huang and Mei-Po Kwan

Int. J. Environ. Res. Public Health 2022, 19(14), 8876; https://doi.org/10.3390/ijerph19148876 - 21 Jul 2022

Cited by 10 | Viewed by 2299

Abstract

Many people have worried about COVID-19 infection, job loss, income reduction, and family conflict during the COVID-19 pandemic. Some social groups may be particularly vulnerable due to their residential neighborhoods and daily activities. On the other hand, people’s daily exposure to greenspace offers [...] Read more.

Many people have worried about COVID-19 infection, job loss, income reduction, and family conflict during the COVID-19 pandemic. Some social groups may be particularly vulnerable due to their residential neighborhoods and daily activities. On the other hand, people’s daily exposure to greenspace offers promising pathways for reducing these worries associated with COVID-19. Using data collected with a questionnaire and a two-day activity diary from two typical neighborhoods in Hong Kong, this study examines how people’s housing conditions and daily greenspace exposure affect their perceived COVID-19 risk and distress (i.e., worries about job loss, income reduction, and family conflict) during the pandemic. First, the study compares people’s perceived COVID-19 risk and distress based on their residential neighborhoods. Further, it examines the associations between people’s perceived COVID-19 risk and distress with their housing conditions and daily greenspace exposure using ordinal logistic regression models. The results indicate that living in a high-risk neighborhood, being married, renting a residential unit, and living in a large household are significantly associated with a higher neighborhood-based perceived COVID-19 risk and distress during the pandemic. In addition, people also reported lower mobility-based perceived COVID-19 risk when compared to their neighborhood-based perceived COVID-19 risk, while they still have a high perceived COVID-19 risk in their occupational venues if they have to work in a high-risk district (e.g., Kowloon). Lastly, daily greenspace exposure (i.e., woodland) could reduce people’s perceived COVID-19 risk and distress. These results have important implications for the public health authority when formulating the measures during the COVID-19 pandemic. Full article

(This article belongs to the Section Environmental Health)

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17 pages, 554 KiB

Open AccessArticle

Exploring the Role of Green Finance and Energy Development towards High-Quality Economic Development: Application of Spatial Durbin Model and Intermediary Effect Model

by Rong Wang and Fayuan Wang

Int. J. Environ. Res. Public Health 2022, 19(14), 8875; https://doi.org/10.3390/ijerph19148875 - 21 Jul 2022

Cited by 21 | Viewed by 2352

Abstract

Finance is the blood of the economy, and energy is the foundation and source of power for economic and social development. It is crucial to the prosperity and development of the country, the improvement of people’s lives and the long-term stability of society. [...] Read more.

Finance is the blood of the economy, and energy is the foundation and source of power for economic and social development. It is crucial to the prosperity and development of the country, the improvement of people’s lives and the long-term stability of society. It is a booster for the implementation of the concept of green development and the realization of high-quality economic development (HQED). Based on the panel data of 11 provinces and cities in the Yangtze River Economic Belt from 2007 to 2019, this paper selects green investment and carbon emission intensity as green financial values and calculates energy development indicators from the three dimensions of energy supply, energy consumption and energy efficiency. The three dimensions of development capability, high-quality development structure and high-quality development benefit are used to construct an indicator system for high-quality economic development, and the spatial Durbin model is selected to study the spatial effects of green finance and energy development on high-quality economic development. At the same time, the mediation effect model is used to test whether there is a mediation effect in the development of green finance on high-quality economic development. The results show that: green finance has a significant positive impact on high-quality economic development, and the spatial spillover effect is not significant; energy development has a significant positive impact on high-quality economic development, and the spatial spillover effect is significantly negative; the interaction term between green finance and energy development has a significant negative impact on high-quality economic development, and the spatial spillover effect is not significant and green finance plays a partial intermediary role in the process of energy development promoting high-quality economic development. Existing research considers less of the impact of green finance on high-quality development. On the one hand, the research in this paper can theoretically supplement and improve existing research and expand the research field; on the other hand, it can provide a policy basis for the realization of high-quality development in the region, which has important practical significance for the realization of sustainable development goals in the region. Full article

(This article belongs to the Special Issue The Effects of Green Promotion Policies on Green Energy Development and Environmental Management)

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10 pages, 2761 KiB

Open AccessArticle

Screening of Patient Impairments in an Outpatient Clinic for Suspected Rare Diseases—A Cross-Sectional Study

by Christoph Gutenbrunner, Joerg Schiller, Vega Goedecke, Christina Lemhoefer and Andrea Boekel

Int. J. Environ. Res. Public Health 2022, 19(14), 8874; https://doi.org/10.3390/ijerph19148874 - 21 Jul 2022

Cited by 1 | Viewed by 1383

Abstract

Background: Most rare diseases are chronic conditions with variable impairment of functionality, which can result in a need for rehabilitation. To our knowledge, there are no systematic studies on the rehabilitation needs of patients in centres for rare diseases in the literature. Our [...] Read more.

