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Editor’s Choice articles are based on recommendations by the scientific editors of MDPI journals from around the world. Editors select a small number of articles recently published in the journal that they believe will be particularly interesting to readers, or important in the respective research area. The aim is to provide a snapshot of some of the most exciting work published in the various research areas of the journal.

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28 pages, 2890 KiB  
Article
Geochemical Modeling Source Provenance, Public Health Exposure, and Evaluating Potentially Harmful Elements in Groundwater: Statistical and Human Health Risk Assessment (HHRA)
Int. J. Environ. Res. Public Health 2022, 19(11), 6472; https://doi.org/10.3390/ijerph19116472 - 26 May 2022
Cited by 16 | Viewed by 2218
Abstract
Groundwater contamination by potentially harmful elements (PHEs) originating from the weathering of granitic and gneissic rock dissolution poses a public health concern worldwide. This study investigated physicochemical variables and PHEs in the groundwater system and mine water of the Adenzai flood plain region, [...] Read more.
Groundwater contamination by potentially harmful elements (PHEs) originating from the weathering of granitic and gneissic rock dissolution poses a public health concern worldwide. This study investigated physicochemical variables and PHEs in the groundwater system and mine water of the Adenzai flood plain region, in Pakistan, emphasizing the fate distribution, source provenance, chemical speciation, and health hazard using the human health risk assessment HHRA-model. The average concentrations of the PHEs, viz., Ni, Mn, Cr, Cu, Cd, Pb, Co, Fe, and Zn 0.23, were 0.27, 0.07, 0.30, 0.07, 0.06, 0.08, 0.68, and 0.23 mg/L, respectively. The average values of chemical species in the groundwater system, viz., H+, OH, Ni2+, Mn2+, Mn3+, Cr3+, Cr6+, Cu+, Cu2+, Cd2+, Pb2+, Pb4+, Co2+, Co3+, Fe2+, Fe3+, and Zn2+, were 1.0 × 10−4 ± 1.0 × 10−6, 1.0 × 10−4 ± 9.0 × 10−7, 2.0 × 10−1 ± 1.0 × 10−3, 3.0 × 10−1 ± 1.0 × 10−3, 1.0 × 10−22 ± 1.0 × 10−23, 4.0 × 10−6 ± 2.0 × 10−6, 4.0 × 10−11 ± 2.0 × 10−11, 9.0 × 10−3 ± 1.0 × 10−2, 2.0 × 10−1 ± 2.0 × 10−3, 7.0 × 10−2 ± 6.0 × 10−2, 5.0 × 10−2 ± 5.0 × 10−2, 2.0 × 10−2 ± 1.5 × 10−2, 6.0 × 10−2 ± 4.0 × 10−2, 8.0 × 10−31 ± 6.0 × 10−31, 3.0 × 10−1 ± 2.0 × 10−4, 4.0 × 10−10 ± 3.0 × 10−10, and 2.0 × 10−1 ± 1.0 × 10−1. The mineral compositions of PHEs, viz. Ni, were bunsenite, Ni(OH)2, and trevorite; Mn viz., birnessite, bixbyite, hausmannite, manganite, manganosite, pyrolusite, and todorokite; Cr viz., chromite and eskolaite; Cu viz., CuCr2O4, cuprite, delafossite, ferrite-Cu, and tenorite; Cd viz., monteponite; Pb viz, crocoite, litharge, massicot, minium, plattnerite, Co viz., spinel-Co; Fe viz., goethite, hematite, magnetite, wustite, and ferrite-Zn; and Zn viz., zincite, and ZnCr2O4 demarcated undersaturation and supersaturation. However, EC, Ca2+, K+, Na+, HCO3, Cr, Cd, Pb, Co, and Fe had exceeded the WHO guideline. The Nemerow’s pollution index (NPI) showed that EC, Ca2+, K+, Na+, HCO3, Mn, Cd, Pb, Co, and Fe had worse water quality. Principal component analysis multilinear regression (PCAMLR) and cluster analysis (CA) revealed that 75% of the groundwater contamination originated from geogenic inputs and 18% mixed geogenic-anthropogenic and 7% anthropogenic sources. The HHRA-model suggested potential non-carcinogenic risks, except for Fe, and substantial carcinogenic risks for evaluated PHEs. The women and infants are extremely exposed to PHEs hazards. The non-carcinogenic and carcinogenic risks in children, males, and females had exceeded their desired level. The HHRA values of PHEs exhibited the following increasing pattern: Co > Cu > Mn > Zn > Fe, and Cd > Pb > Ni > Cr. The higher THI values of PHEs in children and adults suggested that the groundwater consumption in the entire region is unfit for drinking, domestic, and agricultural purposes. Thus, all groundwater sources need immediate remedial measures to secure health safety and public health concerns. Full article
(This article belongs to the Special Issue Water Pollution: Human Health and Ecological Risks)
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30 pages, 6489 KiB  
Systematic Review
Nature-Based Early Childhood Education and Children’s Social, Emotional and Cognitive Development: A Mixed-Methods Systematic Review
Int. J. Environ. Res. Public Health 2022, 19(10), 5967; https://doi.org/10.3390/ijerph19105967 - 13 May 2022
Cited by 22 | Viewed by 9666
Abstract
This systematic review synthesised evidence on associations between nature-based early childhood education (ECE) and children’s social, emotional, and cognitive development. A search of nine databases was concluded in August 2020. Studies were eligible if: (a) children (2–7 years) attended ECE, (b) ECE integrated [...] Read more.
This systematic review synthesised evidence on associations between nature-based early childhood education (ECE) and children’s social, emotional, and cognitive development. A search of nine databases was concluded in August 2020. Studies were eligible if: (a) children (2–7 years) attended ECE, (b) ECE integrated nature, and (c) assessed child-level outcomes. Two reviewers independently screened full-text articles and assessed study quality. Synthesis included effect direction, thematic analysis, and results-based convergent synthesis. One thousand three hundred and seventy full-text articles were screened, and 36 (26 quantitative; 9 qualitative; 1 mixed-methods) studies were eligible. Quantitative outcomes were cognitive (n = 11), social and emotional (n = 13), nature connectedness (n = 9), and play (n = 10). Studies included controlled (n = 6)/uncontrolled (n = 6) before-after, and cross-sectional (n = 15) designs. Based on very low certainty of the evidence, there were positive associations between nature-based ECE and self-regulation, social skills, social and emotional development, nature relatedness, awareness of nature, and play interaction. Inconsistent associations were found for attention, attachment, initiative, environmentally responsible behaviour, and play disruption/disconnection. Qualitative studies (n = 10) noted that nature-based ECE afforded opportunities for play, socialising, and creativity. Nature-based ECE may improve some childhood development outcomes, however, high-quality experimental designs describing the dose and quality of nature are needed to explore the hypothesised pathways connecting nature-based ECE to childhood development (Systematic Review Registration: CRD42019152582). Full article
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22 pages, 3845 KiB  
Article
Effects of Environmental Features in Small Public Urban Green Spaces on Older Adults’ Mental Restoration: Evidence from Tokyo
Int. J. Environ. Res. Public Health 2022, 19(9), 5477; https://doi.org/10.3390/ijerph19095477 - 30 Apr 2022
Cited by 12 | Viewed by 3228
Abstract
Exposure to small public urban green spaces (SPUGS) has been demonstrated to have mental benefits for older adults. However, studies on identifying the objective environmental features of SPUGS and their effects on mental restoration for older adults remain limited. This study employed a [...] Read more.
Exposure to small public urban green spaces (SPUGS) has been demonstrated to have mental benefits for older adults. However, studies on identifying the objective environmental features of SPUGS and their effects on mental restoration for older adults remain limited. This study employed a multilevel regression model to investigate the restorative and vitalizing effects of the environmental features of 11 SPUGS in Tokyo. Onsite measurements were conducted in Kita-Ku, and 202 older adults were surveyed. The results showed that: (1) The fitting curve of the green view index and Restoration Outcome Scale (ROS) score showed an inverted U shape—both green view index and boundary enclosure had a strong impact on the mental restoration of older adults; (2) The colorfulness index showed the strongest relationship with the vitalizing effect. (3) The sky view factor and number of seats only influenced the ROS score, while the results of revitalization suggest that large areas of water should be avoided. (4) Physiological Equivalent Temperature (PET) was also confirmed to have negative effects on the mental restoration of older adults in autumn. These empirical findings can be used as a resource to promote the mental health of older adults in the design of SPUGS in high-density Asian countries. Full article
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18 pages, 648 KiB  
Article
Quality of Life and Mental Health in Children and Adolescents after the First Year of the COVID-19 Pandemic: A Large Population-Based Survey in South Tyrol, Italy
Int. J. Environ. Res. Public Health 2022, 19(9), 5220; https://doi.org/10.3390/ijerph19095220 - 25 Apr 2022
Cited by 25 | Viewed by 4179
Abstract
Background: Methodological heterogeneity of studies and geographical variation limit conclusions about the impact of the COVID-19 pandemic on the mental health of youth. This study aimed to explore the health-related quality of life and mental health of children and adolescents in the second [...] Read more.
Background: Methodological heterogeneity of studies and geographical variation limit conclusions about the impact of the COVID-19 pandemic on the mental health of youth. This study aimed to explore the health-related quality of life and mental health of children and adolescents in the second year of the pandemic in South Tyrol, Italy. Methods: An online survey representative for the age and gender of the children and adolescents in South Tyrol was conducted among 5159 families with children and adolescents aged 7–19 years, between 28 May and 16 June 2021. The survey collecting parental ratings and self-rated questionnaires from children and adolescents aged 11–19 years included instruments to measure health-related quality of life (KIDSCREEN-10), mental health problems (SDQ), anxiety (SCARED), and depression (CES-DC). The results were compared with data from corresponding studies conducted in Germany. Results: Decreased health-related quality of life and increased conduct problems, peer-related mental health problems, anxiety, and depressive and psychosomatic symptoms in children and adolescents observed in the second year of the pandemic in Germany were confirmed in the second year in South Tyrol. Children and adolescents with low socioeconomic status, a migration background, and limited living space were significantly affected. Female sex and older age were associated with increased psychosocial problems and a positive family climate supported the mental health of children and adolescents during the pandemic. Conclusions: Confirmation of findings of decreased health-related quality of life and increased emotional problems after the first year of the pandemic supports the ongoing call for low-threshold health promotion, prevention, and early intervention programs to support children and adolescents who have been severely affected by the pandemic. Full article
(This article belongs to the Special Issue Advances in Child and Adolescent Mental Health)
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14 pages, 1782 KiB  
Article
Increased Physical Activity at School Benefits Arterial Blood Pressure in Children—A Prospective Follow-Up Cohort Study
Int. J. Environ. Res. Public Health 2022, 19(8), 4662; https://doi.org/10.3390/ijerph19084662 - 12 Apr 2022
Cited by 6 | Viewed by 2470
Abstract
(1) Background: A sedentary lifestyle and low physical activity (PA) increase the risk of hypertension in children. The aim of this study was to assess the impact of increased PA at school by elevation of the number of compulsory physical education (PE) lessons [...] Read more.
(1) Background: A sedentary lifestyle and low physical activity (PA) increase the risk of hypertension in children. The aim of this study was to assess the impact of increased PA at school by elevation of the number of compulsory physical education (PE) lessons on arterial blood pressure in children during a two-year follow-up. (2) Methods: Children (n = 245) born in 2007 attending a standard or elevated number of PE lessons in the school timetable (4 and 10 h a week, respectively) took part in the study. Blood pressure was measured starting from age approx. 10 to 12. (3) Results: Starting from a similar level, after 2 years, the percentage of children with normal blood pressure decreased in the standard-PE children from 83.25% to 78.03% but increased in the elevated-PE ones from 83.15% to 86.13%. The prevalence of both prehypertension and hypertension increased by one-third in the standard-PE children from 16.74% to 21.97% but decreased by one-sixth in the elevated-PE ones from 16.85% to 13.87%. The prevalence of hypertension itself increased by one-third in the standard-PE children from 9.82% to 13.12% but decreased in the elevated-PE ones by one-fifth from 9.60% to 7.75% (4) Conclusions: An increase in PA at school by the elevation of the number of PE lessons benefits children’s arterial blood pressure. Early prevention of hypertension in children can be supported by an adequate number of PE lessons in the school timetable. Full article
(This article belongs to the Special Issue Child Physical Activity and Health)
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15 pages, 350 KiB  
Article
Tocolytic Treatment for the Prevention of Preterm Birth from a Taiwanese Perspective: A Survey of Taiwanese Obstetric Specialists
Int. J. Environ. Res. Public Health 2022, 19(7), 4222; https://doi.org/10.3390/ijerph19074222 - 01 Apr 2022
Cited by 8 | Viewed by 2944
Abstract
Preterm birth represents a great burden to the healthcare system, resulting in the consideration for the use of tocolytic therapy to provide a “better time” for delivery in order to buy time to accelerate fetal lung maturity, thereby minimizing prematurity-related morbidity and mortality. [...] Read more.
