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Int. J. Environ. Res. Public Health, Volume 20, Issue 4 (February-2 2023) – 1009 articles

Cover Story (view full-size image): Female hormones and their fluctuations during the menstrual cycle can affect substrate metabolism. For females with type 1 diabetes (T1D), however, these fluctuations during the menstrual cycle can affect blood glucose levels and/or insulin sensitivity. The impact that these cyclic changes may have on blood glucose levels and insulin needs and the consequent risk of hypoglycemia (low blood glucose) during or after exercise are still unknown in this population. This lack of knowledge may act as an important barrier to partaking in exercise in this population. Increasing knowledge in this area can play an important role in eliminating a significant barrier to exercise while also helping to better inform exercise guidelines for females with T1D. View this paper
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20 pages, 1268 KiB  
Article
When Artificial Intelligence Voices Human Concerns: The Paradoxical Effects of AI Voice on Climate Risk Perception and Pro-Environmental Behavioral Intention
by Binbin Ni, Fuzhong Wu and Qing Huang
Int. J. Environ. Res. Public Health 2023, 20(4), 3772; https://doi.org/10.3390/ijerph20043772 - 20 Feb 2023
Cited by 2 | Viewed by 2843
Abstract
Artificial intelligence (AI)-enabled text-to-speech transformation has been widely employed to deliver online information in various fields. However, few studies have investigated the effect of the AI voice in environmental risk communication, especially in the field of climate change, an issue that poses a [...] Read more.
Artificial intelligence (AI)-enabled text-to-speech transformation has been widely employed to deliver online information in various fields. However, few studies have investigated the effect of the AI voice in environmental risk communication, especially in the field of climate change, an issue that poses a severe threat to global public health. To address this gap, the current study examines how the AI voice impacts the persuasive outcome of climate-related information and the potential mechanism that underlies this process. Based on the social and affect heuristics of voice, we propose a serial mediation model to test the effect of climate-related information delivered by different voice types (AI voice vs. human voice) in eliciting risk perception and motivating pro-environmental behavioral intention. Through an online auditory experiment (N = 397), we found the following. First, the AI voice was as effective as the human voice in eliciting risk perception and motivating pro-environmental behavioral intention. Second, compared with human voice, the AI voice yielded a listener’s lower level of perceived identity oneness with the speaker, which decreased risk perception and subsequently inhibited pro-environmental behavioral intention. Third, compared with human voice, the AI voice produced a higher level of auditory fear, which increased risk perception and thereby led to stronger pro-environmental behavioral intention. The paradoxical role of the AI voice and its wise use in environmental risk communication for promoting global public health are discussed. Full article
(This article belongs to the Special Issue The Role of New Technology in Promoting Public Health during Crises)
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22 pages, 3721 KiB  
Article
Longitudinal Effects of Screen Time on Depressive Symptoms among Swedish Adolescents: The Moderating and Mediating Role of Coping Engagement Behavior
by Sebastian Hökby, Joakim Westerlund, Jesper Alvarsson, Vladimir Carli and Gergö Hadlaczky
Int. J. Environ. Res. Public Health 2023, 20(4), 3771; https://doi.org/10.3390/ijerph20043771 - 20 Feb 2023
Cited by 4 | Viewed by 1982
Abstract
Studies suggest that hourly digital screen time increases adolescents’ depressive symptoms and emotional regulation difficulties. However, causal mechanisms behind such associations remain unclear. We hypothesized that problem-focused and/or emotion-focused engagement coping moderates and possibly mediates this association over time. Questionnaire data were collected [...] Read more.
Studies suggest that hourly digital screen time increases adolescents’ depressive symptoms and emotional regulation difficulties. However, causal mechanisms behind such associations remain unclear. We hypothesized that problem-focused and/or emotion-focused engagement coping moderates and possibly mediates this association over time. Questionnaire data were collected in three waves from a representative sample of Swedish adolescents (0, 3 and 12 months; n = 4793; 51% boys; 99% aged 13–15). Generalized Estimating Equations estimated the main effects and moderation effects, and structural regression estimated the mediation pathways. The results showed that problem-focused coping had a main effect on future depression (b = 0.030; p < 0.001) and moderated the effect of screen time (b = 0.009; p < 0.01). The effect size of this moderation was maximum 3.4 BDI-II scores. The mediation results corroborated the finding that future depression was only indirectly correlated with baseline screen time, conditional upon intermittent problem-coping interference (C’-path: Std. beta = 0.001; p = 0.018). The data did not support direct effects, emotion-focused coping effects, or reversed causality. We conclude that hourly screen time can increase depressive symptoms in adolescent populations through interferences with problem-focused coping and other emotional regulation behaviors. Preventive programs could target coping interferences to improve public health. We discuss psychological models of why screen time may interfere with coping, including displacement effects and echo chamber phenomena. Full article
(This article belongs to the Special Issue Emotion Regulation in Children and Adolescents)
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17 pages, 2400 KiB  
Article
The Effect of Vinyasa Yoga Practice on the Well-Being of Breast-Cancer Patients during COVID-19 Pandemic
by Agnieszka Zok, Monika Matecka, Joanna Zapala, Dariusz Izycki and Ewa Baum
Int. J. Environ. Res. Public Health 2023, 20(4), 3770; https://doi.org/10.3390/ijerph20043770 - 20 Feb 2023
Cited by 4 | Viewed by 2884
Abstract
Background: Vinyasa yoga practice improves body fitness and potentially positively affects practitioners’ well-being and health. Due to the diverse intensity of practice and positions customized to the practitioner’s needs, it can also support cancer patients. Undertaking physical activity that has a potentially positive [...] Read more.
Background: Vinyasa yoga practice improves body fitness and potentially positively affects practitioners’ well-being and health. Due to the diverse intensity of practice and positions customized to the practitioner’s needs, it can also support cancer patients. Undertaking physical activity that has a potentially positive effect on well-being and health was particularly important during the self-isolation that followed the COVID-19 pandemic. The purpose of this study was to evaluate the impact of three-month mild and moderate intensity vinyasa yoga practice on breast-cancer patients’ stress perception, self-confidence, and sleep quality during COVID-19 induced self-isolation. Methods: Female breast-cancer patients participated in twelve-weeks of online vinyasa practice during the COVID-19 induced self-isolation period. Meetings were held once a week, where 60-min vinyasa yoga sequences were followed by 15 min of relaxation. Patients completed pre- and post-intervention surveys to evaluate changes in the following outcomes: stress perception, self-confidence, and sleep quality. Forty-one female patients enrolled in the Vinyasa course completed the pre-intervention survey, while 13 attended all the meetings and completed the post-intervention survey. Results: The effect of the twelve-week yoga and relaxation practice significantly reduced sleep problems and stress of oncological patients. The participants also declared an improvement in their general well-being and self-acceptance. Conclusion: Dynamic forms of yoga combined with mindfulness techniques can be applied to patients treated for oncological diseases. It contributes to improving their well-being. However, in-depth studies are needed to analyze the complexity of this effect. Full article
(This article belongs to the Section Health Behavior, Chronic Disease and Health Promotion)
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14 pages, 1070 KiB  
Article
Chinese Virtues and Resilience among Students in Hong Kong
by Xiaoxue Kuang, John Chi-Kin Lee and Junjun Chen
Int. J. Environ. Res. Public Health 2023, 20(4), 3769; https://doi.org/10.3390/ijerph20043769 - 20 Feb 2023
Cited by 1 | Viewed by 1887
Abstract
Character strengths and training have a great impact on students’ whole-person development. This study examined the applicability of the Chinese virtues questionnaire (CVQ) and the relationships between students’ perceptions of virtues and resilience in Hong Kong, SAR, China. A total of 2468 pupils [...] Read more.
