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Int. J. Environ. Res. Public Health, Volume 18, Issue 19 (October-1 2021) – 622 articles

Cover Story (view full-size image): From regulating our hormones to influencing how we sleep at night and function during the day, our circadian rhythms play a critical role in overall health. Daylight is the primary external cue that aligns our internal clock to solar time, yet our indoor lifestyles limit exposure to this natural source. Our study explores how smart windows affect indoor daylight exposure and, ultimately, physiological, behavioral, and subjective measures of circadian health. Residents exhibited consistent melatonin onset, earlier sleep onset, and higher sleep regularity when exposed to daylight through smart windows while exhibiting a delayed circadian phase when exposed to daylight through blinds. The study stresses the importance of designing buildings that optimize daylight for human health and wellbeing. View this paper.
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Article
The Impact of Mobility Restriction Strategies in the Control of the COVID-19 Pandemic: Modelling the Relation between COVID-19 Health and Community Mobility Data
Int. J. Environ. Res. Public Health 2021, 18(19), 10560; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph181910560 - 08 Oct 2021
Viewed by 479
Abstract
Background: Non-pharmaceutical interventions (NPIs), particularly mobility restrictions, are mainstay measures for the COVID-19 pandemic worldwide. We evaluated the effects of Oman’s mobility restriction strategies to highlight their efficacy in controlling the pandemic. Methods: Accessible national data of daily admissions and deaths were collected [...] Read more.
Background: Non-pharmaceutical interventions (NPIs), particularly mobility restrictions, are mainstay measures for the COVID-19 pandemic worldwide. We evaluated the effects of Oman’s mobility restriction strategies to highlight their efficacy in controlling the pandemic. Methods: Accessible national data of daily admissions and deaths were collected from 1 April 2020 to 22 May 2021. Google Community Mobility Report (CMR) data were downloaded for the same period. Among six CMR categories, three were used and reduced to one index—the community mobility index (CMI). We used a generalised linear model with a negative binomial distribution combined with a non-linear distributed lag model to investigate the short-term effects of CMI on the number of admitted PCR-confirmed COVID-19 cases and deaths, controlling for public holidays, day of the week, and Eid/Ramadan days. Results: We demonstrated the feasibility of using CMRs in the evaluation and monitoring of different NPIs, particularly those related to movement restriction. The best movement restriction strategy was a curfew from 7 p.m. to 5 a.m. (level 3 of CMI = 8), which had a total reduction of 35% (95% confidence interval (CI); 25–44%) in new COVID-19 admissions in the following two weeks, and a fatality reduction in the following four weeks by 52% (95% CI; 11–75%). Conclusion: Evening lockdown significantly affected the course of the pandemic in Oman which lines up with similar studies throughout the world. Full article
(This article belongs to the Section Infectious Disease Epidemiology)
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Article
Integration Experiences of Former Afghan Refugees in Australia: What Challenges Still Remain after Becoming Citizens?
Int. J. Environ. Res. Public Health 2021, 18(19), 10559; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph181910559 - 08 Oct 2021
Viewed by 420
Abstract
This paper explores, analyses, and documents the experiences of Afghan-Australians who arrived in Australia as refugees and were granted citizenship after living in Australia for several years. This research adopted a mixed method of qualitative and quantitative approaches and surveyed 102 people, interviewed [...] Read more.
This paper explores, analyses, and documents the experiences of Afghan-Australians who arrived in Australia as refugees and were granted citizenship after living in Australia for several years. This research adopted a mixed method of qualitative and quantitative approaches and surveyed 102 people, interviewed 13 participants, and conducted two focus-groups within its research design. Analysis of data indicates that former Afghan refugees gradually settled down and integrated within Australian society. They value safety and security, open democracy and orderly society of Australia, as well as accessing to education and healthcare services and opportunity for social mobility. However, since the integration is a long process, they are also facing some challenges in this area. Findings of this study show that Afghan-Australians require more support from Australian governments to overcome some of these challenges particularly securing employment within their area of interests and professional occupations that they have qualifications and experiences from Afghanistan. They are also experiencing broader challenges in the area of socio-cultural issues within Australian society. Since the Afghan community is an emerging community in Western Australia, they require more support from local government to enhance their ethnic cohesion and solidarity. Full article
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Article
Factors Associated with Healthcare Workers’ (HCWs) Acceptance of COVID-19 Vaccinations and Indications of a Role Model towards Population Vaccinations from a Cross-Sectional Survey in Greece, May 2021
Int. J. Environ. Res. Public Health 2021, 18(19), 10558; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph181910558 - 08 Oct 2021
Viewed by 478
Abstract
A Knowledge, Attitudes and Practices (KAP) study was conducted at the end of May 2021 engaging 1456 healthcare workers (HCWs) from 20 hospitals throughout Greece. Acceptance of vaccination against coronavirus disease 2019 (COVID-19) was estimated at 77.7%, with lower vaccine acceptance identified in [...] Read more.
A Knowledge, Attitudes and Practices (KAP) study was conducted at the end of May 2021 engaging 1456 healthcare workers (HCWs) from 20 hospitals throughout Greece. Acceptance of vaccination against coronavirus disease 2019 (COVID-19) was estimated at 77.7%, with lower vaccine acceptance identified in nurses compared to physicians. Fears related to vaccine safety, lack of information and general knowledge about vaccinations, influenza vaccine acceptance, education level and years of practice were among the factors independently associated with vaccine acceptance. A strong association was identified between vaccination of HCWs in each health region and the population coverage, indicating that HCWs may be role models for the general population. Information campaigns should continue despite decisions taken regarding mandatory vaccinations. Full article
Article
Adaptation, Student Participation and Gradual Withdrawal by Researchers as Sustainability Strategies in the High School-Based Young and Active Intervention: School Coordinators’ Perspectives
Int. J. Environ. Res. Public Health 2021, 18(19), 10557; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph181910557 - 08 Oct 2021
Viewed by 285
Abstract
Ensuring the sustainability of school-based public health intervention activities remains a challenge. The Young and Active (Y&A) intervention used peer-led workshops to promote movement and strengthen students’ sense of community in 16 Danish high schools. Peer mentors inspired first-year students to implement movement [...] Read more.
