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Int. J. Environ. Res. Public Health, Volume 19, Issue 18 (September-2 2022) – 695 articles

Cover Story (view full-size image): Dementia is a common geriatric disease with a rapidly increasing prevalence, and certain medications are contributing to its exacerbation. These medications are known as potentially inappropriate medications associated with dementia exacerbation (DPIMs). The epidemiology of DPIM use was assessed by retrospectively reviewing electronic medical records over one year at a tertiary, university-affiliated hospital in Korea. Approximately half (47.0%) of the 2100 patients received ≥ 1 DPIM; these were most frequently benzodiazepines followed by anticholinergics. Female patients with multiple comorbidities who used polypharmacy were more likely to be prescribed DPIMs, and thus systematic interventions to prevent DPIM-related harm in these patients should be implemented. View this paper
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8 pages, 323 KiB  
Brief Report
Perceived Social Support Increases Creativity: Experimental Evidence
by Chee-Seng Tan, Xi-Yuan Chin, Samuel Ta-Chuan Chng, Jazen Lee and Chia-Sin Ooi
Int. J. Environ. Res. Public Health 2022, 19(18), 11841; https://doi.org/10.3390/ijerph191811841 - 19 Sep 2022
Cited by 4 | Viewed by 2580
Abstract
The literature has consistently shown that social support has a positive relationship with creativity. However, further investigation is needed to clarify the causal relationship between the two constructs. The present study addressed this need by exploring the impact of experimentally induced perceived social [...] Read more.
The literature has consistently shown that social support has a positive relationship with creativity. However, further investigation is needed to clarify the causal relationship between the two constructs. The present study addressed this need by exploring the impact of experimentally induced perceived social support on creativity among young adults. A total of 135 undergraduate students in Malaysia participated in an online experiment. All participants first answered the creative self-efficacy scale and were then randomly allocated to the experimental and control groups. Perceived social support was primed by a writing test and measured by the Multidimensional Scales of Perceived Social Support. Both groups also answered a divergent thinking test (measured for fluency, flexibility, and originality) and a self-rated creativity scale. Multivariate analysis of covariance showed that, after statistically controlling for the effect of creative self-efficacy, participants in the experimental group reported higher scores in perceived social support and all creativity measures than their counterparts in the control group. The results demonstrated that the manipulation is effective and the induced perceived social support leads to higher creativity. Our findings not only offer empirical evidence of the causality of social support and creativity but also has practical value for creativity development. Full article
(This article belongs to the Section Global Health)
17 pages, 818 KiB  
Article
Family Structure and Family Climate in Relation to Health and Socioeconomic Status for Older Adults: A Longitudinal Moderated Mediation Analysis
by Enrique Alonso-Perez, Paul Gellert, Michaela Kreyenfeld and Julie Lorraine O’Sullivan
Int. J. Environ. Res. Public Health 2022, 19(18), 11840; https://doi.org/10.3390/ijerph191811840 - 19 Sep 2022
Cited by 1 | Viewed by 2933
Abstract
Family characteristics are associated with individuals’ health and wellbeing. However, the link between family structure (e.g., operationalized via marital status) and health outcomes is ambiguous, and whether family climate mediates the relationship is unclear. This study uses the Biobehavioral Family Model (BBFM) to [...] Read more.
Family characteristics are associated with individuals’ health and wellbeing. However, the link between family structure (e.g., operationalized via marital status) and health outcomes is ambiguous, and whether family climate mediates the relationship is unclear. This study uses the Biobehavioral Family Model (BBFM) to investigate the association of older adults’ family structure with later health, the mediating role of family climate and mental health and how these links vary by socioeconomic status (SES). Using data from n = 29,457 respondents aged over 50 in Waves 4, 5 and 6 (2011, 2013 and 2015) of the Survey of Health, Retirement and Ageing in Europe (SHARE), the BBFM was applied in a longitudinal mediation analysis of family structure and health, including both indicators of mental and physical health. Structural equation modeling was applied, and a multigroup analysis was performed to test the role of SES in a moderated mediation. Family climate and mental health mediated the relationship between family structure and subsequent physical health. Good levels of family climate were found to be consistently associated with improved mental and physical health. These relationships were significantly moderated by SES, showing that the association of family climate and health was weaker for those in low SES positions. Family climate and mental health should be considered as potential mechanisms linking family structure to later physical health outcomes across time; however, these associations are diminished for those with low SES. Full article
(This article belongs to the Section Health Behavior, Chronic Disease and Health Promotion)
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11 pages, 1153 KiB  
Review
Pedometers and Accelerometers in Multiple Sclerosis: Current and New Applications
by Jeffer Eidi Sasaki, Gabriel Felipe Arantes Bertochi, Joilson Meneguci and Robert W. Motl
Int. J. Environ. Res. Public Health 2022, 19(18), 11839; https://doi.org/10.3390/ijerph191811839 - 19 Sep 2022
Cited by 2 | Viewed by 2051
Abstract
Pedometers and accelerometers have become commonplace for the assessment of physical behaviors (e.g., physical activity and sedentary behavior) in multiple sclerosis (MS) research. Current common applications include the measurement of steps taken and the classification of physical activity intensity, as well as sedentary [...] Read more.
Pedometers and accelerometers have become commonplace for the assessment of physical behaviors (e.g., physical activity and sedentary behavior) in multiple sclerosis (MS) research. Current common applications include the measurement of steps taken and the classification of physical activity intensity, as well as sedentary behavior, using cut-points methods. The existing knowledge and applications, coupled with technological advances, have spawned new opportunities for using those motion sensors in persons with MS, and these include the utilization of the data as biomarkers of disease severity and progression, perhaps in clinical practice. Herein, we discuss the current state of knowledge on the validity and applications of pedometers and accelerometers in MS, as well as new opportunities and strategies for the improved assessment of physical behaviors and disease progression, and consequently, personalized care. Full article
(This article belongs to the Section Digital Health)
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32 pages, 1313 KiB  
Article
What Factors Influence the Interest in Working in the Public Health Service in Germany? Part I of the OeGD-Studisurvey
by Laura Arnold, Lisa Kellermann, Florian Fischer, Sophie Gepp, Franziska Hommes, Laura Jung, Amir Mohsenpour, Dagmar Starke and Jan M. Stratil
Int. J. Environ. Res. Public Health 2022, 19(18), 11838; https://doi.org/10.3390/ijerph191811838 - 19 Sep 2022
Cited by 3 | Viewed by 2569
Abstract
As in many European countries, the Public Health Service (PHS) in Germany has had considerable difficulties in attracting well-qualified personnel for decades. Despite ongoing political and societal debate, limited empirical research on possible causes and explanations is available. To identify areas of action, [...] Read more.