Character strengths and training have a great impact on students’ whole-person development. This study examined the applicability of the Chinese virtues questionnaire (CVQ) and the relationships between students’ perceptions of virtues and resilience in Hong Kong, SAR, China. A total of 2468 pupils from primary and secondary schools in Hong Kong were recruited as the sample for this study. The results of confirmatory factor analysis (CFA) supported a measurement model of Chinese virtues, and the results of structural equation modeling (SEM) suggested that Chinese virtues were positively related to positive resilience and succumbing. Significant relationships were found between gender and students’ positive resilience, and school grade level showed a significant impact on the Chinese virtues, which in turn affect resilience. Student resilience could be enhanced by nurturing virtues and related character strengths, keeping in mind the role of gender and grade level. Full article
(This article belongs to the Special Issue Well-Being and Health in Education: Challenges, Chances, and Change)
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13 pages, 1593 KiB  
Article
Health Service Management and Patient Safety in Primary Care during the COVID-19 Pandemic in Kosovo
by Gazmend Bojaj, Bernard Tahirbegolli, Petrit Beqiri, Iliriana Alloqi Tahirbegolli, Esther Van Poel, Sara Willems, Nderim Rizanaj and Ilir Hoxha
Int. J. Environ. Res. Public Health 2023, 20(4), 3768; https://doi.org/10.3390/ijerph20043768 - 20 Feb 2023
Cited by 1 | Viewed by 2148
Abstract
Background: Several changes must be made to the services to ensure patient safety and enable delivering services in environments where the danger of infection of healthcare personnel and patients in primary care (PC) institutions is elevated, i.e., during the COVID-19 pandemic. Objective: This [...] Read more.
Background: Several changes must be made to the services to ensure patient safety and enable delivering services in environments where the danger of infection of healthcare personnel and patients in primary care (PC) institutions is elevated, i.e., during the COVID-19 pandemic. Objective: This study aimed to examine patient safety and healthcare service management in PHC practices in Kosovo during the COVID-19 pandemic. Methods: In this cross-sectional study, data were collected using a self-reported questionnaire among 77 PHC practices. Results: Our main finding reveals a safer organization of PC practices and services since the COVID-19 pandemic compared to the previous period before the pandemic. The study also shows a collaboration between PC practices in the close neighborhood and more proper human resource management due to COVID-19 suspicion or infection. Over 80% of the participating PC practices felt the need to introduce changes to the structure of their practice. Regarding infection protection measures (IPC), our study found that health professionals’ practices of wearing a ring or bracelet and wearing nail polish improved during the COVID-19 pandemic compared to the pre-pandemic period. During the COVID-19 pandemic, PC practice health professionals had less time to routinely review guidelines or medical literature. Despite this, implementing triage protocols over the phone has yet to be applied at the intended level by PC practices in Kosovo. Conclusions: Primary care practices in Kosovo responded to the COVID-19 pandemic crisis by modifying how they organize their work, implementing procedures for infection control, and enhancing patient safety. Full article
(This article belongs to the Section Health Care Sciences & Services)
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9 pages, 687 KiB  
Article
Prevalence of Consanguineous Marriage among Saudi Citizens of Albaha, a Cross-Sectional Study
by Mohammad A. Albanghali
Int. J. Environ. Res. Public Health 2023, 20(4), 3767; https://doi.org/10.3390/ijerph20043767 - 20 Feb 2023
Cited by 6 | Viewed by 2404
Abstract
Consanguineous marriage (CM) is a prevalent kind of relationship in Muslim and Arab countries, and this type of relationship is linked to several health risks. This study was conducted to determine the prevalence of (CM), its associated hereditary diseases, and health-related issues among [...] Read more.
Consanguineous marriage (CM) is a prevalent kind of relationship in Muslim and Arab countries, and this type of relationship is linked to several health risks. This study was conducted to determine the prevalence of (CM), its associated hereditary diseases, and health-related issues among Saudi citizens in Albaha. This cross-sectional study was conducted between March 2021 to April 2021. Saudi citizens in Albaha who were aged ≥ 18 years and willing to participate were eligible for the study. A total of 1010 participants were included in this study. In total, 757 participants were married, widowed, or divorced. CM partnerships comprised 40% (N = 302) of the marriages among participants, of which first- and second-cousin marriages comprised 72% and 28%, respectively. The prevalence of CM among the participants’ parents was lower than that among the participants (31% versus 40%, respectively). Children of participants in a CM were more likely to have cardiovascular diseases (p < 0.001), blood diseases (anaemia, thalassemia) (p < 0.001), cancer (p = 0.046), hearing loss and speech disorder (p = 0.003), and ophthalmic diseases (p = 0.037). Albaha showed a high percentage of consanguinity. An educational program must be established to enhance the population’s knowledge of the consequences of CM. The current national premarital screening program should be extended to involve more screening tests for common hereditary diseases that result from CM. Full article
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13 pages, 2476 KiB  
Article
Numerical Solution for Fuzzy Time-Fractional Cancer Tumor Model with a Time-Dependent Net Killing Rate of Cancer Cells
by Hamzeh Zureigat, Mohammed Al-Smadi, Areen Al-Khateeb, Shrideh Al-Omari and Sharifah Alhazmi
Int. J. Environ. Res. Public Health 2023, 20(4), 3766; https://doi.org/10.3390/ijerph20043766 - 20 Feb 2023
Cited by 2 | Viewed by 1327
Abstract
A cancer tumor model is an important tool for studying the behavior of various cancer tumors. Recently, many fuzzy time-fractional diffusion equations have been employed to describe cancer tumor models in fuzzy conditions. In this paper, an explicit finite difference method has been [...] Read more.
A cancer tumor model is an important tool for studying the behavior of various cancer tumors. Recently, many fuzzy time-fractional diffusion equations have been employed to describe cancer tumor models in fuzzy conditions. In this paper, an explicit finite difference method has been developed and applied to solve a fuzzy time-fractional cancer tumor model. The impact of using the fuzzy time-fractional derivative has been examined under the double parametric form of fuzzy numbers rather than using classical time derivatives in fuzzy cancer tumor models. In addition, the stability of the proposed model has been investigated by applying the Fourier method, where the net killing rate of the cancer cells is only time-dependent, and the time-fractional derivative is Caputo’s derivative. Moreover, certain numerical experiments are discussed to examine the feasibility of the new approach and to check the related aspects. Over and above, certain needs in studying the fuzzy fractional cancer tumor model are detected to provide a better comprehensive understanding of the behavior of the tumor by utilizing several fuzzy cases on the initial conditions of the proposed model. Full article
(This article belongs to the Section Infectious Disease Epidemiology)
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19 pages, 3273 KiB  
Systematic Review
Evidence of Use of Whole-Body Vibration in Individuals with Metabolic Syndrome: A Systematic Review and Meta-Analysis
by Ana Carolina Coelho-Oliveira, Bruno Bessa Monteiro-Oliveira, Raphael Gonçalves de Oliveira, Aline Reis-Silva, Luiz Felipe Ferreira-Souza, Ana Cristina Rodrigues Lacerda, Vanessa A. Mendonça, Alessandro Sartorio, Redha Taiar, Mario Bernardo-Filho and Danúbia Sá-Caputo
Int. J. Environ. Res. Public Health 2023, 20(4), 3765; https://doi.org/10.3390/ijerph20043765 - 20 Feb 2023
Viewed by 1853
Abstract
(1) Background: Metabolic syndrome (MSy) is defined by a constellation of interconnected physiological, biochemical, clinical, and metabolic factors that directly increase the risk of cardiovascular disease. This systematic review with meta-analysis was conducted to assess the effects of whole-body vibration exercise (WBVE) in [...] Read more.
