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Int. J. Environ. Res. Public Health, Volume 19, Issue 23 (December-1 2022) – 952 articles

Cover Story (view full-size image): This paper investigates whether the digital economy can improve China’s environmental sustainability by reducing carbon emission intensity. The results show that the digital economy has a significant negative effect on carbon emission intensity, and the conclusion remains robust after conducting several robustness checks. However, this impact shows regional heterogeneity, which is more effective in resource-based eastern regions and the Belt and Road provinces. Moreover, mediating effect analyses indicate that the transmission mechanisms are energy consumption structure, total factor energy productivity, and green technology innovation. Furthermore, the results based on the spatial Durbin model (SDM) demonstrate that digital economy development has a significant spatial spillover effect. View this paper
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11 pages, 866 KiB  
Article
Does Appearance Matter during Pregnancy? A Cross-Sectional Study of Body Satisfaction from Pre-Pregnancy to Late Gestation
Int. J. Environ. Res. Public Health 2022, 19(23), 16375; https://doi.org/10.3390/ijerph192316375 - 06 Dec 2022
Cited by 1 | Viewed by 1473
Abstract
Few studies have explored the associations between body satisfaction and physical activity and weight gain during pregnancy, and none have been conducted in Scandinavia. Hence, the aim of the present study was to evaluate changes in body satisfaction from pre-pregnancy to late pregnancy [...] Read more.
Few studies have explored the associations between body satisfaction and physical activity and weight gain during pregnancy, and none have been conducted in Scandinavia. Hence, the aim of the present study was to evaluate changes in body satisfaction from pre-pregnancy to late pregnancy and investigate whether this differed according to parity. We also wanted to explore the association between body satisfaction and physical activity and weight gain among pregnant women in Norway. This cross-sectional survey used an electronic questionnaire to assess physical activity level, weight gain and women’s satisfaction with body weight and size. In total, 150 pregnant women answered the questionnaire. Related-samples Wilcoxon signed rank tests, Mann–Whitney U tests and chi-square tests were used to answer our research questions. The proportion of women who were dissatisfied with their body weight and shape increased from pre-pregnancy to late gestation (body weight p = 0.030 and body shape p = 0.040). Body dissatisfaction before and during pregnancy was linked to weight gain above recommendations. Characterising oneself as physically active prior to pregnancy was associated with satisfaction with body shape pre-pregnancy. Given that mothers strongly influence how a child will judge their body later in life, the results of this study underline the importance of addressing these issues during pregnancy. Full article
(This article belongs to the Special Issue Physical Activity during Pregnancy)
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12 pages, 1047 KiB  
Article
Association between Pet Ownership and Threatened Abortion in Pregnant Women: The China Birth Cohort Study
Int. J. Environ. Res. Public Health 2022, 19(23), 16374; https://doi.org/10.3390/ijerph192316374 - 06 Dec 2022
Cited by 1 | Viewed by 1979
Abstract
Background: The aim of this study was to assess the association between pet ownership and threatened abortion (TA) in pregnant Chinese women. Materials and Methods: We enrolled pregnant women from 18 provinces and autonomous regions across China between November 2017 and December 2020. [...] Read more.
Background: The aim of this study was to assess the association between pet ownership and threatened abortion (TA) in pregnant Chinese women. Materials and Methods: We enrolled pregnant women from 18 provinces and autonomous regions across China between November 2017 and December 2020. Participants were grouped based on the presence or absence of pet ownership. Pet owners were further sub-grouped based on the presence or absence of close contact with their pets. Pet species included cats, dogs, and both. Generalised linear mixed models, with province as a random effect, were used to estimate the associations between pet ownership and TA. Results: Pet ownership, whether or not one had close contact with pets, was associated with greater odds of TA (OR: 1.30, 95% CI: 1.21, 1.40). Keeping pet cats (OR: 1.24, 95% CI: 1.11, 1.40), dogs (OR: 1.29, 95% CI: 1.18, 1.41), or both cats and dogs (OR: 1.36, 95% CI: 1.04, 1.68) during pregnancy were all risk factors for TA. We observed significant group differences (p for difference < 0.05) in pre-pregnancy body mass index, education levels, and annual household income. Conclusions: Cat or dog ownership during pregnancy was associated with an increased risk of TA, especially among overweight, less educated, or lower-income participants. Full article
(This article belongs to the Special Issue Epidemiology and Medical Statistics)
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12 pages, 326 KiB  
Article
Experience of Pharmacists with Anti-Cancer Medicine Shortages in Pakistan: Results of a Qualitative Study
Int. J. Environ. Res. Public Health 2022, 19(23), 16373; https://doi.org/10.3390/ijerph192316373 - 06 Dec 2022
Cited by 2 | Viewed by 1560
Abstract
This study aimed to examine the current situation of anti-cancer drug shortages in Pakistan, namely its determinants, impacts, adopted mitigation strategies, and proposed solutions. Qualitative semi-structured, in-depth interviews were conducted with 25 pharmacists in oncology hospitals in Pakistan from August to October 2021. [...] Read more.
This study aimed to examine the current situation of anti-cancer drug shortages in Pakistan, namely its determinants, impacts, adopted mitigation strategies, and proposed solutions. Qualitative semi-structured, in-depth interviews were conducted with 25 pharmacists in oncology hospitals in Pakistan from August to October 2021. Data were collected in person and online, recorded, and subjected to inductive thematic analysis after being transcribed verbatim. Most participants experienced anti-cancer drug shortages that increased during the pandemic. Etoposide, paclitaxel, vincristine, dacarbazine, and methotrexate were frequently short. Important causes included the compromised role of regulatory authorities, lack of local production, and inventory mismanagement. The impacts were delayed/suboptimal treatment and out-of-pocket costs for patients, patients’ prioritization, increased workload, negative work environment, and patients’ trust issues for pharmacists. The participants proposed that a cautious regulator’s role is needed to revise policies for all stakeholders and support all stakeholders financially at their level to increase access to these medicines. Based on the outcomes, it is clear that anti-cancer medicine shortages are a current issue in Pakistan. Governmental authorities need to play a role in revising policies for all levels of the drug supply chain and promoting local production of these drugs. Stakeholders should also collaborate and manage inventory. Full article
(This article belongs to the Section Global Health)
23 pages, 1944 KiB  
Systematic Review
Consumers’ Attitudes towards Animal Suffering: A Systematic Review on Awareness, Willingness and Dietary Change
Int. J. Environ. Res. Public Health 2022, 19(23), 16372; https://doi.org/10.3390/ijerph192316372 - 06 Dec 2022
Cited by 5 | Viewed by 4031
Abstract
Planetary and human health depend on Westerners’ ability to reduce meat consumption. Meat production degrades the environment while excessive meat intake is associated with cancer and cardiovascular disease, among others. Effective reasons and motivations are needed for consumers to change their diet. The [...] Read more.