Background: Most rare diseases are chronic conditions with variable impairment of functionality, which can result in a need for rehabilitation. To our knowledge, there are no systematic studies on the rehabilitation needs of patients in centres for rare diseases in the literature. Our hypothesis is that participation of these patients is so limited that there is an increased need for rehabilitation. For this reason, a survey on the need for rehabilitation was carried out in all patients presenting to the centre for rare diseases, in order to assess the need for rehabilitative measures to counteract disturbances in activity and participation. Methods: A cross-sectional study was performed to collect data using a written questionnaire from December 2020 to June 2021, including patients presenting personally in the center for rare diseases. Results: Nearly 70% of the participants assessed their own ability to work as critical. Of those surveyed, n = 30 (44.9%) had PDI total ≥ 33 points and, thus, a clear pain-related impairment. Conclusion: The results show functional restrictions in the areas of mental well-being and activity. As expected, the health-related quality of life is reduced as compared to healthy people. Almost half of the participants reported significant pain-related impairments, however, only 9% of all respondents stated that they had received appropriate pain therapy. The results show the need for rehabilitation-specific skills in the care and counseling of patients with rare diseases. Full article

(This article belongs to the Special Issue Rehabilitation in Health Systems, Rehabilitation Needs and Innovative Rehabilitation Programs)

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15 pages, 1969 KiB

Open AccessArticle

Current and Future Potential of Shellfish and Algae Mariculture Carbon Sinks in China

by Qiuying Lai, Jie Ma, Fei He, Aiguo Zhang, Dongyan Pei and Minghui Yu

Int. J. Environ. Res. Public Health 2022, 19(14), 8873; https://doi.org/10.3390/ijerph19148873 - 21 Jul 2022

Cited by 15 | Viewed by 3326

Abstract

Shellfish and algae mariculture make up an important part of the marine fishery carbon sink. Carbon sink research is necessary to ensure China achieves its goal of carbon neutrality. This study used the material quality assessment method to estimate the carbon sink capacity [...] Read more.

Shellfish and algae mariculture make up an important part of the marine fishery carbon sink. Carbon sink research is necessary to ensure China achieves its goal of carbon neutrality. This study used the material quality assessment method to estimate the carbon sink capacity of shellfish and algae. Product value, carbon storage value, and oxygen release value were used to calculate the economic value of shellfish and algae carbon sequestration. The results showed that the annual average shellfish and algae carbon sink in China was 1.10 million tons from 2003 to 2019, of which shellfish accounted for 91.63%, wherein Crassostreagigas, Ruditapesphilippinarum, and Chlamysfarreri were the main contributors. The annual average economic value of China’s shellfish and algae carbon sequestration was USD 71,303.56 million, and the product value was the main contributor, accounting for 99.11%. The carbon sink conversion ratios of shellfish and algae were 8.37% and 5.20%, respectively, thus making shellfish the aquaculture species with the strongest carbon sink capacity and the greatest carbon sink potential. The estimated growth rate in the shellfish and algae removable carbon sink was 33,900 tons/year in China, but this trend was uncertain. The capacity for carbon sequestration and exchange by aquaculture can be improved by expanding breeding space, promoting multi-level comprehensive breeding modes, and marine artificial upwelling projects. Full article

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20 pages, 1266 KiB

Open AccessSystematic Review

A Systematic Review of Internet-Based Interventions for the Prevention and Self-Management of Cardiovascular Diseases among People of African Descent

by Jesse Enebi Usman, Charmaine Childs, David Rogerson and Markos Klonizakis

Int. J. Environ. Res. Public Health 2022, 19(14), 8872; https://doi.org/10.3390/ijerph19148872 - 21 Jul 2022

Cited by 1 | Viewed by 2477

Abstract

Cardiovascular disease (CVD) risk factors, morbidity, and mortality among people of African descent (PAD) appear to be higher than in the general population. While it has been found that lifestyle changes can prevent around 90% of CVDs, implementing an effective lifestyle programme is [...] Read more.

Cardiovascular disease (CVD) risk factors, morbidity, and mortality among people of African descent (PAD) appear to be higher than in the general population. While it has been found that lifestyle changes can prevent around 90% of CVDs, implementing an effective lifestyle programme is expensive and time-consuming. It has been demonstrated that Internet-based interventions (IbIs) can effectively and inexpensively encourage lifestyle modifications to prevent and manage chronic diseases. Although a number of studies have examined the effectiveness of IbIs in the general population, no comprehensive study of the usefulness and acceptability of IbIs among PAD has been conducted. This is the knowledge gap that this study aimed to address. We searched MEDLINE, EMBASE, CINAHL, and Web of Science to identify eligible studies published from inception to February 2022. Thirteen articles met our criteria for inclusion. Our textual narrative synthesis produced inconsistent results; nonetheless, high acceptability of IbIs and a considerable improvement in clinical and behavioural outcomes associated with CVDs were reported in several trials. The findings of this review are constrained by clinical, methodological and statistical variability among the studies. To have a good grasp on the effect of IbIs on behaviour change in PAD at risk of CVDs, large-scale longitudinal studies with long-term follow-up are required. Full article

(This article belongs to the Topic eHealth and mHealth: Challenges and Prospects)

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15 pages, 397 KiB

Open AccessArticle

Exhaustion in Healthcare Workers after the First Three Waves of the COVID-19 Pandemic

by Marina Ruxandra Oțelea, Agripina Rașcu, Cătălin Staicu, Lavinia Călugăreanu, Mădălina Ipate, Silvia Teodorescu, Ovidiu Persecă, Angelica Voinoiu, Andra Neamțu, Violeta Calotă and Dana Mateș

Int. J. Environ. Res. Public Health 2022, 19(14), 8871; https://doi.org/10.3390/ijerph19148871 - 21 Jul 2022

Cited by 4 | Viewed by 1860

Abstract

This study aims to identify the determinants of exhaustion of frontline and second-line healthcare workers (HCW) during the third wave of the COVID-19 pandemic. A case–control study was conducted based on an anonymously distributed questionnaire, which was completed by 1872 HCW. Exhaustion was [...] Read more.