(1) Background: Metabolic syndrome (MSy) is defined by a constellation of interconnected physiological, biochemical, clinical, and metabolic factors that directly increase the risk of cardiovascular disease. This systematic review with meta-analysis was conducted to assess the effects of whole-body vibration exercise (WBVE) in metabolic syndrome (MSy) individuals. (2) Methods: An electronic search in Pubmed, Embase, Scopus, Web of Science, ScienceDirect, PEDro, and CINAHL databases in December 2022 was performed. Data regarding the included studies were extracted. The level of evidence, the methodological quality, and the risk of bias of each selected publication were individually evaluated. (3) Results: Eight studies were included in the systematic review and four studies in the meta-analysis, with a mean methodological quality score on the Physiotherapy Evidence Database (PEDro scale) of 5.6, considered “fair” quality. The qualitative results suggested positive effects of the systemic vibration therapy in relevant outcomes, such as quality of life, functionality, pain level, trunk flexibility, cardiovascular responses (blood pressure and heart rate), neuromuscular activation, range of motion of the knees, rating of perceived exertion, and body composition. The quantitative results, with weighted mean differences, standard mean differences, and 95% confidence intervals (CIs), were calculated. Conclusions: WBVE may be an alternative capable of interfering with physical—mainly for flexibility with weighted mean differences (1.70; 95% CI 0.15, 3.25; n = 39)—functional, psychosocial, neuromuscular, emotional parameters, and consequently contribute to improvements in metabolic health and reduce the cardiovascular risk factor in MSy individuals. Nevertheless, further additional studies are required to understand the long-term effects of WBVE on MSy and its complications in a better way. Protocol study registration was as follows: PROSPERO (CRD 42020187319). Full article
(This article belongs to the Special Issue Effectiveness of Physical Exercise for People with Chronic Diseases)
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19 pages, 8543 KiB  
Article
Characteristics and Driving Mechanism of Water Resources Trend Change in Hanjiang River Basin
by Ming Kong, Jieni Zhao, Chuanfu Zang, Yiting Li and Jinglin Deng
Int. J. Environ. Res. Public Health 2023, 20(4), 3764; https://doi.org/10.3390/ijerph20043764 - 20 Feb 2023
Cited by 1 | Viewed by 1255
Abstract
Studying the historical and future trends of water resources in a basin and explaining the causes of water resource changes is very important, which is key to the management of water resources in a basin. The Hanjiang River Basin is an important water [...] Read more.
Studying the historical and future trends of water resources in a basin and explaining the causes of water resource changes is very important, which is key to the management of water resources in a basin. The Hanjiang River Basin is an important water supply source for southwestern Fujian and eastern Guangdong, but it has an uneven spatial and temporal distribution of water resources and an outstanding conflict between supply and demand. In this study, the SWAT model was used to simulate the conditions of the Hanjiang River Basin in the last 50 years, using long time series climate data to study the characteristics and driving mechanism of water resources trend change. The results show that the water resources in the basin have not increased significantly in the last 50 years, but evapotranspiration has increased significantly. The forecast results for water resources in the future are reduced. The water resource changes in the basin have been unevenly distributed in the last 50 years. Climate change has been the main factor in total water resource change in the basin, while the difference in water resource change trends within the basin is caused by land use. The key reason for the decrease in water resources in the Hanjiang River Basin is the significant increase in evapotranspiration due to the significant increase in temperature. If this situation continues, the available water resources in the basin will continue to decline. In fact, many basins around the world are currently likely to have such problems, such as the 2022 summer drought in the Danube River Basin in Europe and the Yangtze River Basin in China, so this article is informative and representative of future water resources management in the basin. Full article
(This article belongs to the Special Issue The Impact of Urbanization on Water Resources)
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15 pages, 797 KiB  
Article
Peer Intervention following Suicide-Related Emergency Department Presentation: Evaluation of the PAUSE Pilot Program
by Mandy Gibson, Nick Moreau, Eschleigh Balzamo and David Crompton
Int. J. Environ. Res. Public Health 2023, 20(4), 3763; https://doi.org/10.3390/ijerph20043763 - 20 Feb 2023
Viewed by 2509
Abstract
The risk for future suicidal behaviours is elevated following suicide attempts, particularly for those with complex needs or those who are disconnected from healthcare systems. The PAUSE program was designed to address this gap using peer workers to provide continuity and coordination of [...] Read more.
The risk for future suicidal behaviours is elevated following suicide attempts, particularly for those with complex needs or those who are disconnected from healthcare systems. The PAUSE program was designed to address this gap using peer workers to provide continuity and coordination of care following suicide-related emergency presentations. This study aimed to evaluate the pilot program’s effect on suicidal ideation and hope, and to explore the acceptability and participants’ experiences. A mixed-methods design was employed with pre- and post-evaluation questionnaires, including the GHQ-28-SS (general health questionnaire suicide scale), AHS (adult hope scale), and K10 (Kessler psychological distress scale). Participant engagement rates and semi-structured interviews were used to explore program acceptability. In total, 142 people were engaged with the PAUSE pilot between 24 August 2017 and 11 January 2020. There were no significant gender differences in engagement. The suicidal ideation scores decreased, and the hope scores increased after participation in PAUSE. A thematic analysis revealed that participants identified that the key program mechanisms were holistic and responsive support, ongoing social connectedness, and having peer workers who understood their experiences and treated them like people rather than clients. The small number of participants and lack of a control group limited the result generalizability. The findings suggest that PAUSE was an effective and acceptable model for supporting people following suicide-related hospitalisations in this pilot sample. Full article
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18 pages, 1697 KiB  
Review
Endometrial Inflammation and Impaired Spontaneous Decidualization: Insights into the Pathogenesis of Adenomyosis
by Hiroshi Kobayashi
Int. J. Environ. Res. Public Health 2023, 20(4), 3762; https://doi.org/10.3390/ijerph20043762 - 20 Feb 2023
Cited by 3 | Viewed by 1959
Abstract
Adenomyosis is an estrogen-dependent gynecologic disease characterized by the myometrial invasion of the endometrial tissue. This review summarized the current understanding and recent findings on the pathophysiology of adenomyosis, focusing on repeated menstruation, persistent inflammation, and impaired spontaneous decidualization. A literature search was [...] Read more.
Adenomyosis is an estrogen-dependent gynecologic disease characterized by the myometrial invasion of the endometrial tissue. This review summarized the current understanding and recent findings on the pathophysiology of adenomyosis, focusing on repeated menstruation, persistent inflammation, and impaired spontaneous decidualization. A literature search was performed in the PubMed and Google Scholar databases from inception to 30 April 2022. Thirty-one full-text articles met the eligibility criteria. Repeated episodes of physiological events (i.e., endometrial shedding, damage, proliferation, differentiation, repair, and regeneration) during the menstrual cycle are associated with inflammation, angiogenesis, and immune processes. The decidualization process in humans is driven by the rise in progesterone levels, independently of pregnancy (i.e., spontaneous decidualization). Adenomyotic cells produce angiogenic and fibrogenic factors with the downregulation of decidualization-associated molecules. This decidualization dysfunction and persistent inflammation are closely related to the pathogenesis of adenomyosis. Recently, it has been found that the reproductive tract microbiota composition and function in women with adenomyosis differ from those without. An increase in opportunistic pathogens and a decrease in beneficial commensals may promote impaired defense mechanisms against inflammation and predispose women to uncontrolled endometrial inflammation. However, currently, there is no direct evidence that adenomyosis is linked to pre-existing inflammation and impaired spontaneous decidualization. Overall, persistent inflammation, impaired spontaneous decidualization, and microbiota dysbiosis (i.e., an imbalance in the composition and function of endometrial microbiota) may be involved in the pathophysiology of adenomyosis. Full article
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17 pages, 6080 KiB  
Article
Unveiling the Role of Dissolved Organic Matter on the Hg Phytoavailability in Biochar-Amended Soils
by Wenhao Chen, Zhigang Yu, Xu Yang, Tantan Wang, Zihao Li, Xin Wen, Yubo He and Chang Zhang
Int. J. Environ. Res. Public Health 2023, 20(4), 3761; https://doi.org/10.3390/ijerph20043761 - 20 Feb 2023
Cited by 2 | Viewed by 1591
Abstract
Biochar can effectively reduce the phytoavailability of mercury (Hg) in soil, but the mechanisms are not fully understood. In this study, the dynamic changes in Hg content adsorbed by the biochar (BC-Hg), Hg phytoavailability in the soil (P-Hg), and soil dissolved organic matter [...] Read more.