Preterm birth represents a great burden to the healthcare system, resulting in the consideration for the use of tocolytic therapy to provide a “better time” for delivery in order to buy time to accelerate fetal lung maturity, thereby minimizing prematurity-related morbidity and mortality. However, the benefits and potential side effects and risks of tocolytic treatment for preterm birth should be carefully balanced. Although many countries and societies provide guidelines or consensuses for the management for preterm birth, there is no standardized national guideline or consensus in Taiwan. As such, great heterogeneity is suspected in preterm labor management, contributing to the uncertainty of attitudes and practice patterns of obstetric specialists in Taiwan. This study attempts to understand the attitudes and practice patterns regarding tocolytic therapy in Taiwan. A paper-based survey was conducted at the 2020 Taiwan Society of Perinatology Conference on 8 December 2020, exploring how obstetric specialists would use tocolytics under nine different clinical scenarios, such as a short cervix, preterm labor, maintenance tocolysis, preterm premature rupture of membranes, etc. Three hundred ten specialists attended the conference, and 77 responded to the survey with a response rate of 24.8%. According to the survey, many of these specialists would prescribe tocolytics for less evidence-based indications, including 22% for abdominal tightness, 46% for a short cervix, 60% for maintenance tocolysis, and 89% for repeat tocolysis, with the preferred first line medication being ritodrine and nifedipine. We concluded that tocolysis is widely accepted and practiced in Taiwan. More research is needed to include Taiwan-specific economic and cultural factors as well as associated adverse effects and patients’ outcomes. Full article
(This article belongs to the Special Issue Emerging Research in Maternal and Child Healthcare)
17 pages, 1562 KiB  
Review
Literature Cases Summarized Based on Their Polysomnographic Findings in Rett Syndrome
Int. J. Environ. Res. Public Health 2022, 19(6), 3422; https://doi.org/10.3390/ijerph19063422 - 14 Mar 2022
Cited by 5 | Viewed by 2545
Abstract
Rett syndrome (RTT) is a severe and rare neurodevelopmental disorder affecting mostly girls. In RTT, an impaired sleep pattern is a supportive criterion for the diagnosis, yet little is known regarding the sleep structure and sleep respiratory events. Aiming to delineate sleep by [...] Read more.
Rett syndrome (RTT) is a severe and rare neurodevelopmental disorder affecting mostly girls. In RTT, an impaired sleep pattern is a supportive criterion for the diagnosis, yet little is known regarding the sleep structure and sleep respiratory events. Aiming to delineate sleep by aggregating RTT case (series) data from published polysomnographic studies, seventy-four RTT cases were collected from eleven studies up until 6 February 2022 (PROSPERO: CRD 42020198099). We compared the polysomnographic data within RTT stratifications and to a typically developing population. MECP2 cases demonstrated shortened total sleep time (TST) with increased stage N3 and decreased REM sleep. In cases with CDKL5 mutations, TST was longer and they spent more time in stage N1 but less in stage N3 than those cases affected by MECP2 mutations and a typically developing population. Sleep-disordered breathing was confirmed by the abnormal apnea/hypopnea index of 11.92 ± 23.67/h TST in these aggregated cases. No association of sleep structure with chronological age was found. In RTT, the sleep macrostructure of MECP2 versus CDKL5 cases showed differences, particularly regarding sleep stage N3. A severe REM sleep propensity reduction was found. Aberrant sleep cycling, possibly characterized by a poor REM ‘on switch’ and preponderance in slow and high-voltage sleep, is proposed. Full article
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13 pages, 344 KiB  
Concept Paper
Sex, Gender and Health: Mapping the Landscape of Research and Policy
Int. J. Environ. Res. Public Health 2022, 19(5), 2563; https://doi.org/10.3390/ijerph19052563 - 23 Feb 2022
Cited by 21 | Viewed by 6162
Abstract
Including sex and gender considerations in health research is considered essential by many funders and is very useful for policy makers, program developers, clinicians, consumers and other end users. While longstanding confusions and conflations of terminology in the sex and gender field are [...] Read more.
Including sex and gender considerations in health research is considered essential by many funders and is very useful for policy makers, program developers, clinicians, consumers and other end users. While longstanding confusions and conflations of terminology in the sex and gender field are well documented, newer conceptual confusions and conflations continue to emerge. Contemporary social demands for improved health and equity, as well as increased interest in precision healthcare and medicine, have made obvious the need for sex and gender science, sex and gender-based analyses (SGBA+), considerations of intersectionality, and equity, diversity and inclusion initiatives (EDI) to broaden representation among participants and diversify research agendas. But without a shared and precise understanding of these conceptual areas, fields of study, and approaches and their inter-relationships, more conflation and confusion can occur. This article sets out these areas and argues for more precise operationalization of sex- and gender-related factors in health research and policy initiatives in order to advance these varied agendas in mutually supportive ways. Full article
(This article belongs to the Special Issue Sex, Gender, and Health)
22 pages, 1585 KiB  
Review
Family Adjustment to Hereditary Cancer Syndromes: A Systematic Review
Int. J. Environ. Res. Public Health 2022, 19(3), 1603; https://doi.org/10.3390/ijerph19031603 - 30 Jan 2022
Cited by 13 | Viewed by 4312
Abstract
Hereditary cancer syndromes are inherited pathogenic genetic variants that significantly increase the risk of developing cancer. When individuals become aware of their increased probability of having cancer, the whole family is affected by this new reality and needs to adjust. However, adjustment to [...] Read more.
Hereditary cancer syndromes are inherited pathogenic genetic variants that significantly increase the risk of developing cancer. When individuals become aware of their increased probability of having cancer, the whole family is affected by this new reality and needs to adjust. However, adjustment to hereditary cancer syndromes has been mainly studied at an individual level, and research about familial adjustment remains dispersed and disorganized. To overcome this gap, this review aims to understand how families adjust to genetic testing and risk management, and to what extent the family’s adjustment influences the psychological response and risk management behaviors of mutation carriers. We conducted searches on the PubMed/Med Line, PsycInfo, SCOPUS, and Google Scholar databases and used the Mixed Methods Appraisal Tool (MMAT-v2018) to assess the methodological quality of each selected study. Thirty studies met the inclusion criteria. Most results highlighted the interdependent nature of adjustment of pathogenic variant carriers and their families. The way carriers adjust to the syndrome is highly dependent on family functioning and related to how family members react to the new genetic information, particularly partners and siblings. Couples who share their worries and communicate openly about cancer risk present a better long-term adjustment than couples who use protective buffering (not talking about it to avoid disturbing the partner) or emotional distancing. Parents need help dealing with disclosing genetic information to their children. These findings reinforce the importance of adopting a family-centered approach in the context of genetic counseling and the necessity of involving family members in research. Full article
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24 pages, 1292 KiB  
Review
Powering Research through Innovative Methods for Mixtures in Epidemiology (PRIME) Program: Novel and Expanded Statistical Methods
Int. J. Environ. Res. Public Health 2022, 19(3), 1378; https://doi.org/10.3390/ijerph19031378 - 26 Jan 2022
Cited by 27 | Viewed by 5435
Abstract
Humans are exposed to a diverse mixture of chemical and non-chemical exposures across their lifetimes. Well-designed epidemiology studies as well as sophisticated exposure science and related technologies enable the investigation of the health impacts of mixtures. While existing statistical methods can address the [...] Read more.
Humans are exposed to a diverse mixture of chemical and non-chemical exposures across their lifetimes. Well-designed epidemiology studies as well as sophisticated exposure science and related technologies enable the investigation of the health impacts of mixtures. While existing statistical methods can address the most basic questions related to the association between environmental mixtures and health endpoints, there were gaps in our ability to learn from mixtures data in several common epidemiologic scenarios, including high correlation among health and exposure measures in space and/or time, the presence of missing observations, the violation of important modeling assumptions, and the presence of computational challenges incurred by current implementations. To address these and other challenges, NIEHS initiated the Powering Research through Innovative methods for Mixtures in Epidemiology (PRIME) program, to support work on the development and expansion of statistical methods for mixtures. Six independent projects supported by PRIME have been highly productive but their methods have not yet been described collectively in a way that would inform application. We review 37 new methods from PRIME projects and summarize the work across previously published research questions, to inform methods selection and increase awareness of these new methods. We highlight important statistical advancements considering data science strategies, exposure-response estimation, timing of exposures, epidemiological methods, the incorporation of toxicity/chemical information, spatiotemporal data, risk assessment, and model performance, efficiency, and interpretation. Importantly, we link to software to encourage application and testing on other datasets. This review can enable more informed analyses of environmental mixtures. We stress training for early career scientists as well as innovation in statistical methodology as an ongoing need. Ultimately, we direct efforts to the common goal of reducing harmful exposures to improve public health. Full article
(This article belongs to the Special Issue Combined Environmental Exposures/ Chemical Mixtures)
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27 pages, 405 KiB  
Review
Recycling Plastics from WEEE: A Review of the Environmental and Human Health Challenges Associated with Brominated Flame Retardants
Int. J. Environ. Res. Public Health 2022, 19(2), 766; https://doi.org/10.3390/ijerph19020766 - 11 Jan 2022
Cited by 24 | Viewed by 4786
Abstract
Waste electrical and electronic equipment (WEEE) presents the dual characteristic of containing both hazardous substances and valuable recoverable materials. Mainly found in WEEE plastics, brominated flame retardants (BFRs) are a component of particular interest. Several actions have been taken worldwide to regulate their [...] Read more.
Waste electrical and electronic equipment (WEEE) presents the dual characteristic of containing both hazardous substances and valuable recoverable materials. Mainly found in WEEE plastics, brominated flame retardants (BFRs) are a component of particular interest. Several actions have been taken worldwide to regulate their use and disposal, however, in countries where no regulation is in place, the recovery of highly valuable materials has promoted the development of informal treatment facilities, with serious consequences for the environment and the health of the workers and communities involved. Hence, in this review we examine a wide spectrum of aspects related to WEEE plastic management. A search of legislation and the literature was made to determine the current legal framework by region/country. Additionally, we focused on identifying the most relevant methods of existing industrial processes for determining BFRs and their challenges. BFR occurrence and substitution by novel BFRs (NBFRs) was reviewed. An emphasis was given to review the health and environmental impacts associated with BFR/NBFR presence in waste, consumer products, and WEEE recycling facilities. Knowledge and research gaps of this topic were highlighted. Finally, the discussion on current trends and proposals to attend to this relevant issue were outlined. Full article
(This article belongs to the Special Issue Advances in Hazardous Waste and Human Health)
14 pages, 2382 KiB  
Article
Association between Asthma Control and Exposure to Greenness and Other Outdoor and Indoor Environmental Factors: A Longitudinal Study on a Cohort of Asthmatic Children
Int. J. Environ. Res. Public Health 2022, 19(1), 512; https://doi.org/10.3390/ijerph19010512 - 04 Jan 2022
Cited by 11 | Viewed by 2464
Abstract
Achieving and maintaining asthma control (AC) is the main goal of asthma management. Indoor and outdoor environmental factors may play an important role on AC. The aim of this longitudinal study was to evaluate the association between AC and exposure to greenness and [...] Read more.
