Next Issue
Volume 18, June-2
Previous Issue
Volume 18, May-2
ijerph-logo

Journal Browser

Journal Browser

Int. J. Environ. Res. Public Health, Volume 18, Issue 11 (June-1 2021) – 677 articles

Cover Story (view full-size image): Caffeine is a well-established ergogenic aid. While the performance-enhancing effects of caffeine have been thoroughly explored, the majority of previous studies included only males as participants. Therefore, our meta-analysis aimed to examine the effects of caffeine ingestion on muscular endurance and muscular strength in women. When we pooled the data from the eight included studies, we found an ergogenic effect of caffeine on muscular endurance (effect size = 0.25) and muscular strength (effect size = 0.18). The effects reported in this analysis are similar to those previously observed in men and suggest that women may use caffeine supplementation as an ergogenic aid for muscular performance. View this paper.
  • Issues are regarded as officially published after their release is announced to the table of contents alert mailing list.
  • You may sign up for e-mail alerts to receive table of contents of newly released issues.
  • PDF is the official format for papers published in both, html and pdf forms. To view the papers in pdf format, click on the "PDF Full-text" link, and use the free Adobe Readerexternal link to open them.
Order results
Result details
Select all
Export citation of selected articles as:
Article
Control Models and Spatiotemporal Characteristics of Air Pollution in the Rapidly Developing Urban Agglomerations
Int. J. Environ. Res. Public Health 2021, 18(11), 6177; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18116177 - 07 Jun 2021
Cited by 1 | Viewed by 4654
Abstract
This paper systematically summarizes the hierarchical cross-regional multi-directional linkage in terms of air pollution control models implemented in the Beijing-Tianjin-Hebei urban agglomeration, including the hierarchical linkage structure of national-urban agglomeration-city, the cross-regional linkage governance of multiple provinces and municipalities, the multi-directional linkage mechanism [...] Read more.
This paper systematically summarizes the hierarchical cross-regional multi-directional linkage in terms of air pollution control models implemented in the Beijing-Tianjin-Hebei urban agglomeration, including the hierarchical linkage structure of national-urban agglomeration-city, the cross-regional linkage governance of multiple provinces and municipalities, the multi-directional linkage mechanism mainly involving industry access, energy structure, green transportation, cross-regional assistance, monitoring and warning, consultation, and accountability. The concentration data of six air pollutants were used to analyze spatiotemporal characteristics. The concentrations of SO2, NO2, PM10, PM2.5, CO decreased, and the concentration of O3 increased from 2014 to 2017; the air pollution control has achieved good effect. The concentration of O3 was the highest in summer and lowest in winter, while those of other pollutants were the highest in winter and lowest in summer. The high pollution ranges of O3 diffused from south to north, and those of other pollutants decreased significantly from north to south. Finally, we suggest strengthening the traceability and process research of heavy pollution, increasing the traceability and process research of O3 pollution, promoting the joint legislation of different regions in urban agglomeration, create innovative pollution discharge supervision mechanisms, in order to provide significant reference for the joint prevention and control of air pollution in urban agglomerations. Full article
(This article belongs to the Special Issue Land Use Changes and the Corresponding Ecological Risks)
Show Figures

Figure 1

Review
Manual Therapy in Cervical and Lumbar Radiculopathy: A Systematic Review of the Literature
Int. J. Environ. Res. Public Health 2021, 18(11), 6176; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18116176 - 07 Jun 2021
Viewed by 1502
Abstract
The aim of this study was to describe and update current knowledge of manual therapy accuracy in treating cervical and lumbar radiculopathy, to identify the limitations in current studies, and to suggest areas for future research. The study was conducted according to PRISMA [...] Read more.
The aim of this study was to describe and update current knowledge of manual therapy accuracy in treating cervical and lumbar radiculopathy, to identify the limitations in current studies, and to suggest areas for future research. The study was conducted according to PRISMA guidelines for systematic reviews. A comprehensive literature review was conducted using PubMed and Web of Science databases up to April 2020. The following inclusion criteria were used: (1) presence of radiculopathy; (2) treatment defined as manual therapy (i.e., traction, manipulation, mobilization); and (3) publication defined as a Randomized Controlled Trial. The electronic literature search resulted in 473 potentially relevant articles. Finally, 27 articles were accepted: 21 on cervical (CR) and 6 in lumbar radiculopathy (LR). The mean PEDro score for CR was 6.6 (SD 1.3), and for LR 6.7 (SD 1.6). Traction-oriented techniques are the most frequently chosen treatment form for CR and are efficient in reducing pain and improving functional outcomes. In LR, each of the included publications used a different form of manual therapy, which makes it challenging to summarize knowledge in this group. Of included publications, 93% were either of moderate or low quality, which indicates that quality improvement is necessary for this type of research. Full article
(This article belongs to the Section Health Behavior, Chronic Disease and Health Promotion)
Show Figures

Figure 1

Article
Determinants of Food Choice and Perceptions of Supermarket-Based Nudging Interventions among Adults with Low Socioeconomic Position: The SUPREME NUDGE Project
Int. J. Environ. Res. Public Health 2021, 18(11), 6175; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18116175 - 07 Jun 2021
Viewed by 960
Abstract
Nudging has received ample attention in scientific literature as an environmental strategy to promote healthy diets, and may be effective for reaching populations with low socioeconomic position (SEP). Therefore, the objective of this study was to investigate how the determinants of food choice [...] Read more.
Nudging has received ample attention in scientific literature as an environmental strategy to promote healthy diets, and may be effective for reaching populations with low socioeconomic position (SEP). Therefore, the objective of this study was to investigate how the determinants of food choice shape the perceptions regarding supermarket-based nudging strategies among adults with low SEP. We conducted semi-structured interviews among fifteen adults with low SEP using a pre-defined topic list and visual examples of nudges. Interviews were recorded and transcribed verbatim and content analysis was used to analyse the data. The results show that food costs, convenience, healthiness, taste, and habits were frequently mentioned as determinants of food choice. However, the relative importance of these determinants seemed to be context-dependent. Interviewees generally had a positive attitude towards nudges, especially when they were aligned with product preferences, information needs, and beliefs about the food environment. Still, some interviewees also expressed distrust towards nudging strategies, suspecting ulterior motives. We conclude that nudging strategies should target foods which align with product preferences and information needs. However, the suspicion of ulterior motives highlights an important concern which should be considered when implementing supermarket-based nudging strategies. Full article
(This article belongs to the Section Health Behavior, Chronic Disease and Health Promotion)
Show Figures