Biochar can effectively reduce the phytoavailability of mercury (Hg) in soil, but the mechanisms are not fully understood. In this study, the dynamic changes in Hg content adsorbed by the biochar (BC-Hg), Hg phytoavailability in the soil (P-Hg), and soil dissolved organic matter (DOM) characteristics were determined over a 60-day treatment period. Biochar obtained at 300 °C, 500 °C and 700 °C reduced the P-Hg concentration assessed by MgCl2 extraction by 9.4%, 23.5% and 32.7%, respectively. However, biochar showed a very limited adsorption on Hg, with the maximum BC-Hg content only accounting for 1.1% of the total amount. High-resolution scanning electron microscopy coupled with energy dispersive X-ray spectroscopy (SEM-EDS) results showed that the proportion of Hg atoms in biochar after 60 d was barely detectable. Biochar treatment can shift soil DOM toward higher aromatic content and molecular weight. Additionally, the addition of high-temperature biochar increased more humus-like components, but low-temperature biochar increased more protein-like components. Correlation analysis and partial least squares path modeling (PLS-PM) showed that biochar promoted humus-like fractions formation to reduce the Hg phytoavailability. This research has deepened the understanding of the mechanisms by which biochar stabilizes Hg in agricultural soils. Full article
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16 pages, 817 KiB  
Article
Medication Regimen Complexity Index Score at Admission as a Predictor of Inpatient Outcomes: A Machine Learning Approach
by Yves Paul Vincent Mbous, Todd Brothers and Mohammad A. Al-Mamun
Int. J. Environ. Res. Public Health 2023, 20(4), 3760; https://doi.org/10.3390/ijerph20043760 - 20 Feb 2023
Viewed by 1426
Abstract
Background: In the intensive care unit, traditional scoring systems use illness severity and/or organ failure to determine prognosis, and this usually rests on the patient’s condition at admission. In spite of the importance of medication reconciliation, the usefulness of home medication histories as [...] Read more.
Background: In the intensive care unit, traditional scoring systems use illness severity and/or organ failure to determine prognosis, and this usually rests on the patient’s condition at admission. In spite of the importance of medication reconciliation, the usefulness of home medication histories as predictors of clinical outcomes remains unexplored. Methods: A retrospective cohort study was conducted using the medical records of 322 intensive care unit (ICU) patients. The predictors of interest included the medication regimen complexity index (MRCI) at admission, the Acute Physiology and Chronic Health Evaluation (APACHE) II, the Sequential Organ Failure Assessment (SOFA) score, or a combination thereof. Outcomes included mortality, length of stay, and the need for mechanical ventilation. Machine learning algorithms were used for outcome classification after correcting for class imbalances in the general population and across the racial continuum. Results: The home medication model could predict all clinical outcomes accurately 70% of the time. Among Whites, it improved to 80%, whereas among non-Whites it remained at 70%. The addition of SOFA and APACHE II yielded the best models among non-Whites and Whites, respectively. SHapley Additive exPlanations (SHAP) values showed that low MRCI scores were associated with reduced mortality and LOS, yet an increased need for mechanical ventilation. Conclusion: Home medication histories represent a viable addition to traditional predictors of health outcomes. Full article
(This article belongs to the Special Issue Artificial Intelligence in Healthcare and Health Services)
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23 pages, 11128 KiB  
Article
The Synergistic Effect of Topographic Factors and Vegetation Indices on the Underground Coal Mine Utilizing Unmanned Aerial Vehicle Remote Sensing
by Quansheng Li, Feiyue Li, Junting Guo, Li Guo, Shanshan Wang, Yaping Zhang, Mengyuan Li and Chengye Zhang
Int. J. Environ. Res. Public Health 2023, 20(4), 3759; https://doi.org/10.3390/ijerph20043759 - 20 Feb 2023
Cited by 1 | Viewed by 1682
Abstract
Understanding the synergistic effect between topography and vegetation in the underground coal mine is of great significance for the ecological restoration and sustainable development of mining areas. This paper took advantage of unmanned aerial vehicle (UAV) remote sensing to obtain high-precision topographic factors [...] Read more.
Understanding the synergistic effect between topography and vegetation in the underground coal mine is of great significance for the ecological restoration and sustainable development of mining areas. This paper took advantage of unmanned aerial vehicle (UAV) remote sensing to obtain high-precision topographic factors (i.e., digital elevation model (DEM), slope, and aspect) in the Shangwan Coal Mine. Then, a normalized difference vegetation index (NDVI) was calculated utilizing Landsat images from 2017 to 2021, and the NDVI with the same spatial resolution as the slope and aspect was acquired by down-sampling. Finally, the synergistic effect of topography and vegetation in the underground mining area was revealed by dividing the topography obtained using high-precision data into 21 types. The results show that: (1) the vegetation cover was dominated by “slightly low-VC”, “medium-VC”, and “slightly high-VC” in the study area, and there was a positive correlation between the slope and NDVI when the slope was more than 5°. (2) When the slope was slight, the aspect had less influence on the vegetation growth. When the slope was larger, the influence of the aspect increased in the study area. (3) “Rapidly steep–semi-sunny slope” was the most suitable combination for the vegetation growth in the study area. This paper revealed the relationship between the topography and vegetation. In addition, it provided a scientific and effective foundation for decision-making of ecological restoration in the underground coal mine. Full article
(This article belongs to the Special Issue Remote Sensing Application in Environmental Monitoring)
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9 pages, 657 KiB  
Article
Physical Inactivity Levels of European Adolescents in 2002, 2005, 2013, and 2017
by Jorge López-Fernández, Alejandro López-Valenciano, Gemma Pearce, Robert J. Copeland, Gary Liguori, Alfonso Jiménez and Xian Mayo
Int. J. Environ. Res. Public Health 2023, 20(4), 3758; https://doi.org/10.3390/ijerph20043758 - 20 Feb 2023
Cited by 1 | Viewed by 1061
Abstract
Sport and Physical Activity (PA) Special Eurobarometer surveys may inform of the physical inactivity (PIA) levels in the European Union (EU). This study aimed to analyse the PIA levels of EU adolescents (15–17 years) in four time points, according to gender. The data [...] Read more.
