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Int. J. Environ. Res. Public Health, Volume 18, Issue 22 (November-2 2021) – 537 articles

Cover Story (view full-size image): Although social distancing measures during national lockdowns were necessary for COVID-19 to be controlled, research has shown that they had a negative impact on chronic pain patients’ function. The suggestions made on how to improve the care of patients were based on what was known about the early stages of isolation to which everyone was exposed. However, they may not be applicable to the latter stages of lockdowns or subsequent lockdowns. The main objective of this study was to improve the understanding of the effects of COVID-19 social distancing measures on individuals with chronic pain living in Spain during the latter stages of the lockdown. The findings from this study can be used to inform policy and specific responses for future COVID-19 waves, and new future pandemics. View this paper.
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7 pages, 6625 KiB  
Case Report
Differential Diagnosis between Child Abuse and Infantile Cortical Hyperostosis: A Case Report and Literature Review
by Du-Yeon Lee, Woo-Jong Kim, Byungsung Kim, Jae-Hwi Nho, Chang-Hwa Hong, Sang-Mi Lee, Ik-Dong Yoo, Changeui Lee and Ki-Jin Jung
Int. J. Environ. Res. Public Health 2021, 18(22), 12269; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph182212269 - 22 Nov 2021
Cited by 2 | Viewed by 2723
Abstract
Child abuse is a major public health problem that can lead to critical consequences for the child and family. However, early identification of abuse may be difficult. An 8-month-old boy presented with extensive periosteal reaction in both upper and lower long bones. There [...] Read more.
Child abuse is a major public health problem that can lead to critical consequences for the child and family. However, early identification of abuse may be difficult. An 8-month-old boy presented with extensive periosteal reaction in both upper and lower long bones. There was no specific history of injury. Caffey disease was initially considered as the diagnosis because the patient displayed fever and hyperostosis of multiple bones with elevated erythrocyte sedimentation rates and C-reactive protein and alkaline phosphatase levels. However, we suspected child abuse based on the clinical and radiological features. We eventually found out that the child had been injured through child abuse and were able to treat him. We report this case because child abuse cases may be confused with Caffey disease. This case report can, therefore, help distinguish between Caffey disease and child abuse. Full article
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17 pages, 1900 KiB  
Article
Energy and Environmental Assessment of Steam Management Optimization in an Ethylene Plant
by Miroslav Variny, Kristián Hanus, Marek Blahušiak, Patrik Furda, Peter Illés and Ján Janošovský
Int. J. Environ. Res. Public Health 2021, 18(22), 12267; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph182212267 - 22 Nov 2021
Cited by 2 | Viewed by 2258
Abstract
Steam crackers (ethylene plants) belong to the most complex industrial plants and offer significant potential for energy-saving translated into the reduction of greenhouse gas emissions. Steam export to or import from adjacent units or complexes can boost the associated financial benefit, but its [...] Read more.
Steam crackers (ethylene plants) belong to the most complex industrial plants and offer significant potential for energy-saving translated into the reduction of greenhouse gas emissions. Steam export to or import from adjacent units or complexes can boost the associated financial benefit, but its energy and environmental impact are questionable. A study was carried out on a medium-capacity ethylene plant using field data to: 1. Estimate the energy savings potential achievable by optimizing internal steam management and optimizing steam export/import; 2. Quantify the associated change in air pollutant emissions; 3. Analyze the impact of the increasing carbon price on the measures adopted. Internal steam management optimization yielded steam let-down rate minimization and resulted in a 5% (87 TJ/year) reduction in steam cracker’s steam boiler fuel consumption and the associated cut of CO2 emissions by almost 4900 t/year and that of NOx emissions by more than 5 t/year. Steam import to the ethylene plant from the refinery proved to be purely economic-driven, as it increased the net fuel consumption of the ethylene plant and the refinery complex by 12 TJ/year and resulted in an increase of net emissions of nearly all considered air pollutants (more than 7000 t/year of CO2, over 15 t/year of NOx, over 18 t/year of SOx) except for CO, where the net change was almost zero. The effect of external emissions change due to the associated backpressure electricity production surplus (over 11 GWh/year) was too low to compensate for this increase unless fossil fuel-based electricity production was considered. The increase of carbon price impact on the internal steam management optimization economics was favorable, while a switch to steam export from the ethylene plant, instead of steam import, might be feasible if the carbon price increased to over 100 €/tCO2. Full article
(This article belongs to the Special Issue Future and Feature Paper in Environment and Applied Ecology)
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11 pages, 357 KiB  
Article
Misinformation, Fears and Adherence to Preventive Measures during the Early Phase of COVID-19 Pandemic: A Cross-Sectional Study in Poland
by Bartosz M. Nowak, Cezary Miedziarek, Szymon Pełczyński and Piotr Rzymski
Int. J. Environ. Res. Public Health 2021, 18(22), 12266; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph182212266 - 22 Nov 2021
Cited by 15 | Viewed by 4017
Abstract
The response to the pandemic requires access to accurate information and public understanding and adherence to preventive measures. This online cross-sectional study of adult Poles (n = 1337) assessed the frequency of COVID-19 preventive behaviors, fears related to the COVID-19 pandemic, and [...] Read more.