Achieving and maintaining asthma control (AC) is the main goal of asthma management. Indoor and outdoor environmental factors may play an important role on AC. The aim of this longitudinal study was to evaluate the association between AC and exposure to greenness and other outdoor or indoor environmental factors in a cohort of asthmatic children. This study involved 179 asthmatic children (5–16 years). Parents were interviewed through a modified version of the SIDRIA questionnaire. AC was assessed at each visit. Exposure to greenness was measured using the normalized difference vegetation index (NDVI). A logistic regression model was applied for assessing risk factors for uncontrolled asthma (UA). Low NDVI exposure was a risk factor for UA (OR: 2.662, 95% CI (1.043–6.799)); children exposed to passive smoke during pregnancy had a higher risk of UA than those non-exposed to passive smoke during pregnancy (OR: 3.816, 95% CI (1.114–13.064)); and a unit increase in the crowding index was associated with an increased risk of UA (OR: 3.376, 95% CI (1.294–8.808)). In conclusion, the current study provided a comprehensive assessment of urban-related environmental exposures on asthma control in children, using multiple indicators of greenness and other outdoor or indoor environmental factors. Full article
(This article belongs to the Collection Feature Papers in Children's Health)
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19 pages, 1687 KiB  
Review
Metabolic Syndrome and Endocrine Disrupting Chemicals: An Overview of Exposure and Health Effects
Int. J. Environ. Res. Public Health 2021, 18(24), 13047; https://doi.org/10.3390/ijerph182413047 - 10 Dec 2021
Cited by 47 | Viewed by 7358
Abstract
Increasing prevalence of metabolic syndrome (MetS) is causing a significant health burden among the European population. Current knowledge supports the notion that endocrine-disrupting chemicals (EDCs) interfere with human metabolism and hormonal balance, contributing to the conventionally recognized lifestyle-related MetS risk factors. This review [...] Read more.
Increasing prevalence of metabolic syndrome (MetS) is causing a significant health burden among the European population. Current knowledge supports the notion that endocrine-disrupting chemicals (EDCs) interfere with human metabolism and hormonal balance, contributing to the conventionally recognized lifestyle-related MetS risk factors. This review aims to identify epidemiological studies focusing on the association between MetS or its individual components (e.g., obesity, insulin resistance, diabetes, dyslipidemia and hypertension) and eight HBM4EU priority substances (bisphenol A (BPA), per- and polyfluoroalkyl substances (PFASs), phthalates, polycyclic aromatic hydrocarbons (PAHs), pesticides and heavy metals (cadmium, arsenic and mercury)). Thus far, human biomonitoring (HBM) studies have presented evidence supporting the role of EDC exposures on the development of individual MetS components. The strength of the association varies between the components and EDCs. Current evidence on metabolic disturbances and EDCs is still limited and heterogeneous, and mainly represent studies from North America and Asia, highlighting the need for well-conducted and harmonized HBM programmes among the European population. Rigorous and ongoing HBM in combination with health monitoring can help to identify the most concerning EDC exposures, to guide future risk assessment and policy actions. Full article
(This article belongs to the Section Environmental Health)
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12 pages, 684 KiB  
Article
Differential Effects of Multiple Dimensions of Poverty on Child Behavioral Problems: Results from the A-CHILD Study
Int. J. Environ. Res. Public Health 2021, 18(22), 11821; https://doi.org/10.3390/ijerph182211821 - 11 Nov 2021
Cited by 11 | Viewed by 2282
Abstract
The differential effects of low income and material deprivation—in particular, deprivation related to child educational needs—have not been well examined. This study aimed to examine the effects of low income and life-related and child-related deprivation on child behavioral problems. This study used data [...] Read more.
The differential effects of low income and material deprivation—in particular, deprivation related to child educational needs—have not been well examined. This study aimed to examine the effects of low income and life-related and child-related deprivation on child behavioral problems. This study used data from first-grade students who participated in the Adachi Child Health Impact of Living Difficulty (A-CHILD) study in 2015, 2017, and 2019 (N = 12,367) in Japan. Material deprivation was divided into life-related deprivation (i.e., lack of items for a living) and child-related deprivation (i.e., lack of children’s books, etc.), and low income was assessed via annual household income. We assessed child behavioral problems and prosocial behavior using the Strengths and Difficulties Questionnaire. One in ten children belonged to low-income families, 15.4% of children experienced life-related deprivation, and 5.4% of children experienced child-related deprivation. While life- and child-related deprivation had significant adverse effects on behavioral problems, they had no association with prosocial behavior. The effects of low income were mediated by parental psychological distress (45.0% of the total effect) and the number of consulting sources (20.8%) on behavioral problems. The effects of life-related and child-related deprivation were mediated by parental psychological distress (29.2–35.0%) and the number of consulting sources (6.4–6.9%) on behavioral problems. Life-related and child-related deprivation, but not low income, are important for child mental health. Full article
(This article belongs to the Section Children's Health)
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38 pages, 1621 KiB  
Review
Green Space Quality and Health: A Systematic Review
Int. J. Environ. Res. Public Health 2021, 18(21), 11028; https://doi.org/10.3390/ijerph182111028 - 20 Oct 2021
Cited by 82 | Viewed by 10418
Abstract
(1) Background: As cities densify, researcher and policy focus is intensifying on which green space types and qualities are important for health. We conducted a systematic review to examine whether particular green space types and qualities have been shown to provide health benefits [...] Read more.
(1) Background: As cities densify, researcher and policy focus is intensifying on which green space types and qualities are important for health. We conducted a systematic review to examine whether particular green space types and qualities have been shown to provide health benefits and if so, which specific types and qualities, and which health outcomes. (2) Methods: We searched five databases from inception up to June 30, 2021. We included all studies examining a wide range of green space characteristics on various health outcomes. (3) Results: 68 articles from 59 studies were found, with a high degree of heterogeneity in study designs, definitions of quality and outcomes. Most studies were cross-sectional, ecological or cohort studies. Environment types, vegetation types, and the size and connectivity of green spaces were associated with improved health outcomes, though with contingencies by age and gender. Health benefits were more consistently observed in areas with greater tree canopy, but not grassland. The main outcomes with evidence of health benefits included allergic respiratory conditions, cardiovascular conditions and psychological wellbeing. Both objectively and subjectively measured qualities demonstrated associations with health outcomes. (4) Conclusion: Experimental studies and longitudinal cohort studies will strengthen current evidence. Evidence was lacking for needs-specific or culturally-appropriate amenities and soundscape characteristics. Qualities that need more in-depth investigation include indices that account for forms, patterns, and networks of objectively and subjectively measured green space qualities. Full article
(This article belongs to the Section Environmental Health)
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21 pages, 1188 KiB  
Review
Comparison of the Mental Health Impact of COVID-19 on Vulnerable and Non-Vulnerable Groups: A Systematic Review and Meta-Analysis of Observational Studies
Int. J. Environ. Res. Public Health 2021, 18(20), 10830; https://doi.org/10.3390/ijerph182010830 - 15 Oct 2021
Cited by 23 | Viewed by 3967
Abstract
Vulnerable populations may be more vulnerable to mental health problems posed by the coronavirus disease 2019 (COVID-19) pandemic. A systematic review was performed to compare the mental health impact of COVID-19 between vulnerable and non-vulnerable groups. Five electronic databases were searched for observational [...] Read more.
Vulnerable populations may be more vulnerable to mental health problems posed by the coronavirus disease 2019 (COVID-19) pandemic. A systematic review was performed to compare the mental health impact of COVID-19 between vulnerable and non-vulnerable groups. Five electronic databases were searched for observational studies reporting the psychological outcomes of both vulnerable populations and healthy controls during the COVID-19 era. The primary outcomes are the severity of depression and anxiety, and secondary outcomes include other aspects of mental health such as stress or sleep disturbance. Meta-analysis was performed for the severity of mental health symptoms, and the results were presented as standardized mean difference and 95% confidence intervals. A total of 25 studies were included. According to the findings, the elderly generally experienced significantly lower levels of psychological symptoms including depression, anxiety, and perceived stress. Pregnant women, patients with chronic diseases, and patients with pre-existing severe mental disorders showed mixed results according to each mental health outcome. The results indicate that vulnerable groups have been affected differently in the COVID-19 era. Though the insufficient number and heterogeneity of included studies leave the results inconclusive, our findings may contribute to identifying priorities of mental health needs among various vulnerable populations and allocating health resources with efficiency. Full article
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23 pages, 916 KiB  
Systematic Review
Experiential Learning Interventions and Healthy Eating Outcomes in Children: A Systematic Literature Review
Int. J. Environ. Res. Public Health 2021, 18(20), 10824; https://doi.org/10.3390/ijerph182010824 - 15 Oct 2021
Cited by 19 | Viewed by 5142
Abstract
Experiential learning is the process where learners create meaning from direct experience. This systematic review aimed to examine the effects of experiential learning activities on dietary outcomes (knowledge, attitudes, behaviors) in children. Four databases: Education Research Complete, Scopus, Web of Science and PsychINFO [...] Read more.
Experiential learning is the process where learners create meaning from direct experience. This systematic review aimed to examine the effects of experiential learning activities on dietary outcomes (knowledge, attitudes, behaviors) in children. Four databases: Education Research Complete, Scopus, Web of Science and PsychINFO were searched from database inception to 2020. Eligible studies included children 0–12 years, assessed effect of experiential learning on outcomes of interest compared to non-experiential learning and were open to any setting. The quality of studies was assessed using the revised Cochrane risk of bias tool by two independent reviewers and effect size was calculated on each outcome. Nineteen studies were conducted in primary school, six in pre-school and one in an outside-of-school setting and used nine types of experiential learning strategies. Cooking, taste-testing, games, role-playing, and gardening were effective in improving nutrition outcomes in primary school children. Sensory evaluation, games, creative arts, and storybooks were effective for preschool children. Multiple strategies involving parents, and short/intense strategies are useful for intervention success. Experiential learning is a useful strategy to improve children’s knowledge, attitudes, and behaviors towards healthy eating. Fewer studies in pre-school and outside of school settings and high risk of bias may limit the generalizability and strength of the findings. Full article
(This article belongs to the Collection Review Papers in Children's Health)
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8 pages, 309 KiB  
Opinion
Core Temperature Measurement—Principles of Correct Measurement, Problems, and Complications
Int. J. Environ. Res. Public Health 2021, 18(20), 10606; https://doi.org/10.3390/ijerph182010606 - 10 Oct 2021
Cited by 43 | Viewed by 5468
Abstract
Core temperature reflects the temperature of the internal organs. Proper temperature measurement is essential to diagnose and treat temperature impairment in patients. However, an accurate approach has yet to be established. Depending on the method used, the obtained values may vary and differ [...] Read more.
Core temperature reflects the temperature of the internal organs. Proper temperature measurement is essential to diagnose and treat temperature impairment in patients. However, an accurate approach has yet to be established. Depending on the method used, the obtained values may vary and differ from the actual core temperature. There is an ongoing debate regarding the most appropriate anatomical site for core temperature measurement. Although the measurement of body core temperature through a pulmonary artery catheter is commonly cited as the gold standard, the esophageal temperature measurement appears to be a reasonable and functional alternative in the clinical setting. This article provides an integrative review of invasive and noninvasive body temperature measurements and their relations to core temperature. Full article
(This article belongs to the Special Issue Accidental and Environmental Hypothermia)
6 pages, 454 KiB  
Communication
Why Does the SARS-CoV-2 Delta VOC Spread So Rapidly? Universal Conditions for the Rapid Spread of Respiratory Viruses, Minimum Viral Loads for Viral Aerosol Generation, Effects of Vaccination on Viral Aerosol Generation, and Viral Aerosol Clouds
Int. J. Environ. Res. Public Health 2021, 18(18), 9804; https://doi.org/10.3390/ijerph18189804 - 17 Sep 2021
Cited by 21 | Viewed by 3933
Abstract
This study analyzes the reasons the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) Delta variant of concern (VOC) spreads so rapidly. Novel topics such as universal conditions for the rapid spread of respiratory viruses, minimum viral loads for viral aerosol generation, effects of [...] Read more.