Sport and Physical Activity (PA) Special Eurobarometer surveys may inform of the physical inactivity (PIA) levels in the European Union (EU). This study aimed to analyse the PIA levels of EU adolescents (15–17 years) in four time points, according to gender. The data were from 2002, 2005, 20013, and 2017 Special Eurobarometers. Adolescents were categorised as “Inactive” when performing less than 60 min/day of moderate to vigorous PA on average. A χ2 test was used to compare the levels of PIA between survey years. PIA levels between gender were analysed using a Z-score test for two population proportions. PIA levels ranged from 67.2% for boys (59.4% to 71.5%;) to 76.8% for girls (76.0% to 83.4) across the time points. Adjusted standardised residuals revealed a decrease in the observed levels versus the expected for 2005 (whole sample: −4.2; boys: −3.3) and an increase for 2013 (whole sample: +2.9; boys: +2.5). Boys presented lower PIA levels than girls in all years (p ≤ 0.003), but descriptively, the difference progressively decreased (from 18.4% to 11.8%). No significant reductions in PIA levels were observed between 2002 and 2017, and girls reported consistently higher levels of PIA than boys. Full article
(This article belongs to the Special Issue Exercise Injury and Rehabilitation)
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15 pages, 5361 KiB  
Article
Design and Implementation of a Chain-Type Direct Push Drilling Rig for Contaminated Sites
by Pinghe Sun, Shengwei Zhou, Han Cao, Guojun Cai, Shaohe Zhang, Qiang Gao, Gongbi Cheng, Biao Liu, Gongping Liu, Xinxin Zhang, Yun Liu, Dongyu Wu, Zhenyu Ding, Lan Zeng, Guangdong Liao, Leilei Liu, Xiaokang Wang, Ting Xiao, Jing Jin and Hanhan Yang
Int. J. Environ. Res. Public Health 2023, 20(4), 3757; https://doi.org/10.3390/ijerph20043757 - 20 Feb 2023
Cited by 2 | Viewed by 1696
Abstract
For sites where volatile organic compounds are present, the direct push method, in combination with other sensors for investigation, is a powerful method. The investigation process is an integrated drilling and sensing process, but the trajectory of the probe carrying the sensor is [...] Read more.
For sites where volatile organic compounds are present, the direct push method, in combination with other sensors for investigation, is a powerful method. The investigation process is an integrated drilling and sensing process, but the trajectory of the probe carrying the sensor is ambiguous. This paper explores and introduces the application of a chain-type direct push drilling rig by designing and building a chain-type direct push miniature drilling rig. This rig allows for indoor experimental studies of direct push trajectories. The chain-type direct push drilling model is proposed based on the mechanism of chain transmission. The drilling rig provides a steady direct thrust through the chain, which is driven by a hydraulic motor. In addition, the drilling tests and results described prove that the chain could be applied to direct push drilling. The chain-type direct push drilling rig can drill to a depth of 1940 mm in single-pass and up to 20,000 mm in multiple passes. The test results also indicate that it drills a total length of 462.461 mm and stops after 87.545 s of operation. The machine can provide a drilling angle of 0–90° and keep the borehole angle fluctuating within 0.6° with the characteristics of strong adjustability, flexibility, continuity, stability, and low disturbance, which is of great value and significance for studying the drilling trajectory of direct push tools and obtaining more accurate investigation data. Full article
(This article belongs to the Special Issue Soil Remediation and Prophylaxis in Polluted Environments)
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10 pages, 530 KiB  
Article
Evaluation of Correlation between Sleep and Psychiatric Disorders in a Population of Night Shift Workers: A Pilot Study
by Luigi Cirrincione, Fulvio Plescia, Ginevra Malta, Marcello Campagna, Luigi Isaia Lecca, Alenka Skerjanc, Elisa Carena, Vincenzo Baylon, Kelly Theodoridou, Santo Fruscione and Emanuele Cannizzaro
Int. J. Environ. Res. Public Health 2023, 20(4), 3756; https://doi.org/10.3390/ijerph20043756 - 20 Feb 2023
Cited by 4 | Viewed by 3163
Abstract
Background: Insomnia is the perception of inadequate, insufficient or non-restorative sleep. Of all sleep-related disorders, insomnia is the most common. It is important to remember that the sleep–wake cycle also plays a central role in the genesis of anxiety and depression. The aim [...] Read more.
Background: Insomnia is the perception of inadequate, insufficient or non-restorative sleep. Of all sleep-related disorders, insomnia is the most common. It is important to remember that the sleep–wake cycle also plays a central role in the genesis of anxiety and depression. The aim of our study is to evaluate the association between sleep disturbances and anxiety and depression in a group of workers of both sexes who perform night shift work. Methods: Information on sleep disorders was collected by administering the Insomnia Severity Index (ISI) questionnaire. Statistical analysis was conducted using the Chi-square test to assess whether there were any differences between sex for those who were healthy or who were diagnosed with psychiatric disorders. Results: The results showed that there was a good percentage of subjects with insomnia problems, impairing normal daily activities and promoting the onset of fatigue, daytime sleepiness, cognitive performance deficits and mood disorders. Conclusion: We highlighted how anxious and depressive anxiety disorders are more pronounced in people who suffer from altered sleep–wake rhythms. Further research in this direction could prove to be fundamental for understanding the genesis of the onset of other disorders as well. Full article
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12 pages, 1465 KiB  
Article
Effects of Unilateral Neuromuscular Electrical Stimulation with Illusionary Mirror Visual Feedback on the Contralateral Muscle: A Pilot Study
by Xin Ye, Daniel Vala, Hayden Walker, Victor Gaza, Vinz Umali, Patrick Brodoff, Nathan Gockel and Masatoshi Nakamura
Int. J. Environ. Res. Public Health 2023, 20(4), 3755; https://doi.org/10.3390/ijerph20043755 - 20 Feb 2023
Viewed by 1425
Abstract
We aim to examine the cross-education effects of unilateral muscle neuromuscular electrical stimulation (NMES) training combined with illusionary mirror visual feedback (MVF). Fifteen adults (NMES + MVF: 5; NMES: 5, Control: 5) completed this study. The experimental groups completed a 3-week NMES training [...] Read more.
We aim to examine the cross-education effects of unilateral muscle neuromuscular electrical stimulation (NMES) training combined with illusionary mirror visual feedback (MVF). Fifteen adults (NMES + MVF: 5; NMES: 5, Control: 5) completed this study. The experimental groups completed a 3-week NMES training on their dominant elbow flexor muscle. The NMES + MVF group had a mirror placed in the midsagittal plane between their upper arms, so a visual illusion was created in which their non-dominant arms appeared to be stimulated. Baseline and post-training measurements included both arms’ isometric strength, voluntary activation level, and resting twitch. Cross-education effects were not observed from all dependent variables. For the unilateral muscle, both experimental groups showed greater strength increases when compared to the control (isometric strength % changes: NMES + MVF vs. NMES vs. Control = 6.31 ± 4.56% vs. 4.72 ± 8.97% vs. −4.04 ± 3.85%, p < 0.05). Throughout the training, even with the maximally tolerated NMES, the NMES + MVF group had greater perceived exertion and discomfort than the NMES. Additionally, the NMES-evoked force increased throughout the training for both groups. Our data does not support that NMES combined with or without MVF induces cross-education. However, the stimulated muscle becomes more responsive to the NMES and can become stronger following the training. Full article
(This article belongs to the Special Issue Muscle Responses and Adaptation in Exercise, Sport and Health)
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17 pages, 1031 KiB  
Article
Assessment of Patient Treatment and Rehabilitation Processes Using Electromyography Signals and Selected Industry 4.0 Solutions
by Ewa Stawiarska and Maciej Stawiarski
Int. J. Environ. Res. Public Health 2023, 20(4), 3754; https://doi.org/10.3390/ijerph20043754 - 20 Feb 2023
Cited by 1 | Viewed by 1216
Abstract
Funding treatment and rehabilitation processes for patients with musculoskeletal conditions is an important part of public health insurance in European Union countries. By 2030, these processes will be planned in national health strategies (sequential process activities will be identified, care packages will be [...] Read more.