The response to the pandemic requires access to accurate information and public understanding and adherence to preventive measures. This online cross-sectional study of adult Poles (n = 1337) assessed the frequency of COVID-19 preventive behaviors, fears related to the COVID-19 pandemic, and beliefs in COVID-19-related conspiracy theories during the early phase of the COVID-19 pandemic when the nationwide lockdown was imposed (April 2020). As shown, 22% of surveyed admitted not to wash their hands frequently, while 12% did not use disinfectants. These two behaviors were also less frequent in individuals with medical education. The highest levels of pandemic-related fears were associated with health loss in relatives, pandemic-induced economic crisis, and government using a pandemic to control citizens by the state. A significant share of surveyed individuals believed that the pandemic was intentional action to weaken non-Chinese economies (32%) or was deliberately induced for profits from selling vaccines (27%). Men, individuals with no children, and subjects with lower education were significantly less likely to adhere to sanitary measures (handwashing, disinfection, avoiding face touching, changes in greeting etiquette, face-covering when coughing or sneezing), and were less concerned over self and relatives’ health. At the same time, men were less prone than women to the conspiracy theories related to the COVID-19 pandemic. The results indicate that adherence to sanitary measures during the pandemic can be a challenge also in developed countries, while misinformation campaigns (also concerning vaccines) have already affected the general public during the early phase of the epidemiological outbreak. The study provides observations that may be useful in the management of the public response to future epidemics. Full article
(This article belongs to the Special Issue Health Misinformation on Social Media)
8 pages, 326 KiB  
Article
Effects of Hearing Impairment, Quality of Life and Pain on Depressive Symptoms in Elderly People: A Cross-Sectional Study
by Weiyi Sun, Teruyuki Matsuoka, Ayu Imai, Nozomu Oya and Jin Narumoto
Int. J. Environ. Res. Public Health 2021, 18(22), 12265; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph182212265 - 22 Nov 2021
Cited by 4 | Viewed by 2058
Abstract
Reduction of the incidence of depression and improvement of quality of life (QOL) of elderly people have become important subjects. Various factors are related to depressive symptoms in elderly people, and sensory impairment is a key to health, QOL, and depressive symptoms. In [...] Read more.
Reduction of the incidence of depression and improvement of quality of life (QOL) of elderly people have become important subjects. Various factors are related to depressive symptoms in elderly people, and sensory impairment is a key to health, QOL, and depressive symptoms. In this cross-sectional study, a visual acuity test and audiometry were used to examine the relationships of visual and hearing impairment and other factors with depressive symptoms in elderly people. A group of 490 community-dwelling people aged over 65 years old underwent vision and hearing tests, the Center for Epidemiologic Studies Depression Scale (CES-D), Mini-Mental State Examination (MMSE), and questionnaires on social isolation, QOL, and physical condition. Logistic regression analysis was used to examine factors affecting CES-D. Multivariate logistic regression analysis indicated that hearing impairment, pain score, and satisfaction with human relationships and activities of daily living (ADL) were independent predictors of CES-D scores. Satisfaction with human relationships and ADL can reduce depressive symptoms in elderly people. Hearing impairment, pain, and social contact are also important. Therefore, improvement of social networks, interpersonal relationships, ADL, and hearing impairment may be effective in improving these symptoms in elderly people. Full article
(This article belongs to the Section Mental Health)
14 pages, 382 KiB  
Article
Mental Well-Being during COVID-19: A Cross-Sectional Study of Fly-In Fly-Out Workers in the Mining Industry in Australia
by Bernard Yeboah-Asiamah Asare, Elizabeth Thomas, Jacquita S. Affandi, Myles Schammer, Paul Brown, Matthew Pilbeam, Chris Harris, Chris Ellison, Dominika Kwasnicka, Daniel Powell, Christopher M. Reid and Suzanne Robinson
Int. J. Environ. Res. Public Health 2021, 18(22), 12264; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph182212264 - 22 Nov 2021
Cited by 6 | Viewed by 2885
Abstract
Coronavirus disease 2019 (COVID-19) has devastated the world, and its mental health impact has been recognized in the general population. However, little is known about the mental health impact of COVID-19 on fly-in fly-out (FIFO) workers, who are flown to temporarily stay and [...] Read more.
Coronavirus disease 2019 (COVID-19) has devastated the world, and its mental health impact has been recognized in the general population. However, little is known about the mental health impact of COVID-19 on fly-in fly-out (FIFO) workers, who are flown to temporarily stay and work in remote areas, during this pandemic. This study examined the mental well-being of FIFO workers in the mining industry during COVID-19 restrictions in Western Australia. An online survey was conducted between May to November 2020 among (N = 842) FIFO workers who underwent COVID-19 screening at a large mining company in Western Australia. The mental well-being score among workers was higher than population norms. One-way ANOVA with Bonferroni post-hoc tests showed significant differences in mental well-being by age, being placed under travel quarantine, undertaking self-isolation, impact of social distance guidelines, and experience of COVID-19 related symptoms. Multiple linear regression analysis showed workers who were younger, placed under travel quarantine and experienced two or more COVID-19 related symptoms were more likely to have worse mental well-being. Acknowledging the negative emotions and distress experiences among the vulnerable groups could help in providing suitable support to help lessen these negative experiences in FIFO workers. Full article
(This article belongs to the Topic Burden of COVID-19 in Different Countries)
17 pages, 33585 KiB  
Article
Hydrodynamic Characteristics of Different Undulatory Underwater Swimming Positions Based on Multi-Body Motion Numerical Simulation Method
by Jin Yang, Tianzeng Li, Zhiya Chen, Chuan Zuo and Xiaodong Li
Int. J. Environ. Res. Public Health 2021, 18(22), 12263; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph182212263 - 22 Nov 2021
Cited by 3 | Viewed by 2174
Abstract
The study of hydrodynamic characteristics of swimming is the main way to optimize the swimming movement. The relationship between position, water depth, and swimming performance of undulatory underwater swimming are one of the main concerns of scholars. Therefore, the aim of this study [...] Read more.