Ensuring the sustainability of school-based public health intervention activities remains a challenge. The Young and Active (Y&A) intervention used peer-led workshops to promote movement and strengthen students’ sense of community in 16 Danish high schools. Peer mentors inspired first-year students to implement movement activities. To support sustainability, we applied a three-year stepwise implementation strategy using university students as peer mentors in year 1 and senior high school students in the following two years. This study explores the sustainability potential of Y&A, focusing on school coordinators’ reflections on the intervention’s fit to their schools and the student-driven approach, and we assess the three-step implementation strategy. The study is based on telephone interviews with coordinators (n = 7) from schools that participated in all three years and participant observations of four workshops (a total of approximately 250 participating students). Results were generated through an abductive analysis. Seven schools continued the intervention throughout the three years and adapted it to fit their priorities. The student-driven approach was perceived to be valuable, but few student-driven activities were initiated. Teacher support seemed crucial to support students in starting up activities and acting as peer mentors in workshops. The three-step implementation strategy proved valuable due to the peer-approach and the possibility of gradual adaptation. In future similar initiatives, it is important to address how the adequate staff support of students can be facilitated. Full article
(This article belongs to the Section Health Behavior, Chronic Disease and Health Promotion)
Article
A Survey of Potentially Pathogenic-Incriminated Arthropod Vectors of Health Concern in Botswana
Int. J. Environ. Res. Public Health 2021, 18(19), 10556; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph181910556 - 08 Oct 2021
Viewed by 269
Abstract
Arthropod vectors play a crucial role in the transmission of many debilitating infections, causing significant morbidity and mortality globally. Despite the economic significance of arthropods to public health, public knowledge on vector biology, ecology and taxonomic status remains anecdotal and largely unexplored. The [...] Read more.
Arthropod vectors play a crucial role in the transmission of many debilitating infections, causing significant morbidity and mortality globally. Despite the economic significance of arthropods to public health, public knowledge on vector biology, ecology and taxonomic status remains anecdotal and largely unexplored. The present study surveyed knowledge gaps regarding the biology and ecology of arthropod vectors in communities of Botswana, across all districts. Results showed that communities are largely aware of individual arthropod vectors; however, their ‘potential contribution’ in disease transmission in humans, livestock and wildlife could not be fully attested. As such, their knowledge was largely limited with regards to some aspects of vector biology, ecology and control. Communities were strongly concerned about the burden of mosquitoes, cockroaches, flies and ticks, with the least concerns about fleas, bedbugs and lice, although the same communities did not know of specific diseases potentially vectored by these arthropods. Knowledge on arthropod vector control was mainly limited to synthetic chemical pesticides for most respondents, regardless of their location. The limited knowledge on potentially pathogen-incriminated arthropod vectors reported here has large implications for bridging knowledge gaps on the bio-ecology of these vectors countrywide. This is potentially useful in reducing the local burden of associated diseases and preventing the risk of emerging and re-emerging infectious diseases under global change. Full article
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Article
Age and Cultural Differences in Recognitions of Emotions from Masked Faces among Koreans and Americans
Int. J. Environ. Res. Public Health 2021, 18(19), 10555; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph181910555 - 08 Oct 2021
Viewed by 374
Abstract
This study investigates age and cultural differences in the negative effects of senders’ wearing masks on receivers’ readabilities of senders’ facially expressed emotions in interpersonal interactions. An online experiment was thus conducted with Koreans and Americans aged over 20 years. Based on sampling [...] Read more.
This study investigates age and cultural differences in the negative effects of senders’ wearing masks on receivers’ readabilities of senders’ facially expressed emotions in interpersonal interactions. An online experiment was thus conducted with Koreans and Americans aged over 20 years. Based on sampling quotas by nationality, age group and gender, Korean (n = 240) and American (n = 273) participants were recruited from panel members of a Korean research company and Amazon’s Mechanical Turk via email and the website, respectively. The participants played receiver roles to infer senders’ facially expressed emotions presented in photos in the experiment. They judged emotions facially expressed by the senders without masks and with masks are shown in photos. The results revealed that the senders’ wearing masks reduced the readabilities of the senders’ facially expressed anger among participants aged 30–49 years more than among participants aged 20–29 years. The senders’ wearing masks decreased the readabilities of the senders’ facially expressed fear for participants in their 50’s more than for participants in their 20’s. When the senders wore masks, the readabilities of the senders’ facially expressed happiness dropped among participants aged over 60 years more than among participants aged 20–49 years. When senders wore masks, American participants’ readabilities of disgust, fear, sadness and happiness expressed in the senders’ faces declined more than Korean participants’ readabilities of those emotions. The implications and limitations of these findings are discussed. Full article
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Review
Transgenerational Trauma and Mental Health Needs among Armenian Genocide Descendants
Int. J. Environ. Res. Public Health 2021, 18(19), 10554; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph181910554 - 08 Oct 2021
Viewed by 315
Abstract
The trauma of a genocide can be transmitted to subsequent generations though familial mental health, sociopolitical trauma, and cultural narratives, thereby impacting mental health and well-being. Understanding specific mechanisms that are unique to each ethnic group impacted by genocide illuminates cultural, sociopolitical, and [...] Read more.
The trauma of a genocide can be transmitted to subsequent generations though familial mental health, sociopolitical trauma, and cultural narratives, thereby impacting mental health and well-being. Understanding specific mechanisms that are unique to each ethnic group impacted by genocide illuminates cultural, sociopolitical, and individual factors related to the transmission. For the Armenian community, the unresolved historical loss of the Armenian Genocide of 1915, with the threat of acculturation for such a large diasporic population, a continued denial by the perpetrators, as well as subsequent generations’ refugee experiences, may further exasperate the impact of transgenerational trauma from the genocide. This literature review explores the mental health needs of Armenian youth in the current sociopolitical context and provides implications for how schools and communities may use this knowledge to inform supports that center Armenian community healing. Future directions for research are also discussed. Full article
(This article belongs to the Section Mental Health)
Article
Increased Risk of Neurodegenerative Dementia after Benign Paroxysmal Positional Vertigo
Int. J. Environ. Res. Public Health 2021, 18(19), 10553; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph181910553 - 08 Oct 2021
Viewed by 372
Abstract
The aim of the present study was to estimate the risk of dementia in patients with benign paroxysmal positional vertigo (BPPV), using a population cohort. Data from the Korean National Health Insurance Service-National Sample Cohort for the population ≥60 years of age from [...] Read more.