As in many European countries, the Public Health Service (PHS) in Germany has had considerable difficulties in attracting well-qualified personnel for decades. Despite ongoing political and societal debate, limited empirical research on possible causes and explanations is available. To identify areas of action, we explored reasons for the (lack of) interest in working in the PHS by conducting two cross-sectional surveys among 3019 medical students (MS), public health students, and students from other PHS-relevant fields (PH&ONM) in Germany right before (wave 1, 2019/2020) and during the COVID-19 pandemic (wave 2, 2021). While interest in working in the PHS among MS was low, it was considerably higher among PH&ONM. The prevalent underestimation of the importance of public health and low levels of knowledge about the PHS were identified as potential barriers. Although core activities of the PHS were often considered attractive, they were repeatedly not attributed to the PHS. A negative perception of the PHS (e.g., it being too bureaucratic) was prevalent among students with and without PHS interest, indicating that both a negative image and potentially structural deficits need to be overcome to increase attractiveness. Based on the findings, we propose approaches on how to sustainably attract and retain qualified personnel. Full article
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16 pages, 430 KiB  
Article
Changes in Novel Anthropometric Indices of Abdominal Obesity during Weight Loss with Selected Obesity-Associated Single-Nucleotide Polymorphisms: A Small One-Year Pilot Study
by Katarzyna Iłowiecka, Paweł Glibowski, Justyna Libera and Wojciech Koch
Int. J. Environ. Res. Public Health 2022, 19(18), 11837; https://doi.org/10.3390/ijerph191811837 - 19 Sep 2022
Viewed by 2076
Abstract
Whether BMI and the competing waist circumference (WC)-based anthropometric indices are associated with obesity-related single-nucleotide polymorphisms (SNPs) is as yet unknown. The current study aimed to evaluate the anthropometric indices (fat mass index, body shape index, visceral adiposity index, relative fat mass, body [...] Read more.
Whether BMI and the competing waist circumference (WC)-based anthropometric indices are associated with obesity-related single-nucleotide polymorphisms (SNPs) is as yet unknown. The current study aimed to evaluate the anthropometric indices (fat mass index, body shape index, visceral adiposity index, relative fat mass, body roundness index, and conicity index) during a weight loss intervention in 36 obese individuals. Blood biochemical parameters (total cholesterol, low-density lipoprotein, high-density lipoprotein, and triglycerides) and three SNPs (FTO rs9939609, TFAP2B rs987237, and PLIN1 rs894160) were assessed in 22 women and 14 men (35.58 ± 9.85 years, BMI 35.04 ± 3.80 kg/m2) who completed a 12-month balanced energy-restricted diet weight loss program. Body composition was assessed via bioelectrical impedance (SECA mBCA515). At the end of the weight loss intervention, all anthropometric indices were significantly reduced (p < 0.05). For the SNP FTO rs9939609, the higher risk allele (A) was characteristic of 88.9% of the study group, in which 10 participants (27.8%) were homozygous. We found a similar distribution of alleles in TFAP2B and PLIN1. Heterozygous genotypes in FTO rs9939609 and TFAP2B rs987237 were predisposed to significant reductions in WC-based novel anthropometric indices during weight loss. The influence of PLIN1 rs894160 polymorphisms on the changes in the analyzed indices during weight loss has not been documented in the present study. Full article
(This article belongs to the Special Issue The Effects of Eating Habits on Human Health)
16 pages, 2571 KiB  
Article
Physical Activity, Sedentary Behaviour, Weight Status, and Body Composition among South African Primary Schoolchildren
by Markus Gerber, Christin Lang, Johanna Beckmann, Rosa du Randt, Kurt Z. Long, Ivan Müller, Madeleine Nienaber, Nicole Probst-Hensch, Peter Steinmann, Uwe Pühse, Jürg Utzinger, Siphesihle Nqweniso and Cheryl Walter
Int. J. Environ. Res. Public Health 2022, 19(18), 11836; https://doi.org/10.3390/ijerph191811836 - 19 Sep 2022
Cited by 11 | Viewed by 2367
Abstract
Background: Over the past decades, childhood overweight has increased in many African countries. We examined the relationship between sedentary behaviour, moderate-to-vigorous physical activity (MVPA), and body composition in South African primary schoolchildren living in peri-urban settings. Methods: MVPA was measured via 7-day accelerometry [...] Read more.
Background: Over the past decades, childhood overweight has increased in many African countries. We examined the relationship between sedentary behaviour, moderate-to-vigorous physical activity (MVPA), and body composition in South African primary schoolchildren living in peri-urban settings. Methods: MVPA was measured via 7-day accelerometry and body composition via bioelectrical impedance analysis in 1090 learners (49.2% girls, Mage = 8.3 ± 1.4 years). The relationships between MVPA and sedentary behaviour with the various body composition indicators (body fat and fat-free mass [total, truncal, arms, and legs], bone mass, muscle mass, and body water) were tested with mixed linear regressions. Results: The prevalence of overweight and obesity was 9.8% and 6.6%, respectively; 77.1% of the children engaged in ≥60 min of MVPA/day. Girls were more likely to be overweight/obese, to accumulate less than 60 min of MVPA/day, and had significantly higher relative body fat than boys (ps < 0.001). Lower MVPA was associated with a higher likelihood of being overweight/obese, higher relative body fat, and lower relative fat-free mass, bone mass, muscle mass, and body water (ps < 0.001). For lower sedentary behaviour, the associations with body composition pointed in the opposite direction. Conclusions: In this South African setting, girls are a particularly relevant target group for future physical activity interventions to prevent overweight/obesity-related non-communicable diseases in later life. Full article
(This article belongs to the Special Issue Child Physical Activity and Health)
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18 pages, 6245 KiB  
Article
Urban–Rural Fringe Long-Term Sequence Monitoring Based on a Comparative Study on DMSP-OLS and NPP-VIIRS Nighttime Light Data: A Case Study of Shenyang, China
by Tianyi Zeng, Hong Jin, Zhifei Geng, Zihang Kang and Zichen Zhang
Int. J. Environ. Res. Public Health 2022, 19(18), 11835; https://doi.org/10.3390/ijerph191811835 - 19 Sep 2022
Cited by 3 | Viewed by 2072
Abstract
Urban–rural fringes, as special zones where urban and rural areas meet, are the most sensitive areas in the urbanization process. The quantitative identification of urban–rural fringes is the basis for studying the social structure, landscape pattern, and development gradient of fringes, and is [...] Read more.
Urban–rural fringes, as special zones where urban and rural areas meet, are the most sensitive areas in the urbanization process. The quantitative identification of urban–rural fringes is the basis for studying the social structure, landscape pattern, and development gradient of fringes, and is also a prerequisite for quantitative analyses of the ecological effects of urbanization. However, few studies have been conducted to compare the identification accuracy of The US Air Force Defence Meteorological Satellite Program’s (DMSP) and the Visible Infrared Imaging Radiometer Suite (VIIRS) nighttime light data from the same year, subsequently enabling long time series monitoring of the urban–rural fringe. Therefore, in this study, taking Shenyang as an example, a K-means algorithm was used to delineate and compare the urban–rural fringe identification results of DMSP and VIIRS nighttime light data for 2013 and analyzed the changes between 2013 and 2020. The results of the study showed a high degree of overlap between the two types of data in 2013, with the overlap accounting for 75% of the VIIRS data identification results. Furthermore, the VIIRS identified more urban and rural details than the DMSP data. The area of the urban–rural fringe in Shenyang increased from 1872 km2 to 2537 km2, with the growth direction mainly concentrated in the southwest. This study helps to promote the study of urban–rural fringe identification from static identification to dynamic tracking, and from spatial identification to temporal identification. The research results can be applied to the comparative analysis of urban–rural differences and the study of the ecological and environmental effects of urbanization. Full article
(This article belongs to the Special Issue Urban Spatial Planning and Sustainable Development)
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10 pages, 1733 KiB  
Article
Three-Dimensional Comparison of the Maxillary Surfaces through ICP-Type Algorithm: Accuracy Evaluation of CAD/CAM Technologies in Orthognathic Surgery
by Andrea Cassoni, Luigi Manganiello, Giorgio Barbera, Paolo Priore, Maria Teresa Fadda, Resi Pucci and Valentino Valentini
Int. J. Environ. Res. Public Health 2022, 19(18), 11834; https://doi.org/10.3390/ijerph191811834 - 19 Sep 2022
Cited by 2 | Viewed by 2468
Abstract
Purpose: This retrospective study aims to compare the accuracy of two different CAD/CAM systems in orthognathic surgery. The novelty of this work lies in the method of evaluating the accuracy, i.e., using an Iterative Closest Point (ICP) algorithm, which matches a pair of [...] Read more.