The study of hydrodynamic characteristics of swimming is the main way to optimize the swimming movement. The relationship between position, water depth, and swimming performance of undulatory underwater swimming are one of the main concerns of scholars. Therefore, the aim of this study is to analyze the swimming performance of three different undulatory underwater swimming positions under various swimming depths using a numerical simulation method based on multi-body motion. The simulation was conducted using 3D incompressible Navier–Stokes equations using the RNG k-ε turbulence closure equations, and in combination with the VOF method thus that we could include the water surface in our calculations. Different swimming depths based on the distance from the shoulder joint center to the initial water surface were considered. The velocity of the shoulder joint center was captured with a swimming motion monitoring system (KiSwim) and compared with the calculated results. The study found that there was a significant difference in the hydrodynamic characteristics of the three undulatory underwater swimming positions (i.e., the dorsal, lateral, and frontal positions) when swimming near the water surface, and the difference decreased as the swimming depth increased. There was a negative correlation (R(dorsal) = −0.928, R(frontal) = −0.937, R(lateral) = −0.930) between the swimming velocities of the three undulatory underwater swimming positions and the water depth (water depth = 0.2–0.7 m) and that the lateral position had the greatest average velocity. Therefore, it is recommended that swimmers travel at least 0.5 m below the water surface in any undulatory underwater swimming position in order to avoid excessive drag forces. As the swimmer approaches the water surface, the lateral position is worth considering, which has better velocity and hydrodynamic advantage than the other two undulatory underwater swimming positions. Full article
(This article belongs to the Special Issue Aquatic Activities, Health and Wellbeing)
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20 pages, 1183 KiB  
Review
Discrete-Event Simulation Modeling in Healthcare: A Comprehensive Review
by Jesús Isaac Vázquez-Serrano, Rodrigo E. Peimbert-García and Leopoldo Eduardo Cárdenas-Barrón
Int. J. Environ. Res. Public Health 2021, 18(22), 12262; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph182212262 - 22 Nov 2021
Cited by 38 | Viewed by 5859
Abstract
Discrete-event simulation (DES) is a stochastic modeling approach widely used to address dynamic and complex systems, such as healthcare. In this review, academic databases were systematically searched to identify 231 papers focused on DES modeling in healthcare. These studies were sorted by year, [...] Read more.
Discrete-event simulation (DES) is a stochastic modeling approach widely used to address dynamic and complex systems, such as healthcare. In this review, academic databases were systematically searched to identify 231 papers focused on DES modeling in healthcare. These studies were sorted by year, approach, healthcare setting, outcome, provenance, and software use. Among the surveys, conceptual/theoretical studies, reviews, and case studies, it was found that almost two-thirds of the theoretical articles discuss models that include DES along with other analytical techniques, such as optimization and lean/six sigma, and one-third of the applications were carried out in more than one healthcare setting, with emergency departments being the most popular. Moreover, half of the applications seek to improve time- and efficiency-related metrics, and one-third of all papers use hybrid models. Finally, the most popular DES software is Arena and Simul8. Overall, there is an increasing trend towards using DES in healthcare to address issues at an operational level, yet less than 10% of DES applications present actual implementations following the modeling stage. Thus, future research should focus on the implementation of the models to assess their impact on healthcare processes, patients, and, possibly, their clinical value. Other areas are DES studies that emphasize their methodological formulation, as well as the development of frameworks for hybrid models. Full article
(This article belongs to the Special Issue Whole Systems Approaches to Process Improvement in Health Systems)
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13 pages, 687 KiB  
Article
Why It Is Difficult for Military Personnel to Quit Smoking: From the Perspective of Compensatory Health Beliefs
by Chor-Sum Au-Yeung, Ren-Fang Chao and Li-Yun Hsu
Int. J. Environ. Res. Public Health 2021, 18(22), 12261; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph182212261 - 22 Nov 2021
Cited by 2 | Viewed by 1907
Abstract
Compensatory health beliefs are barriers to healthy behavior. In an effort to understand how the prevalence of these beliefs can be reduced in individuals, 376 valid questionnaires were collected from combat troops in Taiwan. The collected data were analyzed using partial least squares [...] Read more.
Compensatory health beliefs are barriers to healthy behavior. In an effort to understand how the prevalence of these beliefs can be reduced in individuals, 376 valid questionnaires were collected from combat troops in Taiwan. The collected data were analyzed using partial least squares structural equation modelling. It was found that positive attitudes towards smoking cessation had significant negative effects on compensatory health beliefs, while negative attitudes towards smoking cessation significantly enhanced the level of compensatory health beliefs. The motivation for smoking cessation was also found to reinforce the negative effect of positive attitudes towards compensatory health beliefs, while it did not have any significant effect on the relationship between negative attitudes and compensatory health beliefs. Three subconstructs of compensatory health beliefs (exercise, eating habits, and amount of smoking) were found to have simultaneous effects for military personnel. Finally, this study explored the causes of the above-mentioned phenomena, and measures that could reduce the prevalence of compensatory health beliefs were suggested. Full article
(This article belongs to the Section Health Behavior, Chronic Disease and Health Promotion)
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12 pages, 749 KiB  
Article
Psychological Capital and Family Satisfaction among Employees: Do Occupational Stressors Moderate the Relationship?
by Oi-Ling Siu, Qianting Kong and Ting-Kin Ng
Int. J. Environ. Res. Public Health 2021, 18(22), 12260; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph182212260 - 22 Nov 2021
Cited by 5 | Viewed by 2366
Abstract
The COVID-19 pandemic has created more occupational stressors, particularly work–family interface issues. The purpose of this study was to investigate the moderating role of occupational stressors in the relationship between a personal resource (psychological capital) and family satisfaction. A cross-sectional study was carried [...] Read more.
The COVID-19 pandemic has created more occupational stressors, particularly work–family interface issues. The purpose of this study was to investigate the moderating role of occupational stressors in the relationship between a personal resource (psychological capital) and family satisfaction. A cross-sectional study was carried out with a sample of 787 employees (367 males, 420 females) from the Greater Bay Area of China between October and November 2020. Participants completed an online survey which included the Chinese version of the Psychological Capital Questionnaire, measures of occupational stressors from the Work Stress Management DIY Kit and a measure of family satisfaction. Latent moderated structural equation modeling revealed that family satisfaction was positively associated with psychological capital and negatively associated with occupational stressors. Furthermore, occupational stressors weakened the positive association between psychological capital and family satisfaction. These findings provided empirical evidence for the work–home resources model and may suggest that it would be beneficial to boost psychological capital and reduce occupational stressors of employees. Full article
(This article belongs to the Special Issue Occupational Stress and Health: Psychological Burden and Burnout)
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13 pages, 1527 KiB  
Article
Age of Onset and Its Related Factors in Cocaine or Methamphetamine Use in Adults from the United States: Results from NHANES 2005–2018
by Alexandre Arthur Guerin and Jee Hyun Kim
Int. J. Environ. Res. Public Health 2021, 18(22), 12259; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph182212259 - 22 Nov 2021
Cited by 11 | Viewed by 2730
Abstract
Cocaine and methamphetamine are widely used illicit psychostimulants worldwide, with steadily increasing global markets that may impact on the frequency of use. Importantly, their use typically begins in youth. This is a particular concern because there is a link between the early age [...] Read more.