The aim of the present study was to estimate the risk of dementia in patients with benign paroxysmal positional vertigo (BPPV), using a population cohort. Data from the Korean National Health Insurance Service-National Sample Cohort for the population ≥60 years of age from 2002 to 2013 were collected. A total of 11,432 individuals with dementia were matched for age, sex, income, region of residence, hypertension, diabetes, and dyslipidemia with 45,728 individuals comprising the control group. The crude (simple) and adjusted odds ratios (ORs) of dementia in BPPV patients were analyzed using non-conditional logistic regression analyses. Subgroup analyses were conducted according to age and sex. A history of BPPV characterized 5.3% (609/11,432) of the dementia group and 2.6% (1,194/45,728) of the control group (p < 0.001). The adjusted OR of dementia for BPPV was 1.14 (95% CI = 1.03–1.26, p = 0.009). In subgroup analyses according to age and sex, males had higher ORs of dementia for BPPV. BPPV increases the risk of dementia in the 60 years of age or older population. Full article
(This article belongs to the Special Issue 2nd Edition: The Impact of ENT Diseases in Social Life)
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Article
COVID-19 and the Change in Lifestyle: Bodyweight, Time Allocation, and Food Choices
Int. J. Environ. Res. Public Health 2021, 18(19), 10552; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph181910552 - 08 Oct 2021
Viewed by 328
Abstract
We analyze the dynamic changes in individuals’ lifestyle during the COVID-19 outbreak and recovery period through a survey of 1061 Chinese households. Specifically, we are interested in individuals’ bodyweight, time allocation and food choices. We find that COVID-19 is associated with weight gain, [...] Read more.
We analyze the dynamic changes in individuals’ lifestyle during the COVID-19 outbreak and recovery period through a survey of 1061 Chinese households. Specifically, we are interested in individuals’ bodyweight, time allocation and food choices. We find that COVID-19 is associated with weight gain, less time spent on exercise and more time on entertainment. The proportion of online food purchase and snack purchases also shows an upward trend. This study provides useful implications on the impact of COVID-19 and its associated lockdowns on individuals’ lifestyle and offers foresights for countries in different stages of the pandemic. It explains how encouraging exercise, managing new food purchase venues, and reducing the intake of unhealthy food such as snacks may also need to be considered in dealing with the aftermath of COVID-19. Full article
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Communication
IQOS Marketing in the US: The Need to Study the Impact of FDA Modified Exposure Authorization, Marketing Distribution Channels, and Potential Targeting of Consumers
Int. J. Environ. Res. Public Health 2021, 18(19), 10551; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph181910551 - 08 Oct 2021
Viewed by 445
Abstract
IQOS, the leading heated tobacco product globally, recently received ‘reduced exposure’ authorization from the US Food and Drug Administration. Independent research focusing on IQOS marketing and potential impact on consumers’ perceptions and behavior, and ultimately public health, is critical. The literature to date [...] Read more.
IQOS, the leading heated tobacco product globally, recently received ‘reduced exposure’ authorization from the US Food and Drug Administration. Independent research focusing on IQOS marketing and potential impact on consumers’ perceptions and behavior, and ultimately public health, is critical. The literature to date has underscored several concerns. First, Philip Morris’s (PM’s) marketing distribution requires scrutiny, particularly given its innovative promotional strategies. For example, IQOS is distributed via unique points-of-sale (POS; e.g., specialty and pop-up stores, “corners” in convenience stores) and uses various other opportunities (e.g., social media, sponsored events, direct-to-consumer). Second, although PM claims that IQOS’ target market is current combustible tobacco users and not young people, the literature indicates that in some populations, IQOS use is equally prominent among smokers and nonsmokers, and that specific subgroups (e.g., young adults, women) are targeted. Third, the impact of IQOS’ use of ad content promoting IQOS health benefits must be studied (e.g., how consumers interpret modified exposure messages). In conclusion, surveillance of IQOS marketing, particularly following reduced exposure authorization, is critical for obtaining valuable data to estimate population impact, particularly among population subgroups (e.g., young adults), and inform future tobacco regulation. These considerations have implications beyond IQOS—to other products and companies. Full article
(This article belongs to the Special Issue Heated Tobacco Products)
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Article
Ergonomic Risk Assessment of Dental Students—RULA Applied to Objective Kinematic Data
Int. J. Environ. Res. Public Health 2021, 18(19), 10550; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph181910550 - 08 Oct 2021
Viewed by 313
Abstract
Musculoskeletal disorder (MSD) is already prevalent in dental students despite their young age and the short duration of dental practice. The current findings state that the causes of MSD are related to posture during dental work. This study aims to investigate the ergonomic [...] Read more.
Musculoskeletal disorder (MSD) is already prevalent in dental students despite their young age and the short duration of dental practice. The current findings state that the causes of MSD are related to posture during dental work. This study aims to investigate the ergonomic risk of dental students. In order to analyze the ergonomic risk of dental students, 3D motion analyses were performed with inertial sensors during the performance of standardized dental activities. For this purpose, 15 dental students and 15 dental assistant trainees (all right-handed) were measured in a team. Data were analyzed using the Rapid Upper Limb Assessment (RULA), which was modified to evaluate objective data. Ergonomic risk was found for the following body parts in descending order: left wrist, right wrist, neck, trunk, left lower arm, right lower arm, right upper arm, left upper arm. All relevant body parts, taken together, exhibited a posture with the highest RULA score that could be achieved (median Final Overall = 7), with body parts in the very highest RULA score of 7 for almost 80% of the treatment time. Dental students work with poor posture over a long period of time, exposing them to high ergonomic risk. Therefore, it seems necessary that more attention should be paid to theoretical and practical ergonomics in dental school. Full article
(This article belongs to the Special Issue Ergonomics in Dentistry)
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Article
Risk Factors of Right Ventricular Dysfunction and Adverse Cardiac Events in Patients with Repaired Tetralogy of Fallot
Int. J. Environ. Res. Public Health 2021, 18(19), 10549; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph181910549 - 08 Oct 2021
Viewed by 322
Abstract
Aim: This study evaluates the risk factors associated with right ventricular (RV) dilation and dysfunction leading to pulmonary valve replacement (PVR) or adverse cardiac events in repaired Tetralogy of Fallot (rToF) patients. Methods: Data from all rToF patients who underwent magnetic resonance imaging [...] Read more.
Aim: This study evaluates the risk factors associated with right ventricular (RV) dilation and dysfunction leading to pulmonary valve replacement (PVR) or adverse cardiac events in repaired Tetralogy of Fallot (rToF) patients. Methods: Data from all rToF patients who underwent magnetic resonance imaging (MRI) evaluation at our hospital between February 2007 and September 2020 were collected. Results: Three hundred and forty-two patients (60% males, 42% older than 18 years), with a median age of 16 years (IQR 13–24) at the time of MRI, were included. All patients underwent complete repair at a median age of 8 months (IQR 5–16), while palliation was performed in 56 patients (16%). One hundred and forty-four patients (42%) subsequently received pulmonary valve replacement (PVR). At the multivariate analysis, male gender was an independent predictor for significant RV dilation, RV and left ventricular (LV) dysfunction. Transventricular ventricular septal defect (VSD) closure and previous palliation significantly affected LV function and RV size, respectively. Male gender and the transventricular VSD closure were independent predictors for PVR. Conclusions: Male gender and surgical history (palliation, VSD closure approach) significantly affected the long-term outcomes in rToF patients and should be taken into consideration in the follow-up management and in PVR timing in this patient population. Full article
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Article
Prediction and Analysis of Tourist Management Strategy Based on the SEIR Model during the COVID-19 Period
Int. J. Environ. Res. Public Health 2021, 18(19), 10548; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph181910548 - 08 Oct 2021
Viewed by 298
Abstract
Tourism destinations are now facing a dilemma choice of controlling the epidemic or developing the economy. This paper takes Macao, a typical international tourist city, as an example to study the strategy of tourist source control during the COVID-19 period. According to the [...] Read more.