Purpose: This retrospective study aims to compare the accuracy of two different CAD/CAM systems in orthognathic surgery. The novelty of this work lies in the method of evaluating the accuracy, i.e., using an Iterative Closest Point (ICP) algorithm, which matches a pair of 2D or 3D point clouds with unknown dependencies of the transition from scan s(k) to scan s(k+1). Methods: The study population was composed of ten patients who presented to the Maxillofacial Surgery Department of the University “Sapienza” of Rome for the evaluation and management of skeletal malocclusions. The patients were divided into two groups, depending on the technique used: group 1: splintless group (custom-made cutting guide and plates); group 2: splint group (using a 3D-printed splint). STL files were imported into Geomagic® Control X™ software, which allows for comparison and analysis using an ICP algorithm. The RMSE parameter (3D error) was used to calculate the accuracy. In addition, data were compared in two different patient subgroups. The first subgroup only underwent a monobloc Le Fort I osteotomy (p-value = 0.02), and the second subgroup underwent a Le Fort I osteotomy associated with a segmental osteotomy of the maxilla (p-value = 0.23). Results: Group 1 showed a 3D error of 1.22 mm ± SD 0.456, while group 2 showed a 3D error of 1.63 mm ± SD 0.303. These results have allowed us to compare the accuracy of the two CAD/CAM systems (p-value = 0.09). Conclusions: The ICP algorithm provided a reproducible method of comparison. The splintless method would seem more accurate (p-value = 0.02) in transferring the surgical programming into the operating room when only a Le Fort I osteotomy is to be performed. Full article
(This article belongs to the Section Digital Health)
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13 pages, 1893 KiB  
Article
Falsochrobactrum tianjinense sp. nov., a New Petroleum-Degrading Bacteria Isolated from Oily Soils
by Mengjie Hu, Feifan Zhang, Gaoyuan Li, Haihua Ruan, Xinhao Li, Lei Zhong, Guanyi Chen and Yichao Rui
Int. J. Environ. Res. Public Health 2022, 19(18), 11833; https://doi.org/10.3390/ijerph191811833 - 19 Sep 2022
Cited by 5 | Viewed by 1828
Abstract
The microbial remediation technology had great potential and attracted attention to total petroleum hydrocarbon pollution (TPH) remediation, but its efficiency is limited by its application in the field. In this study, a new TPH-degrading strain, TDYN1, was isolated from contaminated oil soil in [...] Read more.
The microbial remediation technology had great potential and attracted attention to total petroleum hydrocarbon pollution (TPH) remediation, but its efficiency is limited by its application in the field. In this study, a new TPH-degrading strain, TDYN1, was isolated from contaminated oil soil in Dagang Oilfield in Tianjin, China, and identified as Falsochrobactrum sp. by 16S rRNA sequence analysis. The physiological characterization of the isolate was observed. The orthogonal experiment was carried out for the optimum degradation conditions to improve its biodegradation efficiency. The strain was the gram-stain-negative, short rod-shaped, non-spore-forming, designated Falsochrobactrum tianjinense sp. nov (strain TDYN1); it had 3.51 Mb, and the DNA G + C content of the strain was 56.0%. The degradation rate of TDYN1 was 69.95% after 7 days of culture in optimal degradation conditions (temperature = 30 °C, pH = 8, salinity = 10 g L−1, petroleum concentration = 1 g L−1, and the inoculation dose of strain TDYN1 = 6%) and also reached more than 30% under other relatively extreme conditions. It suggested that the TDYN1 has great potential for TPH remediation in the soils of North China. Full article
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10 pages, 339 KiB  
Article
Analysis of the Association between Metabolic Syndrome and Renal Function in Middle-Aged Patients with Diabetes
by Yoonjin Park and Su Jung Lee
Int. J. Environ. Res. Public Health 2022, 19(18), 11832; https://doi.org/10.3390/ijerph191811832 - 19 Sep 2022
Cited by 1 | Viewed by 1704
Abstract
This study investigated the effects of metabolic syndrome on the estimated glomerular filtration rate in middle-aged participants with diabetes to provide basic data to enable the development of education programs for middle-aged people to prevent diabetic kidney disease. This cross-sectional descriptive study analyzed [...] Read more.
This study investigated the effects of metabolic syndrome on the estimated glomerular filtration rate in middle-aged participants with diabetes to provide basic data to enable the development of education programs for middle-aged people to prevent diabetic kidney disease. This cross-sectional descriptive study analyzed data obtained in the 2nd year of the 8th Korea National Health and Nutrition Examination Survey in 2020 and enrolled 279 participants aged 40–65 years who were diagnosed with diabetes. Multilevel stratified cluster sampling was used to improve the representativeness of the samples and the accuracy of parameter estimation. The risk factors of metabolic syndrome and the risk of elevated eGFR were analyzed using regression analysis and the correlation between the variables was determined using Pearson’s correlation analysis. Middle-aged participants with diabetes whose eGFR was <90 showed a significant difference in their risk for metabolic syndrome based on sex, age, disease duration, and total cholesterol concentrations. Systolic blood pressure and waist circumference in men, and waist circumference and HDL cholesterol level in women were identified as risk factors that contribute to the increasing prevalence of metabolic syndrome. Full article
(This article belongs to the Topic Metabolism and Health)
11 pages, 937 KiB  
Article
Long Working Hours and the Risk of Glucose Intolerance: A Cohort Study
by Yesung Lee, Eunhye Seo and Woncheol Lee
Int. J. Environ. Res. Public Health 2022, 19(18), 11831; https://doi.org/10.3390/ijerph191811831 - 19 Sep 2022
Cited by 2 | Viewed by 1420
Abstract
Long working hours have negative effects on the health of workers. Several studies have reported the association between long working hours and both diabetes and prediabetes. Therefore, we aimed to examine the temporal relationship between long working hours and glucose intolerance. Our cohort [...] Read more.