Figure 1

Article
Comparison of ARIMA and LSTM in Forecasting the Incidence of HFMD Combined and Uncombined with Exogenous Meteorological Variables in Ningbo, China
Int. J. Environ. Res. Public Health 2021, 18(11), 6174; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18116174 - 07 Jun 2021
Viewed by 1224
Abstract
Background: This study intends to identify the best model for predicting the incidence of hand, foot and mouth disease (HFMD) in Ningbo by comparing Autoregressive Integrated Moving Average (ARIMA) and Long Short-Term Memory Neural Network (LSTM) models combined and uncombined with exogenous meteorological [...] Read more.
Background: This study intends to identify the best model for predicting the incidence of hand, foot and mouth disease (HFMD) in Ningbo by comparing Autoregressive Integrated Moving Average (ARIMA) and Long Short-Term Memory Neural Network (LSTM) models combined and uncombined with exogenous meteorological variables. Methods: The data of daily HFMD incidence in Ningbo from January 2014 to November 2017 were set as the training set, and the data of December 2017 were set as the test set. ARIMA and LSTM models combined and uncombined with exogenous meteorological variables were adopted to fit the daily incidence of HFMD by using the data of the training set. The forecasting performances of the four fitted models were verified by using the data of the test set. Root mean square error (RMSE) was selected as the main measure to evaluate the performance of the models. Results: The RMSE for multivariate LSTM, univariate LSTM, ARIMA and ARIMAX (Autoregressive Integrated Moving Average Model with Exogenous Input Variables) was 10.78, 11.20, 12.43 and 14.73, respectively. The LSTM model with exogenous meteorological variables has the best performance among the four models and meteorological variables can increase the prediction accuracy of LSTM model. For the ARIMA model, exogenous meteorological variables did not increase the prediction accuracy but became the interference factor of the model. Conclusions: Multivariate LSTM is the best among the four models to fit the daily incidence of HFMD in Ningbo. It can provide a scientific method to build the HFMD early warning system and the methodology can also be applied to other communicable diseases. Full article
Show Figures

Figure 1

Article
Kramer Score, an Evidence of Its Use in Accordance with Indonesian Hyperbilirubinemia Published Guideline
Int. J. Environ. Res. Public Health 2021, 18(11), 6173; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18116173 - 07 Jun 2021
Viewed by 930
Abstract
Background: In some hospitals in low/middle-income countries, methods to determine the bilirubin level in newborn infants are unavailable and based on a clinical evaluation, namely a clinical score designed by Kramer. In this study, we evaluated if this score can be used to [...] Read more.
Background: In some hospitals in low/middle-income countries, methods to determine the bilirubin level in newborn infants are unavailable and based on a clinical evaluation, namely a clinical score designed by Kramer. In this study, we evaluated if this score can be used to identify those infants that need phototherapy. Method: Infants admitted between November 2018 and June 2019 to three hospitals in Surabaya, Indonesia were included. The jaundice intensity was scored using the Kramer score. Blood was sampled for total serum bilirubin (TSB) measurement. The infants were categorized into Treatment Needed (TN) group when treatment with phototherapy was indicated and the No Treatment Needed (NTN) group when phototherapy was not indicated, based on the Indonesian Guideline for hyperbilirubinemia. Result: A total of 280 infants with a mean birth weight of 2744.6 ± 685.8 g and a gestational age of 37.3 ± 2.3 weeks were included. Twenty-seven of 113 (24%) infants with Kramer score 2 needed phototherapy, compared with 41 of 90 (46%) infants with score 3 and 20 of 28 (71%) of infants with score 4. The percentage of infants that needed phototherapy was higher with decreasing gestational age. Conclusion: The Kramer score is an invalid method to distinguish between those infants needing phototherapy and those infants where this treatment is not indicated. Full article
(This article belongs to the Section Children's Health)
Show Figures

Figure 1

Article
Between Joy and Sympathy: Smiling and Sad Recipient Faces Increase Prosocial Behavior in the Dictator Game
Int. J. Environ. Res. Public Health 2021, 18(11), 6172; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18116172 - 07 Jun 2021
Viewed by 930
Abstract
In human interactions, the facial expression of a bargaining partner may contain relevant information that affects prosocial decisions. We were interested in whether facial expressions of the recipient in the dictator game influence dictators’ behavior. To test this, we conducted an online study [...] Read more.
In human interactions, the facial expression of a bargaining partner may contain relevant information that affects prosocial decisions. We were interested in whether facial expressions of the recipient in the dictator game influence dictators’ behavior. To test this, we conducted an online study (n = 106) based on a modified version of a dictator game. The dictators allocated money between themselves and another person (recipient), who had no possibility to respond to the dictator. Importantly, before the allocation decision, the dictator was presented with the facial expression of the recipient (angry, disgusted, sad, smiling, or neutral). The results showed that dictators sent more money to recipients with sad or smiling facial expressions and less to recipients with angry or disgusted facial expressions compared with a neutral facial expression. Moreover, based on the sequential analysis of the decision and the interaction partner in the preceding trial, we found that decision-making depends upon previous interactions. Full article
Show Figures

Figure 1

Article
The Perceived Impact of The First UK COVID-19 Lockdown on Companion Animal Welfare and Behaviour: A Mixed-Method Study of Associations with Owner Mental Health
Int. J. Environ. Res. Public Health 2021, 18(11), 6171; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18116171 - 07 Jun 2021
Cited by 1 | Viewed by 3518
Abstract
Background: Companion animals may be a positive presence for their owners during the COVID-19 pandemic. However, the welfare of a companion animal is strongly influenced by the behaviour of their owners, as well as their physical and social environment. We aimed to investigate [...] Read more.
Background: Companion animals may be a positive presence for their owners during the COVID-19 pandemic. However, the welfare of a companion animal is strongly influenced by the behaviour of their owners, as well as their physical and social environment. We aimed to investigate the reported changes in companion animal welfare and behaviour and to examine the association between these changes and companion animal owners’ mental health. Methods: A cross-sectional online survey of UK residents over 18 years of age was conducted between April and June 2020 (n = 5926). The questionnaire included validated, bespoke items measuring outcomes related to mental health, human-animal bonds and reported changes in animal welfare and behaviour. The final item of the survey invited open-ended free-text responses, allowing participants to describe experiences associated with human-animal relationships during the first UK lockdown phase. Results: Animal owners made up 89.8% of the sample (n = 5323), of whom 67.3% reported changes in their animal’s welfare and behaviour during the first lockdown phase (n = 3583). These reported changes were reduced to a positive (0–7) and negative (0–5) welfare scale, following principal component analysis (PCA) of 17 items. Participants reported more positive changes for cats, whereas more negative changes were reported for dogs. Thematic analysis identified three main themes relating to the positive and negative impact on companion animals of the COVID-19 pandemic. Generalised linear models indicated that companion animal owners with poorer mental health scores pre-lockdown reported fewer negative changes in animal welfare and behaviour. However, companion animal owners with poorer mental health scores since lockdown reported more changes, both positive and negative, in animal welfare and behaviour. Conclusion: Our findings extend previous insights into perceived welfare and behaviour changes on a very limited range of species to a wider range of companion animals. Owner mental health status has a clear, albeit small, effect on companion animal welfare and behaviour. Full article
Show Figures