Planetary and human health depend on Westerners’ ability to reduce meat consumption. Meat production degrades the environment while excessive meat intake is associated with cancer and cardiovascular disease, among others. Effective reasons and motivations are needed for consumers to change their diet. The fact that modern animal agriculture inflicts a great deal of pain on animals from their birth to their slaughter, animal welfare/suffering may drive consumers to curtail their meat consumption. This systematic review examined a total of 90 papers to ascertain consumers’ awareness of the pain animals experience in animal agriculture, as well as consumer attitudes towards meat reduction due to animal welfare. Results show that consumers have low awareness of animal agriculture. Awareness of animal agricultural practices and animal sentience is associated with increased negative attitudes towards animal suffering. Animal suffering due to farming practices, transportation, slaughter, and animal sentience are factors that may encourage a reduction in meat consumption, and even dietary change in the short term. There is also evidence that animal suffering may be a more compelling motivation for consumers’ willingness to change their diet than for health or environmental reasons. Therefore, increasing consumers’ awareness of animal suffering in meat production is paramount to contributing to reduced pressure on the environment and improved human health. Full article
(This article belongs to the Special Issue 2nd Edition: Towards More Sustainable Food Systems)
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14 pages, 722 KiB  
Article
Health Complaints, Mental Status and Quality of Life among the Aquaculture Workers: A Cross-Sectional Study in Northern Region of Peninsular Malaysia
Int. J. Environ. Res. Public Health 2022, 19(23), 16371; https://doi.org/10.3390/ijerph192316371 - 06 Dec 2022
Viewed by 1624
Abstract
Aquaculture is seen as an essential food-producing sector for improving global food security and nutrition indices. This cross-sectional study examined the health complaints and mental health status of aquaculture workers, as well as their relationship with quality of life, with respect to the [...] Read more.
Aquaculture is seen as an essential food-producing sector for improving global food security and nutrition indices. This cross-sectional study examined the health complaints and mental health status of aquaculture workers, as well as their relationship with quality of life, with respect to the brackish water and freshwater aquaculture cultivation system in Penang, Malaysia. The workers’ health complaints were collected, and mental health status was evaluated as means of depression, anxiety, stress and self-esteem. Self-perceived quality of life was assessed using a structured questionnaire. This study involved the participation of 88 brackish water (84.6%) and 16 freshwater (15.4%) aquaculture workers. A total of 72.7% of the brackish water aquaculture workers were aged beyond 50 years old and had worked within five years (77.3%) in the aquaculture industry. Both brackish water and freshwater cultivation workers were confronted with fatigue, pain and insomnia. Up to 48%, 40.4%, 26% and 24% of them were facing depression, anxiety, stress and low self-esteem, respectively. A total of 3.4% of the brackish water aquaculture workers were having bad quality of life. The complaints of neck/shoulder/arm pain (F = 13.963; p < 0.001), back pain (F = 10.974; p < 0.01), hand/wrist pain (F = 8.041; p < 0.01), knee/hip pain (F = 12.910; p < 0.01) and insomnia (F = 10.936; p < 0.01) were correlated with bad quality of life among the workers. For mental health status, self-esteem (F = 4.157; p < 0.05) was found to be negatively correlated with quality of life scores. The results outlined the concerning level of health complaints and psychological distress among the aquaculture workers. The study emphasized the importance of developing an appropriate occupational health strategy in the aquaculture industry. Longitudinal investigations aimed to explore the effects of psychological distress on employment productivity among the high-risk workers are warranted. Full article
(This article belongs to the Special Issue Aged Society, Occupational Safety and Health, and Work Sustainability)
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10 pages, 351 KiB  
Article
Weight Stigma and Avoidance of Physical Activity and Sport: Development of a Scale and Establishment of Correlates
Int. J. Environ. Res. Public Health 2022, 19(23), 16370; https://doi.org/10.3390/ijerph192316370 - 06 Dec 2022
Cited by 6 | Viewed by 1525
Abstract
Participation in sport and physical activity (PA) is declining, and the psychosocial factors underpinning avoidance of these activities are not understood. This study developed and tested a new measure assessing the tendency to avoid PA and sport because of weight stigma and appearance-related [...] Read more.
Participation in sport and physical activity (PA) is declining, and the psychosocial factors underpinning avoidance of these activities are not understood. This study developed and tested a new measure assessing the tendency to avoid PA and sport because of weight stigma and appearance-related concerns. University students (n = 581, mean age = 19.8 years) completed an online survey at two time points. Demographic details and measures of weight stigmatization, appearance evaluations, and enjoyment and participation in PA or sport were taken. In addition, we developed and tested a new measure of the tendency to avoid physical activity and sport (TAPAS). Psychometric testing of the scale was conducted, and correlates of TAPAS were examined. The ten-item TAPAS provided a single factor solution, and the final scale score was predictive of lower levels of enjoyment of, and participation in, physical activity and sport (p < 0.001). The scale also displayed good internal and test-retest reliability. This study provides a new measure for assessing people’s tendency to avoid PA and sport because of weight stigma or appearance-related concerns. The results suggest that initiatives seeking to increase participation in PA and sport may need to address weight stigma and associated appearance related concerns. Full article
24 pages, 1720 KiB  
Article
Green-Biased Technical Change and Its Influencing Factors of Agriculture Industry: Empirical Evidence at the Provincial Level in China
Int. J. Environ. Res. Public Health 2022, 19(23), 16369; https://doi.org/10.3390/ijerph192316369 - 06 Dec 2022
Cited by 4 | Viewed by 1125
Abstract
The continued expansion of agriculture must contend with the dual pressures of changing factor endowment structure and constrained resources and environments. The main purpose of this paper is to provide feasible ideas for high-quality agricultural development in the transition period through the research [...] Read more.
The continued expansion of agriculture must contend with the dual pressures of changing factor endowment structure and constrained resources and environments. The main purpose of this paper is to provide feasible ideas for high-quality agricultural development in the transition period through the research on the green-biased technical change in Chinese agriculture. This paper selects China’s provincial panel data of the agriculture industry from 1997 to 2017, combining the DEA-SBM model and Malmquist–Luenberger index decomposition method to calculate the green-biased technical change (BTC) index; second, the influence mechanism of BTC is empirically investigated by using the panel data regression analysis approach. The results show that: (1) in China’s agriculture industry, BTC is the driving force behind long-term and steady improvement of technological advancement. Specifically, input-biased technical change (IBTC) has a substantial enhancing effect on agricultural green total factor productivity (GTFP), whereas output-biased technical change (OBTC) has a certain inhibiting effect. (2) On the whole, the tendency of capital substituting for labor and land is very evident, whereas the biased advantage of desirable output is not particularly prominent. (3) The BTC index in Chinese agriculture varies regionally. The eastern region has the highest IBTC index but the lowest OBTC index. (4) The degree of marketization, urbanization, capital deepening, financial support for agriculture, and other factors have a promoting effect on IBTC, whereas most of them have a restraining effect on OBTC. There is evident regional heterogeneity in the effect of environmental regulation intensity on BTC. The following are the primary contributions of this paper: based on national conditions in China, this paper empirically explores the changes and internal rules of green-biased technical change in China’s agriculture industry from various regional viewpoints. It provides an empirical foundation for the regional diversification of agricultural green transformation. Full article
(This article belongs to the Special Issue Agricultural Green Transformation and Sustainable Development)
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14 pages, 3070 KiB  
Article
Extraction, Purification, Characterization and Application in Livestock Wastewater of S Sulfur Convertase
Int. J. Environ. Res. Public Health 2022, 19(23), 16368; https://doi.org/10.3390/ijerph192316368 - 06 Dec 2022
Viewed by 1377
Abstract
Sulfide is a toxic pollutant in the farming environment. Microbial removal of sulfide always faces various biochemical challenges, and the application of enzymes for agricultural environmental remediation has promising prospects. In this study, a strain of Cellulosimicrobium sp. was isolated: numbered strain L1. [...] Read more.
