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Int. J. Environ. Res. Public Health, Volume 20, Issue 7 (April-1 2023) – 199 articles

Cover Story (view full-size image): Cancer can cause significant disruptions in the lives of both patients and partners. How couples communicate with each other about cancer-related issues impacts their relationship and health. However, the role of attachment in couple communication within the context of cancer and its influence on physical well-being is not well understood. We aimed to examine how patient and partner attachment styles influence the ways in which they convey their thoughts and feelings to each other when talking about cancer. We also examined how attachment styles, observed communication behaviors, and affect were associated with long-term physical well-being. Our findings suggest that attachment is associated with overt communication behaviors, and insecure attachment and affective expression may be potential risk factors for poorer health outcomes. View this paper
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0 pages, 2957 KiB  
Review
Role of Maternal Diet in the Risk of Childhood Acute Leukemia: A Systematic Review and Meta-Analysis
by Jessica Blanco-Lopez, Isabel Iguacel, Silvia Pisanu, Claudia Choma Bettega Almeida, Eva Steliarova-Foucher, Ciska Sierens, Marc J. Gunter, Elena J. Ladas, Ronald D. Barr, Koen Van Herck and Inge Huybrechts
Int. J. Environ. Res. Public Health 2023, 20(7), 5428; https://doi.org/10.3390/ijerph20075428 - 06 Apr 2023
Cited by 11 | Viewed by 2895
Abstract
Many studies have investigated the etiology of acute leukemia, one of the most common types of cancer in children; however, there is a lack of clarity regarding preventable risk factors. This systematic review and meta-analysis aimed to summarize the current evidence regarding the [...] Read more.
Many studies have investigated the etiology of acute leukemia, one of the most common types of cancer in children; however, there is a lack of clarity regarding preventable risk factors. This systematic review and meta-analysis aimed to summarize the current evidence regarding the role of maternal dietary factors in the development of childhood leukemia. All epidemiological studies published until July 2022 that evaluated maternal dietary risk factors for childhood acute leukemia were identified in two electronic databases (PubMed and Web of Science) without limits of publication year or language. A total of 36 studies (1 prospective cohort study, 32 case-control studies and 3 studies with pooled analysis) were included. The published risk estimates were combined into a meta-analysis, using the Generic Inverse Variance method. The maternal consumption of fruits (two or more daily servings vs. less) was inversely associated with acute lymphoblastic leukemia (odds ratio = 0.71; 95% CI, 0.59–0.86), whereas maternal coffee intake (higher than two cups per day vs. no consumption) was associated with an increased risk of acute lymphoblastic leukemia (odds ratio = 1.45; 95% CI, 1.12–1.89). Despite these findings, more high-quality research from cohort studies and the identification of causal factors are needed to develop evidence-based and cost-effective prevention strategies applicable at the population level. Review Registration: PROSPERO registration no. CRD42019128937. Full article
(This article belongs to the Special Issue Promoting Health for Adolescents)
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14 pages, 1312 KiB  
Article
Households’ Practices towards Rabies Prevention and Control in Rural Nepal
by Alok Dhakal, Ramjee P. Ghimire, Sujit Regmi and Krishna Kaphle
Int. J. Environ. Res. Public Health 2023, 20(7), 5427; https://doi.org/10.3390/ijerph20075427 - 06 Apr 2023
Cited by 2 | Viewed by 2341
Abstract
Rabies is a vaccine-preventable, zoonotic, viral disease and a major public health concern for developing countries such as Nepal. A study was conducted from October–December 2021 among 308 household heads from three districts in Nepal (Siraha, Parsa, and Nawalparasi West) through an in-person [...] Read more.
Rabies is a vaccine-preventable, zoonotic, viral disease and a major public health concern for developing countries such as Nepal. A study was conducted from October–December 2021 among 308 household heads from three districts in Nepal (Siraha, Parsa, and Nawalparasi West) through an in-person interview to examine the rural people’s practices towards rabies. Of 70 respondents owning pet animals, 82.9% vaccinated them against rabies but 87.9% (51/58) of them kept a vaccination record. Nearly all respondents (99.7%, 307/308) said they would visit hospitals after being bitten by rabid or rabies suspected animals, and 18.2% (56/308) of them said they would also opt to visit traditional healers seeking treatment against rabies. Seven in ten respondents knew that they should wash bitten body area with soap and water. Around 60% (184/308) of respondents said they would not bother to notify or report to the local authorities if they saw someone bitten by a presumed rabid dog or observed animal behavior suggestive of rabies. The Chi-square test showed a significant association between the socio-demographic characteristics of respondents with practices (good practice and poor practice) towards rabies. The study findings suggest that rural people in Nepal need to be educated with applied rabies control and prevention practices and made aware of health seeking behavior and the role that a community members have to play to control, prevent, and eradicate rabies. Full article
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12 pages, 592 KiB  
Article
Expectations Regarding Gastein Healing Gallery Treatment and Their Connection to Health-Related Quality of Life
by Loren Toussaint, Kien Huynh, Niko Kohls, Fuschia Sirois, Hannah Alberts, Jameson Hirsch, Christian Hanshans, Quang Anh Nguyen, Antje van der Zee-Neuen and Martin Offenbaecher
Int. J. Environ. Res. Public Health 2023, 20(7), 5426; https://doi.org/10.3390/ijerph20075426 - 06 Apr 2023
Cited by 2 | Viewed by 1576
Abstract
The present study examines connections between patient expectations and health-related quality of life. We explore a key distinction between expectations about general health and expectations for functional improvement. Patients were 1444 individuals with multiple conditions experiencing chronic pain who were seeking treatment at [...] Read more.
The present study examines connections between patient expectations and health-related quality of life. We explore a key distinction between expectations about general health and expectations for functional improvement. Patients were 1444 individuals with multiple conditions experiencing chronic pain who were seeking treatment at the Gastein Healing Gallery in Böckstein, near Bad Gastein, Austria. In addition to measures of expectations, patients completed measures of pain, mental and physical health, life satisfaction, fatigue, and sleep problems. Structural equation models were used to fit a latent variable model where both expectation variables were used to predict health-related quality of life. Results showed that expectations regarding potential functional improvement resulting from treatments at the Gastein Healing Gallery were associated with improved health-related quality of life. Expectations about general health improvements related to treatment were not associated with health-related quality of life. To facilitate optimal healing, clinicians may decide to emphasize expectations about functional recovery when discussing treatment methods similar to those offered at the Gastein Healing Gallery, and in so doing, health-related quality of life may benefit. Full article
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14 pages, 836 KiB  
Article
A Mixed-Methods Investigation of Facilitators to Accessing and Utilising Mental Health Services amongst Sri Lankan Australians
by Amanda Daluwatta, Kathryn Fletcher, Chris Ludlow, Ariane Virgona and Greg Murray
Int. J. Environ. Res. Public Health 2023, 20(7), 5425; https://doi.org/10.3390/ijerph20075425 - 06 Apr 2023
Cited by 1 | Viewed by 2503
Abstract
Many individuals with mental health conditions avoid, delay, discontinue, or do not seek mental health services and treatments, despite the existence of evidence-based treatments and support methods. Little is known about the barriers to mental health service utilisation for Sri Lankan Australians, and [...] Read more.