Figure 1

Article
Effects of Adolescents’ Lifestyle Habits and Body Composition on Bone Mineral Density
Int. J. Environ. Res. Public Health 2021, 18(11), 6170; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18116170 - 07 Jun 2021
Viewed by 923
Abstract
The incidence of osteoporosis is increasing as the population ages, as is the need to manage and prevent it. Adolescence is the period when the fastest development of bone mass takes place. Increasing adolescents’ maximum bone mass and avoiding the risk factors for [...] Read more.
The incidence of osteoporosis is increasing as the population ages, as is the need to manage and prevent it. Adolescence is the period when the fastest development of bone mass takes place. Increasing adolescents’ maximum bone mass and avoiding the risk factors for its loss are effective for preventing osteoporosis. This study investigated the factors influencing adolescents’ bone mineral density (BMD). The participants were 126 middle- and high-school students from Gangwon-do; 47.6% (n = 60) were male, with an average age of 15 (range 12–18) years of age. It was found that age, carbonated beverages, snacks, and calcium supplements were variables that showed significant differences in adolescents’ BMD. Additionally, through correlation analysis, it was found that height, weight, body mass index (BMI), body water, protein, minerals, body fat mass, and skeletal muscle mass were correlated with BMD. Multiple regression analysis identified age, calcium supplements, BMI, body fat mass, and skeletal muscle mass as BMD-associated factors. These results show that adolescents’ BMD is higher with lower body fat mass, higher BMI and skeletal muscle mass, and a higher intake of calcium supplements. Full article
(This article belongs to the Section Children's Health)
Show Figures

Figure 1

Article
Are Demanding Job Situations Associated with Alcohol-Related Presenteeism? The WIRUS-Screening Study
Int. J. Environ. Res. Public Health 2021, 18(11), 6169; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18116169 - 07 Jun 2021
Viewed by 1300
Abstract
Alcohol-related presenteeism (impaired work performance caused by alcohol use) is an important but under-researched topic. The aim of this study was to explore whether psychosocial work environment factors were associated with alcohol-related presenteeism. A cross sectional study of Norwegian employees (n = [...] Read more.
Alcohol-related presenteeism (impaired work performance caused by alcohol use) is an important but under-researched topic. The aim of this study was to explore whether psychosocial work environment factors were associated with alcohol-related presenteeism. A cross sectional study of Norwegian employees (n = 6620) was conducted. Logistic regression analyses were used for estimating associations with alcohol-related presenteeism, which was reported among 473 (7.1%) of the employees. Adjusted by age, gender, education level and managerial level, higher levels of overcommitment to work were associated with alcohol-related presenteeism. Higher age, male gender and higher education were also associated with alcohol-related presenteeism. Occupational health services and employers should especially focus on overcommitted employees when designing workplace health promotion programs. Modifying attitudes towards alcohol-related presenteeism among overcommitted employees may be of importance for safety at work. Full article
Review
Systematic Review to Update ‘Value of a Statistical Life’ Estimates for Australia
Int. J. Environ. Res. Public Health 2021, 18(11), 6168; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18116168 - 07 Jun 2021
Viewed by 1186
Abstract
The value of a statistical life (VSL) estimates individuals’ willingness to trade wealth for mortality risk reduction. This economic parameter is often a major component of the quantified benefits estimated in the evaluation of government policies related to health and safety. This study [...] Read more.
The value of a statistical life (VSL) estimates individuals’ willingness to trade wealth for mortality risk reduction. This economic parameter is often a major component of the quantified benefits estimated in the evaluation of government policies related to health and safety. This study reviewed the literature to update the VSL recommended for Australian policy appraisals. A systematic literature review was conducted to capture Australian primary studies and international review papers reporting VSL estimates published from 2007 to January 2019. International estimates were adjusted for income differences and the median VSL estimate was extracted from each review study. VSL estimates were used to calculate the value of a statistical life year. Of the 18 studies that met the inclusion criteria, two studies were primary Australian studies with a weighted mean VSL of A$7.0 million in 2017 values. The median VSL in the review studies was A$7.3 million. For Australian public policy appraisals, we recommend the consideration of a base case VSL for people of all ages and across all risk contexts of A$7.0 million. Sensitivity analyses could use a high value of A$7.3 million and a low value that reflects the value (A$4.3 million) currently recommended by the Australian government. Full article
(This article belongs to the Section Health Economics)
Show Figures

Figure 1

Article
Intention-Based Critical Factors Affecting Willingness to Adopt Novel Coronavirus Prevention in Pakistan: Implications for Future Pandemics
Int. J. Environ. Res. Public Health 2021, 18(11), 6167; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18116167 - 07 Jun 2021
Cited by 5 | Viewed by 1018
Abstract
Since human beings have a long tradition of coexistence with pandemics, which may profoundly impact them, adopting preventive measures is crucial for humankind’s survival. This study explores the intention-based critical factors affecting the willingness of individuals to adopt pandemic prevention. To this end, [...] Read more.
Since human beings have a long tradition of coexistence with pandemics, which may profoundly impact them, adopting preventive measures is crucial for humankind’s survival. This study explores the intention-based critical factors affecting the willingness of individuals to adopt pandemic prevention. To this end, a representative sample of 931 Pakistanis filled in an online questionnaire. However, only 828 questionnaires were found to be complete and valid for path modeling analysis. The core findings are as follows: Firstly, peer groups’ beliefs, self-efficacy, perceived risk, pandemic knowledge, ease of pandemic prevention adoption, and risk-averse behavior are revealed as driving forces of the individuals’ willingness to adopt pandemic prevention. Contrastingly, a lack of trust in political will and mythical attitude towards pandemics are uncovered as inhibitors. Nevertheless, moral values depict a neutral role. Secondly, the peer groups’ beliefs are highest ranked, followed by the lack of trust in political will and a mythical attitude towards pandemic prevention. Finally, moral values are determined as the lowest-ranked critical factor. Based on these results, the government should promote awareness campaigns on lethality and fatality of the pandemic at both centralized and decentralized levels to win people’s trust at the grass-roots level and overcome the mythical attitude of individuals at all societal levels. Besides, access to personal protective gears should be made feasible since an easier pandemic prevention adoption would increase the individuals’ willingness to adopt such preventative measures. Full article
Show Figures