This study analyzes the reasons the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) Delta variant of concern (VOC) spreads so rapidly. Novel topics such as universal conditions for the rapid spread of respiratory viruses, minimum viral loads for viral aerosol generation, effects of vaccination on viral aerosol generation, and viral aerosol clouds were studied. The analyses were based on experimental results and analytic model studies. Four universal conditions, namely asymptomatic host, high viral load, stability of viruses in air, and binding affinity of viruses to human cells, need to be satisfied for the rapid spread of respiratory viruses. SARS-CoV-2 and its variants such as the Alpha VOC and Delta VOC satisfy the four fundamental conditions. In addition, there is an original principle of aerosol generation of respiratory viruses. Assuming that the aerosol–droplet cutoff particle diameter for distinguishing potential aerosols from earthbound respiratory particles is 100 μm, the minimum viral load required in respiratory fluids to generate viral aerosols is ~106 copies mL−1, which is within the range of the reported viral loads in the Alpha VOC cases and the Delta VOC cases. The daily average viral loads of the Delta VOC in hosts have been reported to be between ~109 copies mL−1 and ~1010 copies mL−1 during the four days after symptom onset in 1848 cases of the Delta VOC infection. Owing to the high viral load, the SARS-CoV-2 Delta VOC has the potential to effectively spread through aerosols. COVID-19 vaccination can decrease aerosol transmission of the SARS-CoV-2 Alpha VOC by reducing the viral load. The viral load can explain the conundrum of viral aerosol spreading. The SARS-CoV-2 Delta VOC aerosol clouds have been assumed to be formed in restricted environments, resulting in a massive numbers of infected people in a very short period with a high spreading speed. Strong control methods against bioaerosols should be considered in this SARS-CoV-2 Delta VOC pandemic. Large-scale environmental monitoring campaigns of SARS-CoV-2 Delta VOC aerosols in public places in many countries are necessary, and these activities could contribute to controlling the coronavirus disease pandemic. Full article
(This article belongs to the Section Environmental Health)
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9 pages, 319 KiB  
Article
Effect of the COVID-19 Emergency on Physical Function among School-Aged Children
Int. J. Environ. Res. Public Health 2021, 18(18), 9620; https://doi.org/10.3390/ijerph18189620 - 13 Sep 2021
Cited by 15 | Viewed by 3506
Abstract
In April 2020, the Japanese government declared a state of emergency due to the novel coronavirus disease (COVID-19). Schools were closed and a stay-at-home order was issued in April and May 2020. This before-and-after study aimed to measure the effects of these COVID-19-related [...] Read more.
In April 2020, the Japanese government declared a state of emergency due to the novel coronavirus disease (COVID-19). Schools were closed and a stay-at-home order was issued in April and May 2020. This before-and-after study aimed to measure the effects of these COVID-19-related restrictions on physical function among Japanese children. The study included children aged 6–7 years, enrolled before and after the emergency declaration. Their body fat percentage, single-leg standing time, Gait Deviation Index score, and history of falls were compared. There were 56 and 54 children in the before and after groups, respectively. Children in the after group had a higher body fat percentage (p = 0.037), shorter single-leg standing time (p = 0.003), and a larger number of falls per month (p < 0.001) than those in the before group. In the logistic regression analysis, children in the after group had a significantly shorter single-leg standing time (odds ratio (OR): 0.985, 95% confidence interval (CI): 0.972−0.997, p = 0.013), a greater number of falls per month (OR: 1.899, 95% CI: 1.123−3.210, p = 0.017), and a higher body fat percentage (OR: 1.111, 95% CI: 1.016−1.215, p = 0.020) than those in the before group. The COVID-19 emergency restrictions had a negative effect on children’s physical function, especially on balance. Full article
(This article belongs to the Section Children's Health)
23 pages, 8912 KiB  
Article
The Driving Influence of Multi-Dimensional Urbanization on PM2.5 Concentrations in Africa: New Evidence from Multi-Source Remote Sensing Data, 2000–2018
Int. J. Environ. Res. Public Health 2021, 18(17), 9389; https://doi.org/10.3390/ijerph18179389 - 06 Sep 2021
Cited by 18 | Viewed by 2827
Abstract
Africa’s PM2.5 pollution has become a security hazard, but the understanding of the varying effects of urbanization on driven mechanisms of PM2.5 concentrations under the rapid urbanization remains largely insufficient. Compared with the direct impact, the spillover effect of urbanization on [...] Read more.
Africa’s PM2.5 pollution has become a security hazard, but the understanding of the varying effects of urbanization on driven mechanisms of PM2.5 concentrations under the rapid urbanization remains largely insufficient. Compared with the direct impact, the spillover effect of urbanization on PM2.5 concentrations in adjacent regions was underestimated. Urbanization is highly multi-dimensional phenomenon and previous studies have rarely distinguished the different driving influence and interactions of multi-dimensional urbanization on PM2.5 concentrations in Africa. This study combined grid and administrative units to explore the spatio-temporal change, spatial dependence patterns, and evolution trend of PM2.5 concentrations and multi-dimensional urbanization in Africa. The differential influence and interaction effects of multi-dimensional urbanization on PM2.5 concentrations under Africa’s rapid urbanization was further analyzed. The results show that the positive spatial dependence of PM2.5 concentrations gradually increased over the study period 2000–2018. The areas with PM2.5 concentrations exceeding 35 μg/m3 increased by 2.2%, and 36.78% of the African continent had an increasing trend in Theil–Sen index. Urbanization was found to be the main driving factor causing PM2.5 concentrations changes, and economic urbanization had a stronger influence on air quality than land urbanization or population urbanization. Compared with the direct effect, the spillover effect of urbanization on PM2.5 concentrations in two adjacent regions was stronger, particularly in terms of economic urbanization. The spatial distribution of PM2.5 concentrations resulted from the interaction of multi-dimensional urbanization. The interaction of urbanization of any two different dimensions exhibited a nonlinear enhancement effect on PM2.5 concentrations. Given the differential impact of multi-dimensional urbanization on PM2.5 concentrations inside and outside the region, this research provides support for the cross-regional joint control strategies of air pollution in Africa. The findings also indicate that PM2.5 pollution control should not only focus on urban economic development strategies but should be an optimized integration of multiple mitigation strategies, such as improving residents’ lifestyles, optimizing land spatial structure, and upgrading the industrial structure. Full article
(This article belongs to the Special Issue Air Pollution in Africa and the African Diaspora)
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14 pages, 817 KiB  
Article
School Teachers’ Self-Reported Fear and Risk Perception during the COVID-19 Pandemic—A Nationwide Survey in Germany
Int. J. Environ. Res. Public Health 2021, 18(17), 9218; https://doi.org/10.3390/ijerph18179218 - 01 Sep 2021
Cited by 18 | Viewed by 3494
Abstract
With the coronavirus disease 2019 (COVID-19) cases peaking and health systems reaching their limits in winter 2020/21, schools remained closed in many countries. To better understand teachers’ risk perception, we conducted a survey in Germany. Participants were recruited through various associations and invited [...] Read more.
With the coronavirus disease 2019 (COVID-19) cases peaking and health systems reaching their limits in winter 2020/21, schools remained closed in many countries. To better understand teachers’ risk perception, we conducted a survey in Germany. Participants were recruited through various associations and invited to take part in a cross-sectional COVID-19-specific online survey. Descriptive statistical analysis was performed. Factors associated with teachers’ fears of contracting the severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2) were evaluated with an adjusted multivariable regression analysis. The median age of the 6753 participating teachers was 43 years, and 77% were female. Most teachers worked in high schools (29%) and elementary schools (26%). The majority of participants (73%) feared contracting SARS-CoV-2 at school, while 77% intended to receive their COVID-19 vaccination. Ninety-eight percent considered students to pose the greatest risk. Female and younger teachers were significantly more anxious to get infected and teachers who opposed the re-opening of schools had significantly higher odds of being more anxious (p < 0.001). To the authors’ knowledge, this is the first study to describe teachers’ risk perception of COVID-19 and their attitudes towards vaccinations in a nationwide survey. The anxiety correlates with the COVID-19 protection measures demanded and appears to be a driving factor rather than rational logic. Full article
(This article belongs to the Collection Outbreak of a Novel Coronavirus: A Global Health Threat)
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8 pages, 321 KiB  
Review
Will Nothing Be the Same Again?: Changes in Lifestyle during COVID-19 Pandemic and Consequences on Mental Health
Int. J. Environ. Res. Public Health 2021, 18(16), 8433; https://doi.org/10.3390/ijerph18168433 - 10 Aug 2021
Cited by 90 | Viewed by 12751
Abstract
Social isolation caused by the COVID-19 pandemic has drastically affected lifestyles: from sedentary behaviors to reduced physical activity, from disrupted sleep patterns to altered dietary habits. As a consequence, serious mental and emotional responses have been registered. There was a significant decline in [...] Read more.
Social isolation caused by the COVID-19 pandemic has drastically affected lifestyles: from sedentary behaviors to reduced physical activity, from disrupted sleep patterns to altered dietary habits. As a consequence, serious mental and emotional responses have been registered. There was a significant decline in physical and other meaningful activities of daily living, leisure, social activity, and education. In children, collateral effects of the pandemic include inadequate nutrition with a risk of both overweight and underweight, addiction to screens, lack of schooling, and psychosocial difficulties. Older adults are frequently unable to adapt to lockdown measures and suffer from depression and cognitive complaints. Recent studies focusing on changes in lifestyle during the Covid-19 pandemic and consequences on mental health have been identified in PubMed/Medline, Scopus, Embase, and ScienceDirect. All the available literature has been retrospectively reviewed. The results of the present narrative review suggest that mental distress caused by social isolation seems to be linked not only to personality characteristics but also to several lifestyle components (sleep disruption, altered eating habits, reduced physical activity). This review aims to explore major changes in the lifestyle and quality of life and the impact of these changes on mental health, and to inform clinicians and policymakers about elements that may reduce the negative psychological effects of the quarantine period imposed during this worldwide crisis. There is an urgent need for tailored preventive, diagnostic, and therapeutic mental health interventions for the general population and for higher risk groups. Full article
16 pages, 2916 KiB  
Article
One-Year Lesson: Machine Learning Prediction of COVID-19 Positive Cases with Meteorological Data and Mobility Estimate in Japan
Int. J. Environ. Res. Public Health 2021, 18(11), 5736; https://doi.org/10.3390/ijerph18115736 - 27 May 2021
Cited by 22 | Viewed by 4662
Abstract
With the wide spread of COVID-19 and the corresponding negative impact on different life aspects, it becomes important to understand ways to deal with the pandemic as a part of daily routine. After a year of the COVID-19 pandemic, it has become obvious [...] Read more.
With the wide spread of COVID-19 and the corresponding negative impact on different life aspects, it becomes important to understand ways to deal with the pandemic as a part of daily routine. After a year of the COVID-19 pandemic, it has become obvious that different factors, including meteorological factors, influence the speed at which the disease is spread and the potential fatalities. However, the impact of each factor on the speed at which COVID-19 is spreading remains controversial. Accurate forecasting of potential positive cases may lead to better management of healthcare resources and provide guidelines for government policies in terms of the action required within an effective timeframe. Recently, Google Cloud has provided online COVID-19 forecasting data for the United States and Japan, which would help in predicting future situations on a state/prefecture scale and are updated on a day-by-day basis. In this study, we propose a deep learning architecture to predict the spread of COVID-19 considering various factors, such as meteorological data and public mobility estimates, and applied it to data collected in Japan to demonstrate its effectiveness. The proposed model was constructed using a neural network architecture based on a long short-term memory (LSTM) network. The model consists of multi-path LSTM layers that are trained using time-series meteorological data and public mobility data obtained from open-source data. The model was tested using different time frames, and the results were compared to Google Cloud forecasts. Public mobility is a dominant factor in estimating new positive cases, whereas meteorological data improve their accuracy. The average relative error of the proposed model ranged from 16.1% to 22.6% in major regions, which is a significant improvement compared with Google Cloud forecasting. This model can be used to provide public awareness regarding the morbidity risk of the COVID-19 pandemic in a feasible manner. Full article
(This article belongs to the Special Issue Deep Learning: AI Steps Up in Battle against COVID-19)
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19 pages, 434 KiB  
Review
Associations between Nature Exposure and Health: A Review of the Evidence
Int. J. Environ. Res. Public Health 2021, 18(9), 4790; https://doi.org/10.3390/ijerph18094790 - 30 Apr 2021
Cited by 138 | Viewed by 23366
Abstract
There is extensive empirical literature on the association between exposure to nature and health. In this narrative review, we discuss the strength of evidence from recent (i.e., the last decade) experimental and observational studies on nature exposure and health, highlighting research on children [...] Read more.