Cocaine and methamphetamine are widely used illicit psychostimulants worldwide, with steadily increasing global markets that may impact on the frequency of use. Importantly, their use typically begins in youth. This is a particular concern because there is a link between the early age of first substance use and severity of substance use disorder later in life. The aim of the present study was therefore to investigate trends in prevalence, frequency, and age of onset of cocaine or methamphetamine use between 2005 and 2018 in the United States, using the nationally representative NHANES datasets. Factors associated with the ages of cocaine or methamphetamine use onset were also identified. From 2005 to 2018, prevalence and frequencies of cocaine or methamphetamine use increased, while age of onset remained relatively stable (~20 years of age). Annual household income, use of other substances, and intravenous drug use were identified as factors associated with early onset cocaine or methamphetamine use. These factors have important implications toward developing new prevention programs to reduce psychostimulant use. Full article
(This article belongs to the Collection Health Behaviors, Risk Factors, NCDs and Health Promotion)
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13 pages, 1232 KiB  
Article
Aesthetic Preference in the Transverse Orientation of the Occlusal Plane in Rehabilitation: Perspective of Laypeople and Dentists
by Ana Lidia Carvalho, Liliana Gavinha Costa, Joana Meneses Martins, Maria Conceição Manso, Sandra Gavinha, Mariano Herrero-Climent, Blanca Ríos-Carrasco, Carlos Falcão and Paulo Ribeiro
Int. J. Environ. Res. Public Health 2021, 18(22), 12258; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph182212258 - 22 Nov 2021
Cited by 2 | Viewed by 2200
Abstract
The present study had a convenience sample with 236 laypeople and 242 dentists who completed an online questionnaire to choose the most attractive image among six pairs for comparison. Control image: symmetric (parallelism between occlusal plane (OP), commissural line (CL), and interpupillary line [...] Read more.
The present study had a convenience sample with 236 laypeople and 242 dentists who completed an online questionnaire to choose the most attractive image among six pairs for comparison. Control image: symmetric (parallelism between occlusal plane (OP), commissural line (CL), and interpupillary line (IL)). Change of Control, obtaining three images with a 3-degree inclination of the labial commissures. Image A: OP parallel to IL; Image B: OP parallel to CL; Image C: OP at 1.5 degree mean angulation between IL and CL. Non-parametric comparison (IBM© SPSS Statistics vs. 27.0, p < 0.05). The “Dentists” group’s decreasing order of preference (attractiveness) of the images is: Control > A > C > B (p < 0.05). In the “Lay” group, it is: Control > A > (C not ≠ B). Dentists significantly prefer more the Control and Image A than laypeople (p < 0.001). Sex (single exception in laypeople), age, and dentist’s area of activity did not interfere in the perception of attractiveness. Dentists and laypeople preferred the Control when compared to images with CL canted. In the existence of CL inclination, the preference of the groups was the IL as a reference for OP orientation, with the mean angulation or coincident with the CL being considered less aesthetic. Full article
(This article belongs to the Topic State-of-the-Art Dentistry and Oral Health)
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17 pages, 706 KiB  
Review
Smartphone Addiction and Associated Health Outcomes in Adult Populations: A Systematic Review
by Zubair Ahmed Ratan, Anne-Maree Parrish, Sojib Bin Zaman, Mohammad Saud Alotaibi and Hassan Hosseinzadeh
Int. J. Environ. Res. Public Health 2021, 18(22), 12257; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph182212257 - 22 Nov 2021
Cited by 67 | Viewed by 21116
Abstract
Background: Smartphones play a critical role in increasing human–machine interactions, with many advantages. However, the growing popularity of smartphone use has led to smartphone overuse and addiction. This review aims to systematically investigate the impact of smartphone addiction on health outcomes. Methods: The [...] Read more.
Background: Smartphones play a critical role in increasing human–machine interactions, with many advantages. However, the growing popularity of smartphone use has led to smartphone overuse and addiction. This review aims to systematically investigate the impact of smartphone addiction on health outcomes. Methods: The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were used to carry out the systematic review. Five electronic databases including Medline, Web of Science, PsycINFO, PubMed, and Scopus were searched to identify eligible studies. Eligible studies were screened against predetermined inclusion criteria and data were extracted according to the review questions. This review is registered in PROSPERO (CRD42020181404). The quality of the articles was assessed using the National Institutes of Health (NIH) Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies. Results: A total of 27 of 2550 articles met the inclusion criteria. All of the studies were cross-sectional and focused on physical, mental, and neurological health outcomes. The majority of the studies focused on mental health outcomes and consistent associations were observed between smartphone addiction and several mental health outcomes. Anxiety and depression were commonly found to mediate mental health problems. A wide range of physical health sequelae was also associated with smartphone addiction. Furthermore, there was an association between smartphone addiction and neurological disorders. Conclusions: Our findings suggest that there are consistent associations between smartphone addiction and physical and mental health, especially mental health. Social awareness campaigns about smartphone addiction and its impact on physical and mental health are needed. Further studies, especially randomized controlled trials, are warranted to validate the impacts of smartphone addiction. Full article
(This article belongs to the Section Digital Health)
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16 pages, 1004 KiB  
Article
Four-Year Trajectories of Health-Related Quality of Life in People Living with HIV: Impact of Unmet Basic Needs across Age Groups in Positive Spaces, Healthy Places
by Phan Sok, Mary V. Seeman, Rosane Nisenbaum, James Watson, Sean B. Rourke and on behalf of the PSHP Team
Int. J. Environ. Res. Public Health 2021, 18(22), 12256; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph182212256 - 22 Nov 2021
Cited by 1 | Viewed by 2151
Abstract
Despite significant advances in antiretroviral therapy, unmet basic needs can negatively impact health-related quality of life (HRQoL) in people living with HIV, especially as they age. We aimed to examine the effect of unmet basic needs across age groups on changes in HRQoL [...] Read more.