Tourism destinations are now facing a dilemma choice of controlling the epidemic or developing the economy. This paper takes Macao, a typical international tourist city, as an example to study the strategy of tourist source control during the COVID-19 period. According to the published epidemic data of Macao, this study has established an improved SEIR (Susceptible-Exposed-Infected-Recovered) model, formulated six control strategies against the current epidemic, and used the model above to simulate the time required for all confirmed cases to recover and discharge under different strategies. By taking into consideration the gross revenue of Macao’s gambling industry from 2017 to 2019, the impact of different strategies on the economy is predicted and three control strategies are found to be feasible. This study shows that an effective way to break through the above dilemma is to design the tourist management strategy by screening the source of passengers and controlling the upper limit of capacity of destination. These findings provide a scientific basis for tourism destinations in formulating public policies. The improved SEIR model is more consistent with the actual conversion rule of patients in the current COVID-19 epidemic, and it can be applied to further public health related research. Full article
(This article belongs to the Topic Burden of COVID-19 in Different Countries)
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Article
Changes in Alcohol Consumption during the COVID-19 Pandemic Are Dependent on Initial Consumption Level: Findings from Eight European Countries
Int. J. Environ. Res. Public Health 2021, 18(19), 10547; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph181910547 - 08 Oct 2021
Viewed by 423
Abstract
Evidence suggests that changes in alcohol consumption during the first months of the COVID-19 pandemic were unevenly distributed over consumer groups. We investigated possible inter-country differences in how changes in alcohol consumption are contingent on initial consumption (before or at the start of [...] Read more.
Evidence suggests that changes in alcohol consumption during the first months of the COVID-19 pandemic were unevenly distributed over consumer groups. We investigated possible inter-country differences in how changes in alcohol consumption are contingent on initial consumption (before or at the start of the pandemic), and how changes in consumption translate into possible changes in the prevalence of heavy drinking. We used data from the European Survey on Alcohol use and COVID-19 (ESAC) conducted in Czechia, Denmark, Finland, Germany, Norway, Poland, Spain, and the UK (N = 31921). Past-year alcohol consumption and changes in consumption were measured by AUDIT-C. Drinking habits were compared according to percentiles of pre-pandemic consumption levels, below versus above the 90th percentile. Across countries, drinkers in the highest 10% for pre-pandemic consumption increased their drinking during the pandemic, whereas absolute changes among those initially drinking below this level were modest. The percentage of people reporting >28 alcohol units/week increased significantly in seven of eight countries. During the first months of the COVID-19 pandemic, alcohol consumption in the upper decile of the drinkers increased as did the prevalence of heavy drinkers, in contrast with a declining consumption in other groups in the sample. Full article
(This article belongs to the Special Issue Substance Use, Treatment, and Harms during COVID-19)
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Article
A Low-Cost, High-Throughput Digital Image Analysis of Stain Patterns on Smoked Cigarette Filter Butts to Estimate Mainstream Smoke Exposure
Int. J. Environ. Res. Public Health 2021, 18(19), 10546; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph181910546 - 08 Oct 2021
Viewed by 300
Abstract
Standard machine smoking protocols provide useful information for examining the impact of design parameters, such as filter ventilation, on mainstream smoke delivery. Unfortunately, their results do not accurately reflect human smoke exposure. Clinical research and topography devices in human studies yield insights into [...] Read more.
Standard machine smoking protocols provide useful information for examining the impact of design parameters, such as filter ventilation, on mainstream smoke delivery. Unfortunately, their results do not accurately reflect human smoke exposure. Clinical research and topography devices in human studies yield insights into how products are used, but a clinical setting or smoking a cigarette attached to such a device may alter smoking behavior. To better understand smokers’ use of filtered cigarette products in a more natural environment, we developed a low-cost, high-throughput approach to estimate mainstream cigarette smoke exposure on a per-cigarette basis. This approach uses an inexpensive flatbed scanner to scan smoked cigarette filter butts and custom software to analyze tar-staining patterns. Total luminosity, or optical staining density, of the scanned images provides quantitative information proportional to mainstream smoke-constituent deliveries on a cigarette-by-cigarette basis. Duplicate sample analysis using this new approach and our laboratory’s gold-standard liquid chromatography/tandem mass spectrometry (LC/MS/MS) solanesol method yielded comparable results (+7% bias) from the analysis of 20 commercial cigarettes brands (menthol and nonmentholated). The brands varied in design parameters such as length, filter ventilation, and diameter. Plots correlating the luminosity to mainstream smoked-nicotine deliveries on a per-cigarette basis for these cigarette brands were linear (average R2 > 0.91 for nicotine and R2 > 0.83 for the tobacco-specific nitrosamine NNK), on a per-brand basis, with linearity ranging from 0.15 to 3.00 mg nicotine/cigarette. Analysis of spent cigarette filters allows exposures to be characterized on a per-cigarette basis or a “daily dose” via summing across results from all filter butts collected over a 24 h period. This scanner method has a 100-fold lower initial capital cost for equipment than the LC/MS/MS solanesol method and provides high-throughput results (~200 samples per day). Thus, this new method is useful for characterizing exposure related to filtered tobacco-product use. Full article
(This article belongs to the Special Issue Tobacco Smoke Exposure and Tobacco Product Use)
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Article
The Effectiveness of Disaster Education for Undergraduate Nursing Students’ Knowledge, Willingness, and Perceived Ability: An Evaluation Study
Int. J. Environ. Res. Public Health 2021, 18(19), 10545; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph181910545 - 08 Oct 2021
Viewed by 291
Abstract
As future healthcare professionals, nursing students should possess the appropriate knowledge, skills, and positive attitude to respond to public health emergencies or disasters worldwide. This study evaluated the effectiveness of a disaster management training course at improving Hong Kong nursing students’ disaster knowledge, [...] Read more.