Long working hours have negative effects on the health of workers. Several studies have reported the association between long working hours and both diabetes and prediabetes. Therefore, we aimed to examine the temporal relationship between long working hours and glucose intolerance. Our cohort study collected data from 25,803 healthy male participants at baseline. To evaluate the risk of incident glucose intolerance, we estimated the hazard ratios (HRs) and 95% confidence intervals (CIs) using the Cox proportional hazards regression analyses. During 77,605.0 person-years of follow-up, 6741 participants developed glucose intolerance. Multivariable-adjusted HRs (95% CI) for weekly working 41–52 and >52 h compared with working 35–40 h, were 1.28 (1.17–1.40) and 2.80 (2.54–3.09), respectively. In the dose-response analyses, long working hours had a nearly linear relationship with the development of glucose intolerance across most working hours per week. The association between long working hours and incident glucose intolerance was stronger in the younger-age subgroups than in the older-age subgroups (p for interaction <0.001). Our large-scale cohort study demonstrated that long working hours were associated with incident glucose intolerance, with a dose-response relationship. Full article
(This article belongs to the Special Issue Health Effect of Shift Work and Long Working Hours)
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20 pages, 2567 KiB  
Article
Decoding the Geography of Natural TBEV Microfoci in Germany: A Geostatistical Approach Based on Land-Use Patterns and Climatological Conditions
by Johannes P. Borde, Rüdiger Glaser, Klaus Braun, Nils Riach, Rafael Hologa, Klaus Kaier, Lidia Chitimia-Dobler and Gerhard Dobler
Int. J. Environ. Res. Public Health 2022, 19(18), 11830; https://doi.org/10.3390/ijerph191811830 - 19 Sep 2022
Cited by 7 | Viewed by 2065
Abstract
Background: Tickborne-encephalitis (TBE) is a potentially life-threating neurological disease that is mainly transmitted by ticks. The goal of the present study is to analyze the potential uniform environmental patterns of the identified TBEV microfoci in Germany. The results are used to calculate probabilities [...] Read more.
Background: Tickborne-encephalitis (TBE) is a potentially life-threating neurological disease that is mainly transmitted by ticks. The goal of the present study is to analyze the potential uniform environmental patterns of the identified TBEV microfoci in Germany. The results are used to calculate probabilities for the present distribution of TBEV microfoci in Germany based on a geostatistical model. Methods: We aim to consider the specification of environmental characteristics of locations of TBEV microfoci detected in Germany using open access epidemiological, geographical and climatological data sources. We use a two-step geostatistical approach, where in a first step, the characteristics of a broad set of environmental variables between the 56 TBEV microfoci and a control or comparator set of 3575 sampling points covering Germany are compared using Fisher’s Exact Test. In the second step, we select the most important variables, which are then used in a MaxEnt distribution model to calculate a high resolution (400 × 400 m) probability map for the presence of TBEV covering the entire area of Germany. Results: The findings from the MaxEnt prediction model indicate that multi annual actual evapotranspiration (27.0%) and multi annual hot days (22.5%) have the highest contribution to our model. These two variables are followed by four additional variables with a lower, but still important, explanatory influence: Land cover classes (19.6%), multi annual minimum air temperature (14.9%), multi annual sunshine duration (9.0%), and distance to coniferous and mixed forest border (7.0%). Conclusions: Our findings are based on defined TBEV microfoci with known histories of infection and the repeated confirmation of the virus in the last years, resulting in an in-depth high-resolution model/map of TBEV microfoci in Germany. Multi annual actual evapotranspiration (27%) and multi annual hot days (22.5%) have the most explanatory power in our model. The results may be used to tailor specific regional preventive measures and investigations. Full article
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12 pages, 1320 KiB  
Article
Risk Analysis of Heavy Metals Migration from Sewage Sludge of Wastewater Treatment Plants
by Robert Kowalik, Jarosław Gawdzik, Paulina Bąk-Patyna, Piotr Ramiączek and Nebojša Jurišević
Int. J. Environ. Res. Public Health 2022, 19(18), 11829; https://doi.org/10.3390/ijerph191811829 - 19 Sep 2022
Cited by 11 | Viewed by 1724
Abstract
More and more attention in sewage sludge management is being devoted to its environmental utilization. This approach is justified both from economic and environmental points of view. However, as with any method, there are certain possibilities and limitations. The goal of the natural [...] Read more.
More and more attention in sewage sludge management is being devoted to its environmental utilization. This approach is justified both from economic and environmental points of view. However, as with any method, there are certain possibilities and limitations. The goal of the natural utilization of sewage sludge is to recover the valuable agronomic properties and fertilizing potential of the sludge. The main aspect limiting the possibility of using sludge as a fertilizer is the heavy metal content. In this paper, an analysis of the risk of environmental contamination in the case of application of sewage sludge with different forms of sludge treatment was carried out. Risk indices such as Igeo and PERI, based on the comparison of total metal content in sludge and soil, as well as RAC and ERD indices, which take into account the mobility of metals in soil, were calculated. It was shown that high levels of potential risk and geoaccumulation indicators do not necessarily disqualify the use of sewage sludge, the key aspect is the form of mobility in which the heavy metals are found in the sludge, and this should be the only aspect taken into account for the possibility of their environmental use. Full article
(This article belongs to the Special Issue Second Edition of Municipal Wastewater Treatment)
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19 pages, 972 KiB  
Review
Reducing Sugar Intake in South Africa: Learnings from a Multilevel Policy Analysis on Diet and Noncommunicable Disease Prevention
by Nicole McCreedy, Maylene Shung-King, Amy Weimann, Lambed Tatah, Clarisse Mapa-Tassou, Trish Muzenda, Ishtar Govia, Vincent Were and Tolu Oni
Int. J. Environ. Res. Public Health 2022, 19(18), 11828; https://doi.org/10.3390/ijerph191811828 - 19 Sep 2022
Cited by 1 | Viewed by 3062
Abstract
High sugar intake contributes to diet-related excess weight and obesity and is a key determinant for noncommunicable diseases (NCDs) in low- and middle-income countries (LMICs). The World Health Organization (WHO) gives specific advice on limiting sugar intake in adults and children. Yet, to [...] Read more.
High sugar intake contributes to diet-related excess weight and obesity and is a key determinant for noncommunicable diseases (NCDs) in low- and middle-income countries (LMICs). The World Health Organization (WHO) gives specific advice on limiting sugar intake in adults and children. Yet, to what extent have policy ideas on sugar intake reduction originating at the global level found expression at lower levels of policymaking? A systematic policy document analysis identified policies issued at the African regional, South African national and Western Cape provincial levels between 2000 and 2020 using search terms related to sugar, sugar-sweetened beverages (SSBs), and NCDs. Forty-eight policy documents were included in the review, most were global and national policies and thus the focus of analysis. A policy transfer conceptual framework was applied. Global recommendations for effectively tackling unhealthy diets and NCDs advise implementing a mix of cost-effective policy options that employ a multisectoral approach. South African country-level policy action has followed the explicit global guidance, and ideas on reducing sugar intake have found expression in sectors outside of health, to a limited extent. As proposed in this paper, with the adoption of the SSB health tax and other policy measures, South Africa’s experience offers several learnings for other LMICs. Full article
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11 pages, 684 KiB  
Article
The Relationship between Social Support and Exercise Adherence among Chinese College Students during the COVID-19 Pandemic: The Mediating Effects of Subjective Exercise Experience and Commitment
by Yuge Tian and Zhenguo Shi
Int. J. Environ. Res. Public Health 2022, 19(18), 11827; https://doi.org/10.3390/ijerph191811827 - 19 Sep 2022
Cited by 10 | Viewed by 2391
Abstract
This study aimed to investigate the relationship between social support and exercise adherence among Chinese college students during the COVID-19 pandemic, as well as the mediating effects of subjective exercise experience and commitment in the relationship, in order to provide a reference for [...] Read more.