Despite significant advances in antiretroviral therapy, unmet basic needs can negatively impact health-related quality of life (HRQoL) in people living with HIV, especially as they age. We aimed to examine the effect of unmet basic needs across age groups on changes in HRQoL over a 4-year period in persons with HIV. Physical and mental HRQoL scores from the Positive Spaces, Healthy Spaces cohort interviewed in 2006 (n = 538), 2007 (n = 506), and 2009 (n = 406) were examined across three age groups according to their unmet needs for food, clothing, and housing. Individual growth curve model analyses were used to investigate changes over time, adjusting for demographics, employment, living conditions, social supports, HIV status, and health behavior risks. Low scores on physical and mental HRQoL were positively associated with higher number of unmet basic needs (β = −6.40, standard error (SE) = 0.87, p < 0.001 and β = −7.39, SE = 1.00, p < 0.001, respectively). There was a slight improvement in physical and mental HRQoL over 4 years in this HIV cohort, but the burden of unmet basic needs took its toll on those over 50 years of age. Regularly assessing unmet basic needs is recommended given the impact these can have on HRQOL for people living with HIV. Recognition of unmet needs is vital, as is the development of timely interventions. Full article
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17 pages, 719 KiB  
Article
Child Labor in Family Tobacco Farms in Southern Brazil: Occupational Exposure and Related Health Problems
by Anaclaudia Gastal Fassa, Neice Muller Xavier Faria, Ana Laura Sica Cruzeiro Szortyka, Rodrigo Dalke Meucci, Nadia Spada Fiori and Maitê Peres de Carvalho
Int. J. Environ. Res. Public Health 2021, 18(22), 12255; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph182212255 - 22 Nov 2021
Cited by 3 | Viewed by 2880
Abstract
Tobacco farming is considered Hazardous Child Labor in Brazil. This study examined the work of children and adolescents in tobacco farming, characterizing the level of urinary cotinine and the occurrence of Green Tobacco Sickness (GTS), pesticide poisoning, respiratory symptoms, and musculoskeletal disorders. A [...] Read more.
Tobacco farming is considered Hazardous Child Labor in Brazil. This study examined the work of children and adolescents in tobacco farming, characterizing the level of urinary cotinine and the occurrence of Green Tobacco Sickness (GTS), pesticide poisoning, respiratory symptoms, and musculoskeletal disorders. A cross-sectional descriptive study was conducted with a random sample of tobacco growers under 18 years old in Southern Brazil. Ninety-nine young people were interviewed at 79 family farms. The majority began working in agriculture before they were 14 and worked harvesting and tying hands of tobacco; 60% were 16 or 17 years old, and 51.5% were male. During their lifetime, 24.5% reported GTS, and 3% reported pesticide poisoning. In the previous year, 29.3% reported low back pain, 6.1% wheezing, and 16.2% coughing without having a cold. Half of the 12 young people evaluated had over 100 ng/mL of urinary cotinine. The study indicates that child laborers do various activities and present a high prevalence of health problems. Health workers should be trained to identify child laborers and their impacts on health. Full-time farm schools could provide knowledge about sustainable agricultural production, reducing the rates of age-grade mismatch, without taking young people away from rural areas. Full article
(This article belongs to the Special Issue Child Labour, Working Children and Health)
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19 pages, 1650 KiB  
Article
The Continued Use of Social Commerce Platforms and Psychological Anxiety—The Roles of Influencers, Informational Incentives and FoMO
by Jinjie Li, Jiayin Qi, Lianren Wu, Nan Shi, Xu Li, Yuxin Zhang and Yinyin Zheng
Int. J. Environ. Res. Public Health 2021, 18(22), 12254; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph182212254 - 22 Nov 2021
Cited by 8 | Viewed by 5033
Abstract
Why does the continued use of social commerce platforms fail to promote consumer wellbeing? This study explores the roles of influencers, informational incentives and fear of missing out (FoMO) in the relationships between social commerce platform use and consumer mental health. Data were [...] Read more.
Why does the continued use of social commerce platforms fail to promote consumer wellbeing? This study explores the roles of influencers, informational incentives and fear of missing out (FoMO) in the relationships between social commerce platform use and consumer mental health. Data were obtained through questionnaires, as well as constructing a research model. Statistical analysis and path analysis of the structural equation model were performed by the software IBM SPSS and AMOS, and the following results were obtained. (1) Influencer expertise and interactivity, informational incentives and FoMO have a significant impact on consumers’ continued use of social commerce platforms. (2) Materialism has no significant effect on consumer social commerce platform use. (3) FoMO mediates the relationships between informational incentives and continued use of social commerce platforms. (4) Consumers’ continuous use of social commerce platforms has a strong relationship with mental health. (5) Continued use of social commerce platforms can lead to intense social engagement, as well as more severe outcomes such as psychological anxiety and compulsive buying. The findings of the paper have important implications for the development of social business theory and management practice. Full article
(This article belongs to the Special Issue Consumer Wellbeing and Digitalization: Challenges and Opportunities)
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21 pages, 7546 KiB  
Review
Safety Issues in Buckling of Steel Structures by Improving Accuracy of Historical Methods
by Juan Carlos Pomares, Javier Pereiro-Barceló, Antonio González and Rafael Aguilar
Int. J. Environ. Res. Public Health 2021, 18(22), 12253; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph182212253 - 22 Nov 2021
Cited by 2 | Viewed by 2277
Abstract
Buckling of structural elements is a phenomenon that has great consequences on the bearing capacity of structures. Historically, there have been serious buckling-related structural accidents that have resulted in loss of human lives and high material costs. In this article, an attempt is [...] Read more.