Many individuals with mental health conditions avoid, delay, discontinue, or do not seek mental health services and treatments, despite the existence of evidence-based treatments and support methods. Little is known about the barriers to mental health service utilisation for Sri Lankan Australians, and there is no research on factors that facilitate access for this group. Using quantitative and qualitative methods, this study explored the perspectives of Sri Lankan Australians (N = 262) on the facilitators of mental health service utilisation. Participants rated a set of 18-items (Facilitator Set) and 7 public health interventions (Intervention Set) in relation to their capacity to improve the uptake of mental health services. Participants also completed two open-ended questions about the enablers to seeking professional mental health care. Descriptive statistics were used to summarise quantitative findings, while open-text responses were analysed using reflexive thematic analysis. The Facilitator Set demonstrated that trust in the provider and their confidentiality processes, positive relationships with mental health professionals, and the community having positive attitudes towards seeking help were the primary facilitators to seeking professional help. The Intervention Set suggested that raising community awareness of mental health conditions and providing public stigma reduction interventions may increase access to care. Themes identified in the open-ended responses included access to culturally safe and responsive services and clinicians, improved accessibility and affordability of services, trust, and a community-based approach to increasing mental health literacy and addressing stigma beliefs. Within its limitations, the present study’s findings suggest that providing culturally safe and responsive care, dispelling mental health stigma, and increasing knowledge of mental health conditions within Sri Lankan Australian communities are potential facilitating factors that would enable Sri Lankan Australians to seek and use mental health services. Implications for clinical care and future research are discussed. Full article
(This article belongs to the Section Mental Health)
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8 pages, 692 KiB  
Brief Report
Mountain Hiking: Prolonged Eccentric Muscle Contraction during Simulated Downhill Walking Perturbs Sensorimotor Control Loops Needed for Safe Dynamic Foot–Ground Interactions
by Inge Werner, Francisco J. Valero-Cuevas and Peter Federolf
Int. J. Environ. Res. Public Health 2023, 20(7), 5424; https://doi.org/10.3390/ijerph20075424 - 06 Apr 2023
Viewed by 1394
Abstract
Safe mountain hiking requires precise control of dynamic foot–ground interactions. In addition to vision and vestibular afferents, limb proprioception, sensorimotor control loops, and reflex responses are used to adapt to the specific nature of the ground contact. Diminished leg dexterity and balance during [...] Read more.
Safe mountain hiking requires precise control of dynamic foot–ground interactions. In addition to vision and vestibular afferents, limb proprioception, sensorimotor control loops, and reflex responses are used to adapt to the specific nature of the ground contact. Diminished leg dexterity and balance during downhill walking is usually attributed to fatigue. We investigated the supplementary hypothesis that the eccentric contractions inherent to downhill walking can also disrupt muscle proprioception, as well as the sensorimotor control loops and reflex responses that depend on it. In this study, we measured leg dexterity (LD), anterior–posterior (AP) and medio–lateral (ML) bipedal balance, and maximal voluntary leg extension strength in young and healthy participants before and after 30 min of simulated downhill walking at a natural pace on a treadmill at a 20° decline. Post–pre comparisons of LD (p < 0.001) and AP balance (p = 0.001) revealed significant reductions in dynamic foot–ground interactions after eccentric exercise without an accompanying reduction in leg extension strength. We conclude that eccentric contractions during downhill walking can disrupt the control of dynamic foot–ground interactions independently of fatigue. We speculate that mountaineering safety could be improved by increasing conscious attention to compensate for unadjusted proprioception weighting, especially in the descent. Full article
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16 pages, 855 KiB  
Article
Tuberculosis in Prisons: Importance of Considering the Clustering in the Analysis of Cross-Sectional Studies
by Diana Marín, Yoav Keynan, Shrikant I. Bangdiwala, Lucelly López and Zulma Vanessa Rueda
Int. J. Environ. Res. Public Health 2023, 20(7), 5423; https://doi.org/10.3390/ijerph20075423 - 06 Apr 2023
Viewed by 1769
Abstract
The level of clustering and the adjustment by cluster-robust standard errors have yet to be widely considered and reported in cross-sectional studies of tuberculosis (TB) in prisons. In two cross-sectional studies of people deprived of liberty (PDL) in Medellin, we evaluated the impact [...] Read more.
The level of clustering and the adjustment by cluster-robust standard errors have yet to be widely considered and reported in cross-sectional studies of tuberculosis (TB) in prisons. In two cross-sectional studies of people deprived of liberty (PDL) in Medellin, we evaluated the impact of adjustment versus failure to adjust by clustering on prevalence ratio (PR) and 95% confidence interval (CI). We used log-binomial regression, Poisson regression, generalized estimating equations (GEE), and mixed-effects regression models. We used cluster-robust standard errors and bias-corrected standard errors. The odds ratio (OR) was 20% higher than the PR when the TB prevalence was >10% in at least one of the exposure factors. When there are three levels of clusters (city, prison, and courtyard), the cluster that had the strongest effect was the courtyard, and the 95% CI estimated with GEE and mixed-effect models were narrower than those estimated with Poisson and binomial models. Exposure factors lost their significance when we used bias-corrected standard errors due to the smaller number of clusters. Tuberculosis transmission dynamics in prisons dictate a strong cluster effect that needs to be considered and adjusted for. The omission of cluster structure and bias-corrected by the small number of clusters can lead to wrong inferences. Full article
(This article belongs to the Special Issue Tuberculosis (TB) Prevention and Care: A Global Public Health Issue)
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13 pages, 1026 KiB  
Article
Emergency Air Transport of Patients with Acute Chest Pain in the Adriatic Islands of Croatia: A Four-Year Analysis
by Antonija Zanic, Vedran Kovacic and Ivana Jukic
Int. J. Environ. Res. Public Health 2023, 20(7), 5422; https://doi.org/10.3390/ijerph20075422 - 06 Apr 2023
Cited by 1 | Viewed by 1307
Abstract
Background: An efficient first-aid system usually supports ground services with a helicopter emergency medical service (HEMS). An HEMS is important for patients with acute chest pain on remote islands. The current study sought to identify the characteristics of HEMS in acute chest pain [...] Read more.
Background: An efficient first-aid system usually supports ground services with a helicopter emergency medical service (HEMS). An HEMS is important for patients with acute chest pain on remote islands. The current study sought to identify the characteristics of HEMS in acute chest pain cases on the Croatian Adriatic islands over a four-year period. Methods: We conducted a four-year observational study to investigate HEMS from Adriatic islands. The study population consisted of all patients with acute coronary syndrome or pulmonary embolisms who were urgently transferred by HEMS to the University Hospital in Split 1 June 2018–1 June 2022. Results: During the observation period, 222 adult patients (67 females, or 30.2%) were urgently transferred. The mean age was 71.81 ± 13.42 years. The most common diagnosis was ST-elevated myocardial infarction (113, 50.9%). Most of the HEMS cases were from Hvar (91, 41.0%). The mean call-to-flight time was 19.10 ± 10.94 min, and the total time from call to hospital was 68.50 ± 22.29 min. The total time from call to hospital was significantly correlated with call-to-flight time (r = 0.761, P < 0.001). Of the 222 participants, 5 (2.25%) were transported for more than 120 min, and 35 (15.8%) were transported for more than 90 min. Conclusion: This study provided a detailed insight into HEMS in the area of the Croatian Adriatic islands. The average time from the call to the helicopter taking off was 19.10 min. An increase in dispatching time has a significant impact on the prolongation of the total time for the hospital admission. Shortening the response time is critical to reducing hospital arrival time. Full article
(This article belongs to the Section Disaster Medicine)
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9 pages, 748 KiB  
Brief Report
Feasibility and Acceptability of a Mindfulness-Based Smartphone App among Pregnant Women with Obesity
by Kerrie Ward, Anjali Herekar, Peiyi Wang and Karen L. Lindsay
Int. J. Environ. Res. Public Health 2023, 20(7), 5421; https://doi.org/10.3390/ijerph20075421 - 06 Apr 2023
Viewed by 1547
Abstract
Maternal obesity is associated with an increased risk for prenatal depressive symptoms. Mindfulness-based interventions (MBIs) have been shown to reduce the risk of prenatal depression. This pilot study assesses the feasibility and acceptability of a smartphone-based MBI among pregnant women with obesity, and [...] Read more.