This study aimed to investigate the relationship between social support and exercise adherence among Chinese college students during the COVID-19 pandemic, as well as the mediating effects of subjective exercise experience and commitment in the relationship, in order to provide a reference for improving exercise adherence among Chinese college students during the COVID-19 pandemic. The Perceived Available Support in Sport Questionnaire, Subjective Exercise Experience Scale, Exercise Commitment Scale, and Exercise Adherence Scale were administered to 459 eligible college students in Jinan, Shandong Province, through convenience sampling. Results showed that social support positively predicted exercise adherence among college students. The separate and joint mediating effects of subjective exercise experience and commitment between social support and college students’ exercise adherence were significant. This study demonstrated that social support can positively predict exercise adherence among college students. In addition, subjective exercise experience and commitment played mediation roles between social support and college students’ exercise adherence, both separately and jointly. Therefore, enhancing social support and improving the level of subjective exercise experience and exercise commitment among college students may be an effective strategy for improving exercise adherence among Chinese college students during the COVID-19 pandemic. Full article
(This article belongs to the Special Issue Promoting Health for Adolescents)
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9 pages, 675 KiB  
Article
Association between Heated Tobacco Product Use during Pregnancy and Fetal Growth in Japan: A Nationwide Web-Based Survey
by Yoshihiko Hosokawa, Masayoshi Zaitsu, Sumiyo Okawa, Naho Morisaki, Ai Hori, Yukiko Nishihama, Shoji F. Nakayama, Takeo Fujiwara, Hiromi Hamada, Toyomi Satoh and Takahiro Tabuchi
Int. J. Environ. Res. Public Health 2022, 19(18), 11826; https://doi.org/10.3390/ijerph191811826 - 19 Sep 2022
Cited by 3 | Viewed by 3140
Abstract
Combustible cigarette smoking impacts fetal growth during pregnancy. However, the risk associated with heated tobacco products (HTPs) remains unclear. This nationwide cross-sectional study investigated whether HTP use during pregnancy is associated with small for gestational age (SGA) outcomes among 5647 post-delivery women with [...] Read more.
Combustible cigarette smoking impacts fetal growth during pregnancy. However, the risk associated with heated tobacco products (HTPs) remains unclear. This nationwide cross-sectional study investigated whether HTP use during pregnancy is associated with small for gestational age (SGA) outcomes among 5647 post-delivery women with singleton pregnancies, which were divided into four groups: lifetime never-smokers, former smokers before pregnancy, and current smokers for each of the tobacco products during pregnancy (sole HTP and sole combustion smokers). Information on the prevalence of SGA, defined as birth weight and height below the 10th percentile, was retrieved from the Maternal and Child Health Handbooks of post-delivery women. Using logistic regression, the association between sole HTP smokers during pregnancy and SGA, adjusted for covariates, with lifetime never-smokers as reference, was investigated. The prevalence was: current sole HTP smokers during pregnancy, 1.8% (102/5647); and SGA, 2.9% (164/5647). Sole HTP smokers during pregnancy had a higher prevalence of SGA (5.9% [6/102] vs. 2.7% [111/4144]) with an adjusted odds ratio (OR) of 2.50 (95% confidence interval [CI], 1.03–6.05) than lifetime never-smokers. Among sole combustion smokers, the adjusted OR for SGA was 1.95 (95% CI, 0.81–4.67). In Japan, HTP smoking during pregnancy may be associated with an increased risk for SGA. Full article
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18 pages, 804 KiB  
Review
Colicins and Microcins Produced by Enterobacteriaceae: Characterization, Mode of Action, and Putative Applications
by Katarina G. Marković, Mirjana Ž. Grujović, Maja G. Koraćević, Danijela D. Nikodijević, Milena G. Milutinović, Teresa Semedo-Lemsaddek and Milan D. Djilas
Int. J. Environ. Res. Public Health 2022, 19(18), 11825; https://doi.org/10.3390/ijerph191811825 - 19 Sep 2022
Cited by 12 | Viewed by 2945
Abstract
Enterobacteriaceae are widely present in many environments related to humans, including the human body and the food that they consume, from both plant or animal origin. Hence, they are considered relevant members of the gastrointestinal tract microbiota. On the other hand, these bacteria [...] Read more.
Enterobacteriaceae are widely present in many environments related to humans, including the human body and the food that they consume, from both plant or animal origin. Hence, they are considered relevant members of the gastrointestinal tract microbiota. On the other hand, these bacteria are also recognized as putative pathogens, able to impair human health and, in food, they are considered indicators for the microbiological quality and hygiene status of a production process. Nevertheless, beneficial properties have also been associated with Enterobacteriaceae, such as the ability to synthesize peptides and proteins, which can have a role in the structure of microbial communities. Among these antimicrobial molecules, those with higher molecular mass are called colicins, while those with lower molecular mass are named microcins. In recent years, some studies show an emphasis on molecules that can help control the development of pathogens. However, not enough data are available on this subject, especially related to microcins. Hence, this review gathers and summarizes current knowledge on colicins and microcins, potential usage in the treatment of pathogen-associated diseases and cancer, as well as putative applications in food biotechnology. Full article
(This article belongs to the Special Issue New Insight and Applications of Multifunction Antimicrobial Peptides)
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12 pages, 630 KiB  
Article
A Longitudinal Study of Chronic Periodontitis in Two Cohorts of Community-Dwelling Elderly Australians
by Xiangqun Ju, Jane Harford, Liana Luzzi, Gloria Mejia and Lisa M. Jamieson
Int. J. Environ. Res. Public Health 2022, 19(18), 11824; https://doi.org/10.3390/ijerph191811824 - 19 Sep 2022
Cited by 1 | Viewed by 1441
Abstract
Background: The study aimed to estimate and compare the incidence and progression of chronic periodontitis among two generations of older Australian adults. Methods: Data were from two population-based cohort studies of Australian older adults aged 60+ years South Australian Dental Longitudinal Studies (SADLS), [...] Read more.
Background: The study aimed to estimate and compare the incidence and progression of chronic periodontitis among two generations of older Australian adults. Methods: Data were from two population-based cohort studies of Australian older adults aged 60+ years South Australian Dental Longitudinal Studies (SADLS), SADLS I (1991–1992) and SADLS II (2013–2014). American Academy of Periodontology/the U.S. Centres for Disease Control and Prevention (CDC/AAP), and the 2018 European Federation of Periodontology classification (EFP/AAP) case definitions were used to define and calculate the incidence and progression of chronic periodontitis. Multivariable Poisson regression models were used to estimate incidence risk ratios (IRRs) of periodontitis. Results: A total 567 and 201 dentate respondents had periodontal exams in SADLS I and II, respectively. The incidence rate was greater in SADLS II than in SADLS I, approximately 200 vs. 100/1000 person years, respectively. Current smokers had more than two times higher IRRs, 2.38 (1.30–4.34) and 2.30 (1.24–4.26), than their non-smoking counterparts in the previous generation under the CDC/AAP and EFP/AAP, respectively. Conclusions: The most recent generation of older adults has greater incidence and progression of periodontitis than the previous generation. Being a current tobacco smoker was a significant risk factor for both the incidence and progression of periodontitis. Full article
(This article belongs to the Special Issue Dental Hygiene and Oral Health Research: Lessons and Challenges)
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18 pages, 416 KiB  
Review
Ischemic and Hemorrhagic Cerebrovascular Events Related to COVID-19 Coagulopathy and Hypoxemia
by Michał Sojka, Anna Drelich-Zbroja, Maryla Kuczyńska, Mateusz Cheda, Izabela Dąbrowska, Ewa Kopyto, Izabela Halczuk, Monika Zbroja, Weronika Cyranka and Tomasz Jargiełło
Int. J. Environ. Res. Public Health 2022, 19(18), 11823; https://doi.org/10.3390/ijerph191811823 - 19 Sep 2022
Cited by 6 | Viewed by 2025
Abstract
Since the very beginning of the COVID-19 pandemic, numerous researchers have made an effort to determine the molecular composition of the SARS-CoV-2 virus, and the exact pathomechanism through which the virus exerts such a devastating effect on the host/infected organism. Recent scientific evidence [...] Read more.
