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Open AccessArticle

The Interplay among Empathy, Vicarious Trauma, and Burnout in Greek Mental Health Practitioners

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Kalliope Kounenou

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Antonios Kalamatianos

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Panagiota Nikoltsiou

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Ntina Kourmousi

Int. J. Environ. Res. Public Health 2023, 20(4), 3503; https://doi.org/10.3390/ijerph20043503 - 16 Feb 2023

Viewed by 1336

Abstract

Background. Mental health professionals are at risk of experiencing vicarious trauma and burnout as a consequence of the nature of their work. Studies and scholars so far have demonstrated that empathy interacts directly with burnout, and they imply an interaction with vicarious trauma. [...] Read more.

Background. Mental health professionals are at risk of experiencing vicarious trauma and burnout as a consequence of the nature of their work. Studies and scholars so far have demonstrated that empathy interacts directly with burnout, and they imply an interaction with vicarious trauma. However, research has paid little attention to the interplay among vicarious trauma, empathy, and burnout in mental health professionals who practice psychotherapy. This study examines the interplay between mental health professionals’ (those practicing psychotherapy) vicarious trauma and empathy and investigates the ways they contribute to burnout. Methods. The sample consisted of 214 mental health professionals (32 males and 182 females), working in the public and private sectors. Specific instruments were administered online to the sample: (a) an improvised demographic questionnaire (age, gender, education, specialty, years of experience, years of supervision); (b) the Counselor Burnout Inventory, validated for the Greek population by Kounenou et al.; (c) the Vicarious Trauma Scale; and (d) the Jefferson Scale of Physician Empathy. Results. Correlation analysis showed that empathy and vicarious trauma were positively related to burnout. Moreover, multiple regression analysis revealed that supervision, empathy, and, to a greater degree, vicarious trauma have a significant impact on burnout. Conclusion. Unlike relative research on burnout, gender and work experience did not seem to play a significant role in the prediction of burnout in the present study. Several suggestions for future studies, as well as implications for mental health practitioners, are discussed. Full article

(This article belongs to the Special Issue New Challenges and Crucial Topics for 2030 Public Health)

Open AccessArticle

Research on Influencing Factors of Satisfaction with the Use of Public Health Internet Platform: Evidence from Ding Xiang Doctor (DXY) Internet Medical Platform

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Int. J. Environ. Res. Public Health 2023, 20(3), 2276; https://doi.org/10.3390/ijerph20032276 - 27 Jan 2023

Viewed by 1167

Abstract

With the rapid development of Internet information technology, Internet medical platforms are gradually entering daily life. Especially after the outbreak of the COVID-19 pandemic, it becomes very difficult for patients to go out for medical treatment, and the Internet medical platform plays an [...] Read more.

With the rapid development of Internet information technology, Internet medical platforms are gradually entering daily life. Especially after the outbreak of the COVID-19 pandemic, it becomes very difficult for patients to go out for medical treatment, and the Internet medical platform plays an important role. The study of the use and influencing factors of Internet medical platforms has become a new topic. In this study, evidence from the Chinese Internet medical platform Ding Xiang Doctor(DXY) is combined with an integrated approach of hierarchical analysis and the entropy value method to construct evaluation indexes and questionnaires from four dimensions of perceived quality, perceived value, user trust, and user involvement to analyze the factors influencing users’ satisfaction with Internet medical platforms. The questionnaires were distributed online, and 556 questionnaires were distributed from June to August 2022; 520 questionnaires were collected; the questionnaires’ recovery rate was 93.53%; after excluding some invalid questionnaires, 424 questionnaires remained; the questionnaire efficiency was 81.54%; the Cronbach coefficient was 0.978; the KMO(Kaiser-Meyer-Olkin) value was 0.977; and the reliability performance was good. The study concluded that: (1) Users pay more attention to the content of perceived value, including the cost of time, economy, expense, and effort spent, and emphasize the degree of personal benefit. (2) Users are less satisfied with the information accessibility, design aesthetics, information timeliness, information comprehensiveness, and classification clarity of the DXY platform. (3) Users pay most attention to the protection of personal privacy by the platform side in the dimension of perceived value. (4) Users’ trust in the platform is relatively high, their willingness to use the platform in the future is strong, and the dimensions of online interactive discussion, willingness to pay, and paid services are highly recognized. Full article

(This article belongs to the Special Issue New Challenges and Crucial Topics for 2030 Public Health)

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Open AccessArticle

Association between Shift Work Schedules and Cardiovascular Events in a Multi-Ethnic Cohort

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Andrew Roshan Dicom

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Xiangyuan Huang

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Saima Hilal

Int. J. Environ. Res. Public Health 2023, 20(3), 2047; https://doi.org/10.3390/ijerph20032047 - 22 Jan 2023

Viewed by 1035

Abstract

Background: Shift work is known to increase the risk of cardiometabolic diseases and mortality. We investigate the relationship between shift work schedules and cardiometabolic risk factors (smoking, hypertension, and obesity) and their association with cardiometabolic diseases (diabetes and cardiovascular diseases) in a multi-ethnic [...] Read more.

Background: Shift work is known to increase the risk of cardiometabolic diseases and mortality. We investigate the relationship between shift work schedules and cardiometabolic risk factors (smoking, hypertension, and obesity) and their association with cardiometabolic diseases (diabetes and cardiovascular diseases) in a multi-ethnic population from Singapore. Methods: 2469 participants from the Singapore-based Multi-Ethnic Cohort underwent physical and clinical assessments. Shift work schedules (morning, evening, night, and mixed) were assessed using a validated questionnaire. Results: Among shift workers, night shift workers had a significantly higher prevalence of smoking (54.5%), diabetes (27.3%), and cardiovascular events (14.1%). Compared to non-shift workers, workers in the night (OR = 2.10, 95%CI: 1.26–3.41) and mixed (OR = 1.74, 95%CI: 1.22–2.48) shift groups were more likely to be current smokers. A significant association between shift duration and smoking (OR = 1.02, 95%CI: 1.00–1.03) was also observed, with longer shift duration (in years) leading to an increase in smoking behavior. No significant associations were found between shift work schedules and hypertension, obesity (BMI), diabetes, and cardiovascular disease, as well as other cardiometabolic risk factors and diseases. Conclusion: This study found that shift schedules and shift duration were most strongly associated with smoking status after covariate adjustments (age, gender, ethnicity, socioeconomic status, and work arrangement), with night and mixed shift types being strongly associated with current smoker status. As smoking is a modifiable risk factor for cardiometabolic disease, employers of shift workers should increase work-based health interventions to control smoking and promote a healthier workforce. Full article

(This article belongs to the Special Issue New Challenges and Crucial Topics for 2030 Public Health)

Open AccessArticle

How COVID-19 Pandemic Has Influenced Public Interest in Foods: A Google Trends Analysis of Italian Data

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Int. J. Environ. Res. Public Health 2023, 20(3), 1976; https://doi.org/10.3390/ijerph20031976 - 20 Jan 2023

Cited by 1 | Viewed by 1096

Abstract

Controversy exists about the impact of the COVID-19 pandemic on dietary habits, with studies demonstrating both benefits and drawbacks of this period. We analyzed Google Trends data on specific terms and arguments related to different foods (i.e., fruits, vegetables, legumes, whole grains, nuts [...] Read more.

Controversy exists about the impact of the COVID-19 pandemic on dietary habits, with studies demonstrating both benefits and drawbacks of this period. We analyzed Google Trends data on specific terms and arguments related to different foods (i.e., fruits, vegetables, legumes, whole grains, nuts and seeds, milk, red meat, processed meat, and sugar-sweetened beverages) in order to evaluate the interest of Italian people before and during the COVID-19 pandemic. Joinpoint regression models were applied to identify the possible time points at which public interest in foods changed (i.e., joinpoints). Interestingly, public interest in specific food categories underwent substantial changes during the period under examination. While some changes did not seem to be related to the COVID-19 pandemic (i.e., legumes and red meat), public interest in fruit, vegetables, milk, and whole grains increased significantly, especially during the first lockdown. It should be noted, however, that the interest in food-related issues returned to prepandemic levels after the first lockdown period. Thus, more efforts and ad hoc designed studies should be encouraged to evaluate the duration and direction of the COVID-19 pandemic’s influence. Full article

(This article belongs to the Special Issue New Challenges and Crucial Topics for 2030 Public Health)

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Open AccessArticle

Acculturative Stress, Perceived Social Support, and Mental Health: The Mediating Effect of Negative Emotions Associated with Discrimination

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María José Baeza-Rivera

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Camila Salazar-Fernández

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Diego Manríquez-Robles

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Natalia Salinas-Oñate

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Vanessa Smith-Castro

Int. J. Environ. Res. Public Health 2022, 19(24), 16522; https://doi.org/10.3390/ijerph192416522 - 09 Dec 2022

Cited by 2 | Viewed by 1582

Abstract

The role of perceived social support in the acculturation process of immigrants remains unclear. In this study, we jointly evaluated the associations between acculturative stress and negative emotions associated with discrimination as antecedents of anxiety, depression, and stress symptoms in 283 immigrants living [...] Read more.

The role of perceived social support in the acculturation process of immigrants remains unclear. In this study, we jointly evaluated the associations between acculturative stress and negative emotions associated with discrimination as antecedents of anxiety, depression, and stress symptoms in 283 immigrants living in Chile. Three competing models were tested via structural equation modelling to assess (1) the association among these variables and mental health symptoms and (2) to clarify the role of perceived social support. The third model was theoretically more adequate, showed a better fit, and explained 42.7% of the variance of mental health symptoms. In this model, perceived social support was associated with acculturative stress by reducing mental health symptomatology. Moreover, a direct relationship and an indirect relationship were found between acculturative stress (through negative emotions associated with discrimination) and mental health symptomatology. These results contribute to the understanding of the acculturation process experienced by immigrants in Chile and provide empirical evidence to be used to improve migration policies. Full article

(This article belongs to the Special Issue New Challenges and Crucial Topics for 2030 Public Health)

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Open AccessArticle

Influenza Vaccination Coverage and Its Predictors among Self-Reported Diabetic Patients—Findings from the Hungarian Implementation of the European Health Interview Survey

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Gergő József Szőllősi

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Nguyen Chau Minh

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Jenifer Pataki

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Cornelia Melinda Santoso

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Attila Csaba Nagy

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László Kardos

Int. J. Environ. Res. Public Health 2022, 19(23), 16289; https://doi.org/10.3390/ijerph192316289 - 05 Dec 2022

Cited by 1 | Viewed by 895

Abstract

In high-risk populations, such as the elderly or those with serious medical issues, for instance, people with cardiovascular diseases or diabetes, influenza can have devastating effects because it might contribute to severe complications or even death. This makes vaccination against influenza an essential [...] Read more.

In high-risk populations, such as the elderly or those with serious medical issues, for instance, people with cardiovascular diseases or diabetes, influenza can have devastating effects because it might contribute to severe complications or even death. This makes vaccination against influenza an essential component of public health. The primary objective of our research was to identify the characteristics that influenced whether an individual chose to become vaccinated against influenza, with an emphasis on whether they reported having diabetes. The data were obtained from the Hungarian implementation of the European Health Interview Surveys, which were conducted in 2009, 2014, and 2019. The total sample size was 15,874 people. To determine the variables that were related to vaccination, a multivariate logistic regression analysis that included interactions was performed. The overall vaccination coverage was 13% in 2009 and 12% in 2014 and 2019 among non-diabetic respondents; the coverage was 26% in 2009, 28% in 2014, and 25% in 2019 among diabetic respondents. Despite vaccination coverage in both groups being below the optimal level of 75%, we were able to identify factors influencing vaccination coverage. Among diabetic respondents, younger age, lower education level, sex, and co-morbidities were factors that influenced vaccination status. It is important for authorities managing healthcare and medical practitioners to be aware of the potential effects that influenza can have on diabetic patients; therefore, more efforts need to be made to increase the number of diabetic people receiving a vaccination against influenza. Full article

(This article belongs to the Special Issue New Challenges and Crucial Topics for 2030 Public Health)

Open AccessArticle

Climate Anxiety, Loneliness and Perceived Social Isolation

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André Hajek

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Hans-Helmut König

Int. J. Environ. Res. Public Health 2022, 19(22), 14991; https://doi.org/10.3390/ijerph192214991 - 14 Nov 2022

Cited by 5 | Viewed by 1684

Abstract

Aim: The goal of this study was to investigate the association of climate anxiety with loneliness and perceived social isolation (also stratified by age group). Methods: Data were taken from the general adult population aged 18 to 74 years (n = 3091). Data [...] Read more.

Aim: The goal of this study was to investigate the association of climate anxiety with loneliness and perceived social isolation (also stratified by age group). Methods: Data were taken from the general adult population aged 18 to 74 years (n = 3091). Data collection took place in March 2022. Climate anxiety was measured using the Climate Anxiety Scale. The De Jong Gierveld tool was used to quantify loneliness and the Bude and Lantermann tool was used to assess perceived social isolation. Results: Multiple linear regressions revealed an association between higher climate anxiety and higher loneliness (β = 0.06, p < 0.001) as well as higher perceived social isolation (β = 0.10, p < 0.001) among the total sample. A similar picture was identified in age-stratified regressions (i.e., among individuals aged 18 to 29 years, 30 to 49 years, and among individuals aged 50 to 64 years). However, climate anxiety was neither associated with loneliness nor with perceived social isolation among individuals aged 65 to 74 years. Conclusions: Our current study adds first evidence regarding the link between climate anxiety and loneliness as well as perceived social isolation and can serve as a basis for upcoming studies. Full article

(This article belongs to the Special Issue New Challenges and Crucial Topics for 2030 Public Health)

Open AccessArticle

The Relationship between Health-Related Fitness and Quality of Life in Nonalcoholic Fatty Liver Disease

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Int. J. Environ. Res. Public Health 2022, 19(21), 14215; https://doi.org/10.3390/ijerph192114215 - 31 Oct 2022

Cited by 1 | Viewed by 1326

Abstract

Background: It is well known that patients with nonalcoholic fatty liver disease (NAFLD) suffer from impaired quality of life (QoL) and decreased health-related fitness. Studies on the relationship between them have been scarce. Methods: A cross-sectional survey was performed in 104 NAFLD patients. [...] Read more.