Maternal obesity is associated with an increased risk for prenatal depressive symptoms. Mindfulness-based interventions (MBIs) have been shown to reduce the risk of prenatal depression. This pilot study assesses the feasibility and acceptability of a smartphone-based MBI among pregnant women with obesity, and its potential for improving maternal mental and behavioral health outcomes. Five second-trimester pregnant women with a prepregnancy body mass index > 30 kg/m2 participated in a 30-day audio-guided mindfulness practice using the Headspace app. All participants engaged in the pregnancy module, while three concurrently engaged in the mindful eating module. Daily engagement with the app was tracked and a post-trial survey assessed maternal acceptability. Validated pre- and post-trial questionnaires explored changes in perceived stress, anxiety, depression, and eating habits. All participants completed the study with varying levels of adherence to the prescribed daily practice; the average number of days of engagement was 23/30 (77%) for the pregnancy module and 20/30 (67%) for the mindful eating module. All subjects reported some degree of perceived benefit, and none reported negative experiences. Trends were observed for improvements in maternal mental wellbeing and eating behaviors. This pilot study shows that a smartphone-based MBI is feasible, acceptable, and perceived to provide benefit among pregnant women with obesity. Full article
(This article belongs to the Special Issue Prenatal Wellbeing and Maternal and Child Health Outcomes)
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12 pages, 336 KiB  
Article
Patients’ Perceptions of Exercise-Based Cardiac Telerehabilitation after a Myocardial Infarction—A Qualitative Study
by Ulrika Nilsson, Birgitta Öberg and Maria Bäck
Int. J. Environ. Res. Public Health 2023, 20(7), 5420; https://doi.org/10.3390/ijerph20075420 - 06 Apr 2023
Cited by 1 | Viewed by 1595
Abstract
To be able to design telerehabilitation programs targeting the needs and preferences of end-users, patients’ in-depth perspectives are needed. To date, such studies are lacking and, therefore, the aim of the present study was to describe patients’ perceptions of performing exercise-based cardiac telerehabilitation [...] Read more.
To be able to design telerehabilitation programs targeting the needs and preferences of end-users, patients’ in-depth perspectives are needed. To date, such studies are lacking and, therefore, the aim of the present study was to describe patients’ perceptions of performing exercise-based cardiac telerehabilitation after a myocardial infarction (MI). Individual semi-structured interviews were performed with 15 patients (3 women, median age 69 years) after an MI who had participated in exercise-based cardiac telerehabilitation for three months. The interviews were transcribed verbatim and analyzed with inductive content analysis. An overall theme was defined as “Cardiac telerehabilitation—a new alternative for exercising that is easily accessible and up to date”. Four categories, including “The important role of a physical therapist with expert knowledge”, “Prerequisites playing an important role in the willingness to participate”, “Making exercise accessible and adjustable” and “Inspiring future exercise”, and 15 subcategories were identified. Understanding the patient’s perspective is an important key to further improving and successfully implementing exercise-based cardiac telerehabilitation, as an alternative or adjunct to traditional, centre-based programs. The findings can serve to improve patient–physiotherapist interactions and to inform important aspects related to exercise, technology and a sense of security from an exercise-based cardiac telerehabilitation program. Full article
(This article belongs to the Special Issue Telerehabilitation for Patients)
7 pages, 320 KiB  
Brief Report
Relevance and Feasibility of Group Traumatic Episode Protocol Delivered to Migrants: A Pilot Field Study
by Philippe Vignaud, Nicolas Chauliac, Emmanuel Contamin, Sébastien Richer, Cécile Vuillermoz, Jérôme Brunelin and Nathalie Prieto
Int. J. Environ. Res. Public Health 2023, 20(7), 5419; https://doi.org/10.3390/ijerph20075419 - 06 Apr 2023
Cited by 1 | Viewed by 1614
Abstract
Introduction: Post-Traumatic Stress Disorder (PTSD) and Major Depressive Disorder (MDD) are commonly observed in migrants. Although Eye Movement Desensitization and Reprocessing (EMDR) can be helpful to treat these diseases, it remains difficult to propose EMDR as an individual intervention in help-seeking migrants. Group [...] Read more.
Introduction: Post-Traumatic Stress Disorder (PTSD) and Major Depressive Disorder (MDD) are commonly observed in migrants. Although Eye Movement Desensitization and Reprocessing (EMDR) can be helpful to treat these diseases, it remains difficult to propose EMDR as an individual intervention in help-seeking migrants. Group EMDR, like Group Traumatic Episode Protocol (G-TEP), which was built around the 8 phases of the original EMDR protocol, could offer an effective treatment to a large number of people. It may also be more resource-efficient to provide psychiatric care to migrants. Methods: In this open-label trial, the feasibility and the effectiveness of a 6-session G-TEP intervention was investigated in a group of 10 migrants. Results: The intervention was well tolerated by participants. The final attrition rate was 10%. After the intervention, there was a 28.2% significant decrease in PTSD and complex PTSD symptoms, as measured by the International Trauma Questionnaires (total_ITQ) scores (p = 0.013) and a trend towards a significant decrease in MDD symptoms, as measured with the Patient Health Questionnaire (PHQ-9) (p = 0.057). Conclusions: G-TEP may be effective in decreasing PTSD symptoms in migrants. The accessibility, low-cost, and very structured features of G-TEP may make its implementation sustainable in the field of psychiatric care for migrants. Full article
12 pages, 635 KiB  
Article
Psychological Impact and Women’s Evaluation of the First-Trimester Pre-Eclampsia Screening and Prevention: ASPRE Trial
by Ana V. Nikčević, Chiara Sacchi, Claudia Marino, Neil O’Gorman, Liona C. Poon and Kypros H. Nicolaides
Int. J. Environ. Res. Public Health 2023, 20(7), 5418; https://doi.org/10.3390/ijerph20075418 - 06 Apr 2023
Cited by 1 | Viewed by 1523
Abstract
Objective: This study aims to extend the understanding of the psychological impact of the first-trimester pre-eclampsia (PE) screening on women identified as high risk for preterm PE. We examined the differences between low- vs. high-risk women throughout pregnancy in: symptoms of distress (anxiety, [...] Read more.
Objective: This study aims to extend the understanding of the psychological impact of the first-trimester pre-eclampsia (PE) screening on women identified as high risk for preterm PE. We examined the differences between low- vs. high-risk women throughout pregnancy in: symptoms of distress (anxiety, depression, physical and mental health, and worry), health behaviour changes, the experience of pregnancy, and attitudes towards PE screening. Methods: This study was nested within the ASPRE trial. Pregnant women were screened for preterm-PE risk status in the first trimester; the assessments were carried out before the screening, in the second and in the third trimester (n = 155 low-risk women and N = 82 high-risk women in the second trimester). Results: The high-risk-for-PE women exhibited more depressive symptoms compared to the low-risk women in the second but not in the third trimester. No differences were observed between the two groups in other distress symptoms or in the women’s evaluation of their experience of pregnancy. The high-risk group reported greater health behaviour changes compared to the low-risk group, but this was moderated by depression levels. Conclusions: Overall, pregnant women reported positive attitudes towards first-trimester PE screening, despite transient depressive symptoms. This study offers supportive evidence concerning the appropriateness of PE screening in ethical terms. Full article
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16 pages, 724 KiB  
Review
Does Sport Participation Protect Adolescents from Alcohol Consumption? A Scoping Review
by Bartłomiej Walczak, Anna Walczak, Sandra Tricas-Sauras and Jakub Kołodziejczyk
Int. J. Environ. Res. Public Health 2023, 20(7), 5417; https://doi.org/10.3390/ijerph20075417 - 06 Apr 2023
Viewed by 1603
Abstract
(1) Background: Participation in youth sports is believed to protect against alcohol consumption. Although this concept has been questioned for over 40 years, the review of methodologically reliable evidence data is scarce. This review summarizes the state of knowledge on the association between [...] Read more.