Funding treatment and rehabilitation processes for patients with musculoskeletal conditions is an important part of public health insurance in European Union countries. By 2030, these processes will be planned in national health strategies (sequential process activities will be identified, care packages will be defined, service standards will be described, roles in the implementation of activities will be distinguished). Today, in many countries of the world (including the EU countries), these processes tend not to be very effective and to be expensive for both patients and insurance companies. This article aims to raise awareness of the need for process re-engineering and describes possible tools for assessing patient treatment and rehabilitation processes (using electromyographic signals—EMG and selected Industry 4.0 solutions). This article presents the research methodology prepared for the purpose of process evaluation. The use of this methodology will confirm the hypothesis that the use of EMG signals and selected Industry 4.0 solutions will improve the effectiveness and efficiency of treatment and rehabilitation processes for patients with musculoskeletal injuries. Full article
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20 pages, 13494 KiB  
Article
Urban Ecological Environment Quality Evaluation and Territorial Spatial Planning Response: Application to Changsha, Central China
by Chan Lu, Lei Shi, Lihua Fu, Simian Liu, Jianqiao Li and Zhenchun Mo
Int. J. Environ. Res. Public Health 2023, 20(4), 3753; https://doi.org/10.3390/ijerph20043753 - 20 Feb 2023
Cited by 5 | Viewed by 3928
Abstract
Scientific territorial spatial planning is of great significance in the realization of the sustainable development goals in China, especially in the context of China’s ecological civilization construction and territorial spatial planning. However, limited research has been carried out to understand the spatio-temporal change [...] Read more.
Scientific territorial spatial planning is of great significance in the realization of the sustainable development goals in China, especially in the context of China’s ecological civilization construction and territorial spatial planning. However, limited research has been carried out to understand the spatio-temporal change in EEQ and territorial spatial planning. In this study, Changsha County and six districts of Changsha City were selected as the research objects. Based on the remote sensing ecological index (RSEI) model, the spatio-temporal changes in the EEQ and spatial planning response in the study area during 2003–2018 were analyzed. The results reveal that (1) the EEQ of Changsha declined and then rose between 2003 and 2018, showing an overall decreasing trend. The average RSEI declined from 0.532 in 2003 to 0.500 in 2014 and then increased to 0.523 in 2018, with an overall decrease of 1.7%. (2) In terms of spatial pattern changes, the Xingma Group, the Airport Group and the Huangli Group in the east of the Xiangjiang River had the most serious EEQ degradation. The EEQ degradation of Changsha showed an expanding and polycentric decentralized grouping pattern. (3) Massive construction land expansion during rapid urbanization caused significant EEQ degradation in Changsha. Particularly, the areas with low EEQ were concentrated in the areas with concentrated industrial land. Scientific territorial spatial planning and strict control were conducive to regional EEQ improvement. (4) The prediction using the urban ecological model demonstrates that every 0.549 unit increase in NDVI or 0.2 unit decrease in NDBSI can improve the RSEI of the study area by 0.1 unit, thus improving EEQ. In the future territorial spatial planning and construction of Changsha, it is necessary to promote the transformation and upgrading of low-end industries into high-end manufacturing industries and control the scale of inefficient industrial land. The EEQ degradation caused by industrial land expansion needs to be noted. All of these findings can provide valuable information for relevant decision-makers to formulate ecological environment protection strategies and conduct future territorial spatial planning. Full article
(This article belongs to the Special Issue Ecological Environment Assessment Based on Remote Sensing)
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11 pages, 328 KiB  
Article
Association between Glutathione S-Transferases Gene Variants and COVID-19 Severity in Previously Vaccinated and Unvaccinated Polish Patients with Confirmed SARS-CoV-2 Infection
by Katarzyna Orlewska, Justyna Klusek, Dorota Zarębska-Michaluk, Kamila Kocańda, Ruslan Oblap, Anna Cedro, Bartosz Witczak, Jolanta Klusek, Andrzej Śliwczyński and Ewa Orlewska
Int. J. Environ. Res. Public Health 2023, 20(4), 3752; https://doi.org/10.3390/ijerph20043752 - 20 Feb 2023
Cited by 1 | Viewed by 1633
Abstract
As the outcome of COVID-19 is associated with oxidative stress, it is highly probable that polymorphisms of genes related to oxidative stress were associated with susceptibility and severity of COVID-19. The aim of the study was to assess the association of glutathione S-transferases [...] Read more.
As the outcome of COVID-19 is associated with oxidative stress, it is highly probable that polymorphisms of genes related to oxidative stress were associated with susceptibility and severity of COVID-19. The aim of the study was to assess the association of glutathione S-transferases (GSTs) gene polymorphisms with COVID-19 severity in previously vaccinated and unvaccinated Polish patients with confirmed SARS-CoV-2 infection. A total of 92 not vaccinated and 84 vaccinated patients hospitalized due to COVID-19 were included. The WHO COVID-19 Clinical Progression Scale was used to assess COVID-19 severity. GSTs genetic polymorphisms were assessed by appropriate PCR methods. Univariable and multivariable analyses were performed, including logistic regression analysis. GSTP1 Ile/Val genotype was found to be associated with a higher risk of developing a severe form of the disease in the population of vaccinated patients with COVID-19 (OR: 2.75; p = 0.0398). No significant association was observed for any of the assessed GST genotypes with COVID-19 disease severity in unvaccinated patients with COVID-19. In this group of patients, BMI > 25 and serum glucose level > 99 mg% statistically significantly increased the odds towards more severe COVID-19. Our results may contribute to further understanding of risk factors of severe COVID-19 and selecting patients in need of strategies focusing on oxidative stress. Full article
9 pages, 338 KiB  
Article
Impact of Cervical Cancer on Quality of Life and Sexuality in Female Survivors
by Lucia Membrilla-Beltran, Diana Cardona, Laura Camara-Roca, Adrian Aparicio-Mota, Pablo Roman and Lola Rueda-Ruzafa
Int. J. Environ. Res. Public Health 2023, 20(4), 3751; https://doi.org/10.3390/ijerph20043751 - 20 Feb 2023
Cited by 8 | Viewed by 3219
Abstract
Cervical cancer is the fourth most frequent cancer in women worldwide, and the 11th most frequent neoplasm in Spain. Despite the optimization of treatments and a 5-year survival rate of 70%, side effects and sequelae are described after treatment. The treatments have physical, [...] Read more.
Cervical cancer is the fourth most frequent cancer in women worldwide, and the 11th most frequent neoplasm in Spain. Despite the optimization of treatments and a 5-year survival rate of 70%, side effects and sequelae are described after treatment. The treatments have physical, psychological and sociocultural consequences that deteriorate the quality of life of patients. One of the sequelae that worries patients is the impairment of sexual function and satisfaction, considered a fundamental dimension of the human being. The aim of this study was to examine quality of life and sexual function and satisfaction among Spanish cervical cancer survivors. A retrospective case-control study was conducted between 2019 and 2022. The sample consisted of 66 patients who completed the Female Sexual Function Index, the Golombok Rust Sexual Satisfaction Inventory and European Organization for Research and Treatment of Cancer quality of life questionnaire. The control group consisted of women without cervical cancer and gynecological pathologies obtained using the so-called online virtual sampling method. The patient group consisted of women with cervical cancer who completed treatment. Cervical cancer survivors reported sexual dysfunction and impaired sexual satisfaction in almost half of the domains. Quality of life was also affected, with pain and fatigue being the most frequent symptoms in these patients. Our results indicate that there is dysfunction, sexual dissatisfaction and a lower level of quality of life in cervical cancer survivors than in healthy women without pathology. Full article
(This article belongs to the Special Issue Sexuality, Health, and Gender)
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19 pages, 2398 KiB  
Article
Demands for Community Services and Associated Factors among Residents in Smart Communities: A Case Study of Xuzhou City
by Jiongxun Chen, Linxiu Wang, Tiantian Gu, Chenyang Wang and Enyang Hao
Int. J. Environ. Res. Public Health 2023, 20(4), 3750; https://doi.org/10.3390/ijerph20043750 - 20 Feb 2023
Cited by 1 | Viewed by 1571
Abstract
Smart community enables a sustainable and livable community future, in which residents’ demands play an important role in its success. Though great efforts have been made to encourage residents’ participation in the implementation of smart communities, inefficient service supply still exists. Thus, this [...] Read more.