This study aims to identify the determinants of exhaustion of frontline and second-line healthcare workers (HCW) during the third wave of the COVID-19 pandemic. A case–control study was conducted based on an anonymously distributed questionnaire, which was completed by 1872 HCW. Exhaustion was assessed with a validated Romanian questionnaire. The Siegrist questionnaire was used to determine workload, reward and overcommitment. Frontline HCW reported significantly more frequent longer working hours (p = 0.0009) and a better perception of the management of the risk for infection (p = 0.0002) than second-line HCW. The effort and overcommitment scores were higher in frontline HCW (9.51 + 1.98 vs. 8.45 + 21, p < 0.001 and 16.34 ± 2.80 vs. 15.24 ± 2.94, p < 0.001, respectively) and the reward scores were lower (5.21 ± 1.522 vs. 5.99 ± 1.44, p < 0.001). In the fully adjusted regression model, age, imbalance between effort and reward, overcommitment and management of the risk of infection in the workplace were associated with the exhaustion score in each category of HCW. The number of working hours was correlated with exhaustion in frontline HCW and occupation in second-line HCW. There were more similarities than differences between frontline and second-line HCW. Even if frontline HCW had a higher risk of exhaustion, the risk was not negligible for all HCW. Full article

13 pages, 2944 KiB

Open AccessArticle

Price Promotions of E-Liquid Products Sold in Online Stores

by Shaoying Ma, Shuning Jiang, Meng Ling, Jian Chen and Ce Shang

Int. J. Environ. Res. Public Health 2022, 19(14), 8870; https://doi.org/10.3390/ijerph19148870 - 21 Jul 2022

Cited by 5 | Viewed by 1653

Abstract

Background: Retailer price promotions are an important marketing strategy to attract consumers. However, there is scarce evidence on how retail price promotions are being implemented by e-cigarette online stores, particularly for e-liquid products that are not often found in brick-and-mortar stores and sold [...] Read more.

Background: Retailer price promotions are an important marketing strategy to attract consumers. However, there is scarce evidence on how retail price promotions are being implemented by e-cigarette online stores, particularly for e-liquid products that are not often found in brick-and-mortar stores and sold in lower prices compared to other types of e-cigarettes. Objectives: We collect data on e-liquid price-promotion activities from online stores using web scraping. From February to May 2021, we scraped the price promotion data of over 14,000 e-liquid products, from five popular online vape shops that sell nationwide in the US. We present descriptive analyses of price promotion on those products, assess price promotion practices in online stores, and discuss components of the final purchase price paid by online customers. Findings: Of the 14,000 e-liquid products and over, 13,326 (92.36%) were on sale, and each online store on average offered discounts from 9.20% to 47.53% for these products. The distribution of the after-discount price was largely similar across the five stores, and there is evidence that each store had adopted different price-promotion strategies. Conclusion: Despite low prices, price promotions are common for e-liquid products, which may undermine the effect of e-cigarette pricing policies such as excise tax that are designed to raise e-cigarette prices. Full article

(This article belongs to the Special Issue Public Health Impacts of Exposure to Tobacco, Alcohol, and Other Substances Content on Social Media)

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13 pages, 356 KiB

Open AccessArticle

Adverse Childhood Experiences and Their Relationship with Poor Sexual Health Outcomes: Results from Four Cross-Sectional Surveys

by Sara K. Wood, Kat Ford, Hannah C. E. Madden, Catherine A. Sharp, Karen E. Hughes and Mark A. Bellis

Int. J. Environ. Res. Public Health 2022, 19(14), 8869; https://doi.org/10.3390/ijerph19148869 - 21 Jul 2022

Cited by 4 | Viewed by 2573

Abstract

Improving understanding of risk factors for risky sexual behaviour is fundamental to achieve better population sexual health. Exposure to adverse childhood experiences (ACEs) can increase the risk of poor sexual health outcomes, but most research is US-based. This study explored associations between ACEs [...] Read more.

Improving understanding of risk factors for risky sexual behaviour is fundamental to achieve better population sexual health. Exposure to adverse childhood experiences (ACEs) can increase the risk of poor sexual health outcomes, but most research is US-based. This study explored associations between ACEs and poor sexual health outcomes in the UK. Data from four cross-sectional ACE surveys with adult general populations in different regions of the UK from 2013–2015 (n = 12,788) were analysed. Data included participants’ demographics, ACE exposure, and four sexual health outcomes: having early sex (<16 years), having an accidental teenage pregnancy, becoming a teenage parent, or having a lifetime diagnosis of a sexually transmitted infection. ACE count was a consistent and significant predictor of all four sexual health outcomes for both males and females, with odds of these outcomes between three and seven times higher for those with 4+ ACEs compared to those with no ACEs. Increased risks of some, but not all, sexual health outcomes were also found with higher residential deprivation, younger age, being of white ethnicity, and being born to a teenage mother. Findings highlight the need for effective interventions to prevent and ameliorate the lifelong effects of ACEs. Trauma-informed relationships and sex education, sexual health services, and antenatal/postnatal services, particularly for teenagers and young parents, could provide opportunities to prevent ACEs and support those affected. Ensuring that those living in deprived areas have access to services and that barriers to uptake are addressed is also key. Full article

(This article belongs to the Special Issue Adverse Childhood Experiences (ACEs) and the Life-Course Health Consequences)

12 pages, 376 KiB

Open AccessArticle

Is the Prevalence of Low Physical Activity among Teachers Associated with Depression, Anxiety, and Stress?

by Elżbieta Biernat, Monika Piątkowska and Michał Rozpara

Int. J. Environ. Res. Public Health 2022, 19(14), 8868; https://doi.org/10.3390/ijerph19148868 - 21 Jul 2022

Cited by 10 | Viewed by 2194

Abstract

The aim of this study was to analyze the levels of stress, depression, and anxiety among Polish secondary school teachers and their association with selected psychosocial, sociodemographic, and lifestyle factors. A cross-sectional study was conducted among 116 Polish teachers in 2019, using the [...] Read more.