(1) Background: Participation in youth sports is believed to protect against alcohol consumption. Although this concept has been questioned for over 40 years, the review of methodologically reliable evidence data is scarce. This review summarizes the state of knowledge on the association between practicing sports and alcohol consumption among adolescents (10–19 years old) and its moderators. (2) Methods: The review covers only random-sample-based and population research. A systematic search was conducted on Scopus, PubMed, and WoS, for articles published between 2000 and 2021. From the 1944 identified records, 139 advanced to the full-text review, and 32 to the final data extraction and quality review. (3) Results: About two-thirds of the studies, including all the longitudinal ones, showed a positive association between sport participation and alcohol consumption. The most common mediators were gender (males were at higher risk), discipline (odds for team sports were higher, but professionalization could reduce it), and race, which intersected with gender, putting white males at the highest risk. (4) Conclusions: Further longitudinal research based on random samples using standardized indicators, including psychological and social variables, may provide more consistent outcomes and allow for the identification of mediating mechanisms. Full article
(This article belongs to the Special Issue Alcohol Use and Misuse: A Public Health Perspective)
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17 pages, 683 KiB  
Article
The Role of Health Behaviors in Quality of Life: A Longitudinal Study of Patients with Colorectal Cancer
by Jaroslaw Ocalewski, Michał Jankowski, Wojciech Zegarski, Arkadiusz Migdalski and Krzysztof Buczkowski
Int. J. Environ. Res. Public Health 2023, 20(7), 5416; https://doi.org/10.3390/ijerph20075416 - 06 Apr 2023
Cited by 2 | Viewed by 1467
Abstract
Colorectal cancer (CRC) is the third most common malignancy and the second most common cancer-related cause of death worldwide. CRC incidence depends, in part, on the health behaviors that make up an individual’s lifestyle. We aimed to assess the influence of health behaviors [...] Read more.
Colorectal cancer (CRC) is the third most common malignancy and the second most common cancer-related cause of death worldwide. CRC incidence depends, in part, on the health behaviors that make up an individual’s lifestyle. We aimed to assess the influence of health behaviors and quality of life (QoL) among patients with CRC receiving surgical treatment. In this single-center questionnaire study, 151 patients were surveyed 1 week before and 6 months after colorectal procedures (laparoscopic hemicolectomy, low rectal anterior resection, abdominoperineal resection, and others). This study demonstrated a significant decrease in alcohol consumption and physical activity following the execution of colorectal procedures. No statistically significant changes were observed in smoking or the consumption of healthy food. Global QoL did not change significantly; however, a decrease in physical and role-related functioning was observed. Significant improvements in emotional functioning were also observed. A detailed analysis showed that physical and social functioning were related to smoking, the consumption of healthy food, physical activity, and additional therapies. Emotional functioning was related to smoking, the consumption of healthy food, and complementary treatments. Six months following an operation, it was also dependent on alcohol intake. Physical functioning was the area that decreased the most in the six months after colorectal tumor surgery compared to the period before surgery. Health behaviors such as cessation of smoking, engagement in physical activity, and the consumption of healthy food contributed to a higher quality of life among patients prior to resecting colorectal cancer and six months after the procedure. Patients who received adjuvant/neoadjuvant therapy had a lower quality of life than patients who did not receive this type of therapy. The kind of surgery (laparoscopic hemicolectomy, lower anterior rectum resection, or abdominoperineal rectum resection) was not related to QoL six months after surgery. Full article
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18 pages, 947 KiB  
Article
Moving Forward from Moral Injury: A Mixed Methods Study Investigating the Use of 3MDR for Treatment-Resistant PTSD
by Lorraine Smith-MacDonald, Chelsea Jones, Matthew R. G. Brown, Rachel S. Dunleavy, Annelies VanderLaan, Zornitsa Kaneva, Tristin Hamilton, Lisa Burback, Eric Vermetten and Suzette Brémault-Phillips
Int. J. Environ. Res. Public Health 2023, 20(7), 5415; https://doi.org/10.3390/ijerph20075415 - 06 Apr 2023
Viewed by 2399
Abstract
Background: Exposure to trauma and potentially morally injurious events may lead to moral injury (MI). The link between MI and posttraumatic stress disorder (PTSD) may have particularly relevant implications for treatment-resistant PTSD (TR-PTSD). Multi-modal Motion-Assisted Memory Desensitization and Reconsolidation (3MDR), a technology-assisted exposure-based [...] Read more.
Background: Exposure to trauma and potentially morally injurious events may lead to moral injury (MI). The link between MI and posttraumatic stress disorder (PTSD) may have particularly relevant implications for treatment-resistant PTSD (TR-PTSD). Multi-modal Motion-Assisted Memory Desensitization and Reconsolidation (3MDR), a technology-assisted exposure-based trauma therapy that has been used in the treatment of PTSD, may also be an acceptable modality for patients in the treatment of TR-PTSD and MI. This proof-of-concept study aimed to investigate (1) whether MI co-occurs in military members (MMs) and veterans with TR-PTSD, and (2) the perspectives of MMs and veterans with TR-PTSD utilizing 3MDR for MI. Methods: This study employed a mixed-methods clinical trial. Military Members and veterans participated in this study (N = 11) through self-reported questionnaires, video recordings of treatment sessions, and semi-structured interviews post-session and post-intervention, with longitudinal follow-up to 6 months. Results: MI scores correlated with self-reported measures of mental health symptoms related to PTSD. The thematic analysis revealed three emergent themes: (1) Realities of War, (2) Wrestling Scruples, and (3) Moral Sensemaking. Conclusion: MI was highly correlated with TR-PTSD and themes regarding MI. This result, while preliminary, allows for the postulation that MI may be contributing to the continuation of PTSD symptoms in TR-PTSD, and that 3MDR may be an acceptable modality for addressing these symptoms in MMs and veterans. Full article
(This article belongs to the Special Issue Advances in Mental Health, PTSD and Moral Injury)
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12 pages, 345 KiB  
Article
Accelerometer-Measured Physical Behavior and Cardiorespiratory Fitness as Indicators of Work Ability
by Pauliina Husu, Kari Tokola, Henri Vähä-Ypyä, Harri Sievänen and Tommi Vasankari
Int. J. Environ. Res. Public Health 2023, 20(7), 5414; https://doi.org/10.3390/ijerph20075414 - 05 Apr 2023
Cited by 3 | Viewed by 1914
Abstract
Work ability (WA) reflects an individual’s resources, work demands, and related environment. Self-reports have shown that higher physical activity (PA) is associated with better WA. This study investigated associations of accelerometer-measured (24/7) physical behavior and cardiorespiratory fitness (CRF) with WA. In the FinFit2017-population-based [...] Read more.