Since the very beginning of the COVID-19 pandemic, numerous researchers have made an effort to determine the molecular composition of the SARS-CoV-2 virus, and the exact pathomechanism through which the virus exerts such a devastating effect on the host/infected organism. Recent scientific evidence highlights the affinity of the virus towards ACE2 receptors, which are widespread in multiple human systems, including the central nervous system (CNS) and cerebral vessels. Such an affinity may explain endothelial dysfunction and damage that is observed in COVID-positive patients in histopathological studies, with subsequent dysregulation of the cerebral circulation leading to transient or acute cerebrovascular accidents. In this paper, we aimed to evaluate the effects of COVID-related hypoxemia and direct viral invasion on the cerebral circulation, with special respect to the postulated pathomechanism, vulnerable groups of patients, clinical course and outcomes, as well as diagnostic imaging findings. Full article
(This article belongs to the Special Issue Vascular Disease and Health)
12 pages, 626 KiB  
Article
Moderating Role of Coping Style on the Relationship between Stress and Psychological Well-Being in Hong Kong Nursing Students
by Winnie Lai Sheung Cheng, Phyllis Man Chi Young and Kevin Kar Ho Luk
Int. J. Environ. Res. Public Health 2022, 19(18), 11822; https://doi.org/10.3390/ijerph191811822 - 19 Sep 2022
Cited by 5 | Viewed by 2280
Abstract
Aims and objectives: To examine whether coping styles moderate the influence of stressors and psychological well-being in Hong Kong nursing students. Background: Stress could contribute to psychological distress in nursing students. Coping strategies are essential to mitigate psychological distress. So far, the moderating [...] Read more.
Aims and objectives: To examine whether coping styles moderate the influence of stressors and psychological well-being in Hong Kong nursing students. Background: Stress could contribute to psychological distress in nursing students. Coping strategies are essential to mitigate psychological distress. So far, the moderating effects of coping between stressors and psychological well-being has not been thoroughly investigated. Design: This is a cross-sectional study conducted at four higher education institutions in Hong Kong. Methods: We recruited a convenience sample of 293 nursing students in February 2018. The Stressors in Nursing Students Scale-Chinese version (SINS-CN), Brief Cope Inventory-Chinese version (Brief COPE-C), and the Chinese version of the General Health Questionnaire-12 (C-GHQ-12) were used to measure the stressors, coping styles, and psychological well-being, respectively. Three multiple hierarchical linear regression models were used to identify the associations between the variables. Results: The stressors related to clinical learning, confidence, and personal problems were significant in explaining the psychological well-being. The coping strategies also predicted the psychological well-being and explained 44.5% of the variance. The coping strategy—accommodation—moderated the relationship between personal problems and psychological well-being. Conclusion: Problem-solving and accommodation types of coping were adaptive to stress and effective in promoting psychological well-being. However, using accommodation to cope with stressors related to personal problems will exacerbate the negative effects of the personal problems on the psychological well-being. Relevance to clinical practice: This study reveals the relationships between stressors, coping, and psychological well-being. Nurse educators must be aware of nursing student coping styles so they may devise strategies to promote effective coping to reduce the psychological distress among nursing students. Full article
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15 pages, 1009 KiB  
Article
Understanding the Relationship between Parental Psychological Control and Prosocial Behavior in Children in China: The Role of Self-Efficacy and Gender
by Wangqian Fu, Qianqian Pan, Weida Zhang and Lei Zhang
Int. J. Environ. Res. Public Health 2022, 19(18), 11821; https://doi.org/10.3390/ijerph191811821 - 19 Sep 2022
Cited by 2 | Viewed by 2198
Abstract
Objectives: Prosocial behavior is essential for individuals’ development, and the study aims to analyze the relationship between parental psychological control and prosocial behavior. Method: The current study investigated the relationships among Paternal Psychological Control (endogenous variable), General Self-Efficacy (mediator), and Prosocial Behaviors (exogenous [...] Read more.
Objectives: Prosocial behavior is essential for individuals’ development, and the study aims to analyze the relationship between parental psychological control and prosocial behavior. Method: The current study investigated the relationships among Paternal Psychological Control (endogenous variable), General Self-Efficacy (mediator), and Prosocial Behaviors (exogenous endogenous variable) via a moderated mediation modeling approach (gender as the moderator). A total of 1822 Chinese students aged from 7- to 17-year-old (Mage = 12.4 years old, SDage = 1.89, 48.6% girls) were included in the current study. Results: After controlling participants’ age, the only child status, family income, and parent’s education level, results revealed that higher levels of parental control were associated with lower levels of students’ self-efficacy, which, in turn, reduced students’ prosocial behavior intention. Moreover, the relationship between self-efficacy and prosocial behavior intention was moderated by students’ gender, where the positive effects of self-efficacy on prosocial behavior intentions were reduced in girls. Conclusion: Findings highlight the importance of parental psychological control for supporting children’s self-efficacy to promote prosocial behaviors on different gender groups. Full article
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14 pages, 2011 KiB  
Article
Machine Learning Applications for the Development of a Questionnaire to Identify Sasang Constitution Typology
by Soon Mi Kim, Jeongkun Ryu and Eunhye Olivia Park
Int. J. Environ. Res. Public Health 2022, 19(18), 11820; https://doi.org/10.3390/ijerph191811820 - 19 Sep 2022
Cited by 1 | Viewed by 1489
Abstract
Sasang constitutional medicine emphasizes personalized disease prevention and treatment and has been used in various fields. Nevertheless, more efforts are required to improve the validity and reliability of the Sasang analysis tools. Hence, this study aimed to (1) identify key constructs and measurement [...] Read more.
Sasang constitutional medicine emphasizes personalized disease prevention and treatment and has been used in various fields. Nevertheless, more efforts are required to improve the validity and reliability of the Sasang analysis tools. Hence, this study aimed to (1) identify key constructs and measurement items of the Sasang constitution questionnaire that characterize different Sasang constitutions and (2) investigate the similarities and differences in pathophysiological and personality traits between Sasang constitutions. The results of the Sasang constitution questionnaire were analyzed using multiple machine learning-based approaches, including feature selection, hierarchical clustering analysis, and multiple correspondence analysis. The selected 47 key measurement items were clustered into six groups based on the similarity measures. The findings of this study are expected to be beneficial for future research on the development of more robust and reliable Sasang conservation questionnaires, allowing Sasang constitutional medicine to be more widely implemented in various sectors. Full article
(This article belongs to the Special Issue Healthcare Circular Economy: Opportunities and Challenges)
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17 pages, 4454 KiB  
Article
Spatiotemporal Feature Enhancement Aids the Driving Intention Inference of Intelligent Vehicles
by Huiqin Chen, Hailong Chen, Hao Liu and Xiexing Feng
Int. J. Environ. Res. Public Health 2022, 19(18), 11819; https://doi.org/10.3390/ijerph191811819 - 19 Sep 2022
Cited by 3 | Viewed by 1521
Abstract
In order that fully self-driving vehicles can be realized, it is believed that systems where the driver shares control and authority with the intelligent vehicle offer the most effective solution. An understanding of driving intention is the key to building a collaborative autonomous [...] Read more.