There is extensive empirical literature on the association between exposure to nature and health. In this narrative review, we discuss the strength of evidence from recent (i.e., the last decade) experimental and observational studies on nature exposure and health, highlighting research on children and youth where possible. We found evidence for associations between nature exposure and improved cognitive function, brain activity, blood pressure, mental health, physical activity, and sleep. Results from experimental studies provide evidence of protective effects of exposure to natural environments on mental health outcomes and cognitive function. Cross-sectional observational studies provide evidence of positive associations between nature exposure and increased levels of physical activity and decreased risk of cardiovascular disease, and longitudinal observational studies are beginning to assess long-term effects of nature exposure on depression, anxiety, cognitive function, and chronic disease. Limitations of current knowledge include inconsistent measures of exposure to nature, the impacts of the type and quality of green space, and health effects of duration and frequency of exposure. Future directions include incorporation of more rigorous study designs, investigation of the underlying mechanisms of the association between green space and health, advancement of exposure assessment, and evaluation of sensitive periods in the early life-course. Full article
(This article belongs to the Special Issue Greenspaces and Health: Measures and Methods)
12 pages, 630 KiB  
Article
Quality of Life Changes during the COVID-19 Pandemic for Caregivers of Children with ADHD and/or ASD
Int. J. Environ. Res. Public Health 2021, 18(7), 3667; https://doi.org/10.3390/ijerph18073667 - 01 Apr 2021
Cited by 38 | Viewed by 7161
Abstract
The COVID-19 pandemic has presented many challenges to caregivers of children. Families with children with attention-deficit/hyperactivity disorder (ADHD) and/or autism spectrum disorder (ASD) are an understudied but potentially vulnerable population to changes during the outbreak. As such, the aim of this study was [...] Read more.
The COVID-19 pandemic has presented many challenges to caregivers of children. Families with children with attention-deficit/hyperactivity disorder (ADHD) and/or autism spectrum disorder (ASD) are an understudied but potentially vulnerable population to changes during the outbreak. As such, the aim of this study was to contrast quality of life for caregivers of children with ADHD and/or ASD, before and during the pandemic, compared to caregivers of neurotypical (NT) children. Total, Parent Health-Related Quality of Life, and Family Functioning Summary Scores from the Family Impact Module of the Pediatric Quality of Life InventoryTM were contrasted among caregivers of children with ADHD, ASD, comorbid ADHD and ASD, and NT development. For all scores, caregivers of ADHD and/or ASD children reported lower quality of life, both before and during the pandemic, in comparison to caregivers of NT children. For all diagnoses, quality of life decreased during the pandemic, but caregivers of children with ADHD and/or ASD reported a greater decrease in quality of life than caregivers for NT children. There are limitations to this study in terms of the composition of the sample and the survey methodology, but we are able to conclude that caregivers of children with ADHD and/or ASD have been disproportionately affected by the pandemic, and it is imperative that these families receive additional resources and support to improve their quality of life. Full article
(This article belongs to the Section Children's Health)
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23 pages, 928 KiB  
Review
Green Gentrification and Health: A Scoping Review
Int. J. Environ. Res. Public Health 2021, 18(3), 907; https://doi.org/10.3390/ijerph18030907 - 21 Jan 2021
Cited by 55 | Viewed by 16595
Abstract
Urban greening initiatives are often linked to enhanced human health and wellbeing, but they can also be a driver of gentrification. To date, few studies have focused on how green gentrification shapes health. In this scoping review, we analyzed existing peer-reviewed research on [...] Read more.
Urban greening initiatives are often linked to enhanced human health and wellbeing, but they can also be a driver of gentrification. To date, few studies have focused on how green gentrification shapes health. In this scoping review, we analyzed existing peer-reviewed research on how greening initiatives in gentrifying neighborhoods impact health, well-being, and health pathways (e.g., physical activity, affordable housing). Using a multi-step approach to scoping the literature (including searches in PubMed, JSTOR, and Google Scholar), we identified 15 empirical studies that met our inclusion criteria. We found studies focusing on green space use, physical activity, sense of community, safety, and self-reported health. Overall, longtime, marginalized residents are negatively impacted by green gentrification as they experience a lower sense of community, feel that they do not belong in green space, and, in many studies, use green space less often than newcomers. Overall, the research in this area is limited, and more studies on mental health and cardiovascular health markers could advance this literature. Based on the limited available evidence, we suggest that public health, urban planning, and parks professionals could collaborate to enhance the use of green space for marginalized residents and their feelings of inclusion in gentrifying areas. Full article
(This article belongs to the Special Issue Environmental Health: Feature Review Papers)
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16 pages, 569 KiB  
Review
Psychological Wellbeing in Physical Education and School Sports: A Systematic Review
Int. J. Environ. Res. Public Health 2021, 18(3), 864; https://doi.org/10.3390/ijerph18030864 - 20 Jan 2021
Cited by 35 | Viewed by 10198
Abstract
Mental health in children and adolescents has become an increasingly important topic in recent years. It is against this backdrop that physical education and school sports play an important role in promoting psychological wellbeing. The aim of this review was to analyse interventions [...] Read more.
Mental health in children and adolescents has become an increasingly important topic in recent years. It is against this backdrop that physical education and school sports play an important role in promoting psychological wellbeing. The aim of this review was to analyse interventions for improving psychological wellbeing in this area. To this end, a literature review was conducted using four databases (WOS, SPORTDiscus, SCOPUS and ERIC) and the following keywords: psychological wellbeing, physical education, and school sports. Twenty-one articles met the inclusion criteria. The results showed that interventions varied greatly in terms of duration and used a wide range of strategies (conventional and non-conventional sports, physical activity, games, etc.) for promoting psychological wellbeing, primarily among secondary school students. There was a lack of consensus as to the conceptualisation of the construct of psychological wellbeing, resulting in a variety of tools and methods for assessing it. Some studies also suggested a link between psychological wellbeing and other variables, such as basic psychological needs and self-determination. Finally, this study provides a definition of psychological wellbeing through physical activity based on our findings. Full article
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24 pages, 2271 KiB  
Review
Indoor Exposure to Selected Air Pollutants in the Home Environment: A Systematic Review
Int. J. Environ. Res. Public Health 2020, 17(23), 8972; https://doi.org/10.3390/ijerph17238972 - 02 Dec 2020
Cited by 187 | Viewed by 16811
Abstract
(1) Background: There is increasing awareness that the quality of the indoor environment affects our health and well-being. Indoor air quality (IAQ) in particular has an impact on multiple health outcomes, including respiratory and cardiovascular illness, allergic symptoms, cancers, and premature mortality. (2) [...] Read more.
(1) Background: There is increasing awareness that the quality of the indoor environment affects our health and well-being. Indoor air quality (IAQ) in particular has an impact on multiple health outcomes, including respiratory and cardiovascular illness, allergic symptoms, cancers, and premature mortality. (2) Methods: We carried out a global systematic literature review on indoor exposure to selected air pollutants associated with adverse health effects, and related household characteristics, seasonal influences and occupancy patterns. We screened records from six bibliographic databases: ABI/INFORM, Environment Abstracts, Pollution Abstracts, PubMed, ProQuest Biological and Health Professional, and Scopus. (3) Results: Information on indoor exposure levels and determinants, emission sources, and associated health effects was extracted from 141 studies from 29 countries. The most-studied pollutants were particulate matter (PM2.5 and PM10); nitrogen dioxide (NO2); volatile organic compounds (VOCs) including benzene, toluene, xylenes and formaldehyde; and polycyclic aromatic hydrocarbons (PAHs) including naphthalene. Identified indoor PM2.5 sources include smoking, cooking, heating, use of incense, candles, and insecticides, while cleaning, housework, presence of pets and movement of people were the main sources of coarse particles. Outdoor air is a major PM2.5 source in rooms with natural ventilation in roadside households. Major sources of NO2 indoors are unvented gas heaters and cookers. Predictors of indoor NO2 are ventilation, season, and outdoor NO2 levels. VOCs are emitted from a wide range of indoor and outdoor sources, including smoking, solvent use, renovations, and household products. Formaldehyde levels are higher in newer houses and in the presence of new furniture, while PAH levels are higher in smoking households. High indoor particulate matter, NO2 and VOC levels were typically associated with respiratory symptoms, particularly asthma symptoms in children. (4) Conclusions: Household characteristics and occupant activities play a large role in indoor exposure, particularly cigarette smoking for PM2.5, gas appliances for NO2, and household products for VOCs and PAHs. Home location near high-traffic-density roads, redecoration, and small house size contribute to high indoor air pollution. In most studies, air exchange rates are negatively associated with indoor air pollution. These findings can inform interventions aiming to improve IAQ in residential properties in a variety of settings. Full article
(This article belongs to the Special Issue Designing Healthy Indoor Air Quality)
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20 pages, 1075 KiB  
Article
Updating the Mediterranean Diet Pyramid towards Sustainability: Focus on Environmental Concerns
Int. J. Environ. Res. Public Health 2020, 17(23), 8758; https://doi.org/10.3390/ijerph17238758 - 25 Nov 2020
Cited by 156 | Viewed by 23546
Abstract
Background: Nowadays the food production, supply and consumption chain represent a major cause of ecological pressure on the natural environment, and diet links worldwide human health with environmental sustainability. Food policy, dietary guidelines and food security strategies need to evolve from the limited [...] Read more.
Background: Nowadays the food production, supply and consumption chain represent a major cause of ecological pressure on the natural environment, and diet links worldwide human health with environmental sustainability. Food policy, dietary guidelines and food security strategies need to evolve from the limited historical approach, mainly focused on nutrients and health, to a new one considering the environmental, socio-economic and cultural impact—and thus the sustainability—of diets. Objective: To present an updated version of the Mediterranean Diet Pyramid (MDP) to reflect multiple environmental concerns. Methods: We performed a revision and restructuring of the MDP to incorporate more recent findings on the sustainability and environmental impact of the Mediterranean Diet pattern, as well as its associations with nutrition and health. For each level of the MDP we provided a third dimension featuring the corresponding environmental aspects related to it. Conclusions: The new environmental dimension of the MDP enhances food intake recommendations addressing both health and environmental issues. Compared to the previous 2011 version, it emphasizes more strongly a lower consumption of red meat and bovine dairy products, and a higher consumption of legumes and locally grown eco-friendly plant foods as much as possible. Full article
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12 pages, 2000 KiB  
Article
Severe Housing Insecurity during Pregnancy: Association with Adverse Birth and Infant Outcomes
Int. J. Environ. Res. Public Health 2020, 17(22), 8659; https://doi.org/10.3390/ijerph17228659 - 21 Nov 2020
Cited by 30 | Viewed by 6607
Abstract
Introduction: Housing insecurity is increasingly commonplace among disadvantaged women and children. We measured the individual- and population-level impact of severe housing insecurity during pregnancy on adverse birth and infant outcomes. Methods: We analyzed data from 3428 mother–infant dyads enrolled in the Fragile Families [...] Read more.