Work ability (WA) reflects an individual’s resources, work demands, and related environment. Self-reports have shown that higher physical activity (PA) is associated with better WA. This study investigated associations of accelerometer-measured (24/7) physical behavior and cardiorespiratory fitness (CRF) with WA. In the FinFit2017-population-based study, the physical behavior of 20–69-year-old working Finns was measured in terms of PA, standing, and sedentariness using validated MAD-APE algorithms based on raw triaxial accelerometer data. During waking hours, the accelerometer was hip-worn, while during the time in bed (TIB), it was worn on the non-dominant wrist. CRF was measured with a 6 min walk test. WA was assessed by four questions excerpted from the Work Ability Index (WAI), called the short WAI (sWAI). Participants (n = 1668, mean age 46.6, SD = 10.9, 57% women) scored on average 23.3 on the sWAI (range 6–27), with a higher value indicating a better WA. More minutes in standing (p = 0.001) and in moderate (p = 0.004) and vigorous PA (p < 0.001) as well as a higher step number (p < 0.001) and better CRF (p < 0.001) were associated with a higher sWAI value. More time spent lying down (p < 0.001) and in high-movement (p < 0.001) and total TIB (p = 0.001) was associated with a lower sWAI. Detailed analysis of 24/7 physical behavior can be utilized in identifying individual-related indicators of WA. Full article
(This article belongs to the Special Issue Health-Related Physical Activity and Exercise)
12 pages, 1024 KiB  
Article
The Effects of a 12-Week-Long Sand Exercise Training Program on Neuromechanical and Functional Parameters in Type II Diabetic Patients with Neuropathy
by Judit Prókai, Zsolt Murlasits, Miklós Bánhidi, László Csóka, Viktória Gréci, Tamás Atlasz and Márk Váczi
Int. J. Environ. Res. Public Health 2023, 20(7), 5413; https://doi.org/10.3390/ijerph20075413 - 05 Apr 2023
Cited by 1 | Viewed by 1876
Abstract
Studies have proven the effectiveness of different weight-bearing exercise interventions for diabetic patients with neuropathy; however, several adverse effects were reported using solid surfaces. Thus, in the present study, we investigated the effects of a novel sand exercise training intervention on biomechanical and [...] Read more.
Studies have proven the effectiveness of different weight-bearing exercise interventions for diabetic patients with neuropathy; however, several adverse effects were reported using solid surfaces. Thus, in the present study, we investigated the effects of a novel sand exercise training intervention on biomechanical and functional parameters in seven diabetic patients (age = 62.7 ± 9.7 years) with neuropathy. Patients underwent a 12-week sand exercise training program, using strengthening, stretching, balance, and gait exercises. They were tested for ankle plantar- and dorsiflexion peak torque, active range of motion (ROM), timed up and go (TUG), and bilateral static balance. EMG activity of tibialis anterior (TA), gastrocnemius medialis (GM), and lateralis (GL) muscles were measured during unilateral isometric contraction in plantar- and dorsiflexion. In the intervention period, plantarflexion peak torque improved significantly (p = 0.033), while dorsiflexion torque remained unchanged. Plantar- and dorsiflexion ROM increased (p = 0.032) and (p = 0.021), respectively. EMG activity of GM (p = 0.005) and GL (p = 0.002) measured during dorsiflexion and postural sway in the balance test, as well as time to complete the TUG test, decreased significantly (p = 0.021) and (p = 0.002), respectively. No adverse effect was reported during the intervention period. We concluded that sand exercise training can be a safe and effective method to improve plantarflexion strength, ankle flexibility, and balance, which is reflected in better gait function in patients with diabetic peripheral neuropathy (DPN). Full article
(This article belongs to the Special Issue Research on Exercise and Physical Activity in Older People)
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10 pages, 639 KiB  
Article
The Prevalence of Compassion Fatigue among Oncology Healthcare Professionals in Three Public Healthcare Facilities in Kwazulu-Natal, South Africa
by Phindile C. Mlaba, Themba G. Ginindza and Khumbulani W. Hlongwana
Int. J. Environ. Res. Public Health 2023, 20(7), 5412; https://doi.org/10.3390/ijerph20075412 - 05 Apr 2023
Viewed by 2102
Abstract
Compassion fatigue (CF) is a serious global challenge among healthcare professionals dealing with diseases with poor health outcomes in clinical settings. Chronic exposure to the suffering of others is inevitable in the oncology setting and remains one of the main contributors to CF. [...] Read more.
Compassion fatigue (CF) is a serious global challenge among healthcare professionals dealing with diseases with poor health outcomes in clinical settings. Chronic exposure to the suffering of others is inevitable in the oncology setting and remains one of the main contributors to CF. Therefore, this study determined the prevalence of CF among oncology healthcare professionals (OHPs) in three public healthcare facilities in KwaZulu-Natal, South Africa. This cross-sectional descriptive study was conducted among 73 OHPs using the Professional Quality of Life Scale version 5 questionnaire, and the data were analysed using the Statistical Package for Social Sciences. More than half (56.2%) of the participants reported average scores for CF, with 43.8% of them scoring low. The participants from Inkosi Albert Luthuli Central Hospital had the highest CF mean score (26.8) compared to those from Addington Hospital (21.2) and Greys Hospital (22.9). Female OHPs had a higher mean score (24.3) for CF, compared to their male counterparts (20.6). The CF scores were positively correlated with older age and longer work experience of the OHPs. The prevalence of CF among OHPs was average, compared to those reported by other local and international studies. Nevertheless, these results cannot be taken lightly, given the straining effects of unmanaged CF on the healthcare system generally and on patient care in particular. The results of this study can potentially contribute to policy development and the planning of intervention strategies towards the effective management of CF among OHPs. Full article
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13 pages, 323 KiB  
Article
The Role of Title 1 Secondary School Athletic Trainers in the Primary and Patient-Centered Care of Low Socioeconomic Adolescents
by Nicolette A. Harris and Michelle L. Odai
Int. J. Environ. Res. Public Health 2023, 20(7), 5411; https://doi.org/10.3390/ijerph20075411 - 05 Apr 2023
Cited by 2 | Viewed by 1636
Abstract
Athletic trainers (ATs) provide regular encounters with a healthcare provider for many Title 1 student–athletes with healthcare access and quality barriers. Thus, they are uniquely positioned to serve as a student–athletes’ first point of contact for general medical concerns. This study aimed to [...] Read more.
Athletic trainers (ATs) provide regular encounters with a healthcare provider for many Title 1 student–athletes with healthcare access and quality barriers. Thus, they are uniquely positioned to serve as a student–athletes’ first point of contact for general medical concerns. This study aimed to describe ATs’ experiences providing primary care for Title 1 student–athletes. This qualitative design employing an interpretative phenomenological analysis (IPA) approach used in-depth, virtual focus groups to examine the experiences of ATs practicing at Title 1 secondary schools. The findings reveal that ATs were called upon to evaluate, treat, and, when necessary, refer student–athletes with general medical conditions. However, Title 1 ATs encountered numerous complex social determinants of health (SDoH) preventing efficient and effective referral to specialty healthcare providers. Thus, ATs ultimately felt their most important roles in the primary care of low socioeconomic adolescents were as caregivers who mitigated avoidable healthcare barriers in addition to coordinators of integrated care that assisted student–athletes and their families with navigating the healthcare system. Title I ATs need to be aware of the SDoH affecting their student–athletes and the ability of those SDoH to affect health outcomes as well as overall student–athlete health and well-being. Full article
(This article belongs to the Special Issue Patient-Centered Care in Sports Medicine Services)
18 pages, 2523 KiB  
Article
Pyrrolizidine Alkaloids from Monofloral and Multifloral Italian Honey
by Paola Roncada, Gloria Isani, Mariantonietta Peloso, Thomas Dalmonte, Stefania Bonan and Elisabetta Caprai
Int. J. Environ. Res. Public Health 2023, 20(7), 5410; https://doi.org/10.3390/ijerph20075410 - 05 Apr 2023
Cited by 5 | Viewed by 1699
Abstract
Pyrrolizidine alkaloids (PAs) are secondary metabolites produced by plants as a self-defense against insects. After bioactivation in the liver, some PAs can cause acute or chronic toxicity in humans. The aim of this study was to determine the presence of PAs in 121 [...] Read more.