Background: It is well known that patients with nonalcoholic fatty liver disease (NAFLD) suffer from impaired quality of life (QoL) and decreased health-related fitness. Studies on the relationship between them have been scarce. Methods: A cross-sectional survey was performed in 104 NAFLD patients. Liver fat content and fibrosis were assessed using transient elastography. Health-related fitness was measured by fitness test. VO₂max was determined by YMCA submaximal cycle ergometer test. Body composition was tested by bioimpedance analysis. QoL was evaluated using the 36-item Short Form Health Survey Questionnaire (SF-36). Results: Most patients had severe liver steatosis without significant fibrosis. Most of them exhibited poor health-related fitness. Multiple linear regression analyses demonstrated that body compositions (waist circumference, hip circumference, percent body fat, percent skeletal muscle, visceral fat area) dependently contributed to QoL (health transition, role limitation due to physical problem, general health, physical functioning and vitality). VO₂max was positively related with physical functioning. Conclusion: For NAFLD patients, decreased health-related fitness was associated with impaired QoL both in the physical and mental dimension. Our results indicate that visceral fat together with muscle mass and VO₂max could serve as individual exercise intervention targets to improve QoL. Full article

(This article belongs to the Special Issue New Challenges and Crucial Topics for 2030 Public Health)

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Open AccessFeature PaperArticle

Impact of Visual Elements of Tobacco Packaging on Health Risk Perceptions of Youth Groups

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Yanlong Guo

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Yinrui Xu

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Denghang Chen

Int. J. Environ. Res. Public Health 2022, 19(21), 14097; https://doi.org/10.3390/ijerph192114097 - 28 Oct 2022

Viewed by 1381

Abstract

Tobacco products are hazardous to public health and are one of the greater public health threats facing the world to date. Although international research on tobacco packaging has been thorough and comprehensive, the risk perception of visual elements in tobacco packaging varies by [...] Read more.

Tobacco products are hazardous to public health and are one of the greater public health threats facing the world to date. Although international research on tobacco packaging has been thorough and comprehensive, the risk perception of visual elements in tobacco packaging varies by country, race, and smoking status. Therefore, the study aimed to investigate the risk perceptions of visual elements in tobacco packaging among young and middle-aged people in selected cities in China. This study used a questionnaire to construct an index system for visual elements of tobacco packaging and used it to design a related questionnaire. Our group conducted an online questionnaire survey among 296 young people (18–44 years old) in selected cities in China between 16 June and 26 June 2022. The results of the influence of visual elements of tobacco packaging on the perception of tobacco health risks in the youth group were analyzed by SPSS 26.0. A chi-square test analysis yielded differences in the perception of tobacco package color among youths with different smoking status. A linear regression analysis revealed that age group and visual elements were significant, and five groups of visual element comparisons had an effect on the youth group. First, there were differences in the perceptions of tobacco products among participants with different smoking status. Secondly, the more youthful the respondents were, the greater the probability that they were able to identify that the picture fitness warnings had a greater probability of making them conscious of the fitness dangers of smoking (p < 0.05). The older the participants, the greater the probability that the textual content fitness warnings made them conscious of the fitness risks of smoking (p < 0.05). Third, the percentage of health warnings did not make a good-sized impact for the youth groups (p > 0.05). Fourth, the more youthful the participant, the greater the probability that cigarette products with whole brand images would appeal to buyer(p < 0.01). Full article

(This article belongs to the Special Issue New Challenges and Crucial Topics for 2030 Public Health)

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Open AccessArticle

The Impact of Mobile Payment on Household Poverty Vulnerability: A Study Based on CHFS2017 in China

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Int. J. Environ. Res. Public Health 2022, 19(21), 14001; https://doi.org/10.3390/ijerph192114001 - 27 Oct 2022

Cited by 3 | Viewed by 1229

Abstract

Changes in digital technology have brought about new opportunities in the field of financial poverty alleviation in China, and mobile payment as a new digital financial model is important in helping families to lift themselves out of poverty effectively and prevent a return [...] Read more.

Changes in digital technology have brought about new opportunities in the field of financial poverty alleviation in China, and mobile payment as a new digital financial model is important in helping families to lift themselves out of poverty effectively and prevent a return to poverty. This paper examines the impact of mobile payment on household poverty vulnerability and the mechanism of action using the China Household Finance Survey (CHFS) 2017 microsurvey data. After adopting the IVprobit model and a series of robustness tests, we found: (1) mobile payment significantly negatively impacts household poverty vulnerability; (2) the mechanism analysis indicates that promoting entrepreneurship and improving risk management capabilities are the main channels through which mobile payment mitigates household poverty vulnerability; (3) household entrepreneurship and entrepreneurial survival significantly reduce the probability of poverty vulnerability; and (4) the probit regression analysis explores how mobile payment has a greater negative impact on poverty vulnerability among low-income, homeless, and relatively backward households in rural or western areas. This work contributes to the literature on the use of electronic communication technology to eradicate poverty and on inclusive finance, providing vital results for other countries to use as an example. Full article

(This article belongs to the Special Issue New Challenges and Crucial Topics for 2030 Public Health)

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Open AccessArticle

Undertaking Healthy Nutrition Behaviors by Patients with Type 1 Diabetes as an Important Element of Self-Care

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Beata Irena Sińska

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Karolina Dłużniak-Gołaska

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Int. J. Environ. Res. Public Health 2022, 19(20), 13173; https://doi.org/10.3390/ijerph192013173 - 13 Oct 2022

Cited by 1 | Viewed by 1135

Abstract

Background: Self-control/self-care means the active participation of a diabetic patient in therapy. It involves making numerous decisions and undertaking actions independently. The primary activities under the patient’s control include adherence to medication regimens and maintenance of a health-promoting lifestyle, especially a healthy diet. [...] Read more.

Background: Self-control/self-care means the active participation of a diabetic patient in therapy. It involves making numerous decisions and undertaking actions independently. The primary activities under the patient’s control include adherence to medication regimens and maintenance of a health-promoting lifestyle, especially a healthy diet. However, the sense of responsibility for one’s own health, i.e., high sense of responsibility (HSR), is an important element in the treatment of diabetes and in undertaking pro-health behaviors. The study aimed at analyzing adherence to dietary recommendations in the context of HSR in patients with type 1 diabetes. Methods: The cross-sectional study was conducted on a group of 394 adults. The assessment of adherence to dietary recommendations was performed with the present authors’ Diabetes Dietary Guidelines Adherence Index (DDGA Index). The measurement of HSR was performed with the standardized Sense of Responsibility for Health Scale (HSRS). The assessment of the multifactorial influence of independent variables on the DDGA Index, including the “responsibility for health” variable, was conducted with the use of a linear regression model. Results: The mean DDGA value was 18.68 (SD = 3.97). The patients significantly more often avoided unhealthy products than included recommended products into the diet at a required frequency. A positive correlation was demonstrated between HSR and adherence to dietary recommendations (β_std. = 0.43, p < 0.001). Conclusions: The sense of responsibility for one’s health plays a main role in adherence to dietary recommendations in diabetes. Our study showed that a higher sense of responsibility for health was associated with a higher level of adherence to dietary recommendations. Patients with a high sense of responsibility for one’s health will be more involved in the therapeutic process, including adherence to dietary recommendations. Therefore, all education actions should comprise not only dietary knowledge transfer and shaping appropriate skills, but they should also strengthen the sense of responsibility for one’s health. Full article

(This article belongs to the Special Issue New Challenges and Crucial Topics for 2030 Public Health)

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Open AccessArticle

Potential Impact of FDA Flavor Enforcement Policy on Vaping Behavior on Twitter

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Int. J. Environ. Res. Public Health 2022, 19(19), 12836; https://doi.org/10.3390/ijerph191912836 - 07 Oct 2022

Viewed by 1338

Abstract

In January 2020, the FDA announced an electronic cigarette (e-cigarette) flavor enforcement policy to restrict the sale of all unauthorized cartridge-based flavored e-cigarettes except tobacco and menthol flavors, which was implemented on 6 February 2020. This study aimed to understand the potential influence [...] Read more.

In January 2020, the FDA announced an electronic cigarette (e-cigarette) flavor enforcement policy to restrict the sale of all unauthorized cartridge-based flavored e-cigarettes except tobacco and menthol flavors, which was implemented on 6 February 2020. This study aimed to understand the potential influence of this policy on one vaping behavior change—quitting vaping—using Twitter data. Twitter posts (tweets) related to e-cigarettes were collected between June 2019 and October 2020 through a Twitter streaming API. Based on the geolocation and keywords related to quitting vaping, tweets mentioning quitting vaping from the US were filtered. The demographics (age and gender) of Twitter users who mentioned quitting vaping were further inferred using a deep learning algorithm (deepFace). The proportion of tweets and Twitter users mentioning quitting vaping were compared between before and after the announcement and implementation of the flavor policy. Compared to before the FDA flavor policy, the proportion of tweets (from 0.11% to 0.20% and 0.24%) and Twitter users (from 0.15% to 0.70% and 0.86%) mentioning quitting vaping were significantly higher after the announcement and implementation of the policy (p-value < 0.001). In addition, there was an increasing trend in the proportion of female and young adults (18–35 years old) mentioning quitting vaping on Twitter after the announcement and implementation of the policy compared to that before the policy. Our results showed that the FDA flavor enforcement policy did have a positive impact on quitting vaping on Twitter. Our study provides an initial evaluation of the potential influence of the FDA flavor enforcement policy on user vaping behavior. Full article

(This article belongs to the Special Issue New Challenges and Crucial Topics for 2030 Public Health)

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Open AccessArticle

South Korean Early Cancer Patients’ Perceptions of Difficulties in Fighting Their Disease: A Q Methodological Approach

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Min-Jeung Shim

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Song-Yi Lee

Int. J. Environ. Res. Public Health 2022, 19(19), 12510; https://doi.org/10.3390/ijerph191912510 - 30 Sep 2022

Viewed by 822

Abstract

This study applied the Q methodology to explore breast cancer patients’ perceived difficulties in their fight against the disease. We used literature analysis and in-depth interviews and selected 162 statements for the Q population. Then, we chose 40 universal and representative statements for [...] Read more.

This study applied the Q methodology to explore breast cancer patients’ perceived difficulties in their fight against the disease. We used literature analysis and in-depth interviews and selected 162 statements for the Q population. Then, we chose 40 universal and representative statements for the Q samples from the Q population. The P sample included 13 breast cancer patients in the early stage of the disease who participated in the Q sorting. We interviewed the study participants with high factor weights by type of P sample. The study’s results showed three types of breast cancer patients’ perceptions of difficulties in the initial fight against the disease. Type 1 showed ‘fear of the future’, Type 2 showed ‘helplessness against what cannot be controlled’, and Type 3 showed ‘frustration due to difficulties in role performance.’ Based on these results, we discuss the characteristics, meanings, and significance of individual types of breast cancer patients’ perceptions of the disease, including suggestions for follow-up studies. Full article

(This article belongs to the Special Issue New Challenges and Crucial Topics for 2030 Public Health)

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Open AccessArticle

The Frequency of Tobacco Smoking and E-Cigarettes Use among Primary Health Care Patients—The Association between Anti-Tobacco Interventions and Smoking in Poland

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Małgorzata Znyk

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Ilona Wężyk-Caba

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Dorota Kaleta

Int. J. Environ. Res. Public Health 2022, 19(18), 11584; https://doi.org/10.3390/ijerph191811584 - 14 Sep 2022

Viewed by 1200

Abstract

The aim of this study was to assess the prevalence of smoking and e-cigarette use among primary care patients during the COVID-19 pandemic and to assess the frequency of minimal anti-tobacco interventions by family doctors. A cross-sectional study was conducted from January 2020 [...] Read more.

The aim of this study was to assess the prevalence of smoking and e-cigarette use among primary care patients during the COVID-19 pandemic and to assess the frequency of minimal anti-tobacco interventions by family doctors. A cross-sectional study was conducted from January 2020 to December 2021 encompassing 896 patients over 18 years of age who used primary health care in the city of Lodz, Poland. In total, 21.2% of the respondents were smokers, 11.6% were e-cigarette users, and 7.3% dual users. In addition, 68.4% of smokers had been asked about smoking, while 62.9% of non-smokers and 33.7% of smokers were advised to quit smoking; furthermore, 71.1% of e-cigarette users and 72.3% of dual users were asked about tobacco use, and 17.3% and 21.5%, respectively, had been advised to quit smoking. Multivariate logistic regression analysis found men and alcohol users to receive more minimal anti-tobacco advice than women and non-alcohol users (OR = 1.46; p < 0.05 and OR = 1.45; p < 0.05), socio-demographic and health correlates did not increase the chances of obtaining minimal anti-tobacco interventions among smokers. People with a medium level of education had a higher chance of receiving minimal anti-tobacco intervention from their family doctor when using e-cigarettes and when they were dual users (OR = 2.06; p < 0.05 and OR = 2.51; p < 0.05). Smokers were less likely to receive minimal anti-tobacco interventions than reported in previous studies. Measures should be implemented to increase the minimum interventions provided by GPs in their daily work among all patients, not only those who use tobacco. Non-smokers should be encouraged to abstain. Full article

(This article belongs to the Special Issue New Challenges and Crucial Topics for 2030 Public Health)

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Open AccessArticle

Determinants of Survival of HIV Patients Receiving Dolutegravir: A Prospective Cohort Study in Conflict-Affected Bunia, Democratic Republic of Congo

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Jean Marie N. Kayembe

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Hippolyte N. Situakibanza

Int. J. Environ. Res. Public Health 2022, 19(16), 10220; https://doi.org/10.3390/ijerph191610220 - 17 Aug 2022

Viewed by 1139

Abstract

This study aims to determine the factors influencing HIV-related mortality in settings experiencing continuous armed conflict atrocities. In such settings, people living with HIV (PLHIV), and the partners of those affected may encounter specific difficulties regarding adherence to antiretroviral therapy (ART), and retention [...] Read more.