The aim of this study was to analyze the levels of stress, depression, and anxiety among Polish secondary school teachers and their association with selected psychosocial, sociodemographic, and lifestyle factors. A cross-sectional study was conducted among 116 Polish teachers in 2019, using the International Physical Activity Questionnaire—Short Form (IPAQ-SF), the Depression and Anxiety Stress Scale (DASS-21), and author questionnaire including psychosocial factors specific to the respondents’ work environment. The prevalence of moderately to extremely severe levels of depression, anxiety, and symptoms of stress in teachers was 18.1%, 22.4%, and 51.7%, respectively. Among respondents with moderate or high physical activity level (PAL), normal or mild levels of depression (OR = 3.62; CI [1.31–10.03]), anxiety (OR = 2.61; CI [1.01–6.73]), and stress (OR = 2.79; CI [1.16–6.69]) were more common. The level of individual symptoms of mental disorders was higher than indicated by previous Polish reports. Given that teachers’ low PAL is significantly related to their moderately to extremely severe levels of stress, depression, and anxiety, we suggest running leisure-time physical activity (LTPA) enhancement programs and supporting the leadership of school management and the higher-education system in this regard. Full article

(This article belongs to the Section Sport and Health)

14 pages, 591 KiB

Open AccessArticle

Associations between Physical Activity Level and Health Services Use in Spanish Adults

by Ángel Denche-Zamorano, María Mendoza-Muñoz, Jorge Carlos-Vivas, Laura Muñoz-Bermejo, Jorge Rojo-Ramos, Frano Giakoni-Ramírez, Andrés Godoy-Cumillaf and Sabina Barrios-Fernandez

Int. J. Environ. Res. Public Health 2022, 19(14), 8867; https://doi.org/10.3390/ijerph19148867 - 21 Jul 2022

Cited by 2 | Viewed by 1631

Abstract

One of the main concerns of governments and organisations worldwide is the cost and burden of health services, with sedentary lifestyles being a significant impacting factor, and physical activity is one of the potential solutions. Therefore, this study aims to analyse the possible [...] Read more.

One of the main concerns of governments and organisations worldwide is the cost and burden of health services, with sedentary lifestyles being a significant impacting factor, and physical activity is one of the potential solutions. Therefore, this study aims to analyse the possible associations between the physical activity level, hospitalisation prevalence, and the use and number of visits to emergency services in the Spanish population, examining potential differences between sex and age groups. This is a cross-sectional study based on data from the Spanish National Health Survey 2017 (ENSE 2017), the last one before the COVID-19 pandemic, with 17,199 participants. A descriptive analysis was performed using median and interquartile range (continuous variables) and absolute and relative frequencies (ordinal variables). Intergroup differences were analysed with non-parametric tests: chi-square and z-test for independent proportions (categorical variables), and Kruskal–Wallis and Mann–Whitney U (continuous variables). Spearman’s rho was used to study correlations between variables. A multiple binary regression analysis was performed to predict hospitalisations. Hospitalisations and emergency services use showed a dependence relation with the physical activity level (p < 0.001): those who performed moderate and/or vigorous physical activity used those services less than sedentary individuals and those whose only activity was walking. Thus, associations could be drawn between the hospitalisation prevalence, the use and number of visits to emergency departments, and the physical activity level in the Spanish population aged 18–69 years in the pre-pandemic period. Full article

(This article belongs to the Special Issue The Role of Sport and Physical Activity in Population Health and Wellbeing)

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17 pages, 4825 KiB

Open AccessArticle

Bibliometric Analysis of the Knowledge Base and Future Trends on Sarcopenia from 1999–2021

by Yao Xiao, Ziheng Deng, Hangjing Tan, Tiejian Jiang and Zhiheng Chen

Int. J. Environ. Res. Public Health 2022, 19(14), 8866; https://doi.org/10.3390/ijerph19148866 - 21 Jul 2022

Cited by 13 | Viewed by 3091

Abstract

Sarcopenia is characterized by progressive loss of muscle mass and function, and it is becoming a serious public health problem with the aging population. However, a comprehensive overview of the knowledge base and future trends is still lacking. The articles and reviews with [...] Read more.

Sarcopenia is characterized by progressive loss of muscle mass and function, and it is becoming a serious public health problem with the aging population. However, a comprehensive overview of the knowledge base and future trends is still lacking. The articles and reviews with “sarcopenia” in their title published from 1999 to 2021 in the SCIE database were retrieved. We used Microsoft Excel, VOSviewer, and CiteSpace to conduct a descriptive and bibliometric analysis. A total of 3582 publications were collected, from 4 published in 2000 increasing dramatically to 850 documents in 2021. The USA was the most productive country, with the most citations. The Catholic University of the Sacred Heart and Landi F were the most influential organization and author in this field, respectively. The core journal in this field was the Journal of Cachexia Sarcopenia and Muscle. According to the analysis of keywords and references, we roughly categorized the main research areas into four domains as follows: 1. Definition and diagnosis; 2. Epidemiology; 3. Etiology and pathogenesis; 4. Treatments. Comparing different diagnostic tools and the epidemiology of sarcopenia in different populations are recent hotspots, while more efforts are needed in the underlying mechanism and developing safe and effective treatments. In conclusion, this study provides comprehensive insights into developments and trends in sarcopenia research that can help researchers and clinicians better manage and implement their work. Full article

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19 pages, 760 KiB

Open AccessReview

Examine Race/Ethnicity Disparities in Perception, Intention, and Screening of Dementia in a Community Setting: Scoping Review

by SangA Lee, Deogwoon Kim and Haeok Lee

Int. J. Environ. Res. Public Health 2022, 19(14), 8865; https://doi.org/10.3390/ijerph19148865 - 21 Jul 2022

Cited by 6 | Viewed by 2135

Abstract

Background: Delayed detection and diagnosis of Alzheimer’s Disease and related dementia (ADRD) can lead to suboptimal care and socioeconomic burdens on individuals, families, and communities. Our objective is to investigate dementia screening behavior focusing on minority older populations and assess whether there are [...] Read more.