Buckling of structural elements is a phenomenon that has great consequences on the bearing capacity of structures. Historically, there have been serious buckling-related structural accidents that have resulted in loss of human lives and high material costs. In this article, an attempt is made to perform a historical analysis of the diverse models that experts have been using in designing and calculating compression buckling of simple metallic elements in the last 275 years. The analysis covers the lapse from the mid-18th century, in which the pioneers in this classic field of structural design are located, up to the present, highlighting the main standards that have been applied to steel structural analysis in the past and at present all over the world. What the study tries to provide is an overall view and a sense of continuity of the methods used for improving structural safety regarding buckling failures in the last three centuries. Each analyzed buckling model is compared with the results of a numerical finite element model of compressed steel columns. Finally, the conclusion reached is that in the last one hundred years, the convergence of solutions proposed in the field is gradually greater and more accurate. Full article
(This article belongs to the Special Issue Environmental and Safety Issues to Protect People's Health)
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18 pages, 2646 KiB  
Article
Analysis of the Evolution of User Emotion and Opinion Leaders’ Information Dissemination Behavior in the Knowledge Q&A Community during COVID-19
by Xu Xu, Zhigang Li, Rui Wang and Li Zhao
Int. J. Environ. Res. Public Health 2021, 18(22), 12252; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph182212252 - 22 Nov 2021
Cited by 5 | Viewed by 3241
Abstract
Since its emergence in 2019, COVID-19 has quickly triggered widespread public discussion on social media. From 26 February 2020 to 26 September 2020, this study collected data on COVID-19-related posts in the knowledge Q&A community, identified 220 opinion leaders of this community, and [...] Read more.
Since its emergence in 2019, COVID-19 has quickly triggered widespread public discussion on social media. From 26 February 2020 to 26 September 2020, this study collected data on COVID-19-related posts in the knowledge Q&A community, identified 220 opinion leaders of this community, and used social network analysis and sentiment analysis to analyze the information exchange behavior and emotional evolution of the opinion leaders during COVID-19. The results show that the COVID-19 topic community could be divided into seven main categories. The information dissemination of opinion leader information dissemination network had low efficiency, multiple paths, and a high degree of control. In addition, the emotional evolution of users showed obvious phased characteristics. User emotion changed from initially strong negative to strong positive over the course of the pandemic and eventually tended to be objective and neutral as time passed and the event stabilized. Full article
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11 pages, 319 KiB  
Article
A Qualitative Study of Living in a Healthy Food Priority Area in One Seattle, WA, Neighborhood
by Jenny L. Wool, Lina P. Walkinshaw, Clarence Spigner, Erin K. Thayer and Jessica C. Jones-Smith
Int. J. Environ. Res. Public Health 2021, 18(22), 12251; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph182212251 - 22 Nov 2021
Cited by 2 | Viewed by 1749
Abstract
Policy makers in several major cities have used quantitative data about local food environments to identify neighborhoods with inadequate access to healthy food. We conducted qualitative interviews with residents of a healthy food priority area to assess whether residents’ perceptions of food access [...] Read more.
Policy makers in several major cities have used quantitative data about local food environments to identify neighborhoods with inadequate access to healthy food. We conducted qualitative interviews with residents of a healthy food priority area to assess whether residents’ perceptions of food access were consistent with previous quantitative findings, and to better understand lived experience of food access. We found that proximity to stores, transportation mode, and cost shaped decisions about food shopping. The local food bank played an important role in improving food access. Participants had varied suggestions for ways to improve the neighborhood, both related and unrelated to the food environment. Full article
2 pages, 266 KiB  
Comment
Comment on Khairul Zaman et al. Eco-Friendly Coagulant versus Industrially Used Coagulants: Identification of Their Coagulation Performance, Mechanism and Optimization in Water Treatment Process. Int. J. Environ. Res. Public Health 2021, 18, 9164
by Afia Ivy, Kristian Dubrawski and Caetano Dorea
Int. J. Environ. Res. Public Health 2021, 18(22), 12250; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph182212250 - 22 Nov 2021
Cited by 1 | Viewed by 1464
Abstract
In a recent contribution by Zaman and colleagues, a few issues were noted on the justification of their study, which performed a comparative assessment of chitosan as a proposed alternative to aluminum-based coagulants for drinking water treatment applications. We have provided further clarity [...] Read more.
In a recent contribution by Zaman and colleagues, a few issues were noted on the justification of their study, which performed a comparative assessment of chitosan as a proposed alternative to aluminum-based coagulants for drinking water treatment applications. We have provided further clarity around such issues, which apply to other studies on the same theme. Full article
(This article belongs to the Section Environmental Science and Engineering)
16 pages, 4385 KiB  
Article
The Construction of Ecological Security Patterns in Coastal Areas Based on Landscape Ecological Risk Assessment—A Case Study of Jiaodong Peninsula, China
by Yichen Yan, Hongrun Ju, Shengrui Zhang and Guokun Chen
Int. J. Environ. Res. Public Health 2021, 18(22), 12249; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph182212249 - 22 Nov 2021
Cited by 25 | Viewed by 2788
Abstract
Increasing land utilization, population aggregation and strong land–sea interaction make coastal areas an ecologically fragile environment. The construction of an ecological security pattern is important for maintaining the function of the coastal ecosystem. This paper takes Jiaodong Peninsula in China, a hilly coastal [...] Read more.
Increasing land utilization, population aggregation and strong land–sea interaction make coastal areas an ecologically fragile environment. The construction of an ecological security pattern is important for maintaining the function of the coastal ecosystem. This paper takes Jiaodong Peninsula in China, a hilly coastal area, as an example for evaluating landscape ecological risk within a comprehensive framework of “nature–neighborhood–landscape”, based on spatial principal component analysis, and it constructs the ecological security pattern based on the minimum cumulative resistance model (MCR). The results showed that the overall level of ecological risk in the study area was medium. The connectivity between the areas of low landscape ecological risk was relatively low, and the high risk areas were concentrated in the north of the Peninsula. A total of 11 key ecological corridors of three types (water, green space and road corridors) and 105 potential corridors were constructed. According to the ecological network pattern, landscape ecological optimization suggestions were proposed: key corridors in the north and south of Jiaodong Peninsula should be connected; urban development should consider current ecological sources and corridors to prevent landscape fragmentation; and the ecological roles of potential corridors should be strengthened. This paper can provide a theoretical and practical basis for ecological planning and urban master planning in coastal areas in the future. Full article
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8 pages, 957 KiB  
Article
Relations among Socially Prescribed Perfectionism, Career Stress, Mental Health, and Mindfulness in Korean College Students
by Sukkyung You and Jieun Yoo
Int. J. Environ. Res. Public Health 2021, 18(22), 12248; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph182212248 - 22 Nov 2021
Cited by 4 | Viewed by 2376
Abstract
Korean young adults are exposed to higher career stress than ever before, and such stress exerts a negative impact on mental health outcomes. The present study aimed to understand the mediating effect of career stress on the relationship between socially prescribed perfectionism and [...] Read more.