Introduction: Housing insecurity is increasingly commonplace among disadvantaged women and children. We measured the individual- and population-level impact of severe housing insecurity during pregnancy on adverse birth and infant outcomes. Methods: We analyzed data from 3428 mother–infant dyads enrolled in the Fragile Families and Child Wellbeing Study, a prospective cohort study representing births in 20 large U.S. cities from 1998 to 2000. Severe housing insecurity was defined as threatened eviction or homelessness during pregnancy. Outcomes included low birth weight and/or preterm birth, admission to a neonatal intensive care unit (NICU) or stepdown facility, extended hospitalization after delivery, and infant health and temperament. We estimated exposure–outcome associations with risk ratios adjusted for pre-pregnancy maternal sociodemographic and heath factors and calculated a population attributable fraction (PAF) of outcomes attributable to severe housing insecurity. Results: We found statistically significant associations between severe housing insecurity during pregnancy and low birth weight and/or preterm birth (risk ratio (RR] 1.73, 95% confidence interval (CI) 1.28, 2.32), NICU or stepdown stay (RR 1.64, CI 1.17, 2.31), and extended hospitalization (RR 1.66, CI 1.28, 2.16). Associations between housing insecurity and infant fair or poor health (RR 2.62, CI 0.91, 7.48) and poor temperament (RR 1.52, CI 0.98, 2.34) were not statistically significant. PAF estimates ranged from 0.9–2.7%, suggesting that up to three percent of adverse birth and infant outcomes could be avoided by eliminating severe housing insecurity among low-income, pregnant women in US cities. Conclusions: Results suggest that housing insecurity during pregnancy shapes neonatal and infant health in disadvantaged urban families. Full article
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18 pages, 7611 KiB  
Article
Facing a Second Wave from a Regional View: Spatial Patterns of COVID-19 as a Key Determinant for Public Health and Geoprevention Plans
Int. J. Environ. Res. Public Health 2020, 17(22), 8468; https://doi.org/10.3390/ijerph17228468 - 16 Nov 2020
Cited by 21 | Viewed by 4182
Abstract
Several studies on spatial patterns of COVID-19 show huge differences depending on the country or region under study, although there is some agreement that socioeconomic factors affect these phenomena. The aim of this paper is to increase the knowledge of the socio-spatial behavior [...] Read more.
Several studies on spatial patterns of COVID-19 show huge differences depending on the country or region under study, although there is some agreement that socioeconomic factors affect these phenomena. The aim of this paper is to increase the knowledge of the socio-spatial behavior of coronavirus and implementing a geospatial methodology and digital system called SITAR (Fast Action Territorial Information System, by its Spanish acronym). We analyze as a study case a region of Spain called Cantabria, geocoding a daily series of microdata coronavirus records provided by the health authorities (Government of Cantabria—Spain) with the permission of Medicines Ethics Committee from Cantabria (CEIm, June 2020). Geocoding allows us to provide a new point layer based on the microdata table that includes cases with a positive result in a COVID-19 test. Regarding general methodology, our research is based on Geographical Information Technologies using Environmental Systems Research Institute (ESRI) Technologies. This tool is a global reference for spatial COVID-19 research, probably due to the world-renowned COVID-19 dashboard implemented by the Johns Hopkins University team. In our analysis, we found that the spatial distribution of COVID-19 in urban locations presents a not random distribution with clustered patterns and density matters in the spread of the COVID-19 pandemic. As a result, large metropolitan areas or districts with a higher number of persons tightly linked together through economic, social, and commuting relationships are the most vulnerable to pandemic outbreaks, particularly in our case study. Furthermore, public health and geoprevention plans should avoid the idea of economic or territorial stigmatizations. We hold the idea that SITAR in particular and Geographic Information Technologies in general contribute to strategic spatial information and relevant results with a necessary multi-scalar perspective to control the pandemic. Full article
(This article belongs to the Section Public Health Statistics and Risk Assessment)
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15 pages, 350 KiB  
Article
Vaccine Hesitancy in the Age of Coronavirus and Fake News: Analysis of Journalistic Sources in the Spanish Quality Press
Int. J. Environ. Res. Public Health 2020, 17(21), 8136; https://doi.org/10.3390/ijerph17218136 - 04 Nov 2020
Cited by 40 | Viewed by 6870
Abstract
The study of the quality press and the use of sources is relevant to understand the role of journalists in scientific controversies. The objective was to examine media sourcing patterns, using the case of vaccines as a backdrop. Articles were retrieved from the [...] Read more.
The study of the quality press and the use of sources is relevant to understand the role of journalists in scientific controversies. The objective was to examine media sourcing patterns, using the case of vaccines as a backdrop. Articles were retrieved from the national quality press in Spain. Content analysis was undertaken on the sources and on other variables such as tone, frames and journalistic genre. The software myNews and NVivo were used for data collection and coding, while SPSS and Excel were used for statistical analysis. Findings indicate that sources related to the government, professional associations and scientific companies are the most frequently used, confirming the central role of government institutions as journalistic sources. These were followed by university scientists, scientific journals and clinicians. On the other hand, NGOs and patients groups were included in fewer than 5% of the articles. More than 30% included none or just one source expressing unbalanced perspectives. Frequent use of certain source types, particularly governmental, may indicate state structures of power. The study provides a better understanding of journalistic routines in the coverage of vaccines, including fresh perspectives in the current COVID-19 pandemic. Full article
(This article belongs to the Collection Mass Communication, Digital Media, and Public Health)
11 pages, 281 KiB  
Review
Consideration of the Psychological and Mental Health of the Elderly during COVID-19: A Theoretical Review
Int. J. Environ. Res. Public Health 2020, 17(21), 8098; https://doi.org/10.3390/ijerph17218098 - 03 Nov 2020
Cited by 85 | Viewed by 20841
Abstract
COVID-19 has spread worldwide causing an unprecedented public health crisis. After the World Health Organization declared a pandemic in March 2020, the number of confirmed cases and deaths has continued to increase. This situation may be prolonged until an effective, tested, and safe [...] Read more.
COVID-19 has spread worldwide causing an unprecedented public health crisis. After the World Health Organization declared a pandemic in March 2020, the number of confirmed cases and deaths has continued to increase. This situation may be prolonged until an effective, tested, and safe treatment is available. COVID-19 can occur at any age. However, the maximum confirmed cases and deaths have occurred among the elderly. Particularly, the mental and physical health of the elderly aged above 60 and classified as high-risk groups is more vulnerable than other age groups, requiring more attention. Strong social restraint, social distancing, and quarantine measures to prevent the COVID-19 spread have raised concerns about their mental health. Therefore, it is crucial to analyze and identify the psychological concepts and protective factors that support and constitute these guidelines and strategies and prepare practical suggestions and guidelines to protect the mental health of the elderly during COVID-19. These discussions will facilitate a deeper understanding and expansion of these guidelines and strategies. Therefore, this study explores factors—including pandemic-induced stress, self-integration, self-efficacy, and resilience—in order to prepare practical and detailed suggestions and guidelines using studies that considered these factors, including coping with COVID-19-induced stress, social support, and physical activity. Full article
(This article belongs to the Section Mental Health)
45 pages, 5305 KiB  
Review
PFAS Environmental Pollution and Antioxidant Responses: An Overview of the Impact on Human Field
Int. J. Environ. Res. Public Health 2020, 17(21), 8020; https://doi.org/10.3390/ijerph17218020 - 30 Oct 2020
Cited by 59 | Viewed by 10358
Abstract
Due to their unique properties, perfluorinated substances (PFAS) are widely used in multiple industrial and commercial applications, but they are toxic for animals, humans included. This review presents some available data on the PFAS environmental distribution in the world, and in particular in [...] Read more.
Due to their unique properties, perfluorinated substances (PFAS) are widely used in multiple industrial and commercial applications, but they are toxic for animals, humans included. This review presents some available data on the PFAS environmental distribution in the world, and in particular in Europe and in the Veneto region of Italy, where it has become a serious problem for human health. The consumption of contaminated food and drinking water is considered one of the major source of exposure for humans. Worldwide epidemiological studies report the negative effects that PFAS have on human health, due to environmental pollution, including infertility, steroid hormone perturbation, thyroid, liver and kidney disorders, and metabolic disfunctions. In vitro and in vivo researches correlated PFAS exposure to oxidative stress effects (in mammals as well as in other vertebrates of human interest), produced by a PFAS-induced increase of reactive oxygen species formation. The cellular antioxidant defense system is activated by PFAS, but it is only partially able to avoid the oxidative damage to biomolecules. Full article
(This article belongs to the Special Issue Environmental Pollution and Oxidative Status)
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24 pages, 361 KiB  
Article
The Use of New Digital Information and Communication Technologies in Psychological Counseling during the COVID-19 Pandemic
Int. J. Environ. Res. Public Health 2020, 17(20), 7663; https://doi.org/10.3390/ijerph17207663 - 21 Oct 2020
Cited by 46 | Viewed by 8939
Abstract
The use of digital information and communication technologies (ICTs) has enabled many professionals to continue to provide their services during the COVID-19 pandemic. However, little is known about the adoption of ICTs by psychologists and the impact of such technologies on their practice. [...] Read more.
The use of digital information and communication technologies (ICTs) has enabled many professionals to continue to provide their services during the COVID-19 pandemic. However, little is known about the adoption of ICTs by psychologists and the impact of such technologies on their practice. This study aimed to explore psychologists’ practices related with the use of ICTs before and during the COVID-19 lockdown, to identify the main changes that the pandemic has brought and the impact that such changes have had on their practice with clients, and also identify the factors that potentially have affected such changes. The Portuguese Psychologists Association announced the study, and 108 psychologists responded to an online survey during the mandatory lockdown. The results showed that these professionals continued to provide their services due to having adopted ICTs. Comparing with face-to-face interventions, psychologists recognized that additional precautions/knowledge were needed to use such technologies. Despite the challenges identified, they described the experience with the use of ICTs as positive, meeting clients’ adherence, and yielding positive results. Psychologists with the most years of professional experience maintained their services the most, but those with average experience showed the most favorable attitudes toward the use of technologies and web-based interventions. Full article
13 pages, 338 KiB  
Article
Interference and Impact of Dysmenorrhea on the Life of Spanish Nursing Students
Int. J. Environ. Res. Public Health 2020, 17(18), 6473; https://doi.org/10.3390/ijerph17186473 - 05 Sep 2020
Cited by 15 | Viewed by 3678
Abstract
  1. Dysmenorrhea is a cause of absenteeism in universities which, in the context of nursing studies, may affect mandatory attendance. Moreover, presenteeism is associated with medication errors, patient falls, and a reduced quality of patient care. This study sought to identify the degree of
[...] Read more.
  1. Dysmenorrhea is a cause of absenteeism in universities which, in the context of nursing studies, may affect mandatory attendance. Moreover, presenteeism is associated with medication errors, patient falls, and a reduced quality of patient care. This study sought to identify the degree of interference of dysmenorrhea on daily life and its impact on academic performance among Spanish nursing students, and to explore the reasons for presenteeism. A cross-sectional descriptive study was conducted on 261 nursing students. Data were collected using a self-administered questionnaire. The chi square tests, chi-square linear trend, Student’s t-test, one-way analysis of variance of polynomial contrasts, and post hoc tests for the bi-variate analysis were used to compare the participants’ responses regarding their type of dysmenorrhea and pain intensity. In addition, a multivariate regression was performed to predict absenteeism. The answers to the open questions were analyzed using thematic content analysis techniques. We observed 62.8% of absenteeism and 92.7% of presenteeism due to dysmenorrhea. Absenteeism was observed to be 3.079 (confidence interval (CI): 95%1.724–5.499; p < 0.001) times more likely among women with severe menstrual pain, 2.513 (CI 95%1.314–4.807; p = 0.005) times more in those suffering from menstrual nausea and 1.936 (CI 95%1.098–3.411; p = 0.022) times more frequent in those suffering from diarrhea. The reasons for presenteeism were grouped into five categories: the pain was bearable, it is not a reason to be absent, others don’t consider it a reason to be absent, responsibility and guilt, and academic consequences. Dysmenorrhea can have a significant impact on academic performance. The concern among students about the academic repercussions and even feelings of guilt and incomprehension from others leads to high rates of presenteeism with potentially negative consequences for patient care.
Full article
(This article belongs to the Special Issue Assessment of Health-Related Quality of Life (HRQoL) in Public Health)
29 pages, 772 KiB  
Review
Stigma and Discrimination (SAD) at the Time of the SARS-CoV-2 Pandemic
Int. J. Environ. Res. Public Health 2020, 17(17), 6341; https://doi.org/10.3390/ijerph17176341 - 31 Aug 2020
Cited by 97 | Viewed by 10699
Abstract
Infectious disease control is a crucial public health issue. Although it is important to urgently perform public health measures in order to reduce the risk of spread, it could end up stigmatizing entire groups of people rather than offering control measures based on [...] Read more.