Smart community enables a sustainable and livable community future, in which residents’ demands play an important role in its success. Though great efforts have been made to encourage residents’ participation in the implementation of smart communities, inefficient service supply still exists. Thus, this study aimed to classify residents’ demands for community services in smart communities and to explore relevant influencing factors based on the developed conceptual framework. Data from 221 respondents in Xuzhou city of China were analyzed by using binary logistic regression. The results indicated that more than 70% of respondents had demands for all community services in smart communities. Moreover, the demands were influenced by distinct factors, including sociodemographic characteristics, living characteristics, economic characteristics, and individual attitude characteristics. The types of community services in smart communities are clarified and fresh insights are provided into associated factors related to residents’ demands for these services in this study, through which enhanced provision of community services and effective implementation of smart communities can be achieved. Full article
(This article belongs to the Section Environmental Health)
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19 pages, 374 KiB  
Article
Evaluation of the Conversations about Non-Suicidal Self-Injury Mental Health First Aid Course: Effects on Knowledge, Stigmatising Attitudes, Confidence and Helping Behaviour
by Kathy S. Bond, Julia N. Lyons, Fairlie A. Cottrill, Amanda V. Sabo, Simone E. Baillie, Alyssia Rossetto, Louise Kelly, Claire M. Kelly, Nicola J. Reavley, Anthony F. Jorm and Amy J. Morgan
Int. J. Environ. Res. Public Health 2023, 20(4), 3749; https://doi.org/10.3390/ijerph20043749 - 20 Feb 2023
Viewed by 1973
Abstract
Background: Non-suicidal self-injury (NSSI) is a common mental health problem, with a 19% lifetime prevalence in Australian adolescents and 12% in adults. Though rates of professional help-seeking for NSSI are low, disclosure to family and friends is more common, providing opportunities for them [...] Read more.
Background: Non-suicidal self-injury (NSSI) is a common mental health problem, with a 19% lifetime prevalence in Australian adolescents and 12% in adults. Though rates of professional help-seeking for NSSI are low, disclosure to family and friends is more common, providing opportunities for them to encourage professional support. Mental Health First Aid® Australia’s Conversations about Non-Suicidal Self-Injury course provides evidence-based training for the general public to support a person engaging in NSSI. Methods: This uncontrolled trial evaluated the effects of the Conversations about Non-Suicidal Self-Injury course on participants’ knowledge, confidence, stigmatising attitudes, and intended and actual helping behaviours. Surveys were administered pre- and post-course, and at a six-month follow-up. A linear mixed-model analysis determined mean change over time, and effect sizes were estimated using Cohen’s d. Course satisfaction was assessed using descriptive statistics and summative content analysis of qualitative data. Results: The pre-course survey was completed by 147 Australian participants (77.5% female, mean age 45.8 years), 137 (93.2%) at post-course and 72 (49%) at follow-up. Knowledge, confidence, quality of intended helping behaviours, and quality of actual helping behaviours increased significantly at both time points. Social distance decreased significantly at all time points and stigma decreased significantly at post-course. The course was perceived to be highly acceptable by participants. Conclusions: There is initial evidence that the Conversations about Non-Suicidal Self-Injury course is effective and acceptable for members of the public who may support a person engaging in NSSI. Full article
17 pages, 1124 KiB  
Article
High Intensity Drinking (HID) Assessed by Maximum Quantity Consumed Is an Important Pattern Measure Adding Predictive Value in Higher and Lower Income Societies for Modeling Alcohol-Related Problems
by Thomas K. Greenfield, Camillia K. Lui, Won K. Cook, Katherine J. Karriker-Jaffe, Libo Li, Sharon C. Wilsnack, Kim Bloomfield, Robin Room, Anne-Marie Laslett, Jason Bond, Rachael Korcha and The GENAHTO Consortium
Int. J. Environ. Res. Public Health 2023, 20(4), 3748; https://doi.org/10.3390/ijerph20043748 - 20 Feb 2023
Viewed by 1395
Abstract
Adjusting for demographics and standard drinking measures, High Intensity Drinking (HID), indexed by the maximum quantity consumed in a single day in the past 12 months, may be valuable in predicting alcohol dependence other harms across high and low income societies. The data [...] Read more.
Adjusting for demographics and standard drinking measures, High Intensity Drinking (HID), indexed by the maximum quantity consumed in a single day in the past 12 months, may be valuable in predicting alcohol dependence other harms across high and low income societies. The data consisted of 17 surveys of adult (15,460 current drinkers; 71% of total surveyed) in Europe (3), the Americas (8), Africa (2), and Asia/Australia (4). Gender-disaggregated country analyses used Poison regression to investigate whether HID (8–11, 12–23, 24+ drinks) was incrementally influential, beyond log drinking volume and HED (Heavy Episodic Drinking, or 5+ days), in predicting drinking problems, adjusting for age and marital status. In adjusted models predicting AUDIT-5 for men, adding HID improved the overall model fit for 11 of 15 countries. For women, 12 of 14 countries with available data showed an improved fit with HID included. The results for the five Life-Area Harms were similar for men. Considering the results by gender, each country showing improvements in model fit by adding HID had larger values of the average difference between high intensity and usual consumption, implying variations in amounts consumed on any given day. The amount consumed/day often greatly exceeded HED levels. In many societies of varying income levels, as hypothesized, HID provided important added information on drinking patterns for predicting harms, beyond the standard volume and binging indicators. Full article
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14 pages, 420 KiB  
Article
Age-Dependent Differences in Frequent Mental Distress (FMD) of US Older Adults Living in Multigenerational Families versus Living Alone
by Debasree Das Gupta and David W. S. Wong
Int. J. Environ. Res. Public Health 2023, 20(4), 3747; https://doi.org/10.3390/ijerph20043747 - 20 Feb 2023
Cited by 1 | Viewed by 1542
Abstract
Frequent mental distress (FMD) is prevalent among older Americans, but less is known about disparities in FMD of older adults living in multigenerational families versus living alone. We pooled cross-sectional data (unweighted, n = 126,144) from the Behavioral Risk Factor Surveillance System (BRFSS) [...] Read more.