This study aims to determine the factors influencing HIV-related mortality in settings experiencing continuous armed conflict atrocities. In such settings, people living with HIV (PLHIV), and the partners of those affected may encounter specific difficulties regarding adherence to antiretroviral therapy (ART), and retention in HIV prevention, treatment, and care programs. Between July 2019 and July 2021, we conducted an observational prospective cohort study of 468 PLHIV patients treated with Dolutegravir at all the ART facilities in Bunia. The probability of death being the primary outcome, as a function of time of inclusion in the cohort, was determined using Kaplan–Meier plots. We used the log-rank test to compare survival curves and Cox proportional hazard modeling to determine mortality predictors from the baseline to 31 July 2021 (endpoint). The total number of person-months (p-m) was 3435, with a death rate of 6.70 per 1000 p-m. Compared with the 35-year-old reference group, older patients had a higher mortality risk. ART-naïve participants at the time of enrollment had a higher mortality risk than those already using ART. Patients with a high baseline viral load (≥1000 copies/mL) had a higher mortality risk compared with the reference group (adjusted hazard ratio = 6.04; 95% CI: 1.78–20.43). One-fourth of deaths in the cohort were direct victims of armed conflict, with an estimated excess death of 35.6%. Improving baseline viral load monitoring, starting ART early in individuals with high baseline viral loads, the proper tailoring of ART regimens and optimizing long-term ART, and care to manage non-AIDS-related chronic complications are recommended actions to reduce mortality. Not least, fostering women’s inclusion, justice, peace, and security in conflict zones is critical in preventing premature deaths in the general population as well as among PLHIV. Full article

(This article belongs to the Special Issue New Challenges and Crucial Topics for 2030 Public Health)

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Open AccessArticle

A Psychoeducational Intervention in Prenatal Classes: Positive Effects on Anxiety, Self-Efficacy, and Temporal Focus in Birth Attendants

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Thais Cristina Siqueira

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Alexandro Andrade

Int. J. Environ. Res. Public Health 2022, 19(13), 7904; https://doi.org/10.3390/ijerph19137904 - 28 Jun 2022

Cited by 2 | Viewed by 1365

Abstract

Background: Previous studies have reported associations between high maternal anxiety, temporal perceptions during pregnancy, and a poor sense of self-efficacy. One type of anxiety expecting mothers experience is associated with childbirth, which previous studies have shown can be reduced by antenatal training. Recent [...] Read more.

Background: Previous studies have reported associations between high maternal anxiety, temporal perceptions during pregnancy, and a poor sense of self-efficacy. One type of anxiety expecting mothers experience is associated with childbirth, which previous studies have shown can be reduced by antenatal training. Recent contributions have pointed out that current prenatal courses, while providing important and useful knowledge, do not devote sufficient content to the mental health of the parturient and to the psychological issues that can arise before and after the birth. Methods: In total, 80 pregnant women were provided with a special prepartum course in which ample space was devoted to topics such as maternal mental health, parenting skills and couple relationship, relaxation techniques, and assertiveness. Perception of threat, state anxiety, temporal focus, needs and expectations, and self-efficacy were assessed by comparing this psychoeducational intervention group with a traditional antenatal course group (n = 80), and a control group (n = 80). Two-way mixed ANOVAS (3 × 2) were performed for each dependent variable considered, including the time variable (pre-course–post-course) as a factor within the participants and the group variable as a factor between the subjects. Results: The psychoeducational intervention actually induced significant and positive changes primarily on four dimensions: state anxiety, perceived self-efficacy, the need for information, and reassurance of the pregnant women who participated in this trial. Conclusions: The study suggests improving the quality of prenatal classes by paying particular attention to the content and communication used within the group, in order to gratify at the highest level, the need for information, reassurance, and sharing that characterize the parturient’s request for support. The evidence collected recommends further replicating the intervention protocol described in order to improve the psychophysical well-being of women in a delicate moment such as pregnancy and preparation for childbirth, but especially in terms of the prevention and containment of the risks of psychological distress that currently affect a significant number of women after childbirth. Full article

(This article belongs to the Special Issue New Challenges and Crucial Topics for 2030 Public Health)

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Open AccessArticle

Booster Doses of Anti COVID-19 Vaccines: An Overview of Implementation Policies among OECD and EU Countries

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Int. J. Environ. Res. Public Health 2022, 19(12), 7233; https://doi.org/10.3390/ijerph19127233 - 13 Jun 2022

Cited by 3 | Viewed by 1810

Abstract

The need for an anti-COVID-19 booster dose posed an organizational challenge for health policy makers worldwide. Therefore, this study aimed to explore the health policies regarding the booster dose through an overview of recommendations issued in high-income countries. Between 10 November and 16 [...] Read more.

The need for an anti-COVID-19 booster dose posed an organizational challenge for health policy makers worldwide. Therefore, this study aimed to explore the health policies regarding the booster dose through an overview of recommendations issued in high-income countries. Between 10 November and 16 December 2021, the authors searched for state-level official documents about the offer of the booster dose, considering the 43 countries belonging to the European Union (EU) or the Organisation for Economic Co-operation and Development (OECD). Mainly due to the lack of English translation, 15 countries were excluded. A total of 135 documents were selected. Almost all the countries started administering the booster dose between September and November 2021. The most used products were mRNA vaccines, followed by Vaxzevria-AstraZeneca and Jcovden-Janssen/Johnson & Johnson. All countries established criteria to define categories of individuals to be vaccinated as a priority. A six/five-months interval was the main choice for general population vaccinated with mRNA vaccines, while shorter intervals were chosen for vulnerable individuals or other vaccines. Despite diversities related to the differences in health systems, economical resources, and population numbers, and the need to adapt all these factors to a massive vaccination campaign, a progressive convergence towards the same vaccination policies was highlighted. Full article

(This article belongs to the Special Issue New Challenges and Crucial Topics for 2030 Public Health)

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Open AccessArticle

The Coordinated Development and Regulation Research on Public Health, Ecological Environment and Economic Development: Evidence from the Yellow River Basin of China

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Int. J. Environ. Res. Public Health 2022, 19(11), 6927; https://doi.org/10.3390/ijerph19116927 - 06 Jun 2022

Cited by 4 | Viewed by 1307

Abstract

The dual problems of the public crisis from the global epidemic and the deterioration of the ecological environment constrain the economic development in the Yellow River Basin. To promote the sustainable and balanced development in the Yellow River Basin, this paper takes public [...] Read more.

The dual problems of the public crisis from the global epidemic and the deterioration of the ecological environment constrain the economic development in the Yellow River Basin. To promote the sustainable and balanced development in the Yellow River Basin, this paper takes public health, ecological environment, and economic development, as a whole, to study the coordinated development of the Yellow River Basin. Based on coupling coordinated theory, we use the SMI-P method to evaluate the coordinated development index of public health, the ecological environment, and economic development in the Yellow River Basin. Moreover, we use the coordinated regulation and obstacle factor diagnosis to identify the main influencing factors and design regulation methods to optimize the coordinated development index. The results found that (1), during the research period, there is spatiotemporal heterogeneity in the coordinated development level in the Yellow River Basin. From 2009 to 2019, the overall development index increased steadily, while the regional disparity in the coordinated development level was obvious. (2) The ecological environment indicators contribute more to the relevance and obstacle factors, such as the average concentration of fine particulate matter, per capita arable land area, afforestation area, etc. (3) After regulating the overall development level of the Yellow River Basin, we prove that Path 4, which comprehensively considers the relevance and obstacle factors, performs better. Full article

(This article belongs to the Special Issue New Challenges and Crucial Topics for 2030 Public Health)

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Open AccessArticle

The Effect of Second-Victim-Related Distress and Support on Work-Related Outcomes in Tertiary Care Hospitals in Kelantan, Malaysia

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Ahmad Zulfahmi Mohd Kamaruzaman

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Mohd Ismail Ibrahim

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Ariffin Marzuki Mokhtar

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Maizun Mohd Zain

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Saiful Nazri Satiman

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Najib Majdi Yaacob

Int. J. Environ. Res. Public Health 2022, 19(11), 6454; https://doi.org/10.3390/ijerph19116454 - 26 May 2022

Viewed by 1089

Abstract

After a patient safety incident, the involved healthcare providers may experience sustained second-victim distress and reduced professional efficacy, with subsequent negative work-related outcomes and the cultivation of resilience. This study aims to investigate the factors affecting negative work-related outcomes and resilience with a [...] Read more.

After a patient safety incident, the involved healthcare providers may experience sustained second-victim distress and reduced professional efficacy, with subsequent negative work-related outcomes and the cultivation of resilience. This study aims to investigate the factors affecting negative work-related outcomes and resilience with a hypothetical triad of support as the mediators: colleague, supervisor, and institutional support. This cross-sectional study recruited 733 healthcare providers from three tertiary care hospitals in Kelantan, Malaysia. Three steps of hierarchical linear regression were developed for both outcomes (negative work-related outcomes and resilience). Four multiple mediator models of the support triad were analyzed. Second-victim distress, professional efficacy, and the support triad contributed significantly in all the regression models. Colleague support partially mediated the relationship defining the effects of professional efficacy on negative work-related outcomes and resilience, whereas colleague and supervisor support partially mediated the effects of second-victim distress on negative work-related outcomes. Similar results were found regarding resilience, with all support triads producing similar results. As mediators, the support triads ameliorated the effect of second-victim distress on negative work-related outcomes and resilience, suggesting an important role of having good support, especially after encountering patient safety incidents. Full article

(This article belongs to the Special Issue New Challenges and Crucial Topics for 2030 Public Health)

Open AccessArticle

Dietary Practices during Pregnancy in a Marshallese Community: A Mixed Methods Analysis

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Britni L. Ayers

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Cari A. Bogulski

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Ashlea Bennett-Milburn

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Anna Fisher

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Morda Netwon

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Pearl A. McElfish

Int. J. Environ. Res. Public Health 2022, 19(11), 6360; https://doi.org/10.3390/ijerph19116360 - 24 May 2022

Viewed by 1145

Abstract

Dietary practices during pregnancy play a pivotal role in the health of women and their children and set the foundation for long-term health. Marshallese women have disproportionally higher rates of maternal and infant health disparities, yet little is known about the dietary practices [...] Read more.

Dietary practices during pregnancy play a pivotal role in the health of women and their children and set the foundation for long-term health. Marshallese women have disproportionally higher rates of maternal and infant health disparities, yet little is known about the dietary practices during their pregnancy. The purpose of this study was to identify dietary practices during pregnancy among Marshallese women. From March 2019 to March 2020, a purposive sample of 33 pregnant Marshallese participants participated in a mixed methods study. Two primary themes emerged: (1) traditional beliefs about a healthy diet during pregnancy; and (2) dietary change during pregnancy. Within the first theme, four subthemes emerged: (1) should eat; (2) should not eat; (3) challenges to traditional diet; and (4) spiritual dietary customs during pregnancy. Within the second theme, three subthemes emerged: (1) a healthy diet for my baby; (2) autonomy and diet; and (3) sugar-sweetened beverages. The transition in discourse from traditional customs of dietary practices to an individualistic discourse highlights that acculturation is a complex process that should be included in maternal health education and interventions. Findings from this study provide insight into potential considerations for future interventions aiming to improve maternal and child health outcomes among Marshallese. Full article

(This article belongs to the Special Issue New Challenges and Crucial Topics for 2030 Public Health)

Open AccessArticle

Epidemiological Characteristics of COVID-19 Cases in Non-Italian Nationals in Sicily: Identifying Vulnerable Groups in the Context of the COVID-19 Pandemic in Sicily, Italy

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Int. J. Environ. Res. Public Health 2022, 19(9), 5767; https://doi.org/10.3390/ijerph19095767 - 09 May 2022

Cited by 6 | Viewed by 1382

Abstract

As in other parts of the world, undocumented migrants in Italy suffer worse health status due to their immigration enforcement situation and other vulnerabilities such as precarious illegal jobs, exploitation and abuse or barriers to higher education, with higher prevalence of chronic noncommunicable [...] Read more.

As in other parts of the world, undocumented migrants in Italy suffer worse health status due to their immigration enforcement situation and other vulnerabilities such as precarious illegal jobs, exploitation and abuse or barriers to higher education, with higher prevalence of chronic noncommunicable diseases. The COVID-19 pandemic, as other pandemics, has not affected everyone equally. The undocumented was one of the most affected groups with regard to hospitalization rates and mortality worldwide. Sicily is one of the gates of entrance to Europe for migrants and asylum seekers from Africa and Asia. Herein, we described the epidemiological characteristics of COVID-19 cases in Sicily to compare hospitalization rate and mortality between Italian nationals and foreigners. We extracted data from the integrated national surveillance system established by the Italian National Institute of Health (Istituto Superiore di Sanità, ISS) to collect information on all COVID-19 cases and deaths in Sicily. We found that the hospitalization rates were higher in undocumented foreigners, and they were most likely to present a more severe clinical outcome compared to Italian nationals. Inclusive public health policies should take this population group into consideration to achieve the Health for All goal. Full article

(This article belongs to the Special Issue New Challenges and Crucial Topics for 2030 Public Health)

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Open AccessArticle

Impact of Wearing on Filtration Performance of Electrostatic Filter Face Masks

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Anthony P. Pierlot

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David L. J. Alexander

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Jürg A. Schütz

Int. J. Environ. Res. Public Health 2022, 19(9), 5032; https://doi.org/10.3390/ijerph19095032 - 21 Apr 2022

Cited by 3 | Viewed by 1437

Abstract

Certified disposable respirators afford important protection from hazardous aerosols but lose performance as they are worn. This study examines the effect of wear time on filtration efficiency. Disposable respirators were worn by CSIRO staff over a period of 4 weeks in early 2020. [...] Read more.

Certified disposable respirators afford important protection from hazardous aerosols but lose performance as they are worn. This study examines the effect of wear time on filtration efficiency. Disposable respirators were worn by CSIRO staff over a period of 4 weeks in early 2020. Participants wore the respirator masks for given times up to eight hours whilst working in laboratory/office environments. At that time COVID-19 precautions required staff to wear surgical (or other) masks and increase use of hand sanitizer from dispenser stations. Results obtained from a test group of ten individuals without health preconditions show an increasing number of masks failing with wear time, while the remainder continue to perform nearly unaffected for up to 8 h. Some masks were found to retain filtration performance better than others, possibly due to the type of challenge they were subjected to by the wearer. However, the rate and extent of decay are expected to differ between environments since there are many contributing factors and properties of the aerosol challenge cannot be controlled in a live trial. Penetration and variability increased during wear; the longer the wear time, the more deleterious to particle removal, particularly after approximately 2 h of wear. This behavior is captured in a descriptive statistical model based on results from a trial with this test group. The effectiveness of the masks in preventing the penetration of KCl particles was determined before and after wearing, with the analysis focusing on the most penetrating particles in a size range of 0.3–0.5 µm diameter where respirator masks are most vulnerable. The basic elements of the study, including the approach to filter testing and sample sanitization, are broadly applicable. Conclusions also have applicability to typical commercially available single-use respirator masks manufactured from melt blown polypropylene as they are reliant on the same physical principles for particle capture and electrostatic enhancement was comparable for the particle size range used for detection. Full article

(This article belongs to the Special Issue New Challenges and Crucial Topics for 2030 Public Health)

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Open AccessArticle

Analysis of Factors Influencing Polish Students’ Opinions on Euthanasia

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Tomasz Męcik-Kronenberg

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Magdalena Piegza

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Robert Pudlo

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Piotr Gorczyca

Int. J. Environ. Res. Public Health 2022, 19(9), 5019; https://doi.org/10.3390/ijerph19095019 - 20 Apr 2022

Viewed by 1600

Abstract

Due to the continuous development of palliative care and methods of pain relief in the last moments of patients’ lives, we are faced with the question of how long we should take measures to delay inevitable death for, without providing prolonged therapy against [...] Read more.