Infectious disease control is a crucial public health issue. Although it is important to urgently perform public health measures in order to reduce the risk of spread, it could end up stigmatizing entire groups of people rather than offering control measures based on sound scientific principles. This “us” versus “them” dynamic is common in stigmatization, in general, and indicates a way in which disease stigma can be viewed as a proxy for other types of fears, especially xenophobia and general fear of outsiders. The pandemic risk associated with SARS-CoV-2 infection led us to consider, among other related issues, how stigma and discrimination remain serious barriers to care for people suspected of being infected, even more if they are assisting professions, such as health workers, employed in emergency response. The purpose of this review is to evaluate and promote the importance of psychological aspects of the stigma and social discrimination (SAD) in pandemic realities and, more specifically, nowadays, in the context of SARS-CoV-2/COVID-19. Just as it happened with HIV, HCV, tuberculosis, and Zika, stigma and discrimination undermine the social fabric compromising the ethics and principles of civilization to which each individual in entitled. Recognizing disease stigma history can give us insight into how, exactly, stigmatizing attitudes are formed, and how they are disbanded. Instead of simply blaming the ignorance of people espousing stigmatizing attitudes about certain diseases, we should try to understand precisely how these attitudes are formed so that we can intervene in their dissemination. We should also look at history to see what sorts of interventions against stigma may have worked in the past. Ongoing research into stigma should evaluate what has worked in the past, as above-mentioned, providing us with some clues as to what might work in the current pandemic emergency, to reduce devastating discrimination that keeps people from getting the care they need. We propose a systematic and historical review, in order to create a scientific and solid base for the following SAD analysis. The aim is to propose a coping strategy to face stigma and discrimination (SAD) related to SARS-CoV-2/COVID-19 pandemic outbreak, borrowing coping strategy tools and solutions from other common contagious diseases. Furthermore, our study observes how knowledge, education level, and socioeconomic status (SES) can influence perception of SARS-CoV-2/ COVID-19 risk in a digital world, based on previous research, best practices, and evidence-based research. Full article
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14 pages, 355 KiB  
Review
Key Guidelines in Developing a Pre-Emptive COVID-19 Vaccination Uptake Promotion Strategy
Int. J. Environ. Res. Public Health 2020, 17(16), 5893; https://doi.org/10.3390/ijerph17165893 - 13 Aug 2020
Cited by 129 | Viewed by 28760
Abstract
This paper makes the case for immediate planning for a COVID-19 vaccination uptake strategy in advance of vaccine availability for two reasons: first, the need to build a consensus about the order in which groups of the population will get access to the [...] Read more.
This paper makes the case for immediate planning for a COVID-19 vaccination uptake strategy in advance of vaccine availability for two reasons: first, the need to build a consensus about the order in which groups of the population will get access to the vaccine; second, to reduce any fear and concerns that exist in relation to vaccination and to create demand for vaccines. A key part of this strategy is to counter the anti-vaccination movement that is already promoting hesitancy and resistance. Since the beginning of the COVID-19 pandemic there has been a tsunami of misinformation and conspiracy theories that have the potential to reduce vaccine uptake. To make matters worse, sections of populations in many countries display low trust in governments and official information about the pandemic and how the officials are tackling it. This paper aims to set out in short form critical guidelines that governments and regional bodies should take to enhance the impact of a COVID-19 vaccination strategy. We base our recommendations on a review of existing best practice guidance. This paper aims to assist those responsible for promoting COVID-19 vaccine uptake to digest the mass of guidance that exists and formulate an effective locally relevant strategy. A summary of key guidelines is presented based on best practice guidance. Full article
(This article belongs to the Section Health Communication and Informatics)
17 pages, 623 KiB  
Review
Secular Trends in Physical Fitness of Children and Adolescents: A Review of Large-Scale Epidemiological Studies Published after 2006
Int. J. Environ. Res. Public Health 2020, 17(16), 5671; https://doi.org/10.3390/ijerph17165671 - 05 Aug 2020
Cited by 46 | Viewed by 3843
Abstract
Physical fitness (PF) of children and adolescents is an important resource for their future health. Population-based studies, however, rarely report secular changes of PF, although monitoring of these is crucial to deriving information for adequate interventions. This review aims to report trends in [...] Read more.
Physical fitness (PF) of children and adolescents is an important resource for their future health. Population-based studies, however, rarely report secular changes of PF, although monitoring of these is crucial to deriving information for adequate interventions. This review aims to report trends in PF of children and adolescents. A literature search was conducted in PubMed in July 2019. Cohort studies published in English allowing statements to be made on trends in PF by comparing youth between the ages of four and 18 years were included. The review identified 24 studies from 16 countries meeting the inclusion criteria, with an overall sample size of more than 860,000 children and adolescents. Through a standardized quality assessment tool, we classified two studies as strong, 21 as moderate, and only one as weak. We analyzed specific secular trends separately for the five different dimensions: endurance, strength, speed, flexibility, and coordination. The majority of studies report a decline of PF over time; however, a few studies report conflicting results. Performance in endurance, strength, and flexibility decreased over time, whereas there was no consistent trend reported for speed and coordination. Overall, there is no international standard on examining and reporting changes or secular trends in PF of children and adolescents, and comparability of studies is limited due to heterogeneous conditions of conducting and analyzing PF tests. Consequently, standardized and consistent international monitoring should be implemented. Full article
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20 pages, 2492 KiB  
Article
BCG Vaccination and Mortality of COVID-19 across 173 Countries: An Ecological Study
Int. J. Environ. Res. Public Health 2020, 17(15), 5589; https://doi.org/10.3390/ijerph17155589 - 03 Aug 2020
Cited by 39 | Viewed by 13130
Abstract
Ecological studies have suggested fewer COVID-19 morbidities and mortalities in Bacillus Calmette–Guérin (BCG)-vaccinated countries than BCG-non-vaccinated countries. However, these studies obtained data during the early phase of the pandemic and did not adjust for potential confounders, including PCR-test numbers per population (PCR-tests). Currently—more [...] Read more.
Ecological studies have suggested fewer COVID-19 morbidities and mortalities in Bacillus Calmette–Guérin (BCG)-vaccinated countries than BCG-non-vaccinated countries. However, these studies obtained data during the early phase of the pandemic and did not adjust for potential confounders, including PCR-test numbers per population (PCR-tests). Currently—more than four months after declaration of the pandemic—the BCG-hypothesis needs reexamining. An ecological study was conducted by obtaining data of 61 factors in 173 countries, including BCG vaccine coverage (%), using morbidity and mortality as outcomes, obtained from open resources. ‘Urban population (%)’ and ‘insufficient physical activity (%)’ in each country was positively associated with morbidity, but not mortality, after adjustment for PCR-tests. On the other hand, recent BCG vaccine coverage (%) was negatively associated with mortality, but not morbidity, even with adjustment for percentage of the population ≥ 60 years of age, morbidity, PCR-tests and other factors. The results of this study generated a hypothesis that a national BCG vaccination program seems to be associated with reduced mortality of COVID-19, although this needs to be further examined and proved by randomized clinical trials. Full article
(This article belongs to the Special Issue COVID-19: Prevention, Diagnosis, Therapy and Follow Up)
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13 pages, 1526 KiB  
Article
Genome-Wide DNA Methylation Profiles in Community Members Exposed to the World Trade Center Disaster
Int. J. Environ. Res. Public Health 2020, 17(15), 5493; https://doi.org/10.3390/ijerph17155493 - 30 Jul 2020
Cited by 13 | Viewed by 3209
Abstract
The primary goal of this pilot study was to assess feasibility of studies among local community members to address the hypothesis that complex exposures to the World Trade Center (WTC) dust and fumes resulted in long-term epigenetic changes. We enrolled 18 WTC-exposed cancer-free [...] Read more.
The primary goal of this pilot study was to assess feasibility of studies among local community members to address the hypothesis that complex exposures to the World Trade Center (WTC) dust and fumes resulted in long-term epigenetic changes. We enrolled 18 WTC-exposed cancer-free women from the WTC Environmental Health Center (WTC EHC) who agreed to donate blood samples during their standard clinical visits. As a reference WTC unexposed group, we randomly selected 24 age-matched cancer-free women from an existing prospective cohort who donated blood samples before 11 September 2001. The global DNA methylation analyses were performed using Illumina Infinium MethylationEpic arrays. Statistical analyses were performed using R Bioconductor package. Functional genomic analyses were done by mapping the top 5000 differentially expressed CpG sites to the Kyoto Encyclopedia of Genes and Genomes (KEGG) Pathway database. Among cancer-free subjects, we observed substantial methylation differences between WTC-exposed and unexposed women. The top 15 differentially methylated gene probes included BCAS2, OSGIN1, BMI1, EEF1A2, SPTBN5, CHD8, CDCA7L, AIDA, DDN, SNORD45C, ZFAND6, ARHGEF7, UBXN8, USF1, and USP12. Several cancer-related pathways were enriched in the WTC-exposed subjects, including endocytosis, mitogen-activated protein kinase (MAPK), viral carcinogenesis, as well as Ras-associated protein-1 (Rap1) and mammalian target of rapamycin (mTOR) signaling. The study provides preliminary data on substantial differences in DNA methylation between WTC-exposed and unexposed populations that require validation in further studies. Full article
(This article belongs to the Special Issue Environmental Factors, Epigenetics, and Cancer)
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22 pages, 3568 KiB  
Review
Air Pollution and COVID-19: The Role of Particulate Matter in the Spread and Increase of COVID-19’s Morbidity and Mortality
Int. J. Environ. Res. Public Health 2020, 17(12), 4487; https://doi.org/10.3390/ijerph17124487 - 22 Jun 2020
Cited by 284 | Viewed by 20889
Abstract
Sars-Cov-2 virus (COVID-19) is a member of the coronavirus family and is responsible for the pandemic recently declared by the World Health Organization. A positive correlation has been observed between the spread of the virus and air pollution, one of the greatest challenges [...] Read more.
Sars-Cov-2 virus (COVID-19) is a member of the coronavirus family and is responsible for the pandemic recently declared by the World Health Organization. A positive correlation has been observed between the spread of the virus and air pollution, one of the greatest challenges of our millennium. COVID-19 could have an air transmission and atmospheric particulate matter (PM) could create a suitable environment for transporting the virus at greater distances than those considered for close contact. Moreover, PM induces inflammation in lung cells and exposure to PM could increase the susceptibility and severity of the COVID-19 patient symptoms. The new coronavirus has been shown to trigger an inflammatory storm that would be sustained in the case of pre-exposure to polluting agents. In this review, we highlight the potential role of PM in the spread of COVID-19, focusing on Italian cities whose PM daily concentrations were found to be higher than the annual average allowed during the months preceding the epidemic. Furthermore, we analyze the positive correlation between the virus spread, PM, and angiotensin-converting enzyme 2 (ACE2), a receptor involved in the entry of the virus into pulmonary cells and inflammation. Full article
(This article belongs to the Section Environmental Health)
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14 pages, 361 KiB  
Article
Bone Mineral Density of Femur and Lumbar and the Relation between Fat Mass and Lean Mass of Adolescents: Based on Korea National Health and Nutrition Examination Survey (KNHNES) from 2008 to 2011
Int. J. Environ. Res. Public Health 2020, 17(12), 4471; https://doi.org/10.3390/ijerph17124471 - 22 Jun 2020
Cited by 12 | Viewed by 3026
Abstract
It is most important to reach the maximum bone density in the childhood period to prevent developing osteoporosis; it is widely known that increased body weight has a positive correlation with bone density and that even though both the fat mass and lean [...] Read more.