Frequent mental distress (FMD) is prevalent among older Americans, but less is known about disparities in FMD of older adults living in multigenerational families versus living alone. We pooled cross-sectional data (unweighted, n = 126,144) from the Behavioral Risk Factor Surveillance System (BRFSS) between 2016 and 2020 and compared FMD (≥14 poor mental health days in the past 30 days = 1; 0 otherwise) of older adults (≥65 years) living in multigenerational families versus living alone in 36 states. After controlling for covariates, findings indicate 23% lower odds of FMD among older adults living in multigenerational households compared to counterparts living alone (adjusted odds ratio (AOR): 0.77; 95% confidence interval (CI): 0.60, 0.99). Findings also show that the reduction in the odds of FMD with each 5 year increase in age was larger among older adults living in multigenerational families by 18% (AOR: 0.56; 95% CI: 0.46, 0.70) compared to older adults living alone (AOR: 0.74; 95% CI: 0.71, 0.77), and this difference was significant at the 5% significance level. Multigenerational living may have a protective association with FMD among older adults. Further research is needed to identify multigenerational family and non-kin factors that translate into mental health advantages for older adults. Full article
(This article belongs to the Section Mental Health)
21 pages, 624 KiB  
Review
The Influence of Ventilation Measures on the Airborne Risk of Infection in Schools: A Scoping Review
by Sandra N. Jendrossek, Lukas A. Jurk, Kirsten Remmers, Yunus E. Cetin, Wolfgang Sunder, Martin Kriegel and Petra Gastmeier
Int. J. Environ. Res. Public Health 2023, 20(4), 3746; https://doi.org/10.3390/ijerph20043746 - 20 Feb 2023
Cited by 3 | Viewed by 2556
Abstract
Objectives: To review the risk of airborne infections in schools and evaluate the effect of intervention measures reported in field studies. Background: Schools are part of a country’s critical infrastructure. Good infection prevention measures are essential for reducing the risk of infection in [...] Read more.
Objectives: To review the risk of airborne infections in schools and evaluate the effect of intervention measures reported in field studies. Background: Schools are part of a country’s critical infrastructure. Good infection prevention measures are essential for reducing the risk of infection in schools as much as possible, since these are places where many individuals spend a great deal of time together every weekday in a small area where airborne pathogens can spread quickly. Appropriate ventilation can reduce the indoor concentration of airborne pathogens and reduce the risk of infection. Methods: A systematic search of the literature was conducted in the databases Embase, MEDLINE, and ScienceDirect using keywords such as school, classroom, ventilation, carbon dioxide (CO2) concentration, SARS-CoV-2, and airborne transmission. The primary endpoint of the studies selected was the risk of airborne infection or CO2 concentration as a surrogate parameter. Studies were grouped according to the study type. Results: We identified 30 studies that met the inclusion criteria, six of them intervention studies. When specific ventilation strategies were lacking in schools being investigated, CO2 concentrations were often above the recommended maximum values. Improving ventilation lowered the CO2 concentration, resulting in a lower risk of airborne infections. Conclusions: The ventilation in many schools is not adequate to guarantee good indoor air quality. Ventilation is an important measure for reducing the risk of airborne infections in schools. The most important effect is to reduce the time of residence of pathogens in the classrooms. Full article
(This article belongs to the Topic Advanced Ventilation in and beyond the COVID-19 Pandemic)
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13 pages, 1564 KiB  
Article
Immediate Effect Evaluation of a Robotic Ankle–Foot Orthosis with Customized Algorithm for a Foot Drop Patient: A Quantitative and Qualitative Case Report
by Dimas Adiputra, Ully Asfari, Ubaidillah, Mohd Azizi Abdul Rahman and Ahmad Mukifza Harun
Int. J. Environ. Res. Public Health 2023, 20(4), 3745; https://doi.org/10.3390/ijerph20043745 - 20 Feb 2023
Cited by 1 | Viewed by 2887
Abstract
This study aims to evaluate the immediate effect of a robotic ankle–foot orthosis developed in previous studies on a foot drop patient. The difference with previous research on AFO evaluation is that this research used a setting based on the patient’s request. The [...] Read more.
This study aims to evaluate the immediate effect of a robotic ankle–foot orthosis developed in previous studies on a foot drop patient. The difference with previous research on AFO evaluation is that this research used a setting based on the patient’s request. The robotic AFO locked the foot position on zero radians during the foot flat until the push-off but generates dorsiflexion with a constant velocity in the swing phase to clear the foot drop. A kinematic and spatiotemporal parameter was observed using the sensors available on the robotic AFO. The robotic successfully assisted the foot drop (positive ankle position of 21.77 degrees during the swing phase and initial contact) with good repeatability (σ2 = 0.001). An interview has also conducted to investigate the qualitative response of the patient. The interview result reveals not only the usefulness of the robotic AFO in assisting the foot drop but also some improvement notes for future studies. For instance, the necessary improvement of weight and balance and employing ankle velocity references for controlling the walking gait throughout the whole gait cycle. Full article
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16 pages, 3732 KiB  
Systematic Review
Second-Child Fertility Intentions among Urban Women in China: A Systematic Review and Meta-Analysis
by Yu Yang, Rongxin He, Ning Zhang and Liming Li
Int. J. Environ. Res. Public Health 2023, 20(4), 3744; https://doi.org/10.3390/ijerph20043744 - 20 Feb 2023
Cited by 8 | Viewed by 2703
Abstract
With the adjustment of China’s fertility policy, the topic of women’s fertility has attracted much attention. In particular, urban women face a difficult choice between family and work. This study analyzed the prevalence and determinants of second-child fertility intention among urban women in [...] Read more.
With the adjustment of China’s fertility policy, the topic of women’s fertility has attracted much attention. In particular, urban women face a difficult choice between family and work. This study analyzed the prevalence and determinants of second-child fertility intention among urban women in China and aimed to provide evidence for improving fertility rate measures. A systematic review and meta-analysis were conducted using quantitative primary studies. We identified 16 cross-sectional studies that investigated a total of 24,979 urban women. The prevalence of second-child fertility intentions was 37%. A subgroup analysis revealed that the highest prevalence was observed between 2016 and 2017, and the lowest was observed in first-tier cities. Meta-analyses indicated that 18 factors were significantly associated with second-child fertility intentions, including demographic factors, fertility attitude, husbands, children, parents, or others. The findings of this study highlight the low second-child fertility intentions among urban women in China. Therefore, policymakers should consider various aspects, gradually optimizing fertility-supporting facilities, while encouraging fertility. Full article
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27 pages, 7424 KiB  
Article
Pedestrians’ Perceptions of Motorized Traffic Variables in Relation to Appraisals of Urban Route Environments
by Dan Andersson, Lina Wahlgren, Karin Sofia Elisabeth Olsson and Peter Schantz
Int. J. Environ. Res. Public Health 2023, 20(4), 3743; https://doi.org/10.3390/ijerph20043743 - 20 Feb 2023
Cited by 2 | Viewed by 1475
Abstract
It is important to examine how motorized traffic variables affect pedestrians along a gradient from rural to inner urban settings. Relations between pedestrians’ perceptions of four traffic variables and appraisals of route environments as hindering–stimulating for walking as well as unsafe–safe for reasons [...] Read more.
It is important to examine how motorized traffic variables affect pedestrians along a gradient from rural to inner urban settings. Relations between pedestrians’ perceptions of four traffic variables and appraisals of route environments as hindering–stimulating for walking as well as unsafe–safe for reasons of traffic, were therefore studied in the inner urban area of Stockholm, Sweden (n = 294). The pedestrians rated their perceptions and appraisals with the Active Commuting Route Environment Scale (ACRES). Correlation, multiple regression, and mediation analyses were used to study the relationships between the traffic variables and the outcome variables. Noise related negatively to both hindering–stimulating for walking, and to unsafety–safety for traffic reasons. Vehicle speed related negatively to unsafety–safety for traffic reasons. Furthermore, vehicle speed protruded as an important origin of the deterring effects of traffic among those who commute by foot. The study shows the value of both partial and simultaneous analyses of the effect of all four traffic variables in relation to outcome variables relevant for walking. Full article
(This article belongs to the Section Environmental Health)
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