Due to the continuous development of palliative care and methods of pain relief in the last moments of patients’ lives, we are faced with the question of how long we should take measures to delay inevitable death for, without providing prolonged therapy against the patient’s will. For terminally ill and people experiencing unimaginable suffering, euthanasia is considered as one of the possible options for a dignified farewell. The aim of the study was to determine the views on euthanasia in a group of students from Polish universities. Questionnaire responses were analyzed for 9686 students (79.9% of women and 20.1% of men) aged 18–35 years. Respondents were asked to complete their own questionnaire on demographic data and attitudes toward euthanasia in the case of severe terminal illness or paralysis preventing independent living. Euthanasia was significantly more acceptable among women (85% vs. 75%, p < 0.0001; 69% vs. 62%, p < 0.0001) and non-believers [98% vs. 97% (denominations other than Christian), 84% (other forms of Christianity), 69% (Roman Catholic); p < 0.0001] in every case considered. Religious affiliation was the factor that most influenced attitudes toward euthanasia. Among the other elements influencing attitudes toward euthanasia, residence and field of study were distinguished. Considering the large sample size and specific conclusions, the article should be an important argument in the discussion on euthanasia. Full article

(This article belongs to the Special Issue New Challenges and Crucial Topics for 2030 Public Health)

Open AccessArticle

Academic Teachers about Their Productivity and a Sense of Well-Being in the Current COVID-19 Epidemic

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Grażyna Bartkowiak

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Agnieszka Krugiełka

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Sebastian Dama

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Paulina Kostrzewa-Demczuk

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Elżbieta Gaweł-Luty

Int. J. Environ. Res. Public Health 2022, 19(9), 4970; https://doi.org/10.3390/ijerph19094970 - 19 Apr 2022

Cited by 4 | Viewed by 2272

Abstract

This article looked at the situation of university teachers in Poland during the COVID-19 epidemic as a result of their need to work remotely. The study was conducted in the first stage (I) on 21 academicians and in the second stage (II) on [...] Read more.

This article looked at the situation of university teachers in Poland during the COVID-19 epidemic as a result of their need to work remotely. The study was conducted in the first stage (I) on 21 academicians and in the second stage (II) on 18 academicians. The study was conducted to determine the level of productivity of the study group in their online learning competencies in relation to their well-being, as well as during the height, and weakening of the epidemic. The results of the survey conducted, especially during the height of the epidemic, indicated varying levels of self-evaluation of their productivity in relation to their digital competencies linked to the need for them to work remotely, which also affected their psychological well-being. Several cases of respondents indicated a negative assessment of their own productivity, and thus their quality of work life and sense of psychological well-being. However, some respondents, on the contrary, showed a desire to work, the need for self-improvement, and to continue their mission of teaching. Full article

(This article belongs to the Special Issue New Challenges and Crucial Topics for 2030 Public Health)

Open AccessArticle

The Pattern of Hemoglobin A1C Trajectories and Risk of Herpes Zoster Infection: A Follow-Up Study

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Int. J. Environ. Res. Public Health 2022, 19(5), 2646; https://doi.org/10.3390/ijerph19052646 - 24 Feb 2022

Viewed by 1588

Abstract

To investigate the risks of herpes zoster (HZ) infection among heterogeneous HbA1C trajectories of patients with newly diagnosed type 2 diabetes, this cohort study used data from the Chang Gung Research Database (CGRD), from the 10-year period of 1 January 2007 to 31 [...] Read more.

To investigate the risks of herpes zoster (HZ) infection among heterogeneous HbA1C trajectories of patients with newly diagnosed type 2 diabetes, this cohort study used data from the Chang Gung Research Database (CGRD), from the 10-year period of 1 January 2007 to 31 December 2017. We applied group-based trajectory modeling (GBTM) to identify the patterns of HbA1C trajectories, and multiple Cox proportional hazards regressions were used to estimate the hazard ratio (HR) for the risk of HZ infection with adjustment of age, sex, and comorbidities. This study enrolled 121,999 subjects to perform the analysis. The GBTM identified four HbA1C trajectories: ‘good control’ (58.4%), ‘high decreasing’ (8.9%), ‘moderate control’ (25.1%), and ‘poor control’ (7.6%) with the mean HbA1C of 6.7% (50 mmol/mol), 7.9% (63 mmol/mol), 8.4% (68 mmol/mol), and 10.7% (93 mmol/mol) respectively. The risk of HZ was significantly higher in the poor control with an HR = 1.44 (95% CI 1.26–1.64) after adjustment for confounders and comorbidities. The risk of HZ infection for the high decreasing group (initially poor then rapidly reaching optimal control) was nonsignificant compared to the good control group. In conclusion, the patients with poor glycemic control (mean HbA1C = 10.7%) had the highest risk of HZ infection. The patients with initial hyperglycemia then reaching optimal control could have a lower risk of HZ infection. Full article

(This article belongs to the Special Issue New Challenges and Crucial Topics for 2030 Public Health)

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Open AccessArticle

Internalized Sexual Stigma among Lesbian, Gay, and Bisexual Individuals in Taiwan: Its Related Factors and Association with Mental Health Problems

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Int. J. Environ. Res. Public Health 2022, 19(4), 2427; https://doi.org/10.3390/ijerph19042427 - 19 Feb 2022

Cited by 9 | Viewed by 3469

Abstract

Internalized sexual stigma (ISS) is one of the major issues that can compromise the health of sexual minority populations. This quantitative study aimed to examine: (1) the relationships of individual factors (gender, age, education level, sexual orientation, and age of identification of sexual [...] Read more.

Internalized sexual stigma (ISS) is one of the major issues that can compromise the health of sexual minority populations. This quantitative study aimed to examine: (1) the relationships of individual factors (gender, age, education level, sexual orientation, and age of identification of sexual orientation) and perceived family support with ISS; and (2) the associations of ISS with mood problems and the moderating effects of gender on the associations among Taiwanese young adult lesbian, gay, and bisexual (LGB) individuals. In total, 500 male and 500 female young adult LGB individuals aged between 20 and 30 years participated in this study. The experience of ISS, individual (e.g., gender, age, education level, sexual orientation, and age of identification of sexual orientation) and environmental factors (perceived family), mood problems (e.g., anxiety and depression) were collected. The individual and environmental factors related to ISS and the associations of ISS with mood problems were examined using multivariate linear regression analysis. The results indicated that gender, sexual orientation, age of identification of sexual orientation, and perceived family support were significantly associated with all or some dimensions of ISS in LGB individuals. Various dimensions of ISS had different relationships with anxiety and depression. Gender had moderating effects on the association between the identity dimension of ISS and sexual orientation as well as between the social discomfort dimension of ISS and anxiety. Various dimensions of ISS among LGB individuals should be routinely assessed by mental health service units. Intervention programs should be provided for LGB individuals, especially those with factors related to ISS. Full article

(This article belongs to the Special Issue New Challenges and Crucial Topics for 2030 Public Health)

Open AccessArticle

The Effect of Static Compression via Vibration Foam Rolling on Eccentrically Damaged Muscle

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Int. J. Environ. Res. Public Health 2022, 19(3), 1823; https://doi.org/10.3390/ijerph19031823 - 05 Feb 2022

Cited by 2 | Viewed by 1746

Abstract

Previous research has shown that vibration foam rolling (VFR) on damaged muscle can result in improvements in muscle soreness and range of motion (ROM). Furthermore, static compression via VFR (i.e., VFR without rolling) can increase the ROM and decrease the muscle stiffness of [...] Read more.

Previous research has shown that vibration foam rolling (VFR) on damaged muscle can result in improvements in muscle soreness and range of motion (ROM). Furthermore, static compression via VFR (i.e., VFR without rolling) can increase the ROM and decrease the muscle stiffness of non-damaged muscle. Therefore, it is likely that static compression via VFR on eccentrically damaged muscle can mitigate muscle soreness and the decrease in ROM, and the decrease in muscle strength. The purpose of this study was to investigate the acute effects of a 90 s bout of VFR applied as a static compression on an eccentrically damaged quadriceps muscle, measuring ROM, muscle soreness, muscle strength, and jump performance. This study was a single-arm repeated measure design. Study participants were sedentary healthy male volunteers (n = 14, 20.4 ± 0.8 years) who had not performed habitual exercise activities or any regular resistance training for at least 6 months before the experiment. All participants performed a bout of eccentric exercise of the knee extensors with the dominant leg and then received a 90 s bout of static compression via VFR of the quadriceps 48 h after the eccentric exercise. The knee flexion ROM, muscle soreness at palpation, and countermovement jump height were measured before the eccentric exercise (baseline), before (pre-intervention) and after the VFR intervention (post-intervention), and 48 h after the eccentric exercise. The results showed that the static compression via VFR significantly (p < 0.05) improved the knee flexion ROM (6.5 ± 4.8%, d = 0.76), muscle soreness at palpation (−10.7 ± 8.6 mm, d = −0.68), and countermovement jump height (15.6 ± 16.0%, d = 0.49). Therefore, it can be concluded that static compression via VFR can improve muscle soreness and function. Full article

(This article belongs to the Special Issue New Challenges and Crucial Topics for 2030 Public Health)

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Open AccessFeature PaperArticle

Effects of Using the Surgical Mask and FFP2 during the 6-Min Walking Test. A Randomized Controlled Trial

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Sara Cabanillas-Barea

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Jacobo Rodríguez-Sanz

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Andoni Carrasco-Uribarren

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Carlos López-de-Celis

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Vanessa González-Rueda

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Daniel Zegarra-Chávez

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Simón Cedeño-Bermúdez

and

Albert Pérez-Bellmunt

Int. J. Environ. Res. Public Health 2021, 18(23), 12420; https://doi.org/10.3390/ijerph182312420 - 25 Nov 2021

Cited by 12 | Viewed by 2486

Abstract

During the COVID-19 pandemic, the use of masks has been recommended as a containment measure. The mask is a hindrance to normal breathing that causes discomfort. This could put more work on the respiratory accessory muscles, and, consequently, these muscles could see their [...] Read more.

During the COVID-19 pandemic, the use of masks has been recommended as a containment measure. The mask is a hindrance to normal breathing that causes discomfort. This could put more work on the respiratory accessory muscles, and, consequently, these muscles could see their tone increase. For this reason, during this clinical trial (registered in clincaltrials.gov, number: NCT04789603), it was observed whether the use of the mask produced changes in the distance traveled, in the heart rate, in the oxygenometry, in the self-perceived dyspnea and in the tone of accessory respiratory muscles during a 6-min walk test (6MWT). Fifty healthy volunteers were recruited and carried out the 6MWT on three occasions. They carried out the 6MWT in various situations: using an FFP2/N95 mask, using a surgical mask, and without using a mask. The distance walked, the heart rate, the oxygen therapy, the tone of the accessory respiratory muscles, and the self-perceived dyspnea were recorded in each situation. Significant differences were found between the three situations in terms of self-perceived dyspnea FFP2/N95 > surgical mask > no mask. However, there are no differences between the experimental situations during the 6MWT in terms of distance travelled, heart rate, oxygenometry or respiratory muscle tone. Full article

(This article belongs to the Special Issue New Challenges and Crucial Topics for 2030 Public Health)

Open AccessArticle

External Communication Barriers among Elderly Deaf and Hard of Hearing People in China during the COVID-19 Pandemic Emergency Isolation: A Qualitative Study

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Int. J. Environ. Res. Public Health 2021, 18(21), 11519; https://doi.org/10.3390/ijerph182111519 - 02 Nov 2021

Cited by 9 | Viewed by 2880

Abstract

The COVID-19 pandemic poses a great risk to older people with hearing impairment, who face a higher threshold of external communication after the implementation of the emergency isolation policy. As part of a study on the optimization of external communication among the deaf [...] Read more.

The COVID-19 pandemic poses a great risk to older people with hearing impairment, who face a higher threshold of external communication after the implementation of the emergency isolation policy. As part of a study on the optimization of external communication among the deaf and hard of hearing (DHH) population in central China, this study employed a qualitative research method based on in-depth interviews to explore the needs and difficulties faced by the older DHH group in external communication during public health emergencies in Wuhan, China, in the context of the COVID-19 pandemic. The results showed that older DHH people had weak reception of critical information about the epidemic, and had suboptimal access to medical care during emergency quarantine, which increased interpersonal communication barriers to this group. The current findings highlight the urgent need for targeted strengthening of the original emergency communication and coordination mechanisms in public health emergencies, and for improving policy inclusiveness for older DHH individuals during the COVID-19 pandemic and emergencies alike. Full article

(This article belongs to the Special Issue New Challenges and Crucial Topics for 2030 Public Health)

Open AccessArticle

Self-Rated Health and Pain Problems in Mothers of Healthy Children or Children Requiring Outpatient Observation or Hospitalisation: A Pilot Cross-Sectional Study

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Anna Aftyka

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Wojciech Rosa

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Marzena Samardakiewicz

Int. J. Environ. Res. Public Health 2021, 18(18), 9543; https://doi.org/10.3390/ijerph18189543 - 10 Sep 2021

Viewed by 1349

Abstract

A child’s illness or disability is a considerable stressor for the mother and a risk factor for many psychological problems and somatic diseases. The purpose of the study was to (1) assess the prevalence of poor SRH and pain, (2) compare self-rated health [...] Read more.