Background: Delayed detection and diagnosis of Alzheimer’s Disease and related dementia (ADRD) can lead to suboptimal care and socioeconomic burdens on individuals, families, and communities. Our objective is to investigate dementia screening behavior focusing on minority older populations and assess whether there are ethnic differences in ADRD screening behavior. Methods: The scoping review method was utilized to examine ADRD screening behavior and contributing factors for missed and delayed screening/diagnosis focusing on race/ethnicity. Results: 2288 papers were identified, of which 21 met the inclusion criteria. We identified six dimensions of ADRD screening behavior: Noticing Symptoms, Recognizing a problem, Accepting Screen, Intending Screen, Action, and Integrating with time. Final findings were organized into study race/ethnicity, theoretical background, the methods of quantitative and qualitative studies, description and measures of ADRD screening behavior, and racial/ethnic differences in ADRD screening behavior. Conclusions: A trend in ethnic disparities in screening for ADRD was observed. Our findings point to the fact that there is a scarcity of studies focusing on describing ethnic-specific ADRD screening behavior as well as a lack of those examining the impact of ethnicity on ADRD screening behavior, especially studies where Asian Americans are almost invisible. Full article

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12 pages, 1974 KiB

Open AccessArticle

Physiological Responses at 15 Minutes of Recovery after a Session of Functional Fitness Training in Well-Trained Athletes

by José Luis Maté-Muñoz, Mihai Budurin, Salvador González-Lozano, Juan Ramón Heredia-Elvar, Ana María Cañuelo-Márquez, Manuel Barba-Ruiz, Diego Muriarte, Manuel Vicente Garnacho-Castaño, Juan Hernández-Lougedo and Pablo García-Fernández

Int. J. Environ. Res. Public Health 2022, 19(14), 8864; https://doi.org/10.3390/ijerph19148864 - 21 Jul 2022

Cited by 6 | Viewed by 2102

Abstract

Background: the aim of this study was to analyse muscle fatigue and metabolic stress at 15 min of recovery after performing two independent sessions of functional fitness training (FFT): a session of strength functional fitness training (FFTstrength) and a session of endurance functional [...] Read more.

Background: the aim of this study was to analyse muscle fatigue and metabolic stress at 15 min of recovery after performing two independent sessions of functional fitness training (FFT): a session of strength functional fitness training (FFTstrength) and a session of endurance functional fitness training (FFTendurance). Methods: eighteen well-trained men conducted two protocols, separated by one week of rest: FFTstrength (3 sets of 21, 15 and 9 repetitions of Thruster with bar + Pull ups) and FFTendurance (3 sets × (30 kcal rowing + 15 kcal assault air bike)). Neuromuscular fatigue and metabolic stress were measured right before, right after and at 10 and 15 min after completing the FFT workout, as well as the mean heart rate (HRmean) and the rating of perceived exertion (RPE) at the end of the FFT. Results: FFTendurance recovered the velocity loss values after 15 min of recovery. On the other hand, FFTstrength only recovered velocity in the 1 m·s⁻¹ Tests in squat (SQ), since the velocity levels were 7% lower in the 1 m·s⁻¹ Tests in military press exercise (MP) after 15 min. Conclusions: These data indicate that there are specific recovery patterns not only as a function of the exercise and the body regions involved, but also regarding the recovery of neuromuscular and metabolic factors, since both FFT workouts obtained high blood lactate concentrations. Full article

(This article belongs to the Special Issue Effects of Sports Training and Physical Conditioning on Human Health)

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33 pages, 812 KiB

Open AccessReview

Pre-Existing Medical Conditions: A Systematic Literature Review of a Silent Contributor to Adult Drowning

by Amy E. Peden, Danielle H. Taylor and Richard C. Franklin

Int. J. Environ. Res. Public Health 2022, 19(14), 8863; https://doi.org/10.3390/ijerph19148863 - 21 Jul 2022

Cited by 6 | Viewed by 2543

Abstract

Medical conditions can increase drowning risk. No prior study has systematically reviewed the published evidence globally regarding medical conditions and drowning risk for adults. MEDLINE (Ovid), PubMed, EMBASE, Scopus, PsycINFO (ProQuest) and SPORTDiscus databases were searched for original research published between 1 January [...] Read more.