As future healthcare professionals, nursing students should possess the appropriate knowledge, skills, and positive attitude to respond to public health emergencies or disasters worldwide. This study evaluated the effectiveness of a disaster management training course at improving Hong Kong nursing students’ disaster knowledge, willingness, and perceived ability. A mixed-method design using a single group with pre- and post-intervention comparisons followed by qualitative focus group interviews, was conducted. A 45-h disaster management training course with theoretical and practical inputs was conducted. A total of 157 students participated in and completed the pre- and post-intervention questionnaires. Positive significant results in disaster knowledge (t(156) = −8.12, p < 0.01, d = −0.84) and perceived ability (t(156) = −7.95, p < 0.01, d = −0.72) were found, but no substantial change in willingness to respond to disasters was observed. The participants expressed various concerns regarding their willingness to respond, which can be summarized and grouped as (1) personal risk perceptions, (2) contextual factors of the disaster events, and (3) organizational support. Incorporating disaster training into the tertiary education curricula for basic nursing professionals’ training could be a long-term strategy to prepare and expand the competent workforce for future disasters. Government or healthcare organizations are recommended to provide strategies and adequate support to alleviate nursing professionals’ concerns and enhance their willingness. Full article
(This article belongs to the Special Issue Evidence-Based Practice and Advanced Nursing Care)
Article
Interest of a Joint Use of Two Diagnostic Tools of Burnout: Comparison between the Oldenburg Burnout Inventory and the Early Detection Tool of Burnout Completed by Physicians
Int. J. Environ. Res. Public Health 2021, 18(19), 10544; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph181910544 - 08 Oct 2021
Viewed by 287
Abstract
Most research on burnout is based on self-reported questionnaires. Nevertheless, as far as the clinical judgement is concerned, a lack of consensus about burnout diagnosis constitutes a risk of misdiagnosis. Hence, this study aims to assess the added value of a joint use [...] Read more.
Most research on burnout is based on self-reported questionnaires. Nevertheless, as far as the clinical judgement is concerned, a lack of consensus about burnout diagnosis constitutes a risk of misdiagnosis. Hence, this study aims to assess the added value of a joint use of two tools and compare their diagnostic accuracy: (1) the early detection tool of burnout, a structured interview guide, and (2) the Oldenburg burnout inventory, a self-reported questionnaire. The interview guide was tested in 2019 by general practitioners and occupational physicians among 123 Belgian patients, who also completed the self-reported questionnaire. A receiver operating characteristic curve analysis allowed the identification of a cut-off score for the self-reported questionnaire. Diagnostic accuracy was then contrasted by a McNemar chi-squared test. The interview guide has a significantly higher sensitivity (0.76) than the self-reported questionnaire (0.70), even by comparing the self-reported questionnaires with the interviews of general practitioners and occupational physicians separately. However, both tools have a similar specificity (respectively, 0.60–0.67), except for the occupational physicians’ interviews, where the specificity (0.68) was significantly lower than the self-reported questionnaire (0.70). In conclusion, the early detection tool of burnout is more sensitive than the Oldenburg burnout inventory, but seems less specific. However, by crossing diagnoses reported by patients and by physicians, they both seem useful to support burnout diagnosis. Full article
(This article belongs to the Special Issue Occupational Stress and Health: Psychological Burden and Burnout)
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Article
Three-Year Intervention Effects on Food and Beverage Intake—Results from the Quasi-Experimental Copenhagen School Child Intervention Study (CoSCIS)
Int. J. Environ. Res. Public Health 2021, 18(19), 10543; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph181910543 - 08 Oct 2021
Viewed by 298
Abstract
The diet of Danish children is often not in accordance with dietary guidelines. We aimed to evaluate changes in the intake of selected foods and beverages during a multi-component school-based physical activity intervention, and to investigate if changes were modified by socioeconomic status [...] Read more.
The diet of Danish children is often not in accordance with dietary guidelines. We aimed to evaluate changes in the intake of selected foods and beverages during a multi-component school-based physical activity intervention, and to investigate if changes were modified by socioeconomic status (SES). The study included 307 children (intervention group: 184; comparison group: 123) with information on dietary intake pre- and post-intervention as well as on SES. Linear regression models were conducted to assess the effect of the intervention on changes in dietary factors. Children from the intervention group increased their intake of whole-grain bread during the intervention (group means: 6.1 g/d (95% CI: 2.2 to 10.0) vs. 0.3 g/d (95% CI: −3.1 to 3.7) in the comparison group, p = 0.04). A significant interaction between SES and group allocation was observed to change in fruit intake (p = 0.01). Among children from low SES families, only those from the comparison group decreased their fruit intake (group means: −40.0 g/d (95% CI: −56.0 to −23.9) vs. 9.3 g/d (95% CI: −16.1 to 94) in the intervention group, p = 0.006). The present study found no convincing effect of introducing a multi-component intervention on dietary intake except a small beneficial effect on whole-grain bread consumption. However, beneficial intervention effects in fruit intake were found particularly among children from low SES families. Full article
(This article belongs to the Section Children's Health)
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Article
Communicating Air Quality Index Information: Effects of Different Styles on Individuals’ Risk Perception and Precaution Intention
Int. J. Environ. Res. Public Health 2021, 18(19), 10542; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph181910542 - 08 Oct 2021
Viewed by 299
Abstract
Air Quality Index (AQI) is information about atmospheric pollutants, which is essential for governments to inform the public about the current air quality and potential health risks. By analyzing the AQIs from 11 countries (regions), we discovered considerable variations in the design of [...] Read more.
Air Quality Index (AQI) is information about atmospheric pollutants, which is essential for governments to inform the public about the current air quality and potential health risks. By analyzing the AQIs from 11 countries (regions), we discovered considerable variations in the design of AQI information, which may open up room for unintended interpretation from the public. Therefore, as an attempt to address the inefficiency of some common styles of AQI information in promoting the public’s precaution against bad air and better design such information, an online experiment with a 2 (descriptor: neutral vs. negatively valenced) × 2 (target groups in AQI warning messages: vague vs. specific) factorial design was conducted to test the effects of such information on individuals’ risk perception and precaution intention. The results indicated that AQI information with a neutral descriptor was associated with lower self-risk perception and precaution intention levels than with a negatively valenced one. Among the individuals not included in the at-risk groups, those who read the warning messages with vague target groups had a higher third-person perception toward smog risk than those targeting specific population groups. Practical and theoretical implications are discussed. Full article
(This article belongs to the Collection Mass Communication, Digital Media, and Public Health)
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Article
Effects of Performing Applied Muscle Tension during Recovery after Phlebotomy in Young, First-Time Donors: A Pilot Study
Int. J. Environ. Res. Public Health 2021, 18(19), 10541; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph181910541 - 08 Oct 2021
Viewed by 365
Abstract
Vasovagal reaction (VVR) compromises donor safety and reduces the subsequent return rates. Performing applied muscle tension (AMT) during phlebotomy may reduce the incidence of VVR. However, the effectiveness of performing AMT after phlebotomy to reduce delayed VVR remains unclear. With ethics approval, 12 [...] Read more.