Sulfide is a toxic pollutant in the farming environment. Microbial removal of sulfide always faces various biochemical challenges, and the application of enzymes for agricultural environmental remediation has promising prospects. In this study, a strain of Cellulosimicrobium sp. was isolated: numbered strain L1. Strain L1 can transform S2−, extracellular enzymes play a major role in this process. Next, the extracellular enzyme was purified, and the molecular weight of the purified sulfur convertase was about 70 kDa. The sulfur convertase is an oxidase with thermal and storage stability, and the inhibitor and organic solvent have little effect on its activity. In livestock wastewater, the sulfur convertase can completely remove S2−. In summary, this study developed a sulfur convertase and provides a basis for the application in environmental remediation. Full article
(This article belongs to the Section Environmental Microbiology)
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14 pages, 820 KiB  
Article
The Relationship between Social Participation and Subjective Well-Being among Older People in the Chinese Culture Context: The Mediating Effect of Reciprocity Beliefs
Int. J. Environ. Res. Public Health 2022, 19(23), 16367; https://doi.org/10.3390/ijerph192316367 - 06 Dec 2022
Cited by 3 | Viewed by 1621
Abstract
It is demonstrated that the subjective well-being (SWB) of older people greatly relies on their social participation. However, there are few studies on reciprocity beliefs as a mediating mechanism between social participation and SWB. In this study, 297 participants aged 60 and over [...] Read more.
It is demonstrated that the subjective well-being (SWB) of older people greatly relies on their social participation. However, there are few studies on reciprocity beliefs as a mediating mechanism between social participation and SWB. In this study, 297 participants aged 60 and over in Chengdu, Sichuan Province, China, completed a questionnaire of social participation, reciprocity beliefs, and SWB. We used multiple linear regression and mediation analyses to verify the mediating effect of reciprocity beliefs. Results showed that social participation was positively relative to SWB and reciprocity beliefs, and reciprocity beliefs played an intermediary role in social participation and SWB. These findings suggest the importance of social participation for SWB, with reciprocity beliefs (behaviors) playing a positive mediating role, particularly in China. In conclusion, analysis of the mediating effect of reciprocity beliefs provides us with knowledge that could help in achieving a healthy old age. Additionally, this study opens up new perspectives of research. Full article
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14 pages, 1016 KiB  
Systematic Review
Telesupervision in Psychotherapy: A Bibliometric and Systematic Review
Int. J. Environ. Res. Public Health 2022, 19(23), 16366; https://doi.org/10.3390/ijerph192316366 - 06 Dec 2022
Cited by 1 | Viewed by 1608
Abstract
(1) Background: This systematic review supported by a bibliometric analysis identified quantitative and qualitative empirical studies that allowed us to respond to the objective of identifying and discussing the scope and limitations of the clinical-psychotherapeutic supervision in virtual modality or telesupervision. (2) Methods: [...] Read more.
(1) Background: This systematic review supported by a bibliometric analysis identified quantitative and qualitative empirical studies that allowed us to respond to the objective of identifying and discussing the scope and limitations of the clinical-psychotherapeutic supervision in virtual modality or telesupervision. (2) Methods: The articles were selected according to the Systematic Reviews and Meta-Analyses (PRISMA) guidelines, and the eligibility criteria proposed by the PICOS strategy (population, interventions, comparators, outcomes, and study design) based on 396 records of scientifically identified articles in the Journal Citation Report databases of the Web of Science. (3) Results: The literature review stages allowed the selection of three articles, which were added three others that were already included in a previous review, to enrich the analysis and discussion. The results of the present review highlighted aspects of nonverbal communication, alliance, comfort, preference, trust, and construction of professional identity, among others, both considering only the telesupervision format and comparing it with traditional face-to-face supervision. (4) Conclusions: The contributions that these results are providing to the understanding of the scope and limitations of the practice of telesupervision are discussed, also considering its interference in the construction of the professional identity of supervisors and supervisees. Full article
(This article belongs to the Special Issue Digital Mental Health: Innovative Technology and Service)
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12 pages, 958 KiB  
Article
The First 30 Years of the Universal Hepatitis-B Vaccination-Program in Italy: A Health Strategy with a Relevant and Favorable Economic-Profile
Int. J. Environ. Res. Public Health 2022, 19(23), 16365; https://doi.org/10.3390/ijerph192316365 - 06 Dec 2022
Cited by 1 | Viewed by 1188
Abstract
In 1991, Italy was one of the first countries worldwide to introduce a universal hepatitis-B vaccination for children. Since then, epidemiological data have clearly demonstrated the huge clinical benefits of the vaccination. The aim of this study was to update the favorable economic [...] Read more.
In 1991, Italy was one of the first countries worldwide to introduce a universal hepatitis-B vaccination for children. Since then, epidemiological data have clearly demonstrated the huge clinical benefits of the vaccination. The aim of this study was to update the favorable economic impact of the hepatitis B virus (HBV) vaccination, 30 years after its implementation. A mathematical model was developed to simulate the clinical/economic impact of the universal HBV-vaccination program versus a hypothetical no-vaccination scenario as a posteriori analysis. We assessed the vaccination benefits over a 30-year-immunization-period (1991–2020), and the following period, 2021–2070. Our data showed a big drop in HBV-related diseases (−82% in infections, chronic disease, and hepatocellular-carcinoma cases), and related costs (−67% in the immunization period and −85% in 2021–2070), attributable to vaccination. The return on investment (ROI) and the benefit-to-cost (BCR) ratios are >1 for the first thirty-year-immunization-period, and are predicted to almost triplicate the economic savings in the period 2021–2070, both for the National Health Service (NHS) and from societal perspectives. Our model confirmed that the implementation of universal HBV-vaccination in Italy during the first 30 years continues to be a cost-saving strategy, and more advantageous effects will be further achieved in the future. The HBV-vaccination strategy greatly expresses a huge impact in both the short- and long-term, and from the clinical and economic point-of-views. Full article
(This article belongs to the Special Issue The Impacts of Health Intervention on Cancer Epidemiology)
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13 pages, 610 KiB  
Article
Effects of a Diabetes Self-Management Education Program on Glucose Levels and Self-Care in Type 1 Diabetes: A Pilot Randomized Controlled Trial
Int. J. Environ. Res. Public Health 2022, 19(23), 16364; https://doi.org/10.3390/ijerph192316364 - 06 Dec 2022
Cited by 3 | Viewed by 2383
Abstract
(1) Background: Several factors have been associated with the success of health education programs, such contact time, with better results being obtained from more intensive programs and early outcome measurement. Nurses play an essential role in educating patients with diabetes both in disease-management, [...] Read more.