Korean young adults are exposed to higher career stress than ever before, and such stress exerts a negative impact on mental health outcomes. The present study aimed to understand the mediating effect of career stress on the relationship between socially prescribed perfectionism and mental health using a sample of 420 Korean college students. The present study also investigated the moderating role of mindfulness in the mediated pathways across gender groups. This study’s results showed that there are considerable gender differences in this relationship. Career stress significantly mediates the relationship between socially prescribed perfectionism and depression and life satisfaction only for females. Study findings also indicated that the moderating effect of mindfulness was more remarkable for female students than for male students. Implications and future directions are discussed. Full article
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11 pages, 1021 KiB  
Article
Analysis of Chinese Consumers’ Nutrition Facts Table Use Behavior Based on Knowledge-Attitude-Practice Model
by Zeying Huang, Haijun Li and Jiazhang Huang
Int. J. Environ. Res. Public Health 2021, 18(22), 12247; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph182212247 - 22 Nov 2021
Cited by 12 | Viewed by 2382
Abstract
The nutrition facts table is a nutrition labeling tool designed to help consumers understand the nutritional content of food and make informed food choices. However, the utilization rate of the nutrition facts table has been low in China since its introduction in 2013. [...] Read more.
The nutrition facts table is a nutrition labeling tool designed to help consumers understand the nutritional content of food and make informed food choices. However, the utilization rate of the nutrition facts table has been low in China since its introduction in 2013. This study employed structural equation modeling to investigate consumers’ knowledge, attitudes, and practices related to the nutrition facts table by using an online survey of 930 valid samples from 31 provinces in China based on the knowledge, attitude, practice (KAP) model. The analysis revealed that most respondents had a positive attitude, but not a good level of knowledge or practice in their use of the labeling. Respondents’ knowledge about the nutrition facts table directly affected their attitude, through which it could then affect their practice, whereas knowledge played an indirect role in nutrition labeling use. The results confirmed that the KAP model is suitable for explaining consumers’ use of nutrition labels in China, and that the first step to promoting labeling usage is to enrich consumers’ knowledge on the nutrition facts table. Full article
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16 pages, 2616 KiB  
Article
Nature Exposure and Positive Body Image: A Cross–Sectional Study Examining the Mediating Roles of Physical Activity, Autonomous Motivation, Connectedness to Nature, and Perceived Restorativeness
by Migle Baceviciene, Rasa Jankauskiene and Viren Swami
Int. J. Environ. Res. Public Health 2021, 18(22), 12246; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph182212246 - 22 Nov 2021
Cited by 9 | Viewed by 3112
Abstract
Research shows that nature exposure is directly and indirectly associated with more positive body image, which is an important facet of well-being more generally. In this study, we tested the mediating roles of physical activity in nature, perceived restoration in nature, autonomous motivation, [...] Read more.
Research shows that nature exposure is directly and indirectly associated with more positive body image, which is an important facet of well-being more generally. In this study, we tested the mediating roles of physical activity in nature, perceived restoration in nature, autonomous motivation, and connectedness to nature in explaining the association between nature exposure and positive body image. An online sample of 924 Lithuanian adults (age M = 40.0 years, 73.6% women) completed a survey that included the Nature Exposure (NE) Scale, the Body Appreciation Scale-2, a measure of frequency of physical activity in nature (PAN), the Behavioral Regulation in Exercise Questionnaire-2, the Restoration Outcome Scale, and the Connectedness to Nature Scale. Path analysis was conducted to examine hypothesized direct and indirect effects. Results showed that both greater NE (B = 0.564, SE = 0.057, p < 0.001) and autonomy in exercise motivation (B = 0.039, SE = 0.006, p < 0.001) were associated with more frequent PAN. Direct effects from exercise autonomy to nature restorativeness (B = 0.017, SE = 0.006, p = 0.004) and body appreciation (B = 0.041, SE = 0.004, p < 0.001) were observed. Associations were also found between connectedness to nature and body appreciation (B = 0.166, SE = 0.040, p < 0.001), nature restorativeness and body appreciation (B = 0.075, SE = 0.019, p < 0.001), and frequency of PAN and body appreciation (B = 0.064, SE = 0.019, p < 0.001). PAN mediated the relationship between NE and body appreciation. The final model was invariant across place of residence (urban vs. rural) and gender. Including self-determined physical activity in nature may increase the effectiveness of intervention programs aimed at promoting more positive body image. Full article
(This article belongs to the Section Mental Health)
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12 pages, 576 KiB  
Article
Factor Structure and Psychometric Properties for the PTSD Checklist of Chinese Adolescents in the Closed Period after the COVID-19 Outbreak
by Wei Chen, Rongfen Gao and Tao Yang
Int. J. Environ. Res. Public Health 2021, 18(22), 12245; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph182212245 - 22 Nov 2021
Cited by 6 | Viewed by 2173
Abstract
After COVID-19 appeared in China in December 2019, the mental health of adolescents, as a vulnerable group in public health emergencies, was negatively affected by the epidemic and the unprecedented prevention and control measures. The purpose of this study was to investigate the [...] Read more.
After COVID-19 appeared in China in December 2019, the mental health of adolescents, as a vulnerable group in public health emergencies, was negatively affected by the epidemic and the unprecedented prevention and control measures. The purpose of this study was to investigate the factor structure and psychometric properties of the Posttraumatic Stress Disorder (PTSD) Checklist (PCL) among Chinese adolescents. A total of 915 participants completed the PTSD. Confirmatory factor analyses (CFAs) and multi-group CFAs were used to test the factor structure and psychometric properties of PTSD. The CFA results showed that five-factor PCL was the optimal fitting model with satisfactory reliability and validity; moreover, it was suggested that the properties of PCL were invariant across gender, PTSD and asymptomatic groups, early and late adolescents, as well as over time. In summary, PCL is applicable among Chinese adolescents and can be used for effective measurement of PTSD caused by epidemics and to conduct cross-group studies. Full article
(This article belongs to the Special Issue Promoting Health for Adolescents)
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13 pages, 710 KiB  
Article
Operational Implications and Risk Assessment of COVID-19 in Dental Practices
by Saba Wajeeh, Abhishek Lal, Naseer Ahmed, Md. Ibrahim Khalil, Afsheen Maqsood, Akram Mojidea M Alshammari, Abdulelah Zaid Alshammari, Meshari Musallam Mohammed Alsharari, Abdulelah Hamdan Alrushaydan, Abdulaziz Fandi Alruwaili and Mohammad Khursheed Alam
Int. J. Environ. Res. Public Health 2021, 18(22), 12244; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph182212244 - 22 Nov 2021
Cited by 7 | Viewed by 2953
Abstract
The unprecedented situation of the coronavirus pandemic has impacted the entire world, with dental practice being significantly affected. In this study, we aim to evaluate the operational implications and risk assessment of the coronavirus in dental practice. This observational study comprised the electronic [...] Read more.
The unprecedented situation of the coronavirus pandemic has impacted the entire world, with dental practice being significantly affected. In this study, we aim to evaluate the operational implications and risk assessment of the coronavirus in dental practice. This observational study comprised the electronic distribution of two surveys, one to patients and the second to dental professionals. The first questionnaire consisted of demographics along with 15 closed-ended questions. The second questionnaire consisted of demographics along with 43 questions from eight domains: financial impact, psychological impact, patient satisfaction, hygiene, patient management, COVID-19 lockdown, perspective, and practicing dentistry after the COVID-19 pandemic. The statistical analysis was performed using SPSS-25. A linear regression test was applied to assess the effect of the dependent variable (patient’s satisfaction with the dental practice) on independent variables (age, gender, education). The ANOVA test was applied to assess the effect of the independent variables (financial impact, psychological impact, patient satisfaction, hygiene, patient management, lockdown, perspective, and post-COVID-19) on the dependent variables (age, gender, education, experience of dentists, qualification of dentists). A total of 711 patients and dental professionals participated in this study, with a response rate of 88.87%. Approximately 67.9% of the patients felt comfortable in the dental clinic, with 74.5% being satisfied with the dental clinic’s services. The majority (77.4%) of the dentists were psychologically affected. Many of the participants chose to use masks, gowns, respiratory equipment, and face shields for protection. Teledentistry was preferred by the majority of dentists in non-emergency cases. Many of the dentists chose alternative procedures to minimize the generation of aerosols. The majority of the dentists suggested changes in the dynamics of dentistry in the post-COVID era, such as the suggestion that the management of the finances of a dental practice along with infection control protocols should be practiced more optimally. Patients and dental professionals were well aware of the necessary precautionary measures required to combat the coronavirus, as well as the implications of different operational measures along with performing risk assessment, keeping in mind the changing dynamics of dentistry. Full article
(This article belongs to the Special Issue Oral Health, Dental Practice and COVID-19)
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12 pages, 604 KiB  
Article
Decreased Emotional Dysregulation Following Multi-Modal Motion-Assisted Memory Desensitization and Reconsolidation Therapy (3MDR): Identifying Possible Driving Factors in Remediation of Treatment-Resistant PTSD
by Emily Tang, Chelsea Jones, Lorraine Smith-MacDonald, Matthew R. G. Brown, Eric H. G. J. M. Vermetten and Suzette Brémault-Phillips
Int. J. Environ. Res. Public Health 2021, 18(22), 12243; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph182212243 - 22 Nov 2021
Cited by 7 | Viewed by 2575
Abstract
Multi-modal motion-assisted memory desensitization and reconsolidation therapy (3MDR), an interactive, virtual reality-assisted, exposure-based intervention for PTSD, has shown promising results for treatment-resistant posttraumatic stress disorder (TR-PTSD) among military members (MMs) and veterans in randomized controlled trials (RCT). Previous research has suggested that emotional [...] Read more.
Multi-modal motion-assisted memory desensitization and reconsolidation therapy (3MDR), an interactive, virtual reality-assisted, exposure-based intervention for PTSD, has shown promising results for treatment-resistant posttraumatic stress disorder (TR-PTSD) among military members (MMs) and veterans in randomized controlled trials (RCT). Previous research has suggested that emotional regulation (ER) and emotional dysregulation (ED) may be factors which are correlated with symptom severity and maintenance of TR-PTSD. This embedded mixed-methods pilot study (n = 9) sought to explore the impact of 3MDR on ER and ED of MMs and veterans. Difficulties in Emotional Regulation Scale (DERS-18) data were collected at baseline, prior to each session, and at one week, one month, and three months postintervention and analyzed. Qualitative data collected from sessions, debriefs, and follow-up interviews were transcribed and descriptively analyzed. Results demonstrated statistically significant decreases in DERS-18 scores from preintervention to postintervention at each timepoint. Qualitatively, participants perceived improvements in ER within specified DERS-18 domains. We describe how 3MDR’s unique and novel approach addresses ED through cognitive–motor stimulation, narration, divergent thinking, reappraisal of aversive stimuli, dual-task processing, and reconsolidation of traumatic memories. More studies are needed to better understand the underlying neurobiological mechanisms by which 3MDR addresses ER and PTSD. Full article
(This article belongs to the Collection Emotional Regulation and Mental Health)
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17 pages, 2615 KiB  
Article
Research on Green Total Factor Productivity of Yangtze River Economic Belt Based on Environmental Regulation
by Junxia He, Luxia Wang and Decai Tang