Vasovagal reaction (VVR) compromises donor safety and reduces the subsequent return rates. Performing applied muscle tension (AMT) during phlebotomy may reduce the incidence of VVR. However, the effectiveness of performing AMT after phlebotomy to reduce delayed VVR remains unclear. With ethics approval, 12 young, first-time donors (YFTD) were recruited to study the effects on stroke volume (SV), cardiac output (CO) and systemic vascular resistance (SVR) while performing AMT from needle insertion to end of recovery. Measurements from 12 matched control YFTD were used for comparison. Pre-donation anxiety and VVR severity were assessed. Compared to controls, donors who performed AMT had higher SV (Control: 57 mL vs. AMT: 69 mL, p = 0.045), higher CO (Control: 3.7 L·min−1 vs. AMT: 5.2 L·min−1, p = 0.006) and lower SVR (Control: 1962 dyn·s·cm−5 vs. AMT: 1569 dyn·s·cm−5, p = 0.032) during mid-phlebotomy. During recovery, the AMT group retained higher SV, higher CO and lower SVR than the control, but not reaching statistical significance. Practicing AMT during recovery resulted in sustained haemodynamic improvements beyond the donation period, despite the reduction in delayed VVR was insignificant compared to the control group. A larger sample size is needed to validate the effectiveness of performing AMT after donation to mitigate delayed VVR. Full article
(This article belongs to the Section Exercise and Health)
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Article
Mortality-Risk Prediction Model from Road-Traffic Injury in Drunk Drivers: Machine Learning Approach
Int. J. Environ. Res. Public Health 2021, 18(19), 10540; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph181910540 - 08 Oct 2021
Viewed by 310
Abstract
Background: Alcohol-related road-traffic injury is the leading cause of premature death in middle- and lower-income countries, including Thailand. Applying machine-learning algorithms can improve the effectiveness of driver-impairment screening strategies by legal limits. Methods: Using 4794 RTI drivers from secondary cross-sectional data from the [...] Read more.
Background: Alcohol-related road-traffic injury is the leading cause of premature death in middle- and lower-income countries, including Thailand. Applying machine-learning algorithms can improve the effectiveness of driver-impairment screening strategies by legal limits. Methods: Using 4794 RTI drivers from secondary cross-sectional data from the Thai Governmental Road Safety Evaluation project in 2002–2004, the machine-learning models (Gradient Boosting Classifier: GBC, Multi-Layers Perceptrons: MLP, Random Forest: RF, K-Nearest Neighbor: KNN) and a parsimonious logistic regression (Logit) were developed for predicting the mortality risk from road-traffic injury in drunk drivers. The predictors included alcohol concentration level in blood or breath, driver characteristics and environmental factors. Results: Of 4974 drivers in the derived dataset, 4365 (92%) were surviving drivers and 429 (8%) were dead drivers. The class imbalance was rebalanced by the Synthetic Minority Oversampling Technique (SMOTE) into a 1:1 ratio. All models obtained good-to-excellent discrimination performance. The AUC of GBC, RF, KNN, MLP, and Logit models were 0.95 (95% CI 0.90 to 1.00), 0.92 (95% CI 0.87 to 0.97), 0.86 (95% CI 0.83 to 0.89), 0.83 (95% CI 0.78 to 0.88), and 0.81 (95% CI 0.75 to 0.87), respectively. MLP and GBC also had a good model calibration, visualized by the calibration plot. Conclusions: Our machine-learning models can predict road-traffic mortality risk with good model discrimination and calibration. External validation using current data is recommended for future implementation. Full article
(This article belongs to the Special Issue Machine Learning Applications in Public Health)
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Article
Dementia in Media Coverage: A Comparative Analysis of Two Online Newspapers across Time
Int. J. Environ. Res. Public Health 2021, 18(19), 10539; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph181910539 - 08 Oct 2021
Viewed by 344
Abstract
The news media, specifically online newspapers, is one of the powerful transmitters of discourse due to its rapid accessibility that contributes to social beliefs and attitudes that often shape our perceptions on dementia and Alzheimer’s disease. The media portrayal of dementia is largely [...] Read more.
The news media, specifically online newspapers, is one of the powerful transmitters of discourse due to its rapid accessibility that contributes to social beliefs and attitudes that often shape our perceptions on dementia and Alzheimer’s disease. The media portrayal of dementia is largely heterogeneous, but there is certainly an association between the influence of online news coverage and the social perceptions of dementia that need to be understood more broadly. In this study, we examined the portrayal of dementia in two online newspapers (The New York Times and The Guardian) that might have an influence on dementia discourse by comparing the content and form of the news coverage on dementia across time. This study was guided by three interconnected theoretical understandings: cultivation theory, agenda-setting theory, and spiral of silence theory. A total of 291 published articles featuring dementia from 2014 to 2019 were included in this study and a content analysis of the articles provided insight into the dementia-related news coverage. Our results showed that both newspapers have a decreasing trend in publishing articles related to dementia over time. In addition, dementia-related (modifiable) risk factors as principal news content was significantly associated with the year of publication. Despite a weak association between story categories and newspapers, the majority of articles reported preventive measures as the main story category. Although both newspapers featured more articles with a less negative tone across time when reporting on dementia, derogative wording, as discourse, was commonly used to address the illness. We have provided some insight into understanding how online newspapers potentially affect subjective representations of dementia as well as perpetuate dementia discourse. Finally, we suggest that future study may benefit from establishing a linkage between the depiction of dementia in online newspapers and the contextualization of dementia within cultures. Full article
(This article belongs to the Special Issue Dementia Research: Epidemiology and Public Health)
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Article
What Factors Predict the Use of Coercive Food Parenting Practices among Mothers of Young Children? An Examination of Food Literacy, Disordered Eating and Parent Demographics
Int. J. Environ. Res. Public Health 2021, 18(19), 10538; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph181910538 - 08 Oct 2021
Viewed by 477
Abstract
Parents have the most significant influence on the development of young children’s eating patterns. Understanding what parental factors best predict specific negative feeding practices is important for designing preventive interventions. We examined the relationship between parents’ use of coercive food parenting practices (pressure [...] Read more.