(1) Background: Several factors have been associated with the success of health education programs, such contact time, with better results being obtained from more intensive programs and early outcome measurement. Nurses play an essential role in educating patients with diabetes both in disease-management, therapeutic education, and healthy lifestyles promotion as well as emotion management. The objective was to evaluate the effectiveness of a nurse-led educational program based on patients with type 1 diabetes; (2) Methods: An experimental, two-group comparison design, 69 patients participated in the intervention group and 62 in control group. The control group received routine health education and follow-up. The intervention group received intensive educational program led by nurses. The effects were evaluated after 1 and 3 months of intervention; (3) Results: The differences between groups in sensor usage, knowledge, and diabetes self-care three months after the educational program were significant; (4) Conclusions: The program could help type 1 diabetes patients to improve the control rates for blood glucose. The continuous glucose monitoring sensor allowed knowing which parameters improved one and three months after the intervention. The hypothesis of the influence of the emotional state on glucose levels was confirmed. Full article
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21 pages, 10955 KiB  
Article
Runoff Estimation of Jiulong River Based on Acoustic Doppler Current Profiler Online Monitoring Data and Its Implication for Pollutant Flux Estimation
Int. J. Environ. Res. Public Health 2022, 19(23), 16363; https://doi.org/10.3390/ijerph192316363 - 06 Dec 2022
Viewed by 973
Abstract
The runoff of the Jiulong River (JLR) is a key parameter that affects the estimation of pollutant flux into Xiamen Bay (XMB). The precise runoff estimation of the JLR can be used to determine the accuracy of the pollutant flux estimation flowing into [...] Read more.
The runoff of the Jiulong River (JLR) is a key parameter that affects the estimation of pollutant flux into Xiamen Bay (XMB). The precise runoff estimation of the JLR can be used to determine the accuracy of the pollutant flux estimation flowing into XMB. In this study, to analyze the hydrological dynamic characteristics and identify the correlation between fixed-site real-time ocean current observations and cross-sectional navigation flow observations, we conducted six navigation observations on two cross-sections of the JLR estuary during the spring tide and neap tide in the normal season, wet season, and dry season in 2020. Simultaneously, we measured hydrological observation data by a fixed-site buoy located in the JLR estuary and collected runoff data that were measured upstream of the JLR. The results showed that the average correlation coefficient between the average velocity of the fixed-point buoy and average velocity of the section was more than 0.90, higher than expected, the minimum average deviation was 4%, and the minimum sample standard error was 5.7%, which was a good result. In this study, we constructed a model for estimating the runoff of the JLR into the sea. The findings demonstrated that Acoustic Doppler Current Profiler (ADCP) online monitoring data were useful to estimate runoff of the JLR with high accuracy, could promote the accuracy of estimated pollutant flux of the JLR’s discharge into XMB, and could provide more scientific and reliable basic data for future load flux estimation research. Full article
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17 pages, 2943 KiB  
Article
Understanding Relationships between Cultivated Land Pressure and Economic Development Level across Spatiotemporal Characteristics: Implications for Supporting Land-Use Management Decisions
Int. J. Environ. Res. Public Health 2022, 19(23), 16362; https://doi.org/10.3390/ijerph192316362 - 06 Dec 2022
Cited by 2 | Viewed by 1499
Abstract
Food security is crucial to world peace. Economic development has posed a great threat to the protection of cultivated land. Considering 20 cities in the lower Yellow River (AALYR) as the study area, this study explored the spatial evolution of cultivated land pressure [...] Read more.
Food security is crucial to world peace. Economic development has posed a great threat to the protection of cultivated land. Considering 20 cities in the lower Yellow River (AALYR) as the study area, this study explored the spatial evolution of cultivated land pressure (CLP) and economic development from 1998 to 2018, revealing the spatiotemporal coupling characteristics of the CLP index and economic development. The main results are as follows: we discerned that CLP and economic development have an obvious spatiotemporal consistency during 1998–2018. The CLP showed a spatial pattern of overall stability, as well as local changes. Most prefecture-level cities experienced decreased significantly in CLP and improvements in food security. Overall, there were regional differences in the coupling relationships between CLP and economic development in the study area. The explanatory power of the proportion of secondary and tertiary industries were significantly higher than other driving factors. Therefore, while developing the economy rapidly, we should also protect cultivated land resources and improve the coordination level between them, which is essential to guarantee food security and a steady economic development. Full article
(This article belongs to the Special Issue Management Countermeasures of Ecosystem Degradation)
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12 pages, 867 KiB  
Article
Tele-Medicine Based and Self-Administered Interactive Exercise Program (Tele-Exergame) to Improve Cognition in Older Adults with Mild Cognitive Impairment or Dementia: A Feasibility, Acceptability, and Proof-of-Concept Study
Int. J. Environ. Res. Public Health 2022, 19(23), 16361; https://doi.org/10.3390/ijerph192316361 - 06 Dec 2022
Cited by 3 | Viewed by 2571
Abstract
Improved life expectancy is increasing the number of older adults who suffer from motor-cognitive decline. Unfortunately, conventional balance exercise programs are not tailored to patients with cognitive impairments, and exercise adherence is often poor due to unsupervised settings. This study describes the acceptability [...] Read more.
Improved life expectancy is increasing the number of older adults who suffer from motor-cognitive decline. Unfortunately, conventional balance exercise programs are not tailored to patients with cognitive impairments, and exercise adherence is often poor due to unsupervised settings. This study describes the acceptability and feasibility of a sensor-based in-home interactive exercise system, called tele-Exergame, used by older adults with mild cognitive impairment (MCI) or dementia. Our tele-Exergame is specifically designed to improve balance and cognition during distractive conditioning while a telemedicine interface remotely supervises the exercise, and its exercises are gamified balance tasks with explicit augmented visual feedback. Fourteen adults with MCI or dementia (Age = 68.1 ± 5.4 years, 12 females) participated and completed exergame twice weekly for six weeks at their homes. Before and after 6 weeks, participants’ acceptance was assessed by Technology Acceptance Model (TAM) questionnaire, and participants’ cognition and anxiety level were evaluated by the Montreal Cognitive Assessment (MoCA) and Beck Anxiety Inventory (BAI), respectively. Results support acceptability, perceived benefits, and positive attitudes toward the use of the system. The findings of this study support the feasibility, acceptability, and potential benefit of tele-Exergame to preserve cognitive function among older adults with MCI and dementia. Full article
(This article belongs to the Special Issue Connected Health: Status and Trends)
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12 pages, 357 KiB  
Article
Emotional Regulation Self-Efficacy Influences Moral Decision Making: A Non-Cooperative Game Study of the New Generation of Employees
Int. J. Environ. Res. Public Health 2022, 19(23), 16360; https://doi.org/10.3390/ijerph192316360 - 06 Dec 2022
Cited by 2 | Viewed by 1962
Abstract
Scholars generally believe that personality characteristics and psychological factors influence individual moral decision-making. However, few have ever discussed specific psychological factors and characteristics having such influences. Based on the self-efficacy theory and the social identity theory, this paper has proposed, from the perspective [...] Read more.