A child’s illness or disability is a considerable stressor for the mother and a risk factor for many psychological problems and somatic diseases. The purpose of the study was to (1) assess the prevalence of poor SRH and pain, (2) compare self-rated health and pain, (3) and identify the determinants of SRH and pain in mothers of healthy children and children requiring ambulatory observation or hospitalization. The study covered 234 mothers of both healthy and unhealthy children who required outpatient observation or treatment at an intensive care unit, neonatal intensive care unit, or oncology department. To analyse the variables obtained, the following tools were used: Self-Rated Health, Numerical Rating, Interpersonal Support Evaluation List, Peritraumatic Distress Inventory, Modified Hospital Anxiety and Depression Scale, and Impact of Effects Scale—Revised. The self-assessment of health in mothers of healthy children and those in need of outpatient observation or hospitalization at units with various specialities differed in a statistically significant way. The severity of the average and maximum pain among mothers of healthy children and those with a history of disease differed statistically significantly. Poor SRH co-occurred with severe maximum pain in all of the examined groups. Both in the control group and the group of mothers of children requiring outpatient observation, poor SRH co-occurred with a high level of anxiety. Only in the control group was a correlation found between the severity of the average and maximum pain and the severity of anxiety and depression symptoms. Full article

(This article belongs to the Special Issue New Challenges and Crucial Topics for 2030 Public Health)

Open AccessArticle

Effects of Diacutaneous Fibrolysis on Passive Neuromuscular Response and Mechanosensitivity in Athletes with Hamstring Shortening: A Randomized Controlled Trial

by

Aida Cadellans-Arróniz

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Carlos López-de-Celis

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Albert Pérez-Bellmunt

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Jacobo Rodríguez-Sanz

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Luis Llurda-Almuzara

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Vanessa González-Rueda

and

Pere Ramón Rodríguez-Rubio

Int. J. Environ. Res. Public Health 2021, 18(12), 6554; https://doi.org/10.3390/ijerph18126554 - 18 Jun 2021

Cited by 1 | Viewed by 2297

Abstract

Introduction. Diacutaneous Fibrolysis is defined as specific instrumental intervention to normalize function in the musculoskeletal system. It is considered a treatment method for the mechanical alterations of the locomotor system, and it is widely used in sports for therapeutic and preventive purposes. Despite [...] Read more.

Introduction. Diacutaneous Fibrolysis is defined as specific instrumental intervention to normalize function in the musculoskeletal system. It is considered a treatment method for the mechanical alterations of the locomotor system, and it is widely used in sports for therapeutic and preventive purposes. Despite the clinical benefits observed in different musculoskeletal conditions, the action mechanism of diacutaneous fibrolysis remains uncertain. There are no studies evaluating the neuromuscular response on the posterior muscular chain of the lower extremity in athletes, where overload, stiffness, and injury incidence are high. Objective. To evaluate the immediate, and 30 min post treatment effects of a single diacutaneous fibrolysis session on passive neuromuscular response and mechanosensitibity on hamstring and gluteus in athletes with shortening. Design. A randomized within participant clinical trial. Methods. Sixty-six athletes with hamstring shortening were included (PKE < 160). The lower limbs were randomized between the experimental limb and control limb, regardless of dominance. A single session of diacutaneous fibrolysis was applied to the posterior gluteus maximus, biceps femoris, and semitendinosus of the experimental lower limb whereas the control limb was not treated. Viscoelastic muscle properties (myotonometry), contractile muscle properties (tensomiography), and mechanosensitivity (algometry) were tested before treatment (T0), after treatment (T1), and 30 min post treatment (T2). Results. Regarding viscoelastic properties, in the intra-group analysis we found statistically significant differences in the experimental limb at T1, decreasing muscle stiffness in gluteus maximus (p < 0.042), in biceps femoris (p < 0.001) and in semitendinosus (p < 0.032). We also observed statistically significant differences in Tone decrease (p < 0.011) and relaxation increase (p < 0.001) in biceps femoris. At T2, the decrease in stiffness in all tested muscles was maintained (p < 0.05). There were statistically significant inter-groups differences in stiffness on gluteus (p < 0.048) and biceps femoris (p < 0.019) and in tone on biceps femoris (p < 0.009) compared to the control limb. For contractile properties, we only found statistically significant differences on maximal radial displacement (Dm) in gluteus, both control and experimental at T2 (p < 0.05) and in biceps femoris control (p < 0.030). No changes were found in the mechanosensitivity. Conclusions. A single session of diacutaneous fibrolysis produces changes in some parameters related to viscoelasticity properties of the biceps femoris and gluteus. There were no changes on contractile properties on semitendinosus. Only small changes on the contractile properties on the gluteus maximus and biceps femoris were found. No effect was found on the mechanosensitivity of the posterior chain muscles in athletes with hamstring shortening. Full article

(This article belongs to the Special Issue New Challenges and Crucial Topics for 2030 Public Health)

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Open AccessArticle

Exploring the Occupational Balance of Young Adults during Social Distancing Measures in the COVID-19 Pandemic

by

Paula Rodríguez-Fernández

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Josefa González-Santos

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Mirian Santamaría-Peláez

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Raúl Soto-Cámara

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Jerónimo J. González-Bernal

Int. J. Environ. Res. Public Health 2021, 18(11), 5809; https://doi.org/10.3390/ijerph18115809 - 28 May 2021

Cited by 20 | Viewed by 4071

Abstract

(1) Background: A balanced life is related to good health in young people, one of the groups most affected by confinement and social distancing measures during the COVID-19 pandemic. This study aims to explore the occupational balance of young adults during home confinement [...] Read more.

(1) Background: A balanced life is related to good health in young people, one of the groups most affected by confinement and social distancing measures during the COVID-19 pandemic. This study aims to explore the occupational balance of young adults during home confinement and its association with different sociodemographic factors. (2) Methods: A cross-sectional study was designed, and an online survey was disseminated to collect sociodemographic and occupational balance data, using the Occupational Balance Questionnaire (OBQ). The statistical analysis was performed using the SPSS statistical software package version 24.0. (3) Results: 965 young adults between 18 and 30 years old participated in the study. A predictive model showed that the main predictors of a lower occupational balance were a negative self-perception (β= 0.377; p = <0.0001), student status (β = 0.521; p = 0.001), not receiving enough information (β = 0.951; p = 0.001) and long periods of quarantine (β = 0.036; p = 0.007). (4) Conclusions: Considering people’s occupational health and related factors could lessen many of the psychosocial consequences of isolation and contribute to the well-being of young people. Full article

(This article belongs to the Special Issue New Challenges and Crucial Topics for 2030 Public Health)

Open AccessArticle

The Moderating Effects of Perceived Severity on the Generational Gap in Preventive Behaviors during the COVID-19 Pandemic in the U.S.

by

Yunjuan Luo

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Yang Cheng

and

Mingxiao Sui

Int. J. Environ. Res. Public Health 2021, 18(4), 2011; https://doi.org/10.3390/ijerph18042011 - 19 Feb 2021

Cited by 34 | Viewed by 8339

Abstract

During the COVID-19 pandemic, older adults appear to be more susceptible to the coronavirus disease. Although the health stakes are higher for older adults, individuals of all ages should adopt preventive measures to contain the human-to-human transmission of the virus. This study conducted [...] Read more.

During the COVID-19 pandemic, older adults appear to be more susceptible to the coronavirus disease. Although the health stakes are higher for older adults, individuals of all ages should adopt preventive measures to contain the human-to-human transmission of the virus. This study conducted a national online survey of 1843 adults at the early stage of the COVID-19 pandemic in the U.S. to examine age disparities in preventive behaviors against the virus. The results show that older generations, motivated by a higher perceived severity of the disease, were more likely to take the precautionary actions recommended by the U.S. Centers for Disease Control and Prevention (CDC) than younger generations. This thus suggests that persuasive health messages addressing the severity of COVID-19 might reduce the generational gap and promote preventive behaviors among young people, to protect themselves and the elderly. Full article

(This article belongs to the Special Issue New Challenges and Crucial Topics for 2030 Public Health)

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Open AccessFeature PaperArticle

Searching for General Model of Conspiracy Theories and Its Implication for Public Health Policy: Analysis of the Impacts of Political, Psychological, Structural Factors on Conspiracy Beliefs about the COVID-19 Pandemic

by

Seoyong Kim

and

Sunhee Kim

Int. J. Environ. Res. Public Health 2021, 18(1), 266; https://doi.org/10.3390/ijerph18010266 - 31 Dec 2020

Cited by 48 | Viewed by 10091

Abstract

Along with the spread of the COVID-19 pandemic, beliefs in conspiracy theories are spreading within and across countries. This study aims to analyze predictors of beliefs in conspiracy theories. Because previous studies have emphasized only specific political, psychological, or structural factors or variables, [...] Read more.

Along with the spread of the COVID-19 pandemic, beliefs in conspiracy theories are spreading within and across countries. This study aims to analyze predictors of beliefs in conspiracy theories. Because previous studies have emphasized only specific political, psychological, or structural factors or variables, this study constructs an integrated analytical model that includes all three factors. We analyze data from a large-scale survey of Koreans (N = 1525) and find several results. First, political, psychological, and structural factors influence beliefs in conspiracy theories. Second, when we examine the specific influences of the variables, we find that authoritarianism, support for minority parties, religiosity, trust in SNS (social networking services), perceived risk, anxiety, negative emotions, blame attribution, the quantity of information, health status, and health after COVID-19, all positively influence beliefs in conspiracy theories. Conversely, support for President Moon Jae-In’s government, Christianity, trust in the government, perceived control, analytic thinking, knowledge, the quality of information, and gender, all negatively impact these beliefs. Among the predictors, the quality of information, health status, support for President Moon Jae-In’s government, perceived risk, and anxiety have the most decisive impacts on beliefs in conspiracy theories. Full article

(This article belongs to the Special Issue New Challenges and Crucial Topics for 2030 Public Health)

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Open AccessArticle

Perception, Attitudes, and Experiences Regarding Mental Health Problems and Web Based Mental Health Information Amongst Young People with and without Migration Background in Germany. A Qualitative Study

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Int. J. Environ. Res. Public Health 2021, 18(1), 81; https://doi.org/10.3390/ijerph18010081 - 24 Dec 2020

Cited by 20 | Viewed by 5464

Abstract

Mental illnesses in adolescence and young adulthood are steadily increasing. Thus, mental disorders represent an individual and societal challenge and an enormous health economic burden, creating an urgent need for research and action. Mental health problems are omnipresent in the life of young [...] Read more.

Mental illnesses in adolescence and young adulthood are steadily increasing. Thus, mental disorders represent an individual and societal challenge and an enormous health economic burden, creating an urgent need for research and action. Mental health problems are omnipresent in the life of young people and the internet is the first resource, which helps them to understand their situation. Young people with migration background often have more difficulties accessing health care services. Digital technologies offer an ideal opportunity for a low-threshold platform that addresses the needs of young people. The current project “GeKo:mental” aims to design a multilingual website for Cologne-based adolescents and young adults that will enable them to obtain comprehensive information about mental illness and health, treatment options and first contact points. To design this website, this study aims to find out what kind of health information is needed and how it should best be presented. Nine focus group discussions with adolescents and young adults with and without migration background (N = 68) were conducted; the focus group discussions took place at schools, in an association for social youth work and in an cultural association, which is linked to a mosque in Cologne, Germany. A qualitative content analysis was conducted on the gathered material. The participants reported concrete challenges and needs. The results will form the basis for the development and design of a website. Full article

(This article belongs to the Special Issue New Challenges and Crucial Topics for 2030 Public Health)

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Open AccessArticle

A Study on the Current Situation of Prearranged Shelter Management in Japan for Making a Standard Operation Procedure

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Int. J. Environ. Res. Public Health 2020, 17(24), 9545; https://doi.org/10.3390/ijerph17249545 - 20 Dec 2020

Viewed by 1584

Abstract

To establish a standard operation procedure (SOP) for shelter management, this research analyzed current situations about shelter management in Japanese local governments, focusing on designation of shelters, operation manager and information sharing. The results indicate that some have non-designated shelters, which might lead [...] Read more.

To establish a standard operation procedure (SOP) for shelter management, this research analyzed current situations about shelter management in Japanese local governments, focusing on designation of shelters, operation manager and information sharing. The results indicate that some have non-designated shelters, which might lead to differences of support with designated shelters, local governments ask residents to operate shelters mainly, but this requirement is not shared among them, and system of information sharing is not developed primarily with the department of health and welfare. Besides, this research shows the importance of including the closing and after the closing of the shelters. Full article

(This article belongs to the Special Issue New Challenges and Crucial Topics for 2030 Public Health)

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Open AccessArticle

Predicting Length of Stay and Discharge Destination for Surgical Patients: A Cohort Study

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Int. J. Environ. Res. Public Health 2020, 17(24), 9490; https://doi.org/10.3390/ijerph17249490 - 18 Dec 2020

Cited by 3 | Viewed by 1443

Abstract

Discharge planning is important to prevent surgical site infections, reduce costs, and improve the hospitalization experience. The identification of early variables that can predict a longer-than-expected length of stay or the need for a discharge with additional needs can improve this process. A [...] Read more.

Discharge planning is important to prevent surgical site infections, reduce costs, and improve the hospitalization experience. The identification of early variables that can predict a longer-than-expected length of stay or the need for a discharge with additional needs can improve this process. A cohort study was conducted in the largest hospital of Northern Italy, collecting discharge records from January 2017 to January 2020 and pre-admission visits in the last three months. Socio-demographic and clinical data were collected. Linear and logistic regression models were fitted. The main outcomes were the length of stay (LOS) and discharge destination. The main predictors of a longer LOS were the need for additional care at discharge (+10.76 days), hospitalization from the emergency department (ED) (+5.21 days), and age (+0.04 days per year), accounting for clinical variables (p < 0.001 for all variables). Each year of age and hospitalization from the ED were associated with a higher probability of needing additional care at discharge (OR 1.02 and 1.77, respectively, p < 0.001). No additional findings came from pre-admission forms. Discharge difficulties seem to be related mainly to age and hospitalization procedures: those factors are probably masking underlying social risk factors that do not show up in patients with planned admissions. Full article

(This article belongs to the Special Issue New Challenges and Crucial Topics for 2030 Public Health)

Open AccessArticle

Sustainable Development Goals and 2030 Agenda: Awareness, Knowledge and Attitudes in Nine Italian Universities, 2019

Int. J. Environ. Res. Public Health 2020, 17(23), 8968; https://doi.org/10.3390/ijerph17238968 - 02 Dec 2020

Cited by 17 | Viewed by 5116

Abstract

Sustainable Development Goals (SDGs) and 2030 Agenda represent global development programs. Education can widen the acknowledgement of their relevance and their applications. This survey aims to assess awareness, knowledge and attitudes towards SDGs and sustainability among first-year students in nine Italian Universities. A [...] Read more.