Medical conditions can increase drowning risk. No prior study has systematically reviewed the published evidence globally regarding medical conditions and drowning risk for adults. MEDLINE (Ovid), PubMed, EMBASE, Scopus, PsycINFO (ProQuest) and SPORTDiscus databases were searched for original research published between 1 January 2005 and 31 October 2021 that reported adult (≥15 years) fatal or non-fatal drowning of all intents and pre-existing medical conditions. Conditions were grouped into the relevant International Classifications of Diseases (ICD) codes. Eighty-three studies were included (85.5% high-income countries; 38.6% East Asia and Pacific region; 75.9% evidence level III-3). Diseases of the nervous system (n = 32 studies; 38.6%), mental and behavioural conditions (n = 31; 37.3%) and diseases of the circulatory system (n = 25; 30.1%) were the most common categories of conditions. Epilepsy was found to increase the relative risk of drowning by 3.8 to 82 times, with suggested preventive approaches regarding supervised bathing or showering. Drowning is a common suicide method for those with schizophrenia, psychotic disorders and dementia. Review findings indicate people with pre-existing medical conditions drown, yet relatively few studies have documented the risk. There is a need for further population-level research to more accurately quantify drowning risk for pre-existing medical conditions in adults, as well as implementing and evaluating population-level attributable risk and prevention strategies. Full article

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17 pages, 3502 KiB

Open AccessArticle

Association between Leptin (G2548A) and Leptin Receptor (Q223R) Polymorphisms with Plasma Leptin, BMI, Stress, Sleep and Eating Patterns among the Multiethnic Young Malaysian Adult Population from a Healthcare University

by Jaiprakash Mohanraj, Urban J. A. D’Souza, Siat Yee Fong, Ivan Rolland Karkada and Heethal Jaiprakash

Int. J. Environ. Res. Public Health 2022, 19(14), 8862; https://doi.org/10.3390/ijerph19148862 - 21 Jul 2022

Cited by 2 | Viewed by 2429

Abstract

Relative leptin resistance in childhood to absolute leptin resistance in maturity suggests sleep, eating behaviour, and the psychological state as probable causes. The current body of research provides inconclusive evidence linking G2548A and Q223R to obesity. Furthermore, we could find very little data [...] Read more.

Relative leptin resistance in childhood to absolute leptin resistance in maturity suggests sleep, eating behaviour, and the psychological state as probable causes. The current body of research provides inconclusive evidence linking G2548A and Q223R to obesity. Furthermore, we could find very little data that have observed the association between the environment and gene polymorphism, especially in the multiethnic population that exists in Malaysia. This study searched for a possible link between sleeping habits, eating behaviour, and stress indicators with plasma leptin and its genetic variation in young adult Malaysian healthcare students. The study involved 185 first- and second-year medical and dental students from a healthcare university. Polymerase Chain Reaction–Restriction Fragment Length Polymorphism(PCR-RFLP) determined the genotype, Enzyme Linked Immunoabsorbant Assay (ELISA) tested the serum leptin, and a self-administered questionnaire evaluated sleep, eating behaviour, and psychological condition. Gender and ethnicity are linked to fasting plasma leptin levels (p < 0.001). Plasma leptin also affects stress, anxiety, and sadness. Leptin (LEP) and Leptin Receptor (LEPR) polymorphisms were not associated with BMI, plasma leptin, sleep, eating behaviour, or psychological state. Young adult Malaysian Indians were obese and overweight, while Chinese were underweight. These findings imply overweight and obese participants were in stage I of leptin resistance and lifestyle change or leptin therapy could prevent them from becoming cripplingly obese as they age. Full article

(This article belongs to the Special Issue Obesity and Health Risk Knowledge)

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9 pages, 1503 KiB

Open AccessReview

Cutaneous Manifestations of COVID-19 in the Lower Limbs: A Narrative Review

by Inmaculada C. Palomo-Toucedo, Manuel Jesús López-Sánchez, María Reina-Bueno and Manuel Coheña-Jiménez

Int. J. Environ. Res. Public Health 2022, 19(14), 8861; https://doi.org/10.3390/ijerph19148861 - 21 Jul 2022

Viewed by 3964

Abstract

In 2020, the World Health Organization declared the COVID-19 pandemic. This infectious pathology can be associated with different manifestations in different body systems, among which are dermatological lesions. The purpose of this work is to determine the most frequent dermatological signs, in the [...] Read more.

In 2020, the World Health Organization declared the COVID-19 pandemic. This infectious pathology can be associated with different manifestations in different body systems, among which are dermatological lesions. The purpose of this work is to determine the most frequent dermatological signs, in the lower limbs, produced by SARS-CoV-2. To carry this out, a bibliographic search was performed in the following databases: PubMed, SciELO, ScienceDirect, Cochrane Database of Systematic Reviews, and the Google Scholar literature. The inclusion criteria were articles that included confirmed subjects or those with a clinical suspicion of COVID-19, written in the Spanish or English languages, and the results presented clinical manifestations in the lower extremities. Initially, 128 scientific documents were identified and, after reading the title and abstract, 18 articles were selected. The most frequent skin lesions on the lower limbs are acral lesions such as pernio erythema or ischemic lesions, maculopapular rash, petechiae, and erythematous plaques. Full article

(This article belongs to the Special Issue Impact of Coronavirus (COVID-19))

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16 pages, 13647 KiB

Open AccessArticle

Associations between Awareness of the Risk of Exposure to Pollutants Occurring at Fire Scenes and Health Beliefs among Metropolitan Firefighters in the Republic of Korea

by Hye Eun Oh, Soo Jin Kim, Hyekyung Woo and Seunghon Ham

Int. J. Environ. Res. Public Health 2022, 19(14), 8860; https://doi.org/10.3390/ijerph19148860 - 21 Jul 2022

Viewed by 2041

Abstract

Firefighters are repeatedly exposed to various pollutants that occur at fire scenes. There are three levels of exposure: primary exposure to pollutants, secondary exposure to pollutants on personal protective equipment (PPE), and tertiary exposure to contaminated fire stations and fire engines due to [...] Read more.