Pyrrolizidine alkaloids (PAs) are secondary metabolites produced by plants as a self-defense against insects. After bioactivation in the liver, some PAs can cause acute or chronic toxicity in humans. The aim of this study was to determine the presence of PAs in 121 samples of monofloral and multifloral honey from three different Italian regions (Friuli-Venezia Giulia, Marche and Calabria) to meet the European Food Safety Authority (EFSA) suggestion. An in-house liquid chromatography with tandem mass spectrometry (LC-MS/MS) method was validated according to European Union Reference Laboratory (EURL) performance criteria. This method allowed the detection and quantification of 35 PAs. Of the 121 honey samples, 38 (31%), mostly from Calabria, contained PAs. The total content of the PAs ranged from 0.9 µg/kg to 33.1 µg/kg. In particular, echimidine was the most prevalent PA. A rapid human exposure assessment to PAs in honey and a risk characterization was performed using the EFSA RACE tool. The assessment highlighted a potential health concern only for toddlers who frequently consume elevated quantities of honey. This study showed a low presence of PAs in Italian honey; however, the importance of continuously monitoring these compounds is stressed, along with the suggestion that the relevant authorities establish maximum limits to guarantee support for producers and consumer safety. Full article
(This article belongs to the Special Issue Health Risks and Dietary Intake of Emerging Pollutants)
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12 pages, 379 KiB  
Article
Knowledge, Implementation, and Gaps of Gender-Based Violence Management Guidelines among Health Care Workers
by Caroline Mtaita, Elvis Safary, Katanta Simwanza, Rose Mpembeni, Samuel Likindikoki and Albrecht Jahn
Int. J. Environ. Res. Public Health 2023, 20(7), 5409; https://doi.org/10.3390/ijerph20075409 - 05 Apr 2023
Cited by 2 | Viewed by 2510
Abstract
(1) Background: Gender-based violence (GBV) is widespread globally and has a myriad of adverse effects but is vastly under-reported. Health care workers are among the first responders in GBV. The objective of this study was to assess the knowledge of health workers with [...] Read more.
(1) Background: Gender-based violence (GBV) is widespread globally and has a myriad of adverse effects but is vastly under-reported. Health care workers are among the first responders in GBV. The objective of this study was to assess the knowledge of health workers with regard to GBV and related management guidelines and implementation. (2) Methods: The study employed a descriptive, sequential mix-method study, beginning with the quantitative part, followed by the qualitative component. Qualitative analysis was conducted using a content framework approach. (3) Results: More than two-thirds (71.79%) of health workers were found to be generally knowledgeable about gender-based violence; however, only 36.9% had good knowledge about gender-based violence management guidelines for gender-based violence and the mean value for all the items was less than 3 which indicates poor knowledge of the management guideline. Additionally, only 36.8% found the gender-based violence management guidelines useful and practical in clinical care for gender-based violence cases. (4) Conclusions: The finding of this study revealed that knowledge of gender-based violence management guideline was not adequate among health workers and rarely used during management of GBV cases. This calls for continuous training and specific refresher courses, including on-site practical sessions, professionals’ mentorship, and supervision. Full article
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12 pages, 318 KiB  
Article
Japanese Local Governments’ Dissemination Activities for Advance Care Planning: A Descriptive Analysis of a Nationwide Survey during the COVID-19 Pandemic
by Noriko Morioka, Masayo Kashiwagi, Ako Machida, Kyoko Hanari, Takehiro Sugiyama, Ryota Inokuchi and Nanako Tamiya
Int. J. Environ. Res. Public Health 2023, 20(7), 5408; https://doi.org/10.3390/ijerph20075408 - 05 Apr 2023
Viewed by 1674
Abstract
This study aims to compare the awareness-raising activities between municipalities with and without focused anti-infection measures during the 2019 coronavirus disease (COVID-19) pandemic. Descriptive analysis was conducted using a nationwide self-administered questionnaire survey on municipalities’ activities for residents and for healthcare providers and [...] Read more.
This study aims to compare the awareness-raising activities between municipalities with and without focused anti-infection measures during the 2019 coronavirus disease (COVID-19) pandemic. Descriptive analysis was conducted using a nationwide self-administered questionnaire survey on municipalities’ activities for residents and for healthcare providers and care workers (HCPs) in October 2022 in Japan. This study included 433 municipalities that had conducted awareness-raising activities before 2019 Fiscal Year. Workshops for residents were conducted in 85.2% of the municipalities, and they were more likely to be conducted in areas with focused anti-infection measures than those without measures (86.8% vs. 75.4%). Additionally, 85.9% of the municipalities were impacted by the pandemic; 50.1% canceled workshops, while 26.0% switched to a web-based style. Activities for HCPs were conducted in 55.2–63.7% of the municipalities, and they were more likely to be conducted in areas with focused anti-infection measures. A total of 50.6–62.1% of the municipalities changed their workshops for HCPs to a web-based style. Comparisons between areas with and without focused anti-infection measures indicated that the percentages of those impacted for all activities were not significantly different. In conclusion, awareness-raising activities in municipalities were conducted with new methods during the COVID-19 pandemic. Using information technology is essential to further promote such activities for residents. Full article
(This article belongs to the Special Issue Global Advances in End-of-Life Care)
13 pages, 354 KiB  
Article
Gender-Specificity of Fatigue and Concerns Related to the COVID-19 Pandemic—A Report on the Polish Population
by Katarzyna Domosławska-Żylińska, Magdalena Krysińska-Pisarek and Dorota Włodarczyk
Int. J. Environ. Res. Public Health 2023, 20(7), 5407; https://doi.org/10.3390/ijerph20075407 - 05 Apr 2023
Cited by 1 | Viewed by 1253
Abstract
Background: The COVID-19 pandemic, which is now going on its third year, and its consequences experienced in almost every sphere of life may eventually lead to pandemic fatigue. Previous research indicates that one of the important determinants of the negative consequences of the [...] Read more.
Background: The COVID-19 pandemic, which is now going on its third year, and its consequences experienced in almost every sphere of life may eventually lead to pandemic fatigue. Previous research indicates that one of the important determinants of the negative consequences of the pandemic is gender. Based on the WHO’s definition of pandemic fatigue, a study was undertaken to determine the level of pandemic fatigue and concerns expressed in relation to the pandemic in Poland. Methods: A survey among 1064 respondents was conducted using the CATI technique during the fourth wave of the COVID-19 pandemic in Poland. Questionnaires adopted: the Polish adaptation of the Pandemic Fatigue Scale (PFS), Subjective Fatigue Symptoms (SFS), and the COVID-19 Concerns Checklist (CCC) and sociodemographic questions. The following statistical methods were employed: ANOVA analysis of variance, Mann–Whitney U test or Kruskal–Wallis test, and Chi-square test. Results: The analysis showed that women received higher overall PFS, information PFS, SFS, and pandemic-related concerns scores. Other factors that were associated with pandemic fatigue were age, treatment for chronic diseases, receipt of the COVID-19 vaccine, and COVID-19 survivor status. Conclusions: Women in Poland are experiencing pandemic fatigue, subjective fatigue symptoms, and concerns associated with the COVID-19 pandemic at a higher rate than men. Along with implementing interventions focused on public health safety, it seems reasonable to put in place strategies to assist people who are less capable of coping with prolonged stressful situations. Full article
16 pages, 406 KiB  
Article
Child-Owned Poultry Intervention Effects on Hemoglobin, Anemia, Concurrent Anemia and Stunting, and Morbidity Status of Young Children in Southern Ethiopia: A Cluster Randomized Controlled Community Trial
by Anteneh Omer, Dejene Hailu and Susan Joyce Whiting
Int. J. Environ. Res. Public Health 2023, 20(7), 5406; https://doi.org/10.3390/ijerph20075406 - 05 Apr 2023
Cited by 1 | Viewed by 1743
Abstract
Cereal-based diets contribute to anemia in Ethiopian children. Eggs have nutrients to boost hemoglobin levels as well as counter concurrent anemia and stunting (CAS) and morbidity status. A community trial, targeting 6–18 months old children, was conducted in Halaba. Two clusters were randomly [...] Read more.