Scholars generally believe that personality characteristics and psychological factors influence individual moral decision-making. However, few have ever discussed specific psychological factors and characteristics having such influences. Based on the self-efficacy theory and the social identity theory, this paper has proposed, from the perspective of social cognition, that emotional regulation self-efficacy influences the moral decision-making of the new generation of employees and that the mediating effect of interpersonal trust and the regulating effect of communication also play a role in the decision-making process. This study has designed a “red-blue experiment” based on the complete static information model in the non-cooperative game theory so as to conduct an experimental and qualitative analysis for the new generation of employees and to explore the characteristics of psychological process, self-efficacy, and moral decision-making of the experimental population. Through analysis of the 138 data sources collected from the experiment, the results showed that emotional self-efficacy had a significant positive effect on moral decision-making (p < 0.01), emotional self-efficacy had a significant positive effect on interpersonal trust (r = 0.560, p < 0.01), and interpersonal trust had a significant positive effect on moral decision-making (r = 0.290, p < 0.01). The mediating effect was 0.163. The interaction terms of emotional regulation self-efficacy and communication effect had a significant negative effect on interpersonal trust (r = −0.221, p < 0.01). All the hypotheses proposed in this study are supported by experimental data and reveal the psychological mechanism of moral decision-making in the new generation of employees. The study has further shown that the moral education of the new generation of employees needs to focus on improving emotional regulation self-efficacy and enhancing interpersonal trust, which provides theoretical support for the moral education methods and paths of the new generation of employees. Full article
(This article belongs to the Special Issue Occupational and Psychosocial Determinants of Employees’ Health)
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18 pages, 1342 KiB  
Systematic Review
Artificial Intelligence Implementation in Healthcare: A Theory-Based Scoping Review of Barriers and Facilitators
Int. J. Environ. Res. Public Health 2022, 19(23), 16359; https://doi.org/10.3390/ijerph192316359 - 06 Dec 2022
Cited by 13 | Viewed by 3503
Abstract
There is a large proliferation of complex data-driven artificial intelligence (AI) applications in many aspects of our daily lives, but their implementation in healthcare is still limited. This scoping review takes a theoretical approach to examine the barriers and facilitators based on empirical [...] Read more.
There is a large proliferation of complex data-driven artificial intelligence (AI) applications in many aspects of our daily lives, but their implementation in healthcare is still limited. This scoping review takes a theoretical approach to examine the barriers and facilitators based on empirical data from existing implementations. We searched the major databases of relevant scientific publications for articles related to AI in clinical settings, published between 2015 and 2021. Based on the theoretical constructs of the Consolidated Framework for Implementation Research (CFIR), we used a deductive, followed by an inductive, approach to extract facilitators and barriers. After screening 2784 studies, 19 studies were included in this review. Most of the cited facilitators were related to engagement with and management of the implementation process, while the most cited barriers dealt with the intervention’s generalizability and interoperability with existing systems, as well as the inner settings’ data quality and availability. We noted per-study imbalances related to the reporting of the theoretic domains. Our findings suggest a greater need for implementation science expertise in AI implementation projects, to improve both the implementation process and the quality of scientific reporting. Full article
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15 pages, 1805 KiB  
Article
Impacts of Long-Term Micronutrient Fertilizer Application on Soil Properties and Micronutrient Availability
Int. J. Environ. Res. Public Health 2022, 19(23), 16358; https://doi.org/10.3390/ijerph192316358 - 06 Dec 2022
Cited by 2 | Viewed by 1242
Abstract
Deficiencies of micronutrients in calcareous soils have been reported in different areas of China’s Loess Plateau. The objective of this research was to study the influence of the continuous application of micronutrient fertilizers on soil properties and micronutrient availability in this region. The [...] Read more.
Deficiencies of micronutrients in calcareous soils have been reported in different areas of China’s Loess Plateau. The objective of this research was to study the influence of the continuous application of micronutrient fertilizers on soil properties and micronutrient availability in this region. The micronutrient fertilizer field plot experiment began in 1984. It included Zn, Mn and Cu fertilizer treatments and the control treatment. The crop system was continuously cropped winter wheat. The soil properties and available Zn, Mn, Cu and Fe were measured. Their relationships were analyzed through correlation and path analysis. After 31 years, the soil pH, CaCO3 and available P levels decreased; in contrast, the organic matter, fulvic acid, reducing substances and soil moisture levels in the surface soil increased in the micronutrient fertilized treatments compared to the control treatment. Cu and Zn fertilizers promoted the available Cu and Zn levels in the surface and deep soil, but available Mn was not significantly affected by Mn fertilizer. It can be seen from the interaction between the micronutrient availability and micronutrient fertilizers that Zn, Cu and Mn fertilizers can increase the available Fe level; Mn fertilizer can increase the available Cu level, and Cu and Mn fertilizers can increase the available Zn level. This means that Fe, Cu and Zn availability were easy to implement, whereas the soil-available Mn was difficult to improve in calcareous soils on the Loess Plateau. Fulvic acid and organic matter showed a significant and direct effect on the available Zn; the available Mn and Fe were mainly affected by the soil CaCO3 and moisture; the available Cu was mainly affected by the soil organic matter, available P and reducing substances. These results indicate the importance of organic matter in calcareous soils; it can not only directly affect the availability of micronutrients but also indirectly affect their availability through the indirect interaction with fulvic acid, reducing substances, available P and CaCO3. The above conclusions suggest that the long-term micronutrient fertilizers changed some important soil properties and increased the micronutrient availability in the loess-derived soil. Full article
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51 pages, 1737 KiB  
Review
Organizational Factors Determining Access to Reperfusion Therapies in Ischemic Stroke-Systematic Literature Review
Int. J. Environ. Res. Public Health 2022, 19(23), 16357; https://doi.org/10.3390/ijerph192316357 - 06 Dec 2022
Cited by 5 | Viewed by 2532
Abstract
Background: After onset of acute ischemic stroke (AIS), there is a limited time window for delivering acute reperfusion therapies (ART) aiming to restore normal brain circulation. Despite its unequivocal benefits, the proportion of AIS patients receiving both types of ART, thrombolysis and thrombectomy, [...] Read more.