Sustainable Development Goals (SDGs) and 2030 Agenda represent global development programs. Education can widen the acknowledgement of their relevance and their applications. This survey aims to assess awareness, knowledge and attitudes towards SDGs and sustainability among first-year students in nine Italian Universities. A Likert scale-based online questionnaire of 70 items was compiled by students from March to July 2019. It examined knowledge and expectations referred to sustainable development concepts, indicators and documents/models accounting for sociodemographic variables. Statistical analyses performed were Chi-square test, Fisher’s Exact test, Kendall’s W correlation coefficient, univariate and multivariate analysis. The questionnaire was completed by 1676 students. A low percentage referred a good knowledge of SDGs and 2030 Agenda, most of them had never attended related educational activities previously. Better knowledge of SDGs and 2030 Agenda was observed in case of previous specific educational activities (p < 0.001). The expectation towards university guaranteeing an education on SDGs was high, both for personal wisdom and for usefulness in future professional context. A significant difference (p < 0.001) in such expectations was found, as healthcare students were less interested than colleagues of other areas. The results showed low knowledge but interest towards sustainable development. A scheduled implementation of academic initiatives should be considered. Full article

(This article belongs to the Special Issue New Challenges and Crucial Topics for 2030 Public Health)

Open AccessCommunication

Assessment of Human Health Risks Posed by Nano-and Microplastics Is Currently Not Feasible

by

Andreas Brachner

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Despina Fragouli

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Iola F. Duarte

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Patricia M. A. Farias

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Int. J. Environ. Res. Public Health 2020, 17(23), 8832; https://doi.org/10.3390/ijerph17238832 - 27 Nov 2020

Cited by 33 | Viewed by 5707

Abstract

The exposure of humans to nano-and microplastic particles (NMPs) is an issue recognized as a potential health hazard by scientists, authorities, politics, non-governmental organizations and the general public. The concentration of NMPs in the environment is increasing concomitantly with global plastic production and [...] Read more.

The exposure of humans to nano-and microplastic particles (NMPs) is an issue recognized as a potential health hazard by scientists, authorities, politics, non-governmental organizations and the general public. The concentration of NMPs in the environment is increasing concomitantly with global plastic production and the usage of plastic materials. NMPs are detectable in numerous aquatic organisms and also in human samples, therefore necessitating a risk assessment of NMPs for human health. So far, a comprehensive risk assessment of NMPs is hampered by limited availability of appropriate reference materials, analytical obstacles and a lack of definitions and standardized study designs. Most studies conducted so far used polystyrene (PS) spheres as a matter of availability, although this polymer type accounts for only about 7% of total plastic production. Differently sized particles, different concentration and incubation times, and various biological models have been used, yielding hardly comparable data sets. Crucial physico-chemical properties of NMPs such as surface (charge, polarity, chemical reactivity), supplemented additives and adsorbed chemicals have been widely excluded from studies, although in particular the surface of NMPs determines the interaction with cellular membranes. In this manuscript we give an overview about the critical parameters which should be considered when performing risk assessments of NMPs, including novel reference materials, taking into account surface modifications (e.g., reflecting weathering processes), and the possible role of NMPs as a substrate and/or carrier for (pathogenic) microbes. Moreover, we make suggestions for biological model systems to evaluate immediate toxicity, long-term effects and the potential of NMPs to cross biological barriers. We are convinced that standardized reference materials and experimental parameters along with technical innovations in (nano)-particle sampling and analytics are a prerequisite for the successful realization of conclusive human health risk assessments of NMPs. Full article

(This article belongs to the Special Issue New Challenges and Crucial Topics for 2030 Public Health)

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Open AccessArticle

Projection of the Number of Elderly in Different Health States in Thailand in the Next Ten Years, 2020–2030

by

Panupong Tantirat

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Repeepong Suphanchaimat

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Thanit Rattanathumsakul

and

Thinakorn Noree

Int. J. Environ. Res. Public Health 2020, 17(22), 8703; https://doi.org/10.3390/ijerph17228703 - 23 Nov 2020

Cited by 9 | Viewed by 2727

Abstract

The objective of this study is to predict the volume of the elderly in different health status categories in Thailand in the next ten years (2020–2030). Multistate modelling was performed. We defined four states of elderly patients (aged ≥ 60 years) according to [...] Read more.

The objective of this study is to predict the volume of the elderly in different health status categories in Thailand in the next ten years (2020–2030). Multistate modelling was performed. We defined four states of elderly patients (aged ≥ 60 years) according to four different levels of Activities of Daily Living (ADL): social group; home group; bedridden group; and dead group. The volume of newcomers was projected by trend extrapolation methods with exponential growth. The transition probabilities from one state to another was obtained by literature review and model optimization. The mortality rate was obtained by literature review. Sensitivity analysis was conducted. By 2030, the number of social, home, and bedridden groups was 15,593,054, 321,511, and 152,749, respectively. The model prediction error was 1.75%. Sensitivity analysis with the change of transition probabilities by 20% caused the number of bedridden patients to vary from between 150,249 and 155,596. In conclusion, the number of bedridden elders will reach 153,000 in the next decade (3 times larger than the status quo). Policy makers may consider using this finding as an input for future resource planning and allocation. Further studies should be conducted to identify the parameters that better reflect the transition of people from one health state to another. Full article

(This article belongs to the Special Issue New Challenges and Crucial Topics for 2030 Public Health)

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Open AccessArticle

Strengths and Weaknesses in the Risk Management of Blood-Borne Infections: Qualitative Research in Public Health

by

Anita Gębska Kuczerowska

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Artur Błoński

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Joanna Kuczerowska

and

Robert Gajda

Int. J. Environ. Res. Public Health 2020, 17(18), 6650; https://doi.org/10.3390/ijerph17186650 - 12 Sep 2020

Cited by 1 | Viewed by 2446

Abstract

This article presents the research from the first phase of our study on blood-borne risk management, wherein we solicited epidemiologists’ and healthcare practitioners’ expert opinions on a blood-borne infection risk assessment in Poland. Forty-two experts were recommended by epidemiology consultants and recruited from [...] Read more.

This article presents the research from the first phase of our study on blood-borne risk management, wherein we solicited epidemiologists’ and healthcare practitioners’ expert opinions on a blood-borne infection risk assessment in Poland. Forty-two experts were recommended by epidemiology consultants and recruited from all districts in Poland. We used the SWOT (Strengths, Weaknesses, Opportunities, Threats) method in the evaluation. Experts’ opinions showed that there is room for improvement in the prevention of blood-borne infections. Commonly reported weaknesses in the risk assessment included gaps in knowledge and inappropriate procedures, which are largely caused by financial constraints and practitioners’ lack of awareness of developments in their trade. Strengths included legal regulations for medical services and procedures, surveillance, and increasing awareness on the part of medical staff. When paired with the existing statistical data, these results provide a comprehensive view of the problem of blood-borne infections in Poland. The analysis supported the development of a strategy proposal to prevent blood-borne infections and enhance existing risk assessment procedures. Full article

(This article belongs to the Special Issue New Challenges and Crucial Topics for 2030 Public Health)

Open AccessArticle

Acceptability and Feasibility of HPV Self-Sampling as an Alternative Primary Cervical Cancer Screening in Under-Screened Population Groups: A Cross-Sectional Study

by

Eliza Lai-Yi Wong

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Annie Wai-Ling Cheung

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Amy Yuen-Kwan Wong

and

Paul Kay-Sheung Chan

Int. J. Environ. Res. Public Health 2020, 17(17), 6245; https://doi.org/10.3390/ijerph17176245 - 27 Aug 2020

Cited by 13 | Viewed by 3458

Abstract

Background: Cervical cancer is one of the most common cancers in women and about 90% of cervical cancer can be reduced by regular screening. The Pap smear has been well in place as a primary cervical screening method since 1950s; however, coverage is [...] Read more.

Background: Cervical cancer is one of the most common cancers in women and about 90% of cervical cancer can be reduced by regular screening. The Pap smear has been well in place as a primary cervical screening method since 1950s; however, coverage is still not optimal. This study explored the feasibility of HPV self-sampling in two under-screened population groups in Hong Kong (HK): never screened and not regularly screened females, to estimate the uptake rate and preference rate in the future. Materials and Methods: This was a cross-sectional study to explore the acceptability and feasibility of HPV self-sampling in two age groups: aged 25–35 and aged ≥45, which were reported as the highest proportion of the under-screened population in HK between 2017 and 2018. The study invited eligible women from an HPV study cohort to perform HPV self-sampling at home by themselves. The number of specimens returned from participants was recorded and used to determine the feasibility of HPV self-sampling in the community. The participants were asked to fill in the questionnaires before and after HPV self-sampling to indicate their attitudes, acceptability, and future preference for HPV self-sampling as an acceptable alternative primary cervical cancer screening method. Results: A total of 177 subjects participated in the present study and have achieved a good overall uptake rate of 73% (129/177) who returned the self-collected cervicovaginal sample for HPV testing. Among the under-screened population, there was a higher response rate in aged ≥45 than those aged 25–35. The findings also revealed that women who were under-screened, including those who have never been screened, were more likely to prefer HPV self-sampling than those who had regular screening. This study found that the acceptability of HPV self-sampling was fairly positive among the respondents. The findings also indicated that HPV self-sampling was not only beneficial to enhance their health awareness but also to promote the cervical cancer screening uptake rate, especially among the under-screened or never screened populations. Conclusions: HPV self-sampling would be a solution to overcome the perceived barriers in clinician-based screening. The findings also indicated that it could be feasible to use as an alternative primary cervical cancer screening. Full article

(This article belongs to the Special Issue New Challenges and Crucial Topics for 2030 Public Health)

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Open AccessArticle

Lung Function and Respiratory Health of Populations Living Close to Quarry Sites in Palestine: A Cross-Sectional Study

by

Maysaa Nemer

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Rita Giacaman

and

Abdullatif Husseini

Int. J. Environ. Res. Public Health 2020, 17(17), 6068; https://doi.org/10.3390/ijerph17176068 - 20 Aug 2020

Cited by 6 | Viewed by 3803

Abstract

Environmental exposure to dust from quarrying activities could pose health dangers to the population living nearby. This study aimed to investigate the health effects of dust exposure on people living close to quarry sites and compared them with those who live far from [...] Read more.

Environmental exposure to dust from quarrying activities could pose health dangers to the population living nearby. This study aimed to investigate the health effects of dust exposure on people living close to quarry sites and compared them with those who live far from the quarry sites. A cross-sectional comparative study was conducted among 79 exposed participants, who lived less than 500 m away from the quarry sites, and 79 control participants who lived more than 500 m away. All participants answered a questionnaire on dust exposure at home and health effects, as well as performed a lung function test in which both reported and measured health effects were investigated. People who live in close proximity to the quarry sites reported exposure to dust at home (98%), land destruction (85%), plant leaves covered with dust (97%), and an inability to grow crops (92%). The exposed group reported significantly higher eye and nasal allergy (22% vs. 3%), eye soreness (18% vs. 1%), and dryness (17% vs. 3%), chest tightness (9% vs. 1%), and chronic cough (11% vs. 0%) compared to the control group. Lung function parameters were significantly lower among the exposed group compared to the control group; mean forced vital capacity (FVC) was 3.35 L vs. 3.71 L (p = 0.001), mean forced expiratory volume in the first second (FEV₁) was 2.78 L vs. 3.17 L (p = 0.001). Higher levels of airway restriction were found among the exposed group. Among the exposed group, lung function parameters worsened with the increasing closeness of home to the quarry site. This study demonstrates the negative health effects of environmental dust exposure among two communities living near quarry sites in Palestine. The results highlight the importance of developing and strictly enforcing rules and regulations in Palestine to protect population health. Full article

(This article belongs to the Special Issue New Challenges and Crucial Topics for 2030 Public Health)

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Open AccessArticle

Active Breaks: A Pilot and Feasibility Study to Evaluate the Effectiveness of Physical Activity Levels in a School Based Intervention in an Italian Primary School

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Int. J. Environ. Res. Public Health 2020, 17(12), 4351; https://doi.org/10.3390/ijerph17124351 - 17 Jun 2020

Cited by 10 | Viewed by 3131

Abstract

Background: The school gives access to children, regardless of age, ethnicity, gender and socio-economic class and can be identified as the key environment in which to promote children’s physical activity (PA). The guidelines of the European Union recommend accumulating at least 10-min bouts [...] Read more.

Background: The school gives access to children, regardless of age, ethnicity, gender and socio-economic class and can be identified as the key environment in which to promote children’s physical activity (PA). The guidelines of the European Union recommend accumulating at least 10-min bouts of PA to reach the daily 60 min. Active breaks (ABs) led by teachers inside the classroom represent a good strategy to promote PA. The aim of this pilot and feasibility study was to evaluate the feasibility and effectiveness in terms of PA level of an AB programme in children aged 8–9 years attending primary school. Methods: A pre-post quasi-experimental pilot and feasibility study was performed in two primary school classes, one of which was assigned to a 14-week AB intervention (AB group) and the other to the control group (CG). At baseline and at follow-up, children were monitored for sedentary and motor activity during an entire week using ActiGraph Accelerometer (ActiLife6 wGT3X-BT). The satisfaction of children and teachers was assessed by self-administered questionnaires. Results: In the pre-post comparison, AB group (n = 16) showed a reduction in the minutes spent in weekly sedentary activity (−168.7 min, p > 0.05), an increase in the number of step counts (+14,026.9, p < 0.05) and in time spent in moderate to vigorous PA (MVPA): weekly MVPA: +64.4 min, daily MVPA: +8.05 min, percentage of MVPA: +0.70%. On the contrary, CG showed a worsening in all variables. ANCOVA analysis, after adjusting for baseline values, showed significant differences between the AB group and CG for time spent in MVPA, percentage of MVPA and step counts. The satisfaction of children and teachers was good. Teachers were able to adapt the AB protocol to the needs of the school curriculum, thus confirming the feasibility of the AB programme. Conclusions: This pilot and feasibility study showed the feasibility and effectiveness of the AB protocol and represented the basis for a future controlled trial. Full article

(This article belongs to the Special Issue New Challenges and Crucial Topics for 2030 Public Health)

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Open AccessArticle

Correlation between Preventive Health Behaviors and Psycho-Social Health Based on the Leisure Activities of South Koreans in the COVID-19 Crisis

by

Young-Jae Kim

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Jeong-Hyung Cho

Int. J. Environ. Res. Public Health 2020, 17(11), 4066; https://doi.org/10.3390/ijerph17114066 - 07 Jun 2020

Cited by 26 | Viewed by 6073

Abstract

COVID-19 has caused unprecedented damage worldwide, and quarantine and lockdown measures have been undertaken globally. This study focused on the differences in preventive behaviors and psycho-social health of South Koreans, as people continue engaging in leisure activities under self-regulation without a lockdown measure [...] Read more.