Figure 1

Article
Impact of the COVID-19 Pandemic on Habilitating Residential Communities for Unaccompanied Minors during the First Lockdown in Italy: The Educators’ Relational Perspective
Int. J. Environ. Res. Public Health 2021, 18(11), 6166; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18116166 - 07 Jun 2021
Viewed by 868
Abstract
(1) Background: Italian residential communities for unaccompanied minors suffered a long period of closure during the SARS-COV2 lockdown. Professional educators who work inside these institutions with the aim to habilitate children toward life-span achievements faced a great challenge and responsibility during this period. [...] Read more.
(1) Background: Italian residential communities for unaccompanied minors suffered a long period of closure during the SARS-COV2 lockdown. Professional educators who work inside these institutions with the aim to habilitate children toward life-span achievements faced a great challenge and responsibility during this period. In this context, the psychological well-being and development of unaccompanied children were at high risk. The aim of this study was to investigate the impact of the lockdown on children living in residential communities from the educators’ perspective and to explore whether the educators’ relational lens was related to their perception and sense-making. (2) Methods: We conducted a mix-method study enrolling 21 educators in 10 residential communities who completed an interview and a self-construal scale. (3) Results: The interview was analyzed by a qualitative content method revealing 10 themes (social relationships, stand-by, emotions, new activities, new norms acceptance, end of lockdown, time, space, resilience, and achievements). Moreover, correlation analyses were performed to test the possible association between RISC and themes that emerged from the interviews, showing significant associations with four interview themes. (4) Conclusions: Our study highlights considerable lockdown effects on residential communities and the importance of educators’ relational approach, a tool for habilitating children and a protective factor against emotional overwhelming. Full article
Show Figures

Figure 1

Review
Does Workers’ Compensation Status Affect Outcomes after Lumbar Spine Surgery? A Systematic Review and Meta-Analysis
Int. J. Environ. Res. Public Health 2021, 18(11), 6165; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18116165 - 07 Jun 2021
Viewed by 960
Abstract
Low back pain (LBP) is currently the leading cause of disability worldwide and the most common reason for workers’ compensation (WC) claims. Studies have demonstrated that receiving WC is associated with a negative prognosis following treatment for a vast range of health conditions. [...] Read more.
Low back pain (LBP) is currently the leading cause of disability worldwide and the most common reason for workers’ compensation (WC) claims. Studies have demonstrated that receiving WC is associated with a negative prognosis following treatment for a vast range of health conditions. However, the impact of WC on outcomes after spine surgery is still controversial. The aim of this meta-analysis was to systematically review the literature and analyze the impact of compensation status on outcomes after lumbar spine surgery. A systematic search was performed on Medline, Scopus, CINAHL, EMBASE and CENTRAL databases. The review included studies of patients undergoing lumbar spine surgery in which compensation status was reported. Methodological quality was assessed through ROBINS-I and quality of evidence was estimated using the GRADE rating. A total of 26 studies with a total of 2668 patients were included in the analysis. WC patients had higher post-operative pain and disability, as well as lower satisfaction after surgery when compared to those without WC. Furthermore, WC patients demonstrated to have a delayed return to work. According to our results, compensation status is associated with poor outcomes after lumbar spine surgery. Contextualizing post-operative outcomes in clinical and work-related domains helps understand the multifactorial nature of the phenomenon. Full article
(This article belongs to the Special Issue Low Back Pain (LBP))
Show Figures

Figure 1

Article
Comprehensive Geriatric Assessment and Clinical Outcomes in the Older People at the Emergency Department
Int. J. Environ. Res. Public Health 2021, 18(11), 6164; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18116164 - 07 Jun 2021
Viewed by 821
Abstract
Visits by older people to the Emergency Department (ED) have increased in recent decades with higher revisiting and admission rates after discharge, particularly for those with frailties. This study used a before–after design aimed at evaluating Comprehensive Geriatric Assessment (CGA) screening in older [...] Read more.
Visits by older people to the Emergency Department (ED) have increased in recent decades with higher revisiting and admission rates after discharge, particularly for those with frailties. This study used a before–after design aimed at evaluating Comprehensive Geriatric Assessment (CGA) screening in older ED patients (aged ≥ 75 years) during the 12-month preintervention period. Additionally, a CGA-based structured follow-up program after ED discharge was executed during the next 12-month intervention period. Amongst the 358 participants (median age 82 years), involving 122 in the preintervention period and 236 in the intervention period, 77 participants (21.5%) were identified as pre-frailty, while 274 (76.5%) were identified as frail using the Fried frailty phenotype. One-hundred ten (110) (30.7%) patients revisited the ED with 73 (20.4%) being admitted and 20 (5.6%) dying within three months after ED discharge. Compared with preintervention and intervention period, it was shown that the rates of admission at the index ED visit (50.8% vs. 23.1%), and mortality (10.7% vs. 3.0%), were both were significantly reduced. Using multivariate regression analysis, it was shown frailty was significantly associated with three-month mortality after adjusting for potential confounders. On the contrary, the program significantly decreased admission and death rate. It is suggested that frailty was prevalent amongst the older ED patients, and should be screened for in order to decrease revisits/admissions after ED discharge. Full article
Show Figures

Figure 1

Article
Medication for Opioid Use Disorder Service Provision and Telephone Counseling: A Concurrent Mixed-Methods Approach
Int. J. Environ. Res. Public Health 2021, 18(11), 6163; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18116163 - 07 Jun 2021
Viewed by 861
Abstract
Using quantitative and qualitative evidence, this study triangulates counselors’ perspectives on the use of telemedicine in the context of Opioid Use Disorder (OUD) treatment. A concurrent mixed-methods design examined counselors’ experiences with telephone counseling during the COVID-19 pandemic. N = 42 counselors who [...] Read more.
Using quantitative and qualitative evidence, this study triangulates counselors’ perspectives on the use of telemedicine in the context of Opioid Use Disorder (OUD) treatment. A concurrent mixed-methods design examined counselors’ experiences with telephone counseling during the COVID-19 pandemic. N = 42 counselors who provided OUD counseling services completed a close-ended, quantitative survey examining their experiences in addressing clients’ anxiety, depression, anger, substance use, therapeutic relationship, and substance use recovery using telephone counseling. The survey also assessed comfort, convenience, and satisfaction with telephone counseling. Counselors also completed open-ended responses examining satisfaction, convenience, relationship with patients, substance use, and general feedback with telephone counseling. The synthesis of quantitative and qualitative evidence indicated that a majority of counselors had positive experiences with using telephone counseling to provide services to clients undergoing OUD treatment. Convenience, greater access to clients, and flexibility were among the reasons cited for their positive experience. However, counselors also expressed that the telephone counseling was impersonal, and that some clients may have difficulties accessing appropriate technology for telehealth adoption. Findings suggest that further research with counselors is needed to identify the key elements of an effective integration of telephone counseling with traditional in-person treatment approaches in the post-pandemic era. Full article
(This article belongs to the Section Health Care Sciences & Services)
Show Figures