Parents have the most significant influence on the development of young children’s eating patterns. Understanding what parental factors best predict specific negative feeding practices is important for designing preventive interventions. We examined the relationship between parents’ use of coercive food parenting practices (pressure to eat and restriction) and parents’ disordered eating, food literacy, Body Mass Index (BMI) and socio-economic status (SES). Adult mothers, with a mean age of 33 years, at least one child aged between 6 months and 5 years and living in Australia (n = 819) completed an online questionnaire. Regression models were used to examine predictors of pressure to eat and restriction, respectively. Although the amount of variance accounted for by the models was small, maternal eating disorder symptoms were found to be the most important predictor of coercive food parenting practices. This finding has implications for early nutrition education, which has traditionally focused heavily on nutrition literacy. Parental disordered eating may be a more important preventive target and thus including behavioral strategies for positive feeding practices may better assist mothers in promoting positive eating habits with their children, rather than traditional approaches that aim to increase nutrition literacy. Full article
(This article belongs to the Special Issue Health Literacy, Nutrition and Public Health)
Article
Implementation of the EIRA 3 Intervention by Targeting Primary Health Care Practitioners: Effectiveness in Increasing Physical Activity
Int. J. Environ. Res. Public Health 2021, 18(19), 10537; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph181910537 - 08 Oct 2021
Viewed by 375
Abstract
The World Health Organization (WHO) estimated that physical inactivity (PI) is responsible for 20 to 30% of all non-communicable diseases. We aimed to analyze the effectiveness of a multiple health behavior change (MHBC) intervention to increase physical activity (PA) in patients 45 to [...] Read more.
The World Health Organization (WHO) estimated that physical inactivity (PI) is responsible for 20 to 30% of all non-communicable diseases. We aimed to analyze the effectiveness of a multiple health behavior change (MHBC) intervention to increase physical activity (PA) in patients 45 to 75 years old who had at least 2 of 3 unhealthy behaviors (tobacco use, reduced fruit and vegetable consumption, and insufficient PA). The MHBC intervention is based on the Transtheoretical Model and the conceptual framework of the “5 A’s” and includes an individually tailored intervention, group sessions, and the use of community resources. We included 3062 participants, 1481 in the intervention group and 1581 in the control group. After 12 months, there were no differences in PA intensity measured by metabolic_equivalent_of_task_minutes/week (adjusted mean difference: 284.093, 95% CI: −298.24, 866.42) nor in the proportion of participants who increased PA levels to moderate or high (OR: 1.02, 95% CI: 0.85, 1.23; p = 0.822), and no differences in blood pressure, weight loss, or waist circumference. We found an increased proportion of patients in the intervention group who followed the WHO recommendations for PA (OR: 1.29; 95% CI: 1.04, 1.60; p = 0.02). We concluded that the intervention did not lead to a significant increase in PA. Full article
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Article
Insecticidal Efficacy of Microbial-Mediated Synthesized Copper Nano-Pesticide against Insect Pests and Non-Target Organisms
Int. J. Environ. Res. Public Health 2021, 18(19), 10536; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph181910536 - 08 Oct 2021
Viewed by 360
Abstract
Currently, medical and stored grain pests are major concerns of public health and economies worldwide. The synthetic pesticides cause several side effects to human and non-target organisms. Copper nanoparticles (CuNPs) were synthesized from an aqueous extract of Metarhizium robertsii and screened for insecticidal [...] Read more.
Currently, medical and stored grain pests are major concerns of public health and economies worldwide. The synthetic pesticides cause several side effects to human and non-target organisms. Copper nanoparticles (CuNPs) were synthesized from an aqueous extract of Metarhizium robertsii and screened for insecticidal activity against Anopheles stephensi, Aedes aegypti, Culex quinquefasciatus, Tenebrio molitor and other non-target organisms such as Artemia salina, Artemia nauplii, Eudrilus eugeniae and Eudrilus andrei. The synthesized copper nano-particles were characterized using, UV-vis spectrophotometer, Fourier Transform Infrared Spectroscopy (FTIR), X-Ray Diffraction (XRD), Energy Dispersive X-Ray analysis (EDaX), High Resolution Scanning Electron Microscope (HR-SEM) and Atomic Force Microscope (AFM) analysis. Insects were exposed to 25 μg/mL concentration produced significant mortality against larvae of A. stephensi, A. aegypti, C. quinquefasciatus and T. molitor. The lower toxicity was observed on non-target organisms. Results showed that, M. robertsii mediated synthesized CuNPs is highly toxic to targeted pests while they had lower toxicity were observed on non-target organisms. Full article
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Review
Food Systems Transformation for Child Health and Well-Being: The Essential Role of Dairy
Int. J. Environ. Res. Public Health 2021, 18(19), 10535; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph181910535 - 08 Oct 2021
Viewed by 648
Abstract
Malnutrition, in all its forms, during the critical stages of child growth and development can have lifelong impacts on health and well-being. While most forms of malnutrition can be prevented with simple dietary interventions, both undernutrition and overnutrition remain persistent and burdensome challenges [...] Read more.
Malnutrition, in all its forms, during the critical stages of child growth and development can have lifelong impacts on health and well-being. While most forms of malnutrition can be prevented with simple dietary interventions, both undernutrition and overnutrition remain persistent and burdensome challenges for large portions of the global population, especially for young children who are dependent on others for nourishment. In addition to dietary factors, children’s health also faces the growing challenges of climate change, environmental degradation, pollution, and infectious disease. Food production and consumption practices both sit at the nexus of these issues, and both must be significantly transformed if we are to achieve the 2030 Sustainable Development Goals. Food sources (i.e., animal-source foods vs. plant-source foods), food production practices, the effects of food processing, the impacts of a more globalized food system, and food loss and waste have all been receiving growing attention in health and sustainability research and policy discussions. Much of this work points to recommendations to reduce resource-intensive animal-source foods, heavily processed foods, and foods associated with excessive waste and pollution, while simultaneously increasing plant-source options. However, some of these recommendations require a little more nuance when considered in the context of issues such as global child health. All types of foods can play significant roles in providing essential nutrition for children across the globe, and for improving the well-being and livelihoods of their families and communities. Dairy foods provide a prime example of this need for nuance, as both dairy production practices and consumption patterns vary greatly throughout the world, as do their impacts on child health and food system sustainability. The objective of this narrative review is to highlight the role of dairy in supporting child health in the context of food system sustainability. When considering child health within this context it is recommended to take a holistic approach that considers all four domains of sustainability (health, economics, society, and the environment) to better weigh trade-offs, optimize outcomes, and avoid unintended consequences. To ensure that children have access to nutritious and safe foods within sustainable food systems, special consideration of their needs must be included within the broader food systems transformation narrative. Full article
Article
Knowledge and Perception of Registered Nurses Regarding the Scope of Practice of Speech-Language Pathologists
Int. J. Environ. Res. Public Health 2021, 18(19), 10534; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph181910534 - 08 Oct 2021
Viewed by 486
Abstract
Objective: To assess the knowledge and perception of registered nurses regarding the scope of practice of speech-language pathologists (SLP) in Saudi Arabia. Background: Interdisciplinary collaboration is vital between the SLP and nurses due to the complex care needed by patients with speech problems. [...] Read more.