Cereal-based diets contribute to anemia in Ethiopian children. Eggs have nutrients to boost hemoglobin levels as well as counter concurrent anemia and stunting (CAS) and morbidity status. A community trial, targeting 6–18 months old children, was conducted in Halaba. Two clusters were randomly selected and allocated to intervention (N = 122) and control (N = 121) arms. Intervention group (IG) children received egg-laying hens with caging in a cultural ceremony declaring child ownership of the chickens. Parents promised to feed eggs to the child. Health and agriculture extension workers promoted egg feeding, poultry husbandry, and sanitation to IG families. Control group (CG) had standard health and agriculture education. At baseline, groups were not different by hemoglobin, anemia, CAS, and morbidity status. Mean hemoglobin was 11.0 mg/dl and anemia prevalence was 41.6%. About 11.9% of children had CAS and 52.3% were sick. Using generalized estimating equations, the intervention increased hemoglobin by 0.53 g/dl (ß:0.53; p < 0.001; 95%CI: 0.28–0.79). IG children were 64% (p < 0.001; odds ratio [OR]:0.36; 95%CI: 0.24–0.54) and 57% (p = 0.007; OR: 0.43; 95%CI: 0.21–0.73) less likely to be anemic and have CAS, respectively, than CG, with no difference in morbidity. Child-owned poultry intervention is recommended in settings where anemia is high and animal-source food intake is low. Full article
(This article belongs to the Special Issue Preventive Medicine and Community Health)
16 pages, 1354 KiB  
Article
Variability of Micro- and Macro-Elements in Anaerobic Co-Digestion of Municipal Sewage Sludge and Food Industrial By-Products
by Aleksandra Szaja, Agnieszka Montusiewicz and Magdalena Lebiocka
Int. J. Environ. Res. Public Health 2023, 20(7), 5405; https://doi.org/10.3390/ijerph20075405 - 05 Apr 2023
Cited by 1 | Viewed by 1375
Abstract
The main aim of this study was to evaluate the effect of the addition of selected industrial food wastes on the fate of micro- and macro-elements within an anaerobic digestion process (AD), as well as define the relationship between their content and AD [...] Read more.
The main aim of this study was to evaluate the effect of the addition of selected industrial food wastes on the fate of micro- and macro-elements within an anaerobic digestion process (AD), as well as define the relationship between their content and AD efficiency. Orange peels, (OP), orange pulp (PL) and brewery spent grain (BSG) were used as co-substrates, while municipal sewage sludge (SS) was applied as the main component. The introduction of co-substrates resulted in improvements in feedstock composition in terms of macro-elements, with a simultaneous decrease in the content of HMs (heavy metals). Such beneficial effects led to enhanced methane production, and improved process performance at the highest doses of PL and BSG. In turn, reduced biogas and methane production was found in the three-component digestion mixtures in the presence of OP and BSG; therein, the highest accumulation of most HMs within the process was also revealed. Considering the agricultural application of all digestates, exceedances for Cu, Zn and Hg were recorded, thereby excluding their further use for that purpose. Full article
(This article belongs to the Special Issue Sustainable Agriculture: Soil Health and Waste Management)
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17 pages, 383 KiB  
Article
Consumer Fraud against Older Adults in Digital Society: Examining Victimization and Its Impact
by Steven Kemp and Nieves Erades Pérez
Int. J. Environ. Res. Public Health 2023, 20(7), 5404; https://doi.org/10.3390/ijerph20075404 - 05 Apr 2023
Cited by 3 | Viewed by 3055
Abstract
The European population is aging, which means more people aged sixty-five and over are at risk of financial exploitation. However, there is a lack of consensus regarding whether older persons are at greater risk of fraud than younger counterparts due to physical, economic, [...] Read more.
The European population is aging, which means more people aged sixty-five and over are at risk of financial exploitation. However, there is a lack of consensus regarding whether older persons are at greater risk of fraud than younger counterparts due to physical, economic, and social factors or, rather, whether they are slightly protected from fraud in the digital era due to less frequent online activity. Moreover, little is known about the financial, emotional, psychological, and physical impacts of fraud experiences amongst older generations in digital society. We employ multilevel modelling on a sample of EU citizens (n = 26,735) to analyze these issues. The results show that, holding other factors constant, older adults are more likely to suffer fraud in general, but not fraud via online channels. Identity theft in which the offender attempts to trick the victim by impersonating a reputable organization is found to be particularly relevant for citizens aged sixty-five and above. Older persons are less likely to suffer a financial impact but more likely to experience anger, irritation, embarrassment, and negative impacts on their physical health from fraud in general as well as from online fraud. Many organizations aim to help protect older adults from financial crime and its impacts; thus, the results emphasize the need to understand particular fraud categories suffered by older generations and to design support programs that fully take into account the non-financial impacts of this crime. Full article
(This article belongs to the Special Issue Psychosocial Aspects of Healthy Ageing)
18 pages, 14207 KiB  
Article
Characteristics of Pressure on the Apophysis in the Course of Paediatric Heel Pain—Preliminary Report
by Aleksandra Bitenc-Jasiejko, Anna Walińska, Krzysztof Konior, Kinga Gonta, Piotr Skomro, Konrad Kijak, Małgorzata Kowacka and Danuta Lietz-Kijak
Int. J. Environ. Res. Public Health 2023, 20(7), 5403; https://doi.org/10.3390/ijerph20075403 - 05 Apr 2023
Viewed by 1616
Abstract
Increased pressure on the heel apophysis is often implicated as a cause of paediatric heel pain. However, there are few reports on the causes of the increased pressure and its origin. Therefore, the aim of this study was to analyse the distribution of [...] Read more.
Increased pressure on the heel apophysis is often implicated as a cause of paediatric heel pain. However, there are few reports on the causes of the increased pressure and its origin. Therefore, the aim of this study was to analyse the distribution of pressure on the feet in children with heel pain. The study included 33 paediatric patients with non-traumatic heel pain, i.e., 24 boys (73%) and 9 girls (27%), aged on average 11.2 years (±3 years). Pedobarographic diagnostics proved a decrease in the pressure on the heels in relation to the ground and the transfer of the projection of the centre of gravity to the forefoot. While standing, the average contribution of the pressure on the heel was 0.52, SD = 0.14 in children with normal and reduced weight. In overweight children, the average pressure on the heel was higher (0.60, SD = 0.08), but the small number of children with this characteristic (n = 4) did not allow conclusions to be drawn in this area. Heel underload was also demonstrated during gait. However, the assessment of this aspect requires additional observational analyses in the field of propulsion and gait phases. The reduced pressure on the heel promotes apophysis traction, causing intracanal compression. Studies have shown that the causes of apophysis traction may be postural defects (in particular, forward inclination of body posture) and overpronation of the foot, or defects in the metatarsal area. Full article
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9 pages, 2506 KiB  
Article
Potential Relationship between Poor Oral Hygiene and MRONJ: An Observational Retrospective Study
by Silvia D’Agostino, Giulia Valentini, Marco Dolci and Elisabetta Ferrara
Int. J. Environ. Res. Public Health 2023, 20(7), 5402; https://doi.org/10.3390/ijerph20075402 - 05 Apr 2023
Cited by 3 | Viewed by 1933
Abstract
Medication-related osteonecrosis of the jaw (MRONJ) is a drug-related side effect linked but not limited to antiresorptive and antiangiogenic molecules. It recognizes several triggers in dental procedures, such as surgery, endodontic treatments, and root planing, but also prosthesis decubitus or with a spontaneous [...] Read more.