Background: After onset of acute ischemic stroke (AIS), there is a limited time window for delivering acute reperfusion therapies (ART) aiming to restore normal brain circulation. Despite its unequivocal benefits, the proportion of AIS patients receiving both types of ART, thrombolysis and thrombectomy, remains very low. The organization of a stroke care pathway is one of the main factors that determine timely access to ART. The knowledge on organizational factors influencing access to ART is sparce. Hence, we sought to systematize the existing data on the type and frequency of pre-hospital and in-hospital organizational factors that determine timely access to ART in patients with AIS. Methodology: Literature review on the frequency and type of organizational factors that determine access to ART after AIS. Pubmed and Scopus databases were the primary source of data. OpenGrey and Google Scholar were used for searching grey literature. Study quality analysis was based on the Newcastle-Ottawa Scale. Results: A total of 128 studies were included. The main pre-hospital factors associated with delay or access to ART were medical emergency activation practices, pre-notification routines, ambulance use and existence of local/regional-specific strategies to mitigate the impact of geographic distance between patient locations and Stroke Unit (SU). The most common intra-hospital factors studied were specific location of SU and brain imaging room within the hospital, and the existence and promotion of specific stroke treatment protocols. Most frequent factors associated with increased access ART were periodic public education, promotion of hospital pre-notification and specific pre- and intra-hospital stroke pathways. In specific urban areas, mobile stroke units were found to be valid options to increase timely access to ART. Conclusions: Implementation of different organizational factors and strategies can reduce time delays and increase the number of AIS patients receiving ART, with most of them being replicable in any context, and some in only very specific contexts. Full article
(This article belongs to the Section Health Care Sciences & Services)
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22 pages, 723 KiB  
Systematic Review
The Impact of Heatwaves on Mortality and Morbidity and the Associated Vulnerability Factors: A Systematic Review
Int. J. Environ. Res. Public Health 2022, 19(23), 16356; https://doi.org/10.3390/ijerph192316356 - 06 Dec 2022
Cited by 15 | Viewed by 3705
Abstract
Background: This study aims to investigate the current impacts of extreme temperature and heatwaves on human health in terms of both mortality and morbidity. This systematic review analyzed the impact of heatwaves on mortality, morbidity, and the associated vulnerability factors, focusing on the [...] Read more.
Background: This study aims to investigate the current impacts of extreme temperature and heatwaves on human health in terms of both mortality and morbidity. This systematic review analyzed the impact of heatwaves on mortality, morbidity, and the associated vulnerability factors, focusing on the sensitivity component. Methods: This systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 flow checklist. Four databases (Scopus, Web of Science, EBSCOhost, PubMed) were searched for articles published from 2012 to 2022. Those eligible were evaluated using the Navigation Guide Systematic Review framework. Results: A total of 32 articles were included in the systematic review. Heatwave events increased mortality and morbidity incidence. Sociodemographic (elderly, children, male, female, low socioeconomic, low education), medical conditions (cardiopulmonary diseases, renal disease, diabetes, mental disease), and rural areas were crucial vulnerability factors. Conclusions: While mortality and morbidity are critical aspects for measuring the impact of heatwaves on human health, the sensitivity in the context of sociodemographic, medical conditions, and locality posed a higher vulnerability to certain groups. Therefore, further research on climate change and health impacts on vulnerability may help stakeholders strategize effective plans to reduce the effect of heatwaves. Full article
(This article belongs to the Section Climate Change)
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13 pages, 691 KiB  
Article
Effects of Coaching-Based Teleoccupational Guidance for Home-Based Stroke Survivors and Their Family Caregivers: A Pilot Randomised Controlled Trial
Int. J. Environ. Res. Public Health 2022, 19(23), 16355; https://doi.org/10.3390/ijerph192316355 - 06 Dec 2022
Cited by 3 | Viewed by 1542
Abstract
The aim of this pilot study was to investigate the feasibility and effectiveness of a 3-month coaching-based teleoccupational guidance (CTG) programme for home-based stroke survivors and their family caregivers. An assessor-blind pilot randomised controlled study was conducted. Twenty-five participant dyads (each dyad consisted [...] Read more.
The aim of this pilot study was to investigate the feasibility and effectiveness of a 3-month coaching-based teleoccupational guidance (CTG) programme for home-based stroke survivors and their family caregivers. An assessor-blind pilot randomised controlled study was conducted. Twenty-five participant dyads (each dyad consisted of one home-based stroke patient and their caregivers) were randomised to a control group (RTG, n = 12) or an experimental group (CTG, n = 13). Participant dyads in the RTG group received routine teleoccupational guidance. Participant dyads in the CTG group received a six-step procedure: coaching-based teleoccupational guidance over 3 months via WeChat. Participant dyad compliance, the difficulty and suitability of outcome measures, and adverse effects were used to assess feasibility. The Reintegration to Normal Living Index, the Lawton Instructive Activities of Daily Life (Lawton IADL) scale, the Intrinsic Motivation Inventory, the Fugl–Meyer Assessment—Upper Extremity scale, the 6 min walking test, and the Stroke-Specific Quality of Life Scale were used to assess effectiveness outcomes of home-based stroke survivors; the Caregiver Benefit Finding Scale and the Zarit Caregiver Burden Interview were used to assess the effectiveness outcomes of family caregivers. Feasibility measures were assessed at the end of the pilot trial, and effectiveness measures were evaluated pre-intervention and post-intervention (after 3 months). The CTG programme significantly improved home-based stroke survivors’ participation in daily life, IADL score, and intrinsic motivation, and increased caregivers’ perceived benefit, and tended (not significantly) to reduce care burden. CTG has the potential to promote better integration of home-based stroke patients into their families and society, improve their quality of life and family well-being, and provide a reference for home rehabilitation of other clinical chronic diseases. CTG is a safe, effective, and promising intervention for home-based stroke populations and their caregivers and warrants further investigation in a larger randomised controlled trial. Full article
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19 pages, 852 KiB  
Article
Residential Environment Assessment by Older Adults in Nursing Homes during COVID-19 Outbreak
Int. J. Environ. Res. Public Health 2022, 19(23), 16354; https://doi.org/10.3390/ijerph192316354 - 06 Dec 2022
Cited by 2 | Viewed by 1970
Abstract
The most vulnerable residential settings during the COVID-19 pandemic were older adult’s nursing homes, which experienced high rates of incidence and death from this cause. This paper aims to ascertain how institutionalized older people assessed their residential environment during the pandemic and to [...] Read more.
The most vulnerable residential settings during the COVID-19 pandemic were older adult’s nursing homes, which experienced high rates of incidence and death from this cause. This paper aims to ascertain how institutionalized older people assessed their residential environment during the pandemic and to examine the differences according to personal and contextual characteristics. The COVID-19 Nursing Homes Survey (Madrid region, Spain) was used. The residential environment assessment scale (EVAER) and personal and contextual characteristics were selected. Descriptive and multivariate statistical analysis were applied. The sample consisted of 447 people (mean age = 83.8, 63.1% = women, 50.8% = widowed, 40% = less than primary studies). Four residential assessment subscales (relationships, mobility, residential aspects, privacy space) and three clusters according to residential rating (medium-high with everything = 71.5% of cases, low with mobility = 15.4%, low with everything = 13.1%) were obtained. The logistic regression models for each cluster category showed to be statistically significant. Showing a positive affect (OR = 1.08), fear of COVID-19 (OR = 1.06), high quality of life (OR = 1.05), not having suspicion of depression (OR = 0.75) and performing volunteer activities (OR = 3.67) were associated with the largest cluster. It is concluded that a better residential evaluation was related to more favourable personal and contextual conditions. These results can help in the design of nursing homes for older adults in need of accommodation and care to facilitate an age-friendly environment. Full article
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42 pages, 4837 KiB  
Article
Co-Design in Electrical Medical Beds with Caregivers
Int. J. Environ. Res. Public Health 2022, 19(23), 16353; https://doi.org/10.3390/ijerph192316353 - 06 Dec 2022
Cited by 1 | Viewed by 3531
Abstract
Among the plethora of instruments present in healthcare environments, the hospital bed is undoubtedly one of the most important for patients and caregivers. However, their design usually follows a top-down approach without considering end-users opinions and desires. Exploiting Human-centered design (HCD) permits these [...] Read more.