Firefighters are repeatedly exposed to various pollutants that occur at fire scenes. There are three levels of exposure: primary exposure to pollutants, secondary exposure to pollutants on personal protective equipment (PPE), and tertiary exposure to contaminated fire stations and fire engines due to pollutants on PPE. Therefore, it is important for firefighters to be aware of the risk of exposure to pollutants and to practice health behaviors such as appropriate PPE management. No clear association has been established in the existing literature between firefighters’ risk perception level and their health beliefs about the health impact of awareness of exposure to hazardous substances at fire scenes. This study aims to evaluate the relationship between awareness of the exposure risk to primary, secondary, and tertiary pollutants and health beliefs. It was designed as a cross-sectional study, in which a web-based survey was conducted from 13 May to 31 May 2021. The analysis was conducted in 1940 firefighters working in the Seoul metropolis who agreed to participate in the research. Participants who perceived susceptibility were likely to be aware of the primary (adjusted odds ratio (AOR) = 2.10, 95% confidence interval (CI) 1.16–3.80), secondary (AOR = 2.77, 95% CI 1.77–4.32), and tertiary (AOR = 2.73, 95% CI 1.85–4.03) exposure risks. Participants who perceived barriers were unlikely to be aware of the risk of exposure to primary (AOR = 0.67, 95% CI 0.49–0.91), secondary (AOR = 0.77, 95% CI 0.61–0.96), and tertiary (AOR = 0.75, 95% CI 0.62–0.91) pollutants. Educational intervention is recommended to improve perceived susceptibility and awareness of the risk of exposure to pollutants and reduce perceived barriers. Consequently, educational intervention is expected to positively impact firefighters’ management of appropriate PPE. We confirmed an association between occupational exposure risk and firefighters’ health beliefs. In the health belief model (HBM), health beliefs that affect health behavior also affect awareness of the exposure risk level. Therefore, an intervention for health beliefs can also be used to raise job-related exposure risk awareness. Regular training on the health impacts of fire scenes is necessary for both newcomers and incumbents to enable firefighters to better recognize the risks of each occupational exposure level. Additionally, laws and regulations are necessary for the removal of harmful substances that contaminate PPE, such as self-contained breathing apparatus (SCBA), during exposure to a fire scene. Our research can be used as a basis for improving fire policies and education programs in the future. Full article

(This article belongs to the Special Issue Fire Emissions: Exposure Data and Potential Health Risks for Firefighting Forces and the General Population)

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13 pages, 671 KiB

Open AccessArticle

Linking Self-Control, Hope, Positivity Ratio, Anxiety and Handwashing Habits during the Coronavirus Outbreak

by Shira Bukchin-Peles and Tammie Ronen

Int. J. Environ. Res. Public Health 2022, 19(14), 8859; https://doi.org/10.3390/ijerph19148859 - 21 Jul 2022

Cited by 3 | Viewed by 1683

Abstract

The novel COVID-19 is an infectious disease caused by the coronavirus. In the early stages of the pandemic, Israel struggled to contain its local outbreak through various measures that have virtually halted daily life and placed tens of thousands of people into quarantine. [...] Read more.

The novel COVID-19 is an infectious disease caused by the coronavirus. In the early stages of the pandemic, Israel struggled to contain its local outbreak through various measures that have virtually halted daily life and placed tens of thousands of people into quarantine. This study explored the role played by self-control and hope for obtaining two desired outcomes: (1) maintaining one’s positivity ratio (having more positive than negative affect—an indicator of wellbeing) and (2) increasing one’s contagion-preventing behavior (in this study—handwashing habits). Path analysis was conducted using survey data collected from 537 Israeli adults. Our findings suggest that self-control’s association with the positivity ratio is mediated through hope and anxiety levels. Self-control positively correlates with hope levels and negatively correlates with anxiety levels. Higher hope levels correlate with a higher positivity ratio, while lower anxiety levels correlate with a higher positivity ratio. The relationship between self-control and handwashing habits was mediated by hope, anxiety, and existing handwashing habits. This study brings research a step forward in demonstrating the vital role of positive components in achieving desired psychological and behavioral outcomes during an anxiety-provoking epidemic outbreak. In addition to its theoretical innovation, the importance of this study lies in its practical value: We focus on variables that are influenced by policy, education, and communication. Full article

(This article belongs to the Special Issue 2nd Edition of Survey about Psychological Health)

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11 pages, 348 KiB

Open AccessArticle

Low Cardiorespiratory Fitness, Muscular Fitness, and Flexibility Are Associated with Body Fat Distribution and Obesity Risk Using Bioelectrical Impedance in Taiwanese Adults

by Hsiu-Hsi Chiang, Po-Fu Lee, Yun-Tsung Chen, Chi-Fang Lin, Shu Xu, Yi-Tien Lin, Yu-Ting Lin, Yan-Jhu Su, Ben-Chang Shia, Wen-Sheng ChangChien and Chien-Chang Ho

Int. J. Environ. Res. Public Health 2022, 19(14), 8858; https://doi.org/10.3390/ijerph19148858 - 21 Jul 2022

Cited by 4 | Viewed by 1729

Abstract

In terms of public health, obesity and overweight have become major concerns worldwide. Nevertheless, regarding body composition, it is important to have a more precise understanding of the fat-to-muscle ratio. Hence, this study aimed to adopt bioelectrical impedance measurements to test body fat [...] Read more.