It is most important to reach the maximum bone density in the childhood period to prevent developing osteoporosis; it is widely known that increased body weight has a positive correlation with bone density and that even though both the fat mass and lean mass have a significant impact on bone density, the latter mass has more importance for adults. Therefore, the study analyzed to identify the relationship between bone density and both fat mass and lean mass of Korean adolescents. Subjects were chosen among 21,303 people from the Korea National Health and Nutrition Examination Survey (KNHNES) between 2008 and 2011 that took a bone density checkup; as a result, 1454 teenagers aged between 12 and 18 were selected. Data analysis was performed in SAS ver. 9.4 (SAS Institute Inc., Cary, NC, USA) following the KNHNES and the weighted complex sample analysis was conducted; body fat mass and lean mass were divided into quintile groups, and to figure out the differences in bone density that were analyzed in six models adjusted by body weight (kg) and walking (yes/no), muscle strengthening exercises (yes/no), nutrition (intake of ca (g), and serum vitamin D (ng/mL)). Then, the generalized linear model (GLM) and trend test were conducted for each gender with a significance level of 0.05. The bone density differences of fat mass and lean mass were analyzed. The result of Model 6 considering all correction variables is as follows; in the case of male adolescents, the total femur and lumbar spine showed a significant difference (F = 13.120, p < 0.001; F = 12.900, p < 0.001) for fat mass, and the trend test showed that the figures significantly decreased (β = −0.030, p < 0.001; −0.035, p < 0.001). Meanwhile, for lean mass, the total femur and lumbar spine had a significant difference (F = 16.740, p < 0.001; F = 20.590, p < 0.001) too, but the trend test showed a significant increase (β = 0.054, p < 0.001; 0.057, p < 0.001). In the case of female adolescents, the lumbar spine (F = 3.600, p < 0.05) for lean mass showed a significant difference, and it also significantly rose in the trend test too (β = 0.020, p < 0.01). To sum up the results, for male adolescents, the bone density differences for fat mass (FM) and lean mass (LM) all had significant differences, but for female adolescents, only the lumbar spine for LM showed such a result. Meanwhile, both genders showed that LM had a more positive impact on bone density than FM. Full article
(This article belongs to the Special Issue Big Data, Decision Models, and Public Health)
14 pages, 370 KiB  
Review
The Need for the Right Socio-Economic and Cultural Fit in the COVID-19 Response in Sub-Saharan Africa: Examining Demographic, Economic Political, Health, and Socio-Cultural Differentials in COVID-19 Morbidity and Mortality
Int. J. Environ. Res. Public Health 2020, 17(10), 3445; https://doi.org/10.3390/ijerph17103445 - 15 May 2020
Cited by 62 | Viewed by 11436
Abstract
The coronavirus disease (COVID-19) has spread quickly across the globe with devastating effects on the global economy as well as the regional and societies’ socio-economic fabrics and the way of life for vast populations. The nonhomogeneous continent faces local contextual complexities that require [...] Read more.
The coronavirus disease (COVID-19) has spread quickly across the globe with devastating effects on the global economy as well as the regional and societies’ socio-economic fabrics and the way of life for vast populations. The nonhomogeneous continent faces local contextual complexities that require locally relevant and culturally appropriate COVID-19 interventions. This paper examines demographic, economic, political, health, and socio-cultural differentials in COVID-19 morbidity and mortality. The health systems need to be strengthened through extending the health workforce by mobilizing and engaging the diaspora, and implementing the International Health Regulations (2005) core capacities. In the absence of adequate social protection and welfare programs targeting the poor during the pandemic, sub-Saharan African countries need to put in place flexible but effective policies and legislation approaches that harness and formalise the informal trade and remove supply chain barriers. This could include strengthening cross-border trade facilities such as adequate pro-poor, gender-sensitive, and streamlined cross-border customs, tax regimes, and information flow. The emphasis should be on cross-border infrastructure that not only facilitates trade through efficient border administration but can also effectively manage cross-border health threats. There is an urgent need to strengthen social protection systems to make them responsive to crises, and embed them within human rights-based approaches to better support vulnerable populations and enact health and social security benefits. The COVI-19 response needs to adhere to the well-established ‘do no harm’ principle to prevent further damage or suffering as a result of the pandemic and examined through local lenses to inform peace-building initiatives that may yield long-term gains in the post-COVID-19 recovery efforts. Full article
(This article belongs to the Collection Outbreak of a Novel Coronavirus: A Global Health Threat)
13 pages, 925 KiB  
Article
Sensitivity of Nutrition Indicators to Measure the Impact of a Multi-Sectoral Intervention: Cross-Sectional, Household, and Individual Level Analysis
Int. J. Environ. Res. Public Health 2020, 17(9), 3121; https://doi.org/10.3390/ijerph17093121 - 30 Apr 2020
Cited by 3 | Viewed by 5355
Abstract
Interventions tackling multiple drivers of child malnutrition have potential, yet the evidence is limited and draws on different analysis and nutrition outcomes, reducing comparability. To better understand the advantages and disadvantages of three different analytical approaches on seven common nutrition indicators, we use [...] Read more.
Interventions tackling multiple drivers of child malnutrition have potential, yet the evidence is limited and draws on different analysis and nutrition outcomes, reducing comparability. To better understand the advantages and disadvantages of three different analytical approaches on seven common nutrition indicators, we use panel data (2012, 2014, 2015) on 1420 households from a randomized control study of a multi-sectoral intervention in Chad. We compare program impact using three types of analysis: a cross-sectional analysis of non-matched children; a panel analysis on longitudinal outcomes following the worst-off child in the household; and a panel analysis on longitudinal outcomes of matched children. We find that the sensitivity of the nutrition outcomes to program impact increases with each subsequent analytical approach, despite the reduction in sample size, as the analysis is able to control for more non-measured child and household characteristics. In the matched child panel analysis, the odds of a child being severely wasted were 76% lower (CI: 0.59–0.86, p = 0.001), the odds of being underweight were 33% lower (CI: 0.15–0.48, p = 0.012), and weight-for-height z-score was 0.19 standard deviations higher (CI: 0.09–0.28, p = 0.022) in the treatment versus control group. The study provides evidence for multi-sectoral interventions to tackle acute malnutrition and recommends the best practice analytical approach. Full article
(This article belongs to the Special Issue Early Influences on Child Health and Wellbeing)
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13 pages, 516 KiB  
Review
Five Challenges When Managing Mass Casualty or Disaster Situations: A Review Study
Int. J. Environ. Res. Public Health 2020, 17(9), 3068; https://doi.org/10.3390/ijerph17093068 - 28 Apr 2020
Cited by 31 | Viewed by 6702
Abstract
Background: Managing mass casualty or disaster incidents is challenging to any person or organisation. Therefore, this paper identifies and describes common challenges to managing such situations, using case and lessons learned reports. It focuses on sudden onset, man-made or technologically caused mass [...] Read more.
Background: Managing mass casualty or disaster incidents is challenging to any person or organisation. Therefore, this paper identifies and describes common challenges to managing such situations, using case and lessons learned reports. It focuses on sudden onset, man-made or technologically caused mass casualty or disaster situations. Methods: A management review was conducted based on a structured search in the PubMed and Web of Science databases. Results: The review included 20 case—and lessons learned reports covering natural disasters, man-made events, and accidents across Europe, the United States of Amerika (USA), Asia and the Middle East. Five common challenges were identified: (1) to identify the situation and deal with uncertainty, (2) to balance the mismatch between the contingency plan and the reality, (3) to establish a functional crisis organization, (4) to adapt the medical response to the actual and overall situation and (5) to ensure a resilient response. Conclusions: The challenges when managing mass casualty or disaster events involved were mainly related to the ability to manage uncertainty and surprising situations, using structured processes to respond. The ability to change mind set, organization and procedures, both from an organizational- and individual perspective, was essential. Non-medical factors and internal factors influenced the medical management. In order to respond in an effective, timely and resilient way, all these factors should be taken into consideration. Full article
(This article belongs to the Special Issue Prehospital and Disaster Medicine and Crises Management)
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16 pages, 3841 KiB  
Review
Internet Addiction in the Web of Science Database: A Review of the Literature with Scientific Mapping
Int. J. Environ. Res. Public Health 2020, 17(8), 2753; https://doi.org/10.3390/ijerph17082753 - 16 Apr 2020
Cited by 44 | Viewed by 7220
Abstract
Information and communication technologies (ICT) is a major element of today’s society with great potential that can offer both advantages and disadvantages. Addiction to the Internet and social networks is a growing problem in all age groups. Education is the context in which [...] Read more.
Information and communication technologies (ICT) is a major element of today’s society with great potential that can offer both advantages and disadvantages. Addiction to the Internet and social networks is a growing problem in all age groups. Education is the context in which to work and train in the correct use of these media. The objective of the study focuses on knowing the scientific production and the performance of the concepts “addiction” and “internet” (ADIN). A bibliometric methodology complemented with the scientific mapping technique was followed. Different processes related to the quantification, analysis, evaluation, and estimation of scientific documents were carried out. The literature was analyzed by specific programs such as SciMAT, Analyze Results, and Creation Citation Report. The unit of analysis was specified in 5644 scientific publications extracted from Web of Science (WoS), belonging to the period of years between 1996 and 2019. The results showed that the evolution in the study of the addiction to the Internet is constant and continuous, with articles in English being the most used means to present the information on the part of the investigators. In addition, the subject of study was based on time, given that the coincidence of key words between the periods analyzed was high. In conclusion, the importance of promoting healthy living habits that include responsible use of the Internet are discussed. Full article
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15 pages, 352 KiB  
Article
A New Application of Social Impact in Social Media for Overcoming Fake News in Health
Int. J. Environ. Res. Public Health 2020, 17(7), 2430; https://doi.org/10.3390/ijerph17072430 - 03 Apr 2020
Cited by 121 | Viewed by 32022
Abstract
One of the challenges today is to face fake news (false information) in health due to its potential impact on people’s lives. This article contributes to a new application of social impact in social media (SISM) methodology. This study focuses on the social [...] Read more.
One of the challenges today is to face fake news (false information) in health due to its potential impact on people’s lives. This article contributes to a new application of social impact in social media (SISM) methodology. This study focuses on the social impact of the research to identify what type of health information is false and what type of information is evidence of the social impact shared in social media. The analysis of social media includes Reddit, Facebook, and Twitter. This analysis contributes to identifying how interactions in these forms of social media depend on the type of information shared. The results indicate that messages focused on fake health information are mostly aggressive, those based on evidence of social impact are respectful and transformative, and finally, deliberation contexts promoted in social media overcome false information about health. These results contribute to advancing knowledge in overcoming fake health-related news shared in social media. Full article
(This article belongs to the Special Issue Social Media Intelligence for Public Health Surveillance)
11 pages, 313 KiB  
Article
Longitudinal Patterns of Social Problem-Solving Skills in an Ethnically Diverse Sample of Pediatric Patients with Cancer and their Caregivers
Int. J. Environ. Res. Public Health 2020, 17(5), 1581; https://doi.org/10.3390/ijerph17051581 - 29 Feb 2020
Cited by 3 | Viewed by 2725
Abstract
Pediatric patients with acute lymphoblastic leukemia and lymphoblastic lymphoma are prescribed a daily oral chemotherapy medication named 6-mercaptopurine. Adherence to this medication is vital for survival and decreased risk for disease relapse. Adaptive problem-solving strategies are important for adhering to this complex regimen. [...] Read more.
Pediatric patients with acute lymphoblastic leukemia and lymphoblastic lymphoma are prescribed a daily oral chemotherapy medication named 6-mercaptopurine. Adherence to this medication is vital for survival and decreased risk for disease relapse. Adaptive problem-solving strategies are important for adhering to this complex regimen. This manuscript examined ethnic and racial differences in social problem-solving domains (Social Problem-Solving Inventory) among patients aged 7–19 years old who were diagnosed with cancer; and, their caregivers (N = 139). This was a 15-month longitudinal study. We also examined differences in medication adherence based on behavioral adherence measures. Our study found significant differences between minority and non-minority reporters across multiple social problem-solving domains (p < 0.05). However, there were no significant differences observed for medication adherence. Our findings underscore the importance of implementing culturally sensitive interventions in clinical care that could ultimately positively impact health behaviors, interactions with healthcare providers, and long-term health outcomes. Full article
(This article belongs to the Special Issue Child-Parent Dynamics, Psychosocial Factors, and Health Outcomes)
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