In order that fully self-driving vehicles can be realized, it is believed that systems where the driver shares control and authority with the intelligent vehicle offer the most effective solution. An understanding of driving intention is the key to building a collaborative autonomous driving system. In this study, the proposed method incorporates the spatiotemporal features of driver behavior and forward-facing traffic scenes through a feature extraction module; the joint representation was input into an inference module for obtaining driver intentions. The feature extraction module was a two-stream structure that was designed based on a deep three-dimensional convolutional neural network. To accommodate the differences in video data inside and outside the cab, the two-stream network consists of a slow pathway that processes the driver behavior data with low frame rates, along with a fast pathway that processes traffic scene data with high frame rates. Then, a gated recurrent unit, based on a recurrent neural network, and a fully connected layer constitute an intent inference module to estimate the driver’s lane-change and turning intentions. A public dataset, Brain4Cars, was used to validate the proposed method. The results showed that compared with modeling using the data related to driver behaviors, the ability of intention inference is significantly improved after integrating traffic scene information. The overall accuracy of the intention inference of five intents was 84.92% at a time of 1 s prior to the maneuver, indicating that making full use of traffic scene information was an effective way to improve inference performance. Full article
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16 pages, 5163 KiB  
Article
Water-Quality Assessment and Pollution-Risk Early-Warning System Based on Web Crawler Technology and LSTM
by Guoliang Guan, Yonggui Wang, Ling Yang, Jinzhao Yue, Qiang Li, Jianyun Lin and Qiang Liu
Int. J. Environ. Res. Public Health 2022, 19(18), 11818; https://doi.org/10.3390/ijerph191811818 - 19 Sep 2022
Cited by 2 | Viewed by 2377
Abstract
The openly released and measured data from automatic hydrological and water quality stations in China provide strong data support for water environmental protection management and scientific research. However, current public data on hydrology and water quality only provide real-time data through data tables [...] Read more.
The openly released and measured data from automatic hydrological and water quality stations in China provide strong data support for water environmental protection management and scientific research. However, current public data on hydrology and water quality only provide real-time data through data tables in a shared page. To excavate the supporting effect of these data on water environmental protection, this paper designs a water-quality-prediction and pollution-risk early-warning system. In this system, crawler technology was used for data collection from public real-time data. Additionally, a modified long short-term memory (LSTM) was adopted to predict the water quality and provide an early warning for pollution risks. According to geographic information technology, this system can show the process of spatial and temporal variations of hydrology and water quality in China. At the same time, the current and future water quality of important monitoring sites can be quickly evaluated and predicted, together with the pollution-risk early warning. The data collected and the water-quality-prediction technique in the system can be shared and used for supporting hydrology and in water quality research and management. Full article
(This article belongs to the Special Issue Risk Analysis Method and Model of Pollutants)
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42 pages, 4260 KiB  
Article
Protective Factors against Morally Injurious Memories from the COVID-19 Pandemic on Nurses’ Occupational Wellbeing: A Cross-Sectional Experimental Study
by Mihaela Alexandra Gherman, Laura Arhiri, Andrei Corneliu Holman and Camelia Soponaru
Int. J. Environ. Res. Public Health 2022, 19(18), 11817; https://doi.org/10.3390/ijerph191811817 - 19 Sep 2022
Cited by 2 | Viewed by 1985
Abstract
The COVID-19 pandemic was a fertile ground for nurses’ exposure to self- and other-Potentially Morally Injurious Events (PMIEs). Our study explored the effects of nurses’ memories of self- and other-PMIEs on occupational wellbeing and turnover intentions. Using an experimental design on a convenience [...] Read more.
The COVID-19 pandemic was a fertile ground for nurses’ exposure to self- and other-Potentially Morally Injurious Events (PMIEs). Our study explored the effects of nurses’ memories of self- and other-PMIEs on occupational wellbeing and turnover intentions. Using an experimental design on a convenience sample of 634 Romanian nurses, we tested a conceptual model with PLS-SEM, finding adequate explanatory and predictive power. Memories of self- and other-PMIEs were uniquely associated with work engagement, burnout, and turnover intentions, compared to a control group. These relationships were mediated by the three basic psychological needs. Relatedness was more thwarted for memories of other-PMIEs, while competence and autonomy were more thwarted for memories of self-PMIEs. Perceived supervisor support weakened the indirect effect between type of PMIE and turnover intentions, through autonomy satisfaction, but not through burnout. Self-disclosure weakened the indirect effect between type of PMIE and turnover intentions, through autonomy satisfaction, and both burnout and work engagement. Our findings emphasize the need for different strategies in addressing the negative long-term effects of nurses’ exposure to self- and other-PMIEs, according to the basic psychological need satisfaction and type of wellbeing indicator. Full article
(This article belongs to the Special Issue Nursing and COVID-19 )
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14 pages, 1071 KiB  
Article
COVID-19 Impact on Public Dental Healthcare in Bosnia and Herzegovina: Current Situation and Ongoing Perspectives
by Elmedin Bajrić, Amila Zukanović, Nina Marković, Amra Arslanagić, Amina Huseinbegović, Mediha Selimović-Dragaš, Sedin Kobašlija, Aleksandra Popovac and Dejan Marković
Int. J. Environ. Res. Public Health 2022, 19(18), 11816; https://doi.org/10.3390/ijerph191811816 - 19 Sep 2022
Viewed by 1479
Abstract
Background: As the pandemic time went by in Bosnia and Herzegovina (B&H), various patterns toward COVID-19 itself and its impacts, implementation of prescribed preventive measures among the team members, and those of their patients, including immunization process, have been revealed. These patterns were [...] Read more.
Background: As the pandemic time went by in Bosnia and Herzegovina (B&H), various patterns toward COVID-19 itself and its impacts, implementation of prescribed preventive measures among the team members, and those of their patients, including immunization process, have been revealed. These patterns were of both empirical and evidence-based kind and consequently formed dental personnel behavior. The aim was to evaluate and compare the COVID-19 status of dentists in B&H, implementation of prescribed preventive measures, and usage of various kinds of PPE, at the beginning of the pandemics and now, 2.5 years later, including dentists’ current vaccination status, and their opinions and attitudes toward the national COVID-19 economic impact on dental practice. Methodology: Study research was in a form of a cross-sectional longitudinally designed online survey and was conducted in two parts. Results and conclusions: Dental professionals in B&H had a high frequency of COVID-19 symptoms in the second pandemic year. The vaccination status of dentists in B&H was in line with the global average values of vaccinated professionals. Dentists used patient management preventive measures and PPE recommended by WHO, but some preventive measures have been changed and prioritized recently. The economic impact of pandemics on dentistry was predominantly negative. Full article
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14 pages, 457 KiB  
Article
Health Literacy and Its Sociodemographic Predictors: A Cross-Sectional Study of a Population in Madrid (Spain)
by David García-García and Francisco Javier Pérez-Rivas
Int. J. Environ. Res. Public Health 2022, 19(18), 11815; https://doi.org/10.3390/ijerph191811815 - 19 Sep 2022
Cited by 4 | Viewed by 1839
Abstract
Background: Health literacy enhances a population’s self-care capacity and helps to reduce health inequalities. This work examines the health literacy of a population attending primary care services and explores its relationship with sociodemographic factors. Methods: This cross-sectional study, conducted at a healthcare center [...] Read more.