COVID-19 has caused unprecedented damage worldwide, and quarantine and lockdown measures have been undertaken globally. This study focused on the differences in preventive behaviors and psycho-social health of South Koreans, as people continue engaging in leisure activities under self-regulation without a lockdown measure imposed by the government. For the sample, the frame of the “2018 Population and Housing Census” in South Korea was applied, and data from 1770 people were analyzed. The results showed that the groups participating in culture and arts and social activities displayed characteristics with high prevention. Additionally, the groups that continued leisure activities for more than five years and with family showed high preventive behaviors. Meanwhile, participation in leisure activities with friends of the opposite sex lowered preventive behavior. In terms of psycho-social health, all groups were affiliated to the potential stress group and there were no differences in the period and participation time for leisure activities. Furthermore, the group participating in leisure activities with their school and group experienced psychological stability. When lockdown measures are eased, the aforementioned characteristics should be considered to design government policy; they can also be used as a reference for public health in case of a future outbreak of an epidemic. Full article

(This article belongs to the Special Issue New Challenges and Crucial Topics for 2030 Public Health)

Open AccessArticle

Knowledge, Attitudes, and Beliefs Regarding Drug Abuse and Misuse among Community Pharmacists in Saudi Arabia

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Abdulmajeed M. Mobrad

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Salmeen D. Babelghaith

Int. J. Environ. Res. Public Health 2020, 17(4), 1334; https://doi.org/10.3390/ijerph17041334 - 19 Feb 2020

Cited by 11 | Viewed by 3885

Abstract

Background and Objective: Several over-the-counter drugs have been documented as an essential issue in the community pharmacy setting owing to their liability to abuse. Pharmacists act as a critical monitor for these concerns and evaluate the seriousness of the patients’ condition. Therefore, this [...] Read more.

Background and Objective: Several over-the-counter drugs have been documented as an essential issue in the community pharmacy setting owing to their liability to abuse. Pharmacists act as a critical monitor for these concerns and evaluate the seriousness of the patients’ condition. Therefore, this study aimed to assess the knowledge, attitudes, and beliefs regarding drug abuse and misuse among pharmacists at a community pharmacy in Riyadh city, Saudi Arabia. Methods: A cross-sectional study using a validated self-administered questionnaire was carried out among community pharmacists over three months April to June 2019. The survey had 25 items on the experience, knowledge, attitudes, beliefs, strategies, and opinions of participants toward drug abuse and misuse. Results: A total of 239 community pharmacists responded to the survey. About 84% of them had received training on drug misuse or abuse. The majority of community pharmacists (85.8%) would like to be provided educational programs on drug abuse in the future. Nearly all the pharmacists (94.9%) reported providing suitable advice to suspected drug misusers either in written or oral form at their pharmacies. Approximately 31% agreed or strongly agreed to dispense controlled drugs through a pharmacy. Regarding the ethical matter of selling misusers controlled drugs, 93.7% of the respondents believed that it is deceptive to offer misusers controlled medications. A comparison of knowledge and beliefs (univariate analysis) showed that the results were significant only for respondents who had graduated from Yemen (p = 0.007) and respondents who had an experience of four to six years or more (p < 0.01). Conclusion: The findings revealed that the majority of community pharmacists had been trained in recognizing drug abuse or dependence during their pharmacy college education. In addition, majority of them reported that they warned or counseled patients about the occurrence of adverse drug reactions to specific medications. However, majority of them agreed that selling controlled drugs is unethical in a community pharmacy. Thus, effective implementation of pharmaceutical rules and laws is a fundamental need in the Saudi Arabian health care system and we suggest stringent execution of the regulations by the Saudi health care authorities. Full article

(This article belongs to the Special Issue New Challenges and Crucial Topics for 2030 Public Health)

Review

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Open AccessReview

Long-Term Kinetics of Serological Antibodies against Vibrio cholerae Following a Clinical Cholera Case: A Systematic Review and Meta-Analysis

by

Basilua Andre Muzembo

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Int. J. Environ. Res. Public Health 2022, 19(12), 7141; https://doi.org/10.3390/ijerph19127141 - 10 Jun 2022

Cited by 1 | Viewed by 1566

Abstract

Background: Approximately 2.9 million people worldwide suffer from cholera each year, many of whom are destitute. However, understanding of immunity against cholera is still limited. Several studies have reported the duration of antibodies following cholera; however, systematic reviews including a quantitative synthesis are [...] Read more.

Background: Approximately 2.9 million people worldwide suffer from cholera each year, many of whom are destitute. However, understanding of immunity against cholera is still limited. Several studies have reported the duration of antibodies following cholera; however, systematic reviews including a quantitative synthesis are lacking. Objective: To meta-analyze cohort studies that have evaluated vibriocidal, cholera toxin B subunit (CTB), and lipopolysaccharide (LPS) antibody levels following a clinical cholera case. Methods: Design: Systematic review and meta-analysis. We searched PubMed and Web of science for studies assessing antibodies against Vibrio cholerae in cohorts of patients with clinical cholera. Two authors independently extracted data and assessed the quality of included studies. Random effects models were used to pool antibody titers in adults and older children (aged ≥ 6 years). In sensitivity analysis, studies reporting data on young children (2–5 years) were included. Results: Nine studies met our inclusion criteria for systematic review and seven for meta-analysis. The pooled mean of vibriocidal antibody titers in adults and older children (aged ≥ 6 years) was 123 on day 2 post-symptom onset, which sharply increased on day 7 (pooled mean = 6956) and gradually waned to 2247 on day 30, 578 on day 90, and 177 on day 360. Anti-CTB IgA antibodies also peaked on day 7 (pooled mean = 49), followed by a rapid decrease on day 30 (pooled mean = 21), and further declined on day 90 (pooled mean = 10), after which it plateaued from day 180 (pooled mean = 8) to 360 (pooled mean = 6). Similarly, anti-CTB IgG antibodies peaked in early convalescence between days 7 (pooled mean = 65) and 30 (pooled mean = 69), then gradually waned on days 90 (pooled mean = 42) and 180 (pooled mean = 30) and returned to baseline on day 360 (pooled mean = 24). Anti-LPS IgA antibodies peaked on day 7 (pooled mean = 124), gradually declined on day 30 (pooled mean = 44), which persisted until day 360 (pooled mean = 10). Anti LPS IgG antibodies peaked on day 7 (pooled mean = 94). Thereafter, they decreased on day 30 (pooled mean = 85), and dropped further on days 90 (pooled mean = 51) and 180 (pooled mean = 47), and returned to baseline on day 360 (pooled mean = 32). Sensitivity analysis including data from young children (aged 2–5 years) showed very similar findings as in the primary analysis. Conclusions: This study confirms that serological antibody (vibriocidal, CTB, and LPS) titers return to baseline levels within 1 year following clinical cholera, i.e., before the protective immunity against subsequent cholera wanes. However, this decay should not be interpreted as waning immunity because immunity conferred by cholera against subsequent disease lasts 3–10 years. Our study provides evidence for surveillance strategies and future research on vaccines and also demonstrates the need for further studies to improve our understanding of immunity against cholera. Full article

(This article belongs to the Special Issue New Challenges and Crucial Topics for 2030 Public Health)

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Open AccessReview

Can Social Prescribing Foster Individual and Community Well-Being? A Systematic Review of the Evidence

by

Dragana Vidovic

,

Gina Yannitell Reinhardt

and

Clare Hammerton

Int. J. Environ. Res. Public Health 2021, 18(10), 5276; https://doi.org/10.3390/ijerph18105276 - 15 May 2021

Cited by 16 | Viewed by 5598

Abstract

Social prescribing programmes (SP) are person-centred coaching schemes meant to help participants improve individual circumstances, thereby to reduce demand on health and social care. SP could be an innovative means to improve preventive and public health in the pursuit of universal financially sustainable [...] Read more.

Social prescribing programmes (SP) are person-centred coaching schemes meant to help participants improve individual circumstances, thereby to reduce demand on health and social care. SP could be an innovative means to improve preventive and public health in the pursuit of universal financially sustainable healthcare. Given its potential, our systematic review assesses type, content, and quality of evidence available regarding SP effectiveness at the individual, system, and community levels. We examine the impact of SP on addressing loneliness, social isolation, well-being, and connectedness, as well as related concepts, which are not yet considered jointly in one study. Following PRISMA, we search: EBSCOHost (CINAHL Complete; eBook Collection; E-Journals; MEDLINE Full Text; Open Dissertations; PsycARTICLES; PsycINFO); Web of Science Core Collection; and UK National Institute for Health and Care Excellence. Excluding systematic reviews and articles without impact evaluations, we review 51 studies. Several studies do not distinguish between core concepts and/or provide information on the measures used to assess outcomes; exactly one peer-reviewed study presents a randomised controlled trial. If we wish to know the potential of social prescribing to lead to universal financially sustainable healthcare, we urge researchers and practitioners to standardise definitions and metrics, and to explore conceptual linkages between social prescribing and system/community outcomes. Full article

(This article belongs to the Special Issue New Challenges and Crucial Topics for 2030 Public Health)

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Open AccessReview

The Economic Costs of Childhood Disability: A Literature Review

by

Ahmed Ramadan Shokry Shahat

and

Giulia Greco

Int. J. Environ. Res. Public Health 2021, 18(7), 3531; https://doi.org/10.3390/ijerph18073531 - 29 Mar 2021

Cited by 15 | Viewed by 3449

Abstract

Background: This literature review investigates the economic costs of childhood disability analysing methodologies used and summarizing the burden worldwide comparing developed and developing countries. Methods: Four electronic databases were searched. Studies were categorised according to country, perspective, methods of costing, disability category, and [...] Read more.

Background: This literature review investigates the economic costs of childhood disability analysing methodologies used and summarizing the burden worldwide comparing developed and developing countries. Methods: Four electronic databases were searched. Studies were categorised according to country, perspective, methods of costing, disability category, and time horizon. Annual costs were converted to 2019 current US dollars then compared to the country’s per capita current health expenditure (CHE) and gross domestic product (GDP). Results: Of 2468 references identified, 20 were included in the review. Annual burden of childhood disability ranged ≈$450–69,500 worldwide. Childhood disability imposes a heavy economic burden on families, health systems, and societies. The reason for the wide range of costs is the variability in perspective, costs included, methods, and disability type. Conclusion: The annual societal costs for one disabled child could be up to the country’s GDP per capita. The burden is heavier on households in developing countries as most of the costs are paid out-of-pocket leading to impoverishment of the whole family. Efforts should be directed to avoid preventable childhood disabilities and to support disabled children and their households to make them more independent and increase their productivity. More studies from developing countries are needed. Full article

(This article belongs to the Special Issue New Challenges and Crucial Topics for 2030 Public Health)

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Open AccessReview

Reopening Schools during the COVID-19 Pandemic: Overview and Rapid Systematic Review of Guidelines and Recommendations on Preventive Measures and the Management of Cases

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Maria Rosaria Gualano

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Roberta Siliquini

Int. J. Environ. Res. Public Health 2020, 17(23), 8839; https://doi.org/10.3390/ijerph17238839 - 27 Nov 2020

Cited by 26 | Viewed by 7450

Abstract

Given the limited evidence of school closure effectiveness in containing the pandemic and the consequences for young people, reopening schools with appropriate measures is essential. This overview aimed to describe the main measures planned for the 2020–2021 academic year within the WHO European [...] Read more.

Given the limited evidence of school closure effectiveness in containing the pandemic and the consequences for young people, reopening schools with appropriate measures is essential. This overview aimed to describe the main measures planned for the 2020–2021 academic year within the WHO European Region. A rapid systematic review of scientific databases was also performed. The websites of the government, Ministry of Health, and Ministry of Education of European Region countries were searched through 1 October for official documents about the prevention and management of suspected cases/confirmed cases in primary and secondary schools. To find further suggestions, a rapid systematic review was conducted through 20 October searching Pubmed, Scopus, and Embase. There were 23 official documents. France, Luxembourg, Malta, Ireland, Italy, Portugal, the UK, Spain, and San Marino were considered. Performing the rapid review, 855 records were identified and 7 papers were finally selected. The recommendations mostly agreed. However, there was no consensus on the criteria for the return to school of students that tested positive, and the flexibility between attendance at school and remote education for high-risk children often varied. School closure was commonly considered as the very last resort for COVID-19 control. Studies are required to evaluate the impact of different recommendations during this autumn term. Full article

(This article belongs to the Special Issue New Challenges and Crucial Topics for 2030 Public Health)

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Open AccessReview

Fundamental Concepts of Human Thermoregulation and Adaptation to Heat: A Review in the Context of Global Warming

by

Chin Leong Lim

Int. J. Environ. Res. Public Health 2020, 17(21), 7795; https://doi.org/10.3390/ijerph17217795 - 24 Oct 2020

Cited by 19 | Viewed by 5517

Abstract

The international community has recognized global warming as an impending catastrophe that poses significant threat to life on earth. In response, the signatories of the Paris Agreement (2015) have committed to limit the increase in global mean temperature to <1.5 °C from pre-industry [...] Read more.