Among the plethora of instruments present in healthcare environments, the hospital bed is undoubtedly one of the most important for patients and caregivers. However, their design usually follows a top-down approach without considering end-users opinions and desires. Exploiting Human-centered design (HCD) permits these users to have a substantial role in the final product outcome. This study aims to empower caregivers to express their opinion about the hospital bed using a qualitative approach. For a holistic vision, we conducted six focus groups and six semi-structured interviews with nurses, nursing students, social-health operators and physiotherapists belonging to many healthcare situations. We then used thematic analysis to extract the themes that participants faced during the procedures, providing a comprehensive guide to designing the future electrical medical bed. These work results could also help overcome many issues that caregivers face during their everyday working life. Moreover, we identified the User Experience features that could represent the essential elements to consider. Full article
(This article belongs to the Special Issue Intelligent Systems for One Digital Health)
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8 pages, 628 KiB  
Article
First-Trimester Biochemical Serum Markers in Female Kidney Transplant Recipients—The Impact of Graft Function
Int. J. Environ. Res. Public Health 2022, 19(23), 16352; https://doi.org/10.3390/ijerph192316352 - 06 Dec 2022
Viewed by 1117
Abstract
Data on serum biochemistry markers as a component of the first-trimester screening test in pregnant kidney graft recipients are limited. In the absence of a separate validated algorithm, biochemical testing is commonly used in the first-trimester screening in kidney transplant recipients. Therefore, the [...] Read more.
Data on serum biochemistry markers as a component of the first-trimester screening test in pregnant kidney graft recipients are limited. In the absence of a separate validated algorithm, biochemical testing is commonly used in the first-trimester screening in kidney transplant recipients. Therefore, the study aimed to analyze first-trimester serum biochemical markers and the first trimester combined screening results in pregnant kidney graft recipients. A retrospective study was carried out in pregnant women who underwent the first-trimester combined screening test performed per the Fetal Medicine Foundation (FMF) protocol in 2009–2020. The study group included 27 pregnancies in kidney graft transplant recipients, and the control group was 110 patients with normal kidney function, matched according to age, body mass index (BMI), and gestational age. The biochemical serum markers (free beta-human chorionic gonadotropin [beta-hCG] and pregnancy-associated plasma protein A [PAPP-A]) were evaluated using the FMF-approved Roche Elecsys® assay and exhibited as multiples of the median (MoM) values. Data on first-trimester screening test results, perinatal outcomes, and graft function (assessed using serum creatinine concentrations) were analyzed. The analysis of first-trimester screening parameters revealed no difference in nuchal translucency (NT) measurements and uterine artery flow. However, free beta-hCG MoM and PAPP-A values were higher in posttransplant pregnancies than in controls: 3.47 ± 2.08 vs. 1.38 ± 0.85 (p = 0.035) and 1.46 ± 0.81 vs. 0.98 ± 0.57 (p = 0.007), respectively. The false positive rate of trisomy 21 (T21) screening in graft recipients was 25.9% vs. 3% in the controls. The free β-hCG MoM values positively correlated with serum creatinine levels before (r = 0.653; p < 0.001), during (r = 0.619; p = 0.001), and after pregnancy (r = 0.697; p < 0.001). There was a statistically significant negative correlation for PAPP-A MoM values for postpartum serum creatinine concentration (r = −0.424, p = 0.035). Our results show significantly higher serum concentrations of free beta-hCG and PAPP-A in posttransplant pregnancies than in healthy controls, confirmed when exhibited as MoM values and their association with graft function was assessed by serum creatinine concentration. Taking those changes into account would reduce the high number of false positive test results in this group. The validated first-trimester screening algorithm that considers altered kidney function in pregnant kidney graft recipients remains to be developed. Full article
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16 pages, 959 KiB  
Article
How Big Data Affect Urban Low-Carbon Transformation—A Quasi-Natural Experiment from China
Int. J. Environ. Res. Public Health 2022, 19(23), 16351; https://doi.org/10.3390/ijerph192316351 - 06 Dec 2022
Cited by 4 | Viewed by 1550
Abstract
As a new factor of production, data play a key role in driving low-carbon and sustainable development relying on the digital economy. However, previous studies have ignored this point. Based on the panel data of 283 cities in China from 2007 to 2019, [...] Read more.
As a new factor of production, data play a key role in driving low-carbon and sustainable development relying on the digital economy. However, previous studies have ignored this point. Based on the panel data of 283 cities in China from 2007 to 2019, we investigated the construction of national big data comprehensive pilot zones (NBDCPZs) in China as a quasi-natural experiment, using the difference-in-differences (DID) model to empirically test the impact of NBDCPZ policies on urban low-carbon transformation. The following conclusions can be drawn: NBDCPZ construction significantly promotes urban low-carbon transformation, and a series of robustness analysis supports this conclusion. NBDCPZ constructions mainly promotes urban low-carbon transformation by stimulating urban green innovation and optimizing the allocation of urban resource elements. Compared with eastern cities, small and medium-sized cities, and resource-based cities, the construction of NBDCPZs can promote the low-carbon transformation of cities in central and western China, large cities, and non-resource-based cities. Further analysis shows that the construction of NBDCPZs can only improve the low-carbon transformation of local cities, with negative spatial spillover effects on the low-carbon transformation of surrounding cities. Therefore, in the future, it is vital to consider the promotion effect of the construction of NBDCPZs on the low-carbon transformation of local cities and prevent its negative impact on the low-carbon transformation of surrounding cities. Full article
(This article belongs to the Special Issue Environment, Planning and Land Use)
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11 pages, 459 KiB  
Review
Physical Activity Counseling in Saudi Arabia: A Systematic Review of Content, Outcomes, and Barriers
Int. J. Environ. Res. Public Health 2022, 19(23), 16350; https://doi.org/10.3390/ijerph192316350 - 06 Dec 2022
Cited by 2 | Viewed by 1446
Abstract
Objectives: This study aimed to map the characteristics and the predominant components of clinical physical activity (PA) counseling in Saudi Arabia for adult patients and outline evidence of outcomes and prevalent barriers to its implementation. Methods: We conducted a systematic literature search of [...] Read more.