Background: Health literacy enhances a population’s self-care capacity and helps to reduce health inequalities. This work examines the health literacy of a population attending primary care services and explores its relationship with sociodemographic factors. Methods: This cross-sectional study, conducted at a healthcare center in the Madrid region (Spain), involved adult patients requiring primary care nursing services. One hundred and sixty-six participants were recruited via systematic random sampling. Health literacy was measured using the Health Literacy Questionnaire (HLQ). Results: The studied population showed higher health literacy scores for literacy dimensions 1 (feeling understood and supported by healthcare providers) and 4 (social support for health); the lowest scores were recorded for dimensions 5 (appraisal of health information) and 8 (ability to find good health information). People with a better perceived health status showed a higher level of health literacy. People over 65 years of age, those with an incomplete secondary education, and those who were unemployed returned lower scores for several literacy dimensions. Conclusions: The results contribute to our understanding of the factors that influence health literacy. Identifying the areas in which patients show the poorest health literacy may help us comprehend their needs and better support them. Full article
(This article belongs to the Special Issue Advances in Primary Health Care and Community Health)
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18 pages, 605 KiB  
Article
Has the Digital Economy Reduced Carbon Emissions?: Analysis Based on Panel Data of 278 Cities in China
by Zhuoxi Yu, Shan Liu and Zhichuan Zhu
Int. J. Environ. Res. Public Health 2022, 19(18), 11814; https://doi.org/10.3390/ijerph191811814 - 19 Sep 2022
Cited by 34 | Viewed by 3589
Abstract
China is undergoing an urbanization process at an unprecedented scale, and low-carbon urban development is of great significance to the completion of the “dual carbon goals”. At the same time, the digital economy has become an important engine for urban development, and its [...] Read more.
China is undergoing an urbanization process at an unprecedented scale, and low-carbon urban development is of great significance to the completion of the “dual carbon goals”. At the same time, the digital economy has become an important engine for urban development, and its role in environmental improvement has become increasingly prominent. While the digital economy is booming, can it promote the low-carbon development of cities? Based on the panel data of 278 cities in China from 2011 to 2019, this paper discusses the impact of the digital economy on carbon emissions and the long-term development trend between the digital economy and carbon emissions, the impact of differences in the development level of the digital economy on carbon emissions reduction, and the impact of green energy efficiency in the relationship between the digital economy and carbon emissions. The results show that the digital economy has a significant inhibitory effect on carbon emissions, and with the development of the digital economy, more and more cities show an absolute decoupling of the digital economy and carbon emissions and are turning to low-carbon development. The development level of the digital economy has a heterogeneous impact on carbon emissions. With the improvement of the development level of the digital economy, the effect on emission reduction is more significant. As a threshold variable, green energy efficiency affects the relationship between digital economy and carbon emissions. When green energy efficiency is low, the digital economy promotes carbon emissions, and when green energy efficiency is high, the digital economy reduces carbon emissions. Full article
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16 pages, 1196 KiB  
Systematic Review
Factors That Foster Therapeutic Alliance in Pediatric Sports and Orthopedics: A Systematic Review
by Rachel N. Meyers, Robyn B. McHugh and Alissa M. Conde
Int. J. Environ. Res. Public Health 2022, 19(18), 11813; https://doi.org/10.3390/ijerph191811813 - 19 Sep 2022
Viewed by 2482
Abstract
Therapeutic alliance has been defined as building rapport between provider and patient in order to enhance patient motivation to improve outcomes. The purpose of this systematic review was to identify factors that patients look for that help build a strong therapeutic alliance in [...] Read more.
Therapeutic alliance has been defined as building rapport between provider and patient in order to enhance patient motivation to improve outcomes. The purpose of this systematic review was to identify factors that patients look for that help build a strong therapeutic alliance in their pediatric sports or orthopedics healthcare provider, to identify if these factors differ across healthcare professions, and to identify any differences in therapeutic alliance between patients and their provider regarding in-person and telehealth visits. Scientific databases were searched from inception until August 2022. The search strategy resulted in 2195 articles with 11 studies included in the final analysis. The main attributes adolescents look for in their pediatric sports healthcare provider were shared decision making and understanding patients’ sports and goals. These factors were found to differ among parents, sex, race, and socioeconomic status. The top factors improving therapeutic alliance in telehealth were having an already established relationship with the provider, visits lasting longer than 30 min, and having an English-speaking provider for English-speaking patients. The available literature highlights factors that contribute to the development of a stronger therapeutic alliance in the pediatric sports and orthopedics population. As these factors differ among adolescents, parents, sex, race, and socioeconomic status, this review provides insight in what patients and families look for in their provider when seeking care. Full article
(This article belongs to the Special Issue Shared Decision Making and Patient Autonomy in Healthcare)
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10 pages, 1100 KiB  
Article
Perceived Disaster Preparedness and Willingness to Respond among Emergency Nurses in South Korea: A Cross-Sectional Study
by Won-Seok Choi, Sung Youl Hyun and Hyunjin Oh
Int. J. Environ. Res. Public Health 2022, 19(18), 11812; https://doi.org/10.3390/ijerph191811812 - 19 Sep 2022
Cited by 4 | Viewed by 2350
Abstract
Introduction: Emergency nurses serve a vital role in disaster situations. Understanding their disaster preparedness and willingness to respond to a disaster is important in maintaining appropriate disaster management. The purpose of this study was to explore emergency nurses’ disaster preparedness and willingness to [...] Read more.
Introduction: Emergency nurses serve a vital role in disaster situations. Understanding their disaster preparedness and willingness to respond to a disaster is important in maintaining appropriate disaster management. The purpose of this study was to explore emergency nurses’ disaster preparedness and willingness to respond based on demographic and disaster-related characteristics, and their willingness to respond based on specific disaster situations. Methods: In this descriptive, cross-sectional study, the Disaster Preparedness Questionnaire for Nurses and willingness to report to duty by type of event were used to collect data from 158 nurses working in four regional emergency medical centers from 1 December 2019 to 30 April 2020 in the early stages of the COVID-19 pandemic. Results: Emergency nurses with personal disaster experience as a victim or witness (t = 3.65, p < 0.001), professional disaster experience (i.e., working as a nurse) (t = 3.58, p < 0.001), who were current members of Korean Disaster Medical Assistance Teams (t = 6.26, p < 0.001), and who received disaster-related training within a year (t = 5.84, p < 0.001) showed a high level of perceived disaster preparedness. Emergency nurses who have professional disaster experience (i.e., working as a nurse) (t = 2.42, p = 0.017), are on a current disaster team (t = 2.39, p = 0.018), and have received disaster training (t = 2.73, p = 0.007) showed a high level of willingness to respond. Our study showed a high willingness to respond to natural disasters and low willingness to respond to technological disasters. Discussion: To promote the engagement of emergency nurses in disaster response, disaster education programs should be expanded. Enhancing the safety of disaster response environments through supplementing medical personnel, distributing available resources, and providing sufficient compensation for emergency nurses is also essential. Full article
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