The international community has recognized global warming as an impending catastrophe that poses significant threat to life on earth. In response, the signatories of the Paris Agreement (2015) have committed to limit the increase in global mean temperature to <1.5 °C from pre-industry period, which is defined as 1850–1890. Considering that the protection of human life is a central focus in the Paris Agreement, the naturally endowed properties of the human body to protect itself from environmental extremes should form the core of an integrated and multifaceted solution against global warming. Scholars believe that heat and thermoregulation played important roles in the evolution of life and continue to be a central mechanism that allows humans to explore, labor and live in extreme conditions. However, the international effort against global warming has focused primarily on protecting the environment and on the reduction of greenhouse gases by changing human behavior, industrial practices and government policies, with limited consideration given to the nature and design of the human thermoregulatory system. Global warming is projected to challenge the limits of human thermoregulation, which can be enhanced by complementing innate human thermo-plasticity with the appropriate behavioral changes and technological innovations. Therefore, the primary aim of this review is to discuss the fundamental concepts and physiology of human thermoregulation as the underlying bases for human adaptation to global warming. Potential strategies to extend human tolerance against environmental heat through behavioral adaptations and technological innovations will also be discussed. An important behavioral adaptation postulated by this review is that sleep/wake cycles would gravitate towards a sub-nocturnal pattern, especially for outdoor activities, to avoid the heat in the day. Technologically, the current concept of air conditioning the space in the room would likely steer towards the concept of targeted body surface cooling. The current review was conducted using materials that were derived from PubMed search engine and the personal library of the author. The PubMed search was conducted using combinations of keywords that are related to the theme and topics in the respective sections of the review. The final set of articles selected were considered “state of the art,” based on their contributions to the strength of scientific evidence and novelty in the domain knowledge on human thermoregulation and global warming. Full article

(This article belongs to the Special Issue New Challenges and Crucial Topics for 2030 Public Health)

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Open AccessReview

Clinical and Regulatory Concerns of Biosimilars: A Review of Literature

by

Vesa Halimi

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Armond Daci

,

Katerina Ancevska Netkovska

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Ljubica Suturkova

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Zaheer-Ud-Din Babar

and

Aleksandra Grozdanova

Int. J. Environ. Res. Public Health 2020, 17(16), 5800; https://doi.org/10.3390/ijerph17165800 - 11 Aug 2020

Cited by 21 | Viewed by 3402

Abstract

Although biosimilars have been part of clinical practice for more than a decade, healthcare professionals (HCPs) do not fully accept them. This is because of the perception that biosimilars may not be like their originators in terms of quality, safety, and efficacy. This [...] Read more.

Although biosimilars have been part of clinical practice for more than a decade, healthcare professionals (HCPs) do not fully accept them. This is because of the perception that biosimilars may not be like their originators in terms of quality, safety, and efficacy. This study aims to evaluate the current knowledge and attitudes of healthcare professionals toward biosimilar prescription, and to elaborate on their concerns. We reviewed the literature using PubMed, Cochrane Library, and Science Direct electronic databases in the period from 2018 to 2020. The knowledge and confidence of healthcare professionals vary between countries, between clinical profiles and between studies. Although most of the healthcare professionals had a positive attitude to prescribing biosimilars, they would still prefer to prescribe them in initial treatment. Generally, HCPs were against multiple switches and substitution of biosimilars at the pharmacy level. HCP’s key concern was interchangeability, with eventual consequences on the clinical outcome of patients. HCPs still approach biosimilars with caution and stigma. HCPs need to have an unbiased coherent understanding of biosimilars at clinical, molecular and regulatory levels. It was also observed that most of their concerns are more theoretical than science-based. Physicians are in an excellent position to accept biosimilars, but they need the additional support of regulatory authorities to approve and take into consideration the available scientific data regarding biosimilars. Full article

(This article belongs to the Special Issue New Challenges and Crucial Topics for 2030 Public Health)

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Open AccessReview

Climate Change and Childhood Respiratory Health: A Call to Action for Paediatricians

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Valentina Agnese Ferraro

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Maria Furno

,

Valentina Tranchino

and

Stefania La Grutta

Int. J. Environ. Res. Public Health 2020, 17(15), 5344; https://doi.org/10.3390/ijerph17155344 - 24 Jul 2020

Cited by 27 | Viewed by 4666

Abstract

Climate change (CC) is one of the main contributors to health emergencies worldwide. CC appears to be closely interrelated with air pollution, as some pollutants like carbon dioxide (CO₂), nitrogen oxides (NOx) and black carbon are naturally occurring greenhouse gases. Air [...] Read more.

Climate change (CC) is one of the main contributors to health emergencies worldwide. CC appears to be closely interrelated with air pollution, as some pollutants like carbon dioxide (CO₂), nitrogen oxides (NOx) and black carbon are naturally occurring greenhouse gases. Air pollution may enhance the allergenicity of some plants and, also, has an adverse effect on respiratory health. Children are a uniquely vulnerable group that suffers disproportionately from CC burden. The increasing global warming related to CC has a big impact on plants’ lifecycles, with earlier and longer pollen seasons, as well as higher pollen production, putting children affected by asthma and allergic rhinitis at risk for exacerbations. Extreme weather events may play a role too, not only in the exacerbations of allergic respiratory diseases but, also, in favouring respiratory infections. Even though paediatricians are already seeing the impacts of CC on their patients, their knowledge about CC-related health outcomes with specific regards to children’s respiratory health is incomplete. This advocates for paediatricians’ increased awareness and a better understanding of the CC impact on children’s respiratory health. Having a special responsibility for children, paediatricians should actively be involved in policies aimed to protect the next generation from CC-related adverse health effects. Hence, there is an urgent need for them to take action and successfully educate families about CC issues. This paper aims at reviewing the evidence of CC-related environmental factors such as temperature, humidity, rainfall and extreme events on respiratory allergic diseases and respiratory infections in children and proposing specific actionable items for paediatricians to deal with CC-related health issues in their clinical practice. Full article

(This article belongs to the Special Issue New Challenges and Crucial Topics for 2030 Public Health)

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Open AccessReview

Smart Sanitation—Biosensors as a Public Health Tool in Sanitation Infrastructure

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Int. J. Environ. Res. Public Health 2020, 17(14), 5146; https://doi.org/10.3390/ijerph17145146 - 16 Jul 2020

Cited by 13 | Viewed by 3250

Abstract

The health of individuals and communities is more interconnected than ever, and emergent technologies have the potential to improve public health monitoring at both the community and individual level. A systematic literature review of peer-reviewed and gray literature from 2000-present was conducted on [...] Read more.

The health of individuals and communities is more interconnected than ever, and emergent technologies have the potential to improve public health monitoring at both the community and individual level. A systematic literature review of peer-reviewed and gray literature from 2000-present was conducted on the use of biosensors in sanitation infrastructure (such as toilets, sewage pipes and septic tanks) to assess individual and population health. 21 relevant papers were identified using PubMed, Embase, Global Health, CDC Stacks and NexisUni databases and a reflexive thematic analysis was conducted. Biosensors are being developed for a range of uses including monitoring illicit drug usage in communities, screening for viruses and diagnosing conditions such as diabetes. Most studies were nonrandomized, small-scale pilot or lab studies. Of the sanitation-related biosensors found in the literature, 11 gathered population-level data, seven provided real-time continuous data and 14 were noted to be more cost-effective than traditional surveillance methods. The most commonly discussed strength of these technologies was their ability to conduct rapid, on-site analysis. The findings demonstrate the potential of this emerging technology and the concept of Smart Sanitation to enhance health monitoring at the individual level (for diagnostics) as well as at the community level (for disease surveillance). Full article

(This article belongs to the Special Issue New Challenges and Crucial Topics for 2030 Public Health)

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Open AccessPerspective

Understanding the Interplay between Antimicrobial Resistance, Microplastics and Xenobiotic Contaminants: A Leap towards One Health?

by

Federica Piergiacomo

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Lorenzo Brusetti

and

Leonardo Pagani

Int. J. Environ. Res. Public Health 2023, 20(1), 42; https://doi.org/10.3390/ijerph20010042 - 20 Dec 2022

Cited by 3 | Viewed by 1525

Abstract

According to the World Health Organization, the two major public health threats in the twenty-first century are antibiotic-resistant bacteria and antibiotic-resistant genes. The reason for the global prevalence and the constant increase of antibiotic-resistant bacteria is owed to the steady rise in overall [...] Read more.

According to the World Health Organization, the two major public health threats in the twenty-first century are antibiotic-resistant bacteria and antibiotic-resistant genes. The reason for the global prevalence and the constant increase of antibiotic-resistant bacteria is owed to the steady rise in overall antimicrobial consumption in several medical, domestic, agricultural, industrial, and veterinary applications, with consequent environmental release. These antibiotic residues may directly contaminate terrestrial and aquatic environments in which antibiotic-resistance genes are also present. Reports suggest that metal contamination is one of the main drivers of antimicrobial resistance (AMR). Moreover, the abundance of antibiotic-resistance genes is directly connected to the predominance of metal concentrations in the environment. In addition, microplastics have become a threat as emerging contaminants because of their ubiquitous presence, bio-inertness, toughness, danger to aquatic life, and human health implications. In the environment, microplastics and AMR are interconnected through biofilms, where genetic information (e.g., ARGs) is horizontally transferred between bacteria. From this perspective, we tried to summarize what is currently known on this topic and to propose a more effective One Health policy to tackle these threats. Full article

(This article belongs to the Special Issue New Challenges and Crucial Topics for 2030 Public Health)

Open AccessSystematic Review

Ultrasonographic Evaluation of Skin Toxicity Following Radiotherapy of Breast Cancer: A Systematic Review

by

Fatimah Alaa Hussein

,

Hanani Abdul Manan

,

Aida W. M. Mohd Mustapha

,

Khairiyah Sidek

and

Noorazrul Yahya

Int. J. Environ. Res. Public Health 2022, 19(20), 13439; https://doi.org/10.3390/ijerph192013439 - 18 Oct 2022

Cited by 2 | Viewed by 1174

Abstract

The present review aimed to systematically review skin toxicity changes following breast cancer radiotherapy (RT) using ultrasound (US). PubMed and Scopus databases were searched according to PRISMA guidelines. The characteristics of the selected studies, measured parameters, US skin findings, and their association with [...] Read more.

The present review aimed to systematically review skin toxicity changes following breast cancer radiotherapy (RT) using ultrasound (US). PubMed and Scopus databases were searched according to PRISMA guidelines. The characteristics of the selected studies, measured parameters, US skin findings, and their association with clinical assessments were extracted. Seventeen studies were included with a median sample size of 29 (range 11–166). There were significant US skin changes in the irradiated skin compared to the nonirradiated skin or baseline measurements. The most observed change is skin thickening secondary to radiation-induced oedema, except one study found skin thinning after pure postmastectomy RT. However, eight studies reported skin thickening predated RT attributed to axillary surgery. Four studies used US radiofrequency (RF) signals and found a decrease in the hypodermis’s Pearson correlation coefficient (PCC). Three studies reported decreased dermal echogenicity and poor visibility of the dermis–subcutaneous fat boundary (statistically analysed by one report). The present review revealed significant ultrasonographic skin toxicity changes in the irradiated skin most commonly skin thickening. However, further studies with large cohorts, appropriate US protocol, and baseline evaluation are needed. Measuring other US skin parameters and statistically evaluating the degree of the association with clinical assessments are also encouraged. Full article

(This article belongs to the Special Issue New Challenges and Crucial Topics for 2030 Public Health)

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Open AccessSystematic Review

Risk Perception towards COVID-19: A Systematic Review and Qualitative Synthesis

by

Sabrina Cipolletta

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Gabriela Rios Andreghetti

and

Giovanna Mioni

Int. J. Environ. Res. Public Health 2022, 19(8), 4649; https://doi.org/10.3390/ijerph19084649 - 12 Apr 2022

Cited by 32 | Viewed by 3107 | Correction

Abstract

Several studies have attempted to identify how people’s risk perceptions differ in regard to containing COVID-19 infections. The aim of the present review was to illustrate how risk awareness towards COVID-19 predicts people’s preventive behaviors and to understand which features are associated with [...] Read more.

Several studies have attempted to identify how people’s risk perceptions differ in regard to containing COVID-19 infections. The aim of the present review was to illustrate how risk awareness towards COVID-19 predicts people’s preventive behaviors and to understand which features are associated with it. For the review, 77 articles found in six different databases (ProQuest, PsycInfo, PubMed, Science Direct, SCOPUS, and Web of Science) were considered, the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines was followed, and data synthesis was conducted using a mixed-methods approach. The results indicate that a high-risk perception towards COVID-19 predicts, in general, compliance with preventive behaviors and social distancing measures. Additionally, risk awareness was found to be associated with four other key themes: demographic factors, individual factors, geographical factors, and timing. Therefore, gaining a greater understanding of individual and cultural differences as well as how people behave could be the basis of an effective strategy for raising public risk awareness and for countering COVID-19. Full article

(This article belongs to the Special Issue New Challenges and Crucial Topics for 2030 Public Health)

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Open AccessConcept Paper

Establishing a Theory-Based Multi-Level Approach for Primary Prevention of Mental Disorders in Young People

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Int. J. Environ. Res. Public Health 2020, 17(24), 9445; https://doi.org/10.3390/ijerph17249445 - 16 Dec 2020

Cited by 10 | Viewed by 3521

Abstract

The increasing prevalence of mental health disorders and psychosocial distress among young people exceeds the capacity of mental health services. Social and systemic factors determine mental health as much as individual factors. To determine how best to address multi-level risk factors, we must [...] Read more.

The increasing prevalence of mental health disorders and psychosocial distress among young people exceeds the capacity of mental health services. Social and systemic factors determine mental health as much as individual factors. To determine how best to address multi-level risk factors, we must first understand the distribution of risk. Previously, we have used psychometric methods applied to two epidemiologically-principled samples of people aged 14–24 to establish a robust, latent common mental distress (CMD) factor of depression and anxiety normally distributed across the population. This was linearly associated with suicidal thoughts and non-suicidal self-harm such that effective interventions to reduce CMD across the whole population could have a greater total benefit than those that focus on the minority with the most severe scores. In a randomised trial of mindfulness interventions in university students (the Mindful Student Study), we demonstrated a population-shift effect whereby the intervention group appeared resilient to a universal stressor. Given these findings, and in light of the COVID-19 pandemic, we argue that population-based interventions to reduce CMD are urgently required. To target all types of mental health determinants, these interventions must be multi-level. Careful design and evaluation, interdisciplinary work, and extensive local stakeholder involvement are crucial for these interventions to be effective. Full article

(This article belongs to the Special Issue New Challenges and Crucial Topics for 2030 Public Health)

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