Objectives: This study aimed to map the characteristics and the predominant components of clinical physical activity (PA) counseling in Saudi Arabia for adult patients and outline evidence of outcomes and prevalent barriers to its implementation. Methods: We conducted a systematic literature search of four online databases: Web of Science, PubMed, ScienceDirect, and The Cochrane Library. Each study was assessed and evaluated using the Mixed Methods Appraisal Tool (MMAT) for methodological quality. Results: A total of 120 studies were screened, and 47 studies were sought for retrieval. In total, 25 articles were eligible and were subjected to extensive review. After a detailed evaluation, only nine studies met the inclusion criteria. All included were quantitative studies that compiled descriptive and numerical data on physical activity counseling. Four studies described PA counseling information in Saudi Arabia or prescription as lifestyle modification and program structure. The programs used various techniques to motivate patients to adhere to PA protocols. In general, practitioners indicated a high perceived competence in helping patients meet PA guidelines. The most frequently stated barrier was a lack of time for PA discussions with patients, followed by a lack of training in PA counseling, and a lack of patient compliance. Significant improvements in clinical parameters and smoking, food, and exercise habits were detected in experimental trials with respective intervention programs. Conclusion: This review provides preliminary insights into the delivered intervention and standard care content, its outcomes, and clinicians’ perceived competence and barriers regarding current PA counseling approaches in Saudi Arabia. Despite the small number of studies included, this review contributes to the limited understanding of current PA counseling practices in Saudi Arabia and serves as an informational source for clinicians and policymakers and a starting point for further research. Full article
(This article belongs to the Special Issue Exercise for Health)
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9 pages, 274 KiB  
Article
Childhood Predictors of Healthcare Use and Health Status in Early Adulthood: Findings from the Twins Early Development Study
Int. J. Environ. Res. Public Health 2022, 19(23), 16349; https://doi.org/10.3390/ijerph192316349 - 06 Dec 2022
Viewed by 976
Abstract
The use of healthcare services is likely to be associated with need but also the factors relating to the care system and the ability to negotiate around it. Healthcare use and health status may also be associated with the factors that exist in [...] Read more.
The use of healthcare services is likely to be associated with need but also the factors relating to the care system and the ability to negotiate around it. Healthcare use and health status may also be associated with the factors that exist in childhood. This study aims to identify the demographic, clinical, and cognitive characteristics of children at age 4 that impact healthcare use and health status at age 21. The data from the Twins Early Development Study were used. Health problems, healthcare use, and cognitive ability at age 4 were entered into generalised estimating equations to predict the use of general practitioners, outpatient services, counselling, emergency clinic visits, and a healthcare helpline at age 21. Similar models existed for the prediction of whether problems were recorded on the EQ-5D-5L EuroQol instrument. The data on up to 6707 individuals were available for analysis. Sex was a significant predictor of service use, with boys being more likely than girls to later use all services, except for emergency clinic visits. Certain health conditions at age 4 predicted the use of services with models differing according to service type. Greater general cognitive ability predicted higher use of general practitioners, outpatient care, and health helplines. The current health status was strongly predictive of service use. Service use in young adulthood was significantly related to concurrent health status as well as health conditions in childhood. General cognitive ability was significantly associated with the use of general practitioner contacts, outpatient visits, and the use of a health helpline. Full article
11 pages, 760 KiB  
Article
Effective Response to Hospital Congestion Scenarios: Simulation-Based Evaluation of Decongestion Interventions
Int. J. Environ. Res. Public Health 2022, 19(23), 16348; https://doi.org/10.3390/ijerph192316348 - 06 Dec 2022
Viewed by 1184
Abstract
Hospital overcrowding is becoming a major concern in the modern era due to the increasing demand for hospital services. This study seeks to identify effective and efficient ways to resolve the serious problem of congestion in hospitals by testing a range of decongestion [...] Read more.
Hospital overcrowding is becoming a major concern in the modern era due to the increasing demand for hospital services. This study seeks to identify effective and efficient ways to resolve the serious problem of congestion in hospitals by testing a range of decongestion strategies with simulated scenarios. In order to determine more efficient solutions, interventions with smaller changes were consistently tested at the beginning through a simulation platform. In addition, the implementation patterns were investigated, which are important to hospital managers with respect to the decisions made to control hospital congestion. The results indicated that diverting a small number of ambulances seems to be more effective and efficient in congestion reduction compared to other approaches. Furthermore, instead of implementing an isolated approach continuously, combining one approach with other strategies is recommended as a method for dealing with hospital overcrowding. Full article
(This article belongs to the Special Issue Focus on the Quality and Governance of Healthcare Services)
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13 pages, 2439 KiB  
Article
Exploring the Sustainable Use Strategy of Scarce Water Resources for Rural Revitalization in Yanchi County from Arid Region of Northwest China
Int. J. Environ. Res. Public Health 2022, 19(23), 16347; https://doi.org/10.3390/ijerph192316347 - 06 Dec 2022
Cited by 1 | Viewed by 1367
Abstract
Water scarcity limits the coordination between economic development and ecological protection of arid regions. This study presented the consumption pattern and future challenges for water resources and proposed sustainable use strategies for water security in Yanchi county from the arid region of northwest [...] Read more.
Water scarcity limits the coordination between economic development and ecological protection of arid regions. This study presented the consumption pattern and future challenges for water resources and proposed sustainable use strategies for water security in Yanchi county from the arid region of northwest China. Our results showed that water withdrawals were close to the total available water resources. Agriculture consumed about 84.72% of the total water supply. Agricultural water use was influenced by breeding stock, rural per capita net income and effective irrigation area. Estimation of agricultural water demand was about 6582.20 × 104 m3 under the rural revitalization scenario. Limited water supply and increased water demand pose challenges and impediments for rural revitalization and water security in Yanchi county. Water sustainable utilization can be achieved by increasing water supply from unconventional water resources and improving water use efficiency with governmental management. These findings may help policymakers to develop sustainable water use strategies during rural revitalization in arid regions. Full article
(This article belongs to the Special Issue Land Use and Urban-Rural Integration)
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16 pages, 1341 KiB  
Article
The Associations between Sibling Victimization, Sibling Bullying, Parental Acceptance–Rejection, and School Bullying
Int. J. Environ. Res. Public Health 2022, 19(23), 16346; https://doi.org/10.3390/ijerph192316346 - 06 Dec 2022
Cited by 10 | Viewed by 2943
Abstract
Bullying has been identified as the most common form of aggression experienced by school-age youth. However, it is still unclear about the family’s influence on school bullying. Therefore, the current study aimed to explore the associations between sibling bullying and school bullying, sibling [...] Read more.
Bullying has been identified as the most common form of aggression experienced by school-age youth. However, it is still unclear about the family’s influence on school bullying. Therefore, the current study aimed to explore the associations between sibling bullying and school bullying, sibling victimization and school victimization, and parental acceptance–rejection and school bullying victimization. The study was cross-sectional and conducted on a sample of students aged between 11 and 20 years recruited from middle schools in Algeria. The study used a survey adopted from the scale of Sibling Bullying, Student Survey of Bullying Behavior—Revised 2, and the Survey of parental acceptance–rejection in collecting the data. The model’s results assessing the association between sibling bullying and school bullying demonstrated that the effect of sibling physical and sibling verbal victims on school victimization was statistically significant. Despite the non-significant effect of sibling emotional victims on school victimization, the effect of sibling physical and sibling verbal bullying on school bullying was statistically significant. However, the effect of sibling emotional bullying on school bullying was not statistically significant. The direct effect of parental acceptance on school victimization was not statistically significant, whereas the effect of parental rejection on school victimization was statistically significant. The direct effect of parental acceptance on school bullying was not statistically significant, while the effect of parental rejection on school bullying was statistically significant. Based on the results, this study provides insights into the understanding of how the family and siblings contribute to school bullying. In particular, sibling victimization, sibling bullying, and parental acceptance–rejection are predictive factors of school bullying among adolescents. Future research should take into account factors based on family to explore the risks of school bullying. Full article
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