Figure 1

Article
Purification Efficiency of Three Combinations of Native Aquatic Macrophytes in Artificial Wastewater in Autumn
Int. J. Environ. Res. Public Health 2021, 18(11), 6162; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18116162 - 07 Jun 2021
Viewed by 716
Abstract
Water pollution caused by excessive nutrient and biological invasion is increasingly widespread in China, which can lead to problems with drinking water as well as serious damage to the ecosystem if not be properly treated. Aquatic plant restoration (phytoremediation) has become a promising [...] Read more.
Water pollution caused by excessive nutrient and biological invasion is increasingly widespread in China, which can lead to problems with drinking water as well as serious damage to the ecosystem if not be properly treated. Aquatic plant restoration (phytoremediation) has become a promising and increasingly popular solution. In this study, eight native species of low-temperature-tolerant aquatic macrophytes were chosen to construct three combinations of aquatic macrophytes to study their purification efficiency on eutrophic water in large open tanks during autumn in Guangzhou City. The total nitrogen (TN) removal rates of group A (Vallisneria natans + Ludwigia adscendens + Monochoria vaginalis + Saururus chinensis), group B (V. natans + Ipomoea aquatica + Acorus calamus + Typha orientalis), and group C (V. natans + L. adscendens + Schoenoplectus juncoides + T. orientalis) were 79.10%, 46.39%, and 67.46%, respectively. The total phosphorus (TP) removal rates were 89.39%, 88.37%, and 91.96% in groups A, B, and C, respectively, while the chemical oxygen demand (COD) removal rates were 93.91%, 96.48%, and 92.78%, respectively. In the control group (CK), the removal rates of TN, TP, and COD were 70.42%, 86.59%, and 87.94%, respectively. The overall removal rates of TN, TP, and COD in the plant groups were only slightly higher than that in CK group, which did not show a significant advantage. This may be related to the leaf decay of some aquatic plants during the experiment, whereby the decay of V. natans was the most obvious. The results suggest that a proper amount of plant residue will not lead to a significant deterioration of water quality. Full article
(This article belongs to the Special Issue State-of-the-Art Environmental Science and Technology)
Show Figures

Figure 1

Article
Prenatal Exposure to Favorable Social and Environmental Neighborhood Conditions Is Associated with Healthy Pregnancy and Infant Outcomes
Int. J. Environ. Res. Public Health 2021, 18(11), 6161; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18116161 - 07 Jun 2021
Viewed by 1105
Abstract
Neighborhood and individual level risks commonly co-occur for pregnant women and may cumulatively contribute to birth outcomes. Moreover, the relationship between favorable social and environmental neighborhood conditions and perinatal outcomes has been understudied. This study considered the accumulated impact of prenatal exposure to [...] Read more.
Neighborhood and individual level risks commonly co-occur for pregnant women and may cumulatively contribute to birth outcomes. Moreover, the relationship between favorable social and environmental neighborhood conditions and perinatal outcomes has been understudied. This study considered the accumulated impact of prenatal exposure to positive neighborhood social, environmental, and educational conditions in relation to maternal health during pregnancy and birth size outcomes. In a prospective study of a multi-ethnic and socioeconomically diverse cohort (n = 239) of pregnant women and their infants, neighborhoods were characterized by the Child Opportunity Index (COI), a census-tract composite indicator representing favorable social, environmental, and educational community conditions. Adjusted generalized estimating equations showed that favorable neighborhood conditions promoted the growth of longer and heavier infant bodies, and reduced the risk of intrauterine growth restriction. The associations were stronger for female versus male infants, though not significantly different. Moreover, COI was associated with better maternal mental health and diet during pregnancy; diet significantly mediated the association between COI and birth size outcomes. This study underscores the importance of considering the accumulated benefit of neighborhood assets for maternal and infant health. Interventions that capitalizes on the full range of contextual assets in which mothers live may promote pregnancy health and fetal growth. Full article
(This article belongs to the Special Issue Prenatal Stress, Health Behaviors and Child Development)
Show Figures

Figure 1

Article
Associations of Sociodemographic Factors and Health Behaviors with the Emotional Well-Being of Adolescents during the COVID-19 Pandemic in Brazil
Int. J. Environ. Res. Public Health 2021, 18(11), 6160; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18116160 - 07 Jun 2021
Cited by 3 | Viewed by 1177
Abstract
This cross-sectional study utilizes data from a nationwide web-based survey aimed to identify the factors affecting the emotional well-being of Brazilian adolescents aged 12–17 during the period of school closures and confinement. Data collection took place from 27 June to 17 September 2020. [...] Read more.
This cross-sectional study utilizes data from a nationwide web-based survey aimed to identify the factors affecting the emotional well-being of Brazilian adolescents aged 12–17 during the period of school closures and confinement. Data collection took place from 27 June to 17 September 2020. We used the “virtual snowball” sampling method, and students from private and public schools were included. A total of 9470 adolescents were analyzed. A hierarchical logistic regression model was used to find the factors associated with reporting at least two of three self-reported problems—sadness, irritability, and sleep problems. The main proximal factor was loneliness (AdjOR = 8.12 p < 0.001). Problems related to school closures also played an important role. Regular intake of fruits and vegetables, as well as physical activity, demonstrated a positive influence on emotional well-being, while excessive screen time (AdjOR = 2.05, p < 0.001) and alcohol consumption negatively affected outcomes (AdjOR = 1.73, p < 0.001). As for distal variables, less affluent adolescents were the most affected, and males reported fewer emotional problems than females. Uncertainty regarding the disease in a context of socioeconomic vulnerability, together with rises in unhealthy behaviors and isolation from their immediate social circles, have negatively affected adolescents’ emotional status throughout the COVID-19 pandemic. Full article
Article
Quality Evaluation of Health Services Using the Kano Model in Two Hospitals in Peru
Int. J. Environ. Res. Public Health 2021, 18(11), 6159; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18116159 - 07 Jun 2021
Viewed by 1125
Abstract
Public–private partnerships (PPP) represent an alternative model of health management focused on improving the quality of health services, particularly in emerging countries. To date, a systematic method to improve the perceived quality of health services by healthcare users in Peru has not been [...] Read more.
Public–private partnerships (PPP) represent an alternative model of health management focused on improving the quality of health services, particularly in emerging countries. To date, a systematic method to improve the perceived quality of health services by healthcare users in Peru has not been established. The purpose of this study was to evaluate the quality of health services in two PPP hospitals in Peru using the Kano model. A prospective cross-sectional descriptive observational study was carried out through a health service satisfaction survey using the Kano model methodology, measuring six categories of attributes. A total of 250 users of the health services were surveyed in the two PPP hospitals, located in Lima and Callao, using non-probability convenience sampling. Of the 31 attributes evaluated by the patients, 27 (81%) were classified as having a one-dimensional-type attribute, 3 (10%) were reported as mandatory, and 1 (3%) was considered as inverse. These results suggest that the presence of most of the attributes evaluated was relevant to maintaining the level of user satisfaction and that the absence of these attributes generated dissatisfaction in the users. The results showed that the users’ evaluation of health services was multidimensional—namely, their evaluation was focused not only on the interaction space between the patient and medical personnel but also addressed other interaction services. Full article
Show Figures

Figure 1

Article
Factors Related to Depression Associated with Chewing Problems in the Korean Elderly Population
Int. J. Environ. Res. Public Health 2021, 18(11), 6158; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18116158 - 07 Jun 2021
Viewed by 802
Abstract
Unlike younger adults, depression in older adults is sometimes related to chewing problems. This study examined the risk factors related to depression associated with chewing problems in 3747 elderly individuals using the Korean National Health and Nutrition Examination Survey. Approximately 41.2% of the [...] Read more.
Unlike younger adults, depression in older adults is sometimes related to chewing problems. This study examined the risk factors related to depression associated with chewing problems in 3747 elderly individuals using the Korean National Health and Nutrition Examination Survey. Approximately 41.2% of the total subjects reported chewing problems. There were significant differences in age, education, marital status, individual income, current smoking status, and aerobic physical activity in relation to chewing problems (p < 0.001 for all). The subjects who experienced chewing problems showed a higher score on the EuroQoL 5 Dimension index (p < 0.001) but a lower health-related quality of life than those with no chewing problems (p < 0.001). The prevalence of depression, which was classified by the patient health questionnaire—9, in subjects with chewing problems was approximately 2 times higher than that in those with no chewing problems (p < 0.001). Subjects with chewing problems were found to have a 1.945-fold higher adjusted risk of depression than those who did not have chewing problems (95% CI = 1.583–2.390, p < 0.001), and subjects with high protein consumption showed a 1.410-fold greater risk of depression (95% CI = 1.144–1.739, p = 0.001) than those with low protein consumption. Full article
Show Figures

Figure 1

Article
UNRAQ—A Questionnaire for the Use of a Social Robot in Care for Older Persons. A Multi-Stakeholder Study and Psychometric Properties
Int. J. Environ. Res. Public Health 2021, 18(11), 6157; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18116157 - 07 Jun 2021
Cited by 1 | Viewed by 745
Abstract
(1) Background: while there exist validated measures to assess the needs of older people, there are comparatively few validated tools to assess needs and requirements for the use of robots. Henceforth, the aim of the study is to present and validate such a [...] Read more.
(1) Background: while there exist validated measures to assess the needs of older people, there are comparatively few validated tools to assess needs and requirements for the use of robots. Henceforth, the aim of the study is to present and validate such a tool. (2) Methods: The study group included 720 subjects (mean age 52.0 ± 37.0, 541 females) who agreed to fill the Users’ Needs, Requirements, and Abilities Questionnaire (UNRAQ). The validation part of the study included 125 persons. (3) Results: the acceptance of the robot was good in the whole group. The social functions were rated worse than assistive ones. A correlation was found between the scores of social and assistive functions. The respondents claimed that older adults were not prepared to interact with the robot and not very good at handling it, and were sceptical about their willingness to learn to operate the robot. The Cronbach alpha value for the whole questionnaire was 0.95 suggesting excellent internal consistency, and the ICC value of 0.88 represents excellent agreement; (4) Conclusions: We observed a good overall acceptance of the robot across the studied group. There is considerable demand for the use of a social robot in care for older people. Full article
Show Figures

Figure 1

Article
Lack of Consistent Association between Asthma, Allergic Diseases, and Intestinal Helminth Infection in School-Aged Children in the Province of Bengo, Angola
Int. J. Environ. Res. Public Health 2021, 18(11), 6156; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18116156 - 07 Jun 2021
Viewed by 802
Abstract
Epidemiological studies have shown conflicting findings on the relationship between asthma, atopy, and intestinal helminth infections. There are no such studies from Angola; therefore, we aimed to evaluate the relationship between asthma, allergic diseases, atopy, and intestinal helminth infection in Angolan schoolchildren. We [...] Read more.
Epidemiological studies have shown conflicting findings on the relationship between asthma, atopy, and intestinal helminth infections. There are no such studies from Angola; therefore, we aimed to evaluate the relationship between asthma, allergic diseases, atopy, and intestinal helminth infection in Angolan schoolchildren. We performed a cross-sectional study of schoolchildren between September and November 2017. Five schools (three urban, two rural) were randomly selected. Asthma, rhinoconjunctivitis, and eczema were defined by appropriate symptoms in the previous 12 months: atopy was defined by positive skin prick tests (SPT) or aeroallergen-specific IgE; intestinal helminths were detected by faecal sample microscopy. In total, 1023 children were evaluated (48.4% female; 57.6% aged 10–14 years; 60.5% urban). Asthma, rhinoconjunctivitis, or eczema were present in 9%, 6%, and 16% of the studies children, respectively. Only 8% of children had positive SPT, but 64% had positive sIgE. Additionally, 40% were infected with any intestinal helminth (A. lumbricoides 25.9%, T. trichiura 7.6%, and H. nana 6.3%). There were no consistent associations between intestinal helminth infections and asthma, allergic diseases, or atopy, except for A. lumbricoides, which was inversely associated with rhinoconjuctivitis and directly associated with aeroallergen-specific IgE. We concluded that, overall, intestinal helminth infections were not consistently associated with allergic symptoms or atopy. Future, preferably longitudinal, studies should collect more detailed information on helminth infections as part of clusters of environmental determinants of allergies. Full article
(This article belongs to the Special Issue Diagnosis and Prevention of Asthma in Children)
Article
Challenges and Strategies of Successful Mentoring: The Perspective of LEADS Scholars and Mentors from Minority Serving Institutions
Int. J. Environ. Res. Public Health 2021, 18(11), 6155; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18116155 - 07 Jun 2021
Viewed by 811
Abstract
Mentoring continues to be a salient conversation in academia among junior and senior faculty and administrators. Mentors provide guidance and structure to junior faculty so that they can meet their academic and professional goals. Mentors also convey skills in balancing life and academic [...] Read more.
Mentoring continues to be a salient conversation in academia among junior and senior faculty and administrators. Mentors provide guidance and structure to junior faculty so that they can meet their academic and professional goals. Mentors also convey skills in balancing life and academic pursuits. Therefore, the purpose of this descriptive study was to provide additional insight from a training program called Leading Emerging and Diverse Scientists to Success (LEADS) regarding successful strategies and challenges of mentoring relating to lessons learned from the scholars and mentees’ perspective. The LEADS program provided multiple training platforms to increase skills and knowledge regarding research to promote expertise in grant writing and submission for funding opportunities among diverse scientists. These findings reinforce the knowledge about the value of a mentor in helping define the research pathway of their mentee and underscoring the importance of mentoring. Full article
Article
Sleep Duration and Waking Activities in Relation to the National Sleep Foundation’s Recommendations: An Analysis of US Population Sleep Patterns from 2015 to 2017
Int. J. Environ. Res. Public Health 2021, 18(11), 6154; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18116154 - 07 Jun 2021
Cited by 1 | Viewed by 773
Abstract
The objective was to investigate the association between time spent on waking activities and nonaligned sleep duration in a representative sample of the US population. We analysed time use data from the American Time Use Survey (ATUS), 2015–2017 (N = 31,621). National [...] Read more.
The objective was to investigate the association between time spent on waking activities and nonaligned sleep duration in a representative sample of the US population. We analysed time use data from the American Time Use Survey (ATUS), 2015–2017 (N = 31,621). National Sleep Foundation (NSF) age-specific sleep recommendations were used to define recommended (aligned) sleep duration. The balanced, repeated, replicate variance estimation method was applied to the ATUS data to calculate weighted estimates. Less than half of the US population had a sleep duration that mapped onto the NSF recommendations, and alignment was higher on weekdays (45%) than at weekends (33%). The proportion sleeping longer than the recommended duration was higher than those sleeping shorter on both weekdays and weekends (p < 0.001). Time spent on work, personal care, socialising, travel, TV watching, education, and total screen time was associated with nonalignment to the sleep recommendations. In comparison to the appropriate recommended sleep group, those with a too-short sleep duration spent more time on work, travel, socialising, relaxing, and leisure. By contrast, those who slept too long spent relatively less time on each of these activities. The findings indicate that sleep duration among the US population does not map onto the NSF sleep recommendations, mostly because of a higher proportion of long sleepers compared to short sleepers. More time spent on work, travel, and socialising and relaxing activities is strongly associated with an increased risk of nonalignment to NSF sleep duration recommendations. Full article
Show Figures

Figure 1

Article
Influencing Factors of Psychosocial Stress among Korean Adults during the COVID-19 Outbreak
Int. J. Environ. Res. Public Health 2021, 18(11), 6153; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18116153 - 07 Jun 2021
Viewed by 687
Abstract
The restriction of an individual’s daily life due to the strengthening of quarantine and lockdown increases psychosocial stress. This study aimed to determine the factors that influence psychosocial stress during a period of strict quarantine and lockdown to curb the COVID-19 pandemic in [...] Read more.
The restriction of an individual’s daily life due to the strengthening of quarantine and lockdown increases psychosocial stress. This study aimed to determine the factors that influence psychosocial stress during a period of strict quarantine and lockdown to curb the COVID-19 pandemic in Korea. A total of 338 adults participated in a cross-sectional online survey conducted from 19–25 May 2020, which measured knowledge of COVID-19, health belief, resilience, and psychosocial stress. According to the results, there was no difference between the participants’ scores from the Daegu area (with concentrated confirmed COVID-19 cases) and the non-Daegu area except for health belief. Eighty-two percent of participants constituted the high-risk group for psychosocial stress. Individual resilience was positively correlated with health belief and negatively correlated with psychosocial stress (p < 0.001). Further, the following factors affected the level of psychosocial stress: resilience, subjective health status, and monthly household income, with an explanatory power of 39.8%. Therefore, those with higher subjective health and higher monthly household income experienced higher psychosocial stress, whereas higher resilience indicated lower psychosocial stress. Full article
Show Figures

Figure 1

Article
Tipsters and Addiction in Spain. Young People’s Perception of Influencers on Online Sports Gambling
Int. J. Environ. Res. Public Health 2021, 18(11), 6152; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18116152 - 07 Jun 2021
Viewed by 787
Abstract
This research analyzes young people’s perception of the presence of tipsters as influencers on online sports gambling and whether their presence can promote addiction to this activity. To achieve this goal, we designed a questionnaire that was administered to young people in public [...] Read more.
This research analyzes young people’s perception of the presence of tipsters as influencers on online sports gambling and whether their presence can promote addiction to this activity. To achieve this goal, we designed a questionnaire that was administered to young people in public universities in Madrid, being answered by 1032 individuals, out of whom 613 claimed to be regular bettors. We proceeded to the factor analysis of the variables with a high or very high correlation, and results showed that young people perceive a clear relationship between gambling and addiction. An even more enlightening aspect is the result that links tipsters with addiction to online sports gambling; young people’s perception correlates both concepts with extraordinary strength. This study’s main conclusion makes it clear that there is a huge amount of influence of tipsters on the world of online sports betting, as well as the risk of marrying these two concepts, since young people perceive that either they or others could be initiated into the world of problem gambling. Full article
(This article belongs to the Collection Mass Communication, Digital Media, and Public Health)
Article
Comparison of Access Site-Related Complications and Quality of Life in Patients after Invasive Cardiology Procedures According to the Use of Radial, Femoral, or Brachial Approach
Int. J. Environ. Res. Public Health 2021, 18(11), 6151; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18116151 - 07 Jun 2021
Viewed by 1053
Abstract
The radial approach (RA) is the most common in invasive cardiology, but depending on the clinical situation, the femoral approach (FA) and brachial approach (BA) are also used. The BA is associated with the highest odds of complications so it is used mainly [...] Read more.
The radial approach (RA) is the most common in invasive cardiology, but depending on the clinical situation, the femoral approach (FA) and brachial approach (BA) are also used. The BA is associated with the highest odds of complications so it is used mainly if a first-choice approach fails. The aim of the study was to assess clinical outcomes after invasive cardiology procedures stratified by the use of the RA, FA, and BA, with a focus on access site-related complications, quality of life (QoL), and patients’ perspective. A total of 250 procedures (RA: 98; FA: 99; BA: 53) performed between 2013 and 2020 were retrospectively analyzed. Puncture site-related complications, vascular events, patient preferences, and QoL were assessed by the analysis of medical records and telephone follow-up using a proprietary questionnaire and the modified EQ-5D-3L questionnaire. Patients from the RA group received the smallest volume of contrast during a percutaneous coronary interventions (PCI) procedure (RA vs. FA vs. BA: 180 (150–240) mL vs. 200 (180–270) mL vs. 190 (100–200) mL, p = 0.045). The access site was changed most frequently in the procedures initiated from the RA (p < 0.04). Overall puncture site-related complications, especially local hematomas, occurred most commonly in the BA group (7.1, 14.1, and 24.5% for RA, FA, and BA, respectively, p = 0.01). During the index procedure, the access site was changed most frequently in procedures initiated from the RA (19.7, 8.5 and 0%, p = 0.04). The RA was indicated as an approach preferred by the patient for a hypothetical next procedure (87.9, 55.4, and 70.0% for subjects preferring the same approach out of patients who underwent a procedure by the RA, FA, and BA, respectively, p < 0.001). For the RA and FA, the prevalence of moderate or extreme access site-related problems in self-care decreased significantly (RA: p < 0.01, FA: p < 0.05) within 1 month after the index procedure (RA: 18.1, 4.2, and 1.4%; FA: 20.7, 11.1, and 9.6% periprocedurally, after 1 and 6 months, respectively). In contrast, for the BA these percentages were higher and a significant improvement (p < 0.05) was delayed until 6 months (54.6, 36.4, and 18.2% periprocedurally, after 1 and 6 months, respectively). In conclusion, compared to the BA and FA, the RA appears to be not only the safest, mainly due to the lowest risk of puncture site-related complications after coronary procedures but also represents a preferable approach from the patient’s perspective. Although overall post-procedural QoL outcomes did not differ significantly according to the access site, nevertheless, the BA was associated with more frequent self-care problems whose improvement was delayed until more than one month after the index procedure. Full article
Show Figures

Figure 1

Article
Bibliometric Evaluation of Global Tai Chi Research from 1980–2020
Int. J. Environ. Res. Public Health 2021, 18(11), 6150; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18116150 - 07 Jun 2021
Viewed by 985
Abstract
While studies on the health benefits of Tai Chi have sprung up over the past four decades, few have engaged in collecting global data, estimating the developing trends, and conducting reviews from the perspective of visualization and bibliometric analysis. This study aimed to [...] Read more.
While studies on the health benefits of Tai Chi have sprung up over the past four decades, few have engaged in collecting global data, estimating the developing trends, and conducting reviews from the perspective of visualization and bibliometric analysis. This study aimed to provide a summary of the global scientific outputs on Tai Chi research from 1980 to 2020, explore the frontiers, identify cooperation networks, track research trends and highlight emerging hotspots. Relevant publications were downloaded from the Web of Science Core Collection (WoSCC) database between 1980 and 2020. Bibliometric visualization and comparative analysis of authors, cited authors, journals, co-cited journals, institutions, countries, references, and keywords were systematically conducted using CiteSpace software. A total of 1078 publications satisfied the search criteria, and the trend of annual related publications was generally in an upward trend, although with some fluctuations. China (503) and Harvard University (74) were the most prolific country and institution, respectively. Most of the related researches were published in the journals with a focus on sport sciences, alternative medicine, geriatrics gerontology, and rehabilitation. Our results indicated that the current concerns and difficulties of Tai Chi research are “Intervention method”, “Targeted therapy”, “Applicable population”, “Risk factors”, and “Research quality”. The frontiers and promising domains of Tai Chi exercise in the health science field are preventions and rehabilitations of “Fall risk”, “Cardiorespiratory related disease”, “Stroke”, “Parkinson’s disease”, and “Depression”, which should receive more attention in the future. Full article
(This article belongs to the Special Issue Data Science for Environment and Health Applications)
Show Figures

Graphical abstract

Article
Factors Influencing Emergency Department Nurses’ Compliance with Standard Precautions Using Multilevel Analysis
Int. J. Environ. Res. Public Health 2021, 18(11), 6149; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18116149 - 07 Jun 2021
Viewed by 864
Abstract
Standard precautions protect patients and nurses from infection. Nevertheless, compliance with standard precautions is lower among emergency department nurses than other nurses. We examined the individual and organizational factors that influence emergency department nurses’ compliance with standard precautions via a cross-sectional study. A [...] Read more.
Standard precautions protect patients and nurses from infection. Nevertheless, compliance with standard precautions is lower among emergency department nurses than other nurses. We examined the individual and organizational factors that influence emergency department nurses’ compliance with standard precautions via a cross-sectional study. A self-reported questionnaire survey was administered to 140 nurses working in nine emergency departments in South Korea. It included items regarding ethical awareness and standard precaution self-efficacy at the individual level as well as safety environment, organizational culture for infection control, and degree of compliance with standard precautions at the organizational level. Individual and organizational predictors were identified using a multilevel analysis. The results indicated that 81.1% of nurses’ compliance with standard precautions was influenced by individual differences, while only 18.9% was influenced by organizational differences. Individual- and organizational-level predictors explained 46.7% and 55.4% of the variance in emergency department nurses’ compliance with standard precautions, respectively. Emergency department nurses’ compliance with standard precautions was predicted by ethical awareness and standard precaution self-efficacy at the individual level and by organizational culture for infection control at the organizational level. Our findings provide evidence for the need to improve facilities and human resource management as well as the organizational culture for infection control. Full article
Article
Education of Adolescents in the Prevention of HIV/AIDS in the Czech Republic
Int. J. Environ. Res. Public Health 2021, 18(11), 6148; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18116148 - 07 Jun 2021
Viewed by 962
Abstract
The number of HIV-positive people in the Czech Republic has trebled over the last decade. An educational programme aimed at the prevention of HIV and STDs in adolescents between 13 and 19 years of age is underway in the Moravian-Silesian Region in the [...] Read more.
The number of HIV-positive people in the Czech Republic has trebled over the last decade. An educational programme aimed at the prevention of HIV and STDs in adolescents between 13 and 19 years of age is underway in the Moravian-Silesian Region in the Czech Republic. All schools in the region have been offered the chance to participate in the programme (on a voluntary basis). The programme consists of an educational lecture and a game with interactive elements; the students perform various tasks in groups. An anonymous paired questionnaire (input/output) was used to assess the efficacy of the programme. In order to evaluate the programme efficacy, descriptive statistics, non-parametric Wilcoxon paired test at the level of significance of 5%, and a model of logistic regression for a dichotomous variable were used. A total of 1210 students took part in the programme. The students’ knowledge improved, on average, by 15.5%. The highest efficacy was observed in the age group of 13–14-year-olds, where the improvement reached 17.9%. The educational programme was effective in raising awareness about STDs. Due to the observed increase in knowledge especially among the youngest participants (13–14 years old), we recommend aiming further interventions at the youngest age groups. Full article
Show Figures

Figure 1

Previous Issue
Next Issue
Back to TopTop