In terms of public health, obesity and overweight have become major concerns worldwide. Nevertheless, regarding body composition, it is important to have a more precise understanding of the fat-to-muscle ratio. Hence, this study aimed to adopt bioelectrical impedance measurements to test body fat percentage (BF%) and to determine the associations between health-related physical fitness and both body fat (BF) distribution and BF obesity risk in Taiwanese adults. We conducted a cross-sectional study and reviewed data derived from Taiwan’s Scientific Physical Fitness Survey. From the database, responses from 17,970 participants aged 23–64 years were collected in this study. Each participant completed a series of health-related physical fitness measurements, including cardiorespiratory fitness (3 min of a progressive knee-up and step (3MPKS) test), muscular fitness (hand-grip strength), and flexibility (sit-and-reach test). The BF% of each participant was assessed using the bioelectrical impedance analysis method. BF% was negatively associated with low performance on the 3MPKS (β = 11.314, p < 0.0001 for men; β = 12.308, p < 0.0001 for women), hand-grip strength (β = 2.071, p < 0.0001 for men; β = 0.859, p < 0.0001 for women), and sit-and-reach (β = 0.337, p = 0.008 for women) tests but was positively associated with sit-and-reach (β = −0.394, p = 0.004 for men). A risk of BF obesity for low performance of 3MPKS (odds ratio (OR) = 26.554, p < 0.0001 for men; OR = 25.808, p < 0.0001 for women), hand-grip strength (OR = 1.682, p < 0.0001 for men; OR = 1.234, p < 0.0001 for women), and sit-and-reach (OR = 1.142, p = 0.007 for women) tests was observed. These results suggest that low levels of cardiorespiratory fitness, muscular fitness, and flexibility are associated with an increased risk of BF obesity. Full article

(This article belongs to the Special Issue Physical Activity and Non-communicable Diseases)

14 pages, 560 KiB

Open AccessArticle

Maintenance of Physical Activity Behavior by Individuals with Prediabetes and Diabetes during the COVID-19 Pandemic after Completing an Exercise Intervention in Brazil

by Isabela Coelho Ponciano, Mariana Balbi Seixas, Tiago Peçanha, Adriano Luiz Pereira, Patrícia Fernandes Trevizan, Raquel Rodrigues Britto and Lilian Pinto da Silva

Int. J. Environ. Res. Public Health 2022, 19(14), 8857; https://doi.org/10.3390/ijerph19148857 - 21 Jul 2022

Cited by 1 | Viewed by 1837

Abstract

This cross-sectional study evaluated the perception of individuals with prediabetes/diabetes about their living conditions during the COVID-19 pandemic to identify the facilitators, barriers, and reasons to remain physically active at home and adhere to recommended exercise. It included individuals with prediabetes/diabetes who had [...] Read more.

This cross-sectional study evaluated the perception of individuals with prediabetes/diabetes about their living conditions during the COVID-19 pandemic to identify the facilitators, barriers, and reasons to remain physically active at home and adhere to recommended exercise. It included individuals with prediabetes/diabetes who had completed an exercise intervention, which started on-site and moved to a remote home-based regime due to the COVID-19 pandemic and were advised to keep exercising at home. The outcomes were assessed by a bespoke questionnaire that was developed by the research team, the Brazilian Portuguese adapted version of the Exercise Adherence Rating scale, and the Motives for Physical Activity Measure-Revised scale. Of 15 participants (8 female, 58 ± 11 years), most reported positive perceptions about their living conditions and few difficulties maintaining some physical activity at home. However, only 53.8% of them adhered to the recommended exercise. Time flexibility, no need for commuting, and a sense of autonomy were the main facilitators of home exercise, while a lack of adequate space was the main barrier. The descending order of median scores that were obtained in each reason for physical activity was fitness, enjoyment, competence, social, and appearance. Individuals with prediabetes/diabetes maintained some physical activity during the pandemic, mainly motivated by health concerns. Full article

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

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9 pages, 300 KiB

Open AccessArticle

Regular Exercise with Suicide Ideation, Suicide Plan and Suicide Attempt in University Students: Data from the Health Minds Survey 2018–2019

by Ke Ning, Chun Yan, Yanjie Zhang and Sitong Chen

Int. J. Environ. Res. Public Health 2022, 19(14), 8856; https://doi.org/10.3390/ijerph19148856 - 21 Jul 2022

Cited by 5 | Viewed by 2522

Abstract

Background: Participating in exercise has been frequently recognized as a protective factor of suicide-related outcome (e.g., suicidal ideation) in children and adolescents, albeit with less of a focus on university/college students (especially using nationally representative sample). This study aimed to explore the associations [...] Read more.

Background: Participating in exercise has been frequently recognized as a protective factor of suicide-related outcome (e.g., suicidal ideation) in children and adolescents, albeit with less of a focus on university/college students (especially using nationally representative sample). This study aimed to explore the associations between regular exercise with suicide ideation, plan, and suicide attempts using the data from Health Minds Survey (2018–2019 round). Methods: Using the cross-sectional data from a nationally representative sample (n = 62,026; mean age = 23.1 years) with self-reported information on exercise and the three suicide-related measures, binary logistic regression was used to estimate the associations of exercise with suicide ideation, plans, and attempts, respectively, while controlling for age, gender, being an international student or not, and race/ethnicity. Results: Compared with university students reporting five or more hours for exercise a week, those reporting less were more likely to report yes in terms of suicide ideation and a similar association was also observed in exercise and suicide plan. However, exercise was not significantly associated with suicide attempts. Conclusion: Spending more time exercising may be a protective factor against suicide ideation and plan for university students. Owing to the cross-sectional design nature, our research findings should be further investigated for confirmation or negation. Full article

(This article belongs to the Special Issue Physical Activity, Physical Function and Suicide)

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Int. J. Environ. Res. Public Health, Volume 19, Issue 14 (July-2 2022) – 662 articles

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