Medication-related osteonecrosis of the jaw (MRONJ) is a drug-related side effect linked but not limited to antiresorptive and antiangiogenic molecules. It recognizes several triggers in dental procedures, such as surgery, endodontic treatments, and root planing, but also prosthesis decubitus or with a spontaneous onset. Although there are many reports about the onset of this pathology, oral hygiene status is mainly described as a consequence of MRONJ. Not so much is known about the oral hygiene situation as a concurrent factor in the pathogenesis of severe stages and about non-surgical periodontal therapy in patients affected by MRONJ. Actually, clear instructions for non-surgical periodontal therapy are poor in the literature. The primary outcome of the present study is to evaluate the oral hygiene status in MRONJ patients. In addition, a secondary outcome is to review the factor of poor oral hygiene as a cause or worsening aspect for MRONJ. A total of 45 subjects (19 males and 26 females) with a mean age of 59 ± 12 were enrolled. The Pearson correlation coefficient showed no significant results for the variable of the Simplified Oral Hygiene Index (OHI-S) and the American Association of Oral and Maxillofacial Surgeons (AAOMS) stage, although the majority of patients showed poor oral hygiene with an OHI-S average of 3.39 ± 1.83. As stated by the last AAOMS position paper, poor plaque control is related to a worsened MRONJ stage. The relation between the lack of oral hygiene and MRONJ onset is still unclear. Full article
(This article belongs to the Special Issue Medication Related Osteonecrosis of the Jaw: What We Know)
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19 pages, 619 KiB  
Article
The Knowledge and Use of the International Classification of Functioning, Disability and Health (ICF) Framework in Athletic Training
by Nathaniel J. Millet, Alison R. Snyder Valier, Lindsey E. Eberman, Matthew J. Rivera and Zachary K. Winkelmann
Int. J. Environ. Res. Public Health 2023, 20(7), 5401; https://doi.org/10.3390/ijerph20075401 - 04 Apr 2023
Cited by 1 | Viewed by 1965
Abstract
In 2015, the Strategic Alliance adopted the International Classification of Functioning, Disability, and Health (ICF) as the disablement model framework for delivery of and communication about patient care in athletic training. The purpose of this study was to examine athletic trainers’ familiarity, knowledge, [...] Read more.
In 2015, the Strategic Alliance adopted the International Classification of Functioning, Disability, and Health (ICF) as the disablement model framework for delivery of and communication about patient care in athletic training. The purpose of this study was to examine athletic trainers’ familiarity, knowledge, application, and implementation of the ICF framework. We used a cross-sectional online survey with 185 athletic trainers (age = 35 ± 9 y), which included 32 items focused on familiarity, knowledge, application, and implementation of the ICF framework. Most participants (n = 96, 51.9%) reported never learning about the ICF framework. During the knowledge assessment, participants scored 4.3 ± 2.7 out of 8, which is equivalent to 53.7%. For the sorting assessment, participants scored 10.9 ± 3.9 out of 18, which is equivalent to 60.5%. On the implementation matrix, the most frequently reported ICF tasks elicited by the athletic trainers included neuromusculoskeletal and movement, structure related to movement, and mobility. The most common ‘never elicited’ ICF tasks included voice and speech, sexual orientation, and structures related to genitourinary and reproductive system. Deficits related to the ICF framework exist. Athletic trainers reported low implementation across all ICF categories. The decision to not elicit information on these areas of health may reduce the ability to provide patient-centered healthcare. Full article
(This article belongs to the Section Nursing)
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28 pages, 517 KiB  
Review
The Role of Diet and Specific Nutrients during the COVID-19 Pandemic: What Have We Learned over the Last Three Years?
by Petra Rust and Cem Ekmekcioglu
Int. J. Environ. Res. Public Health 2023, 20(7), 5400; https://doi.org/10.3390/ijerph20075400 - 04 Apr 2023
Cited by 1 | Viewed by 5166
Abstract
Nutrients and diets have an important impact on our immune system and infection risk and a huge number of papers have been published dealing with various aspects of nutrition in relation to SARS-CoV-2 infection risk or COVID-19 severity. This narrative review aims to [...] Read more.
Nutrients and diets have an important impact on our immune system and infection risk and a huge number of papers have been published dealing with various aspects of nutrition in relation to SARS-CoV-2 infection risk or COVID-19 severity. This narrative review aims to give an update on this association and tries to summarize some of the most important findings after three years of pandemic. The analysis of major studies and systematic reviews leads to the conclusion that a healthy plant-based diet reduces the risks for SARS-CoV-2 infection and especially COVID-19 severity. Regarding micronutrients, vitamin D is to the fore, but also zinc, vitamin C and, to some extent, selenium may play a role in COVID-19. Furthermore, omega-3-fatty acids with their anti-inflammatory effects also deserve attention. Therefore, a major aim of societal nutritional efforts in future should be to foster a high quality plant-based diet, which not only exerts beneficial effects on the immune system but also reduces the risk for non-communicable diseases such as type 2 diabetes or obesity which are also primary risk factors for worse COVID-19 outcomes. Another aim should be to focus on a good supply of critical immune-effective nutrients, such as vitamin D and zinc. Full article
(This article belongs to the Special Issue 2nd Edition of Nutrition, Diets and Public Health)
11 pages, 533 KiB  
Article
Prevention Aiming at Functioning—Describing Prevention in the Context of Rehabilitation: A Discussion Paper
by Christoph Gutenbrunner, Boya Nugraha and Thorsten Meyer
Int. J. Environ. Res. Public Health 2023, 20(7), 5399; https://doi.org/10.3390/ijerph20075399 - 04 Apr 2023
Viewed by 1833
Abstract
The widely accepted model of prevention, including primary, secondary and tertiary prevention, focuses predominantly on diseases. The WHO provides a comprehensive model of health conceptualized on the basis of the International Classification of Functioning, Disability and Health (ICF). This paper develops a conceptual [...] Read more.
The widely accepted model of prevention, including primary, secondary and tertiary prevention, focuses predominantly on diseases. The WHO provides a comprehensive model of health conceptualized on the basis of the International Classification of Functioning, Disability and Health (ICF). This paper develops a conceptual description of prevention aimed at functioning on the basis of the ICF model. Starting from the ICF-based conceptual descriptions of rehabilitation as a health strategy, a conceptual description of functioning prevention has been developed. Prevention aiming at functioning is the health strategy that applies approaches to avoid or reduce risks of impairing bodily functions and structures, activity limitations and participation restrictions; to strengthen the resources of the person; to optimize capacity and performance; to prevent impairments of bodily functions and structures; to prevent activity limitations and participation restrictions; to reduce contextual risk factors and barriers, including personal and environmental factors; to promote and strengthen contextual facilitators, with the goal of enabling people with impairments and people at risk of disability; and to maintain or improve the level of functioning in interactions with the environment. The proposed concept widens the scope of prevention to all aspects of functioning, including contextual factors. Full article
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