Objective: To assess the knowledge and perception of registered nurses regarding the scope of practice of speech-language pathologists (SLP) in Saudi Arabia. Background: Interdisciplinary collaboration is vital between the SLP and nurses due to the complex care needed by patients with speech problems. Methods: A total of 294 registered nurses were surveyed utilizing the Knowledge and Perception of Speech-Language Pathologists questionnaire. Descriptive statistics and tests for differences and relationships were performed. Results: The findings revealed that nursing respondents had an overall good understanding of the value and scope of practice of the SLP. However, they frequently and wrongly responded to scenarios concerning patients who suffered from Alzheimer’s dementia, laryngeal cancer, traumatic brain injury, and stroke. Conclusions: It is vital for nurses to understand the value, role, and scope of practice of the SLP. Further educational nursing interventions and training are necessary for effective interprofessional collaboration and teamwork. Full article
(This article belongs to the Special Issue Nursing Research)
Brief Report
Progression of the Pathway for Public Health Care during the COVID-19 Outbreak at District Health Office
Int. J. Environ. Res. Public Health 2021, 18(19), 10533; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph181910533 - 07 Oct 2021
Viewed by 483
Abstract
Public health activities under district health offices (DHOs) play a major role in Malaysia’s fight against COVID-19. This article aims to describe and illustrate the public health activity pathway in combating the COVID-19 pandemic, and a team of public health workers who are [...] Read more.
Public health activities under district health offices (DHOs) play a major role in Malaysia’s fight against COVID-19. This article aims to describe and illustrate the public health activity pathway in combating the COVID-19 pandemic, and a team of public health workers who are familiar with DHO work settings was created in April 2020 for that purpose. Review of documents and the Ministry of Health’s updates was carried out, followed by a series of discussions with stakeholders. Based on the steps in the outbreak investigation tasks, the flow of activities from January to May 2020 was listed in line with the phases of the country’s National Movement Control Order 2020. Results show that the activities can be classified into three different sections—namely, the main action areas, category of cases, and level of care. The main process flow of activities comprised the case management and support activities. Case management flow was split into tasks for patients under investigation and persons under surveillance, while the support services existed throughout the phases. The pathways illustrate that the progression of the pandemic translated directly to changes in the pattern of activities, with additional subgroups of activities in accordance with all imposed guidelines. Full article
(This article belongs to the Section Health Care Sciences & Services)
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Article
An Empirical Perception of Economic Resilience Responded to the COVID-19 Epidemic Outbreak in Beijing–Tianjin–Hebei Urban Agglomeration, China: Characterization and Interaction
Int. J. Environ. Res. Public Health 2021, 18(19), 10532; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph181910532 - 07 Oct 2021
Viewed by 436
Abstract
The COVID-19 has caused a serious impact on the global economy, and all countries are in a predicament of fighting the epidemic and recovering their economies. Aiming to discuss the impact of the COVID-19 on the economic resilience of urban agglomerations, the economic [...] Read more.
The COVID-19 has caused a serious impact on the global economy, and all countries are in a predicament of fighting the epidemic and recovering their economies. Aiming to discuss the impact of the COVID-19 on the economic resilience of urban agglomerations, the economic data of each quarter from June 2019 to September 2020 of the Beijing–Tianjin–Hebei Urban Agglomeration are selected, and the economic development index (EDI) is calculated based on the entropy method. Combining the fundamental conditions of urban agglomerations and industrial policies during the COVID-19, urban economic resilience is discussed by the changing trend of the economic development index (EDI) and dividing into resistance and restoration. The results show that: (1) The economic development level of the urban agglomeration has been affected by the epidemic and has changed significantly. The change of endogenous power is the main cause of change; (2) During the outbreak of the COVID-19, the economic resilience of the Beijing–Tianjin–Hebei urban agglomeration shows four different development types: high resistance and restoration, high resistance but low restoration, low resistance but high restoration, low resistance and restoration cities; (3) High resistance but low restoration, low resistance but high restoration, and low resistance and restoration cities influence each other, but the relationship between cities is mainly dependent; (4) The economic restoration within the urban agglomeration forms a synergy, which promotes the economic recovery and development of the urban agglomeration during the recovery period of the COVID-19. Urban agglomerations should enhance the combined effect of resistance and increase the impact of high resistance and restoration cities on surrounding cities in the future. Full article
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Article
Psychosocial Impact of the COVID-19 Pandemic on Healthcare Workers and Initial Areas of Action for Intervention and Prevention—The egePan/VOICE Study
Int. J. Environ. Res. Public Health 2021, 18(19), 10531; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph181910531 - 07 Oct 2021
Viewed by 468
Abstract
Introduction: Epidemics lead to an increase in occupational stress and psychological strain among healthcare workers. However, the impact of a pandemic outbreak on healthcare systems is yet to be clearly defined. Therefore, this work aims to describe and analyze specific areas of workload [...] Read more.
Introduction: Epidemics lead to an increase in occupational stress and psychological strain among healthcare workers. However, the impact of a pandemic outbreak on healthcare systems is yet to be clearly defined. Therefore, this work aims to describe and analyze specific areas of workload among different groups of healthcare workers during the first wave of the COVID-19 pandemic. Methods: A sample of N = 8088 persons working in the German-speaking healthcare sector participated in the VOICE/egePan online survey, which addressed the impact of the COVID-19 pandemic during the second quarter of 2020. We used 15 self-constructed items, based on the work of Matsuishi et al. (2012), to identify potential COVID-19-specific topics. Results: N = 7542 records of healthcare workers were analyzed. Of these, 60.80% reported, retrospectively, an increase in stress since the outbreak of the pandemic. Problem areas tended to be indicated more frequently by the women surveyed than by the men. Nurses, paramedics and medical technicians reported the highest fear of infecting others while physicians reported the highest fear of physical or mental exhaustion. With respect to age, older respondents indicated less fear and felt more protected. Men and people living alone were more likely to use dysfunctional coping strategies. Migrants reported a higher fear of becoming infected or infecting others as well as they reported about increased levels of smoking. Discussion: Retrospectively, the COVID-19 pandemic led to an increase in stress among healthcare workers. Problem areas have different focuses with regard to different living situations, environmental conditions and professions. In order to lay the best basis for healthy and efficient work, it seems necessary to take measures especially tailored to the needs of different groups of healthcare workers. Full article
(This article belongs to the Special Issue Mental Health in the Time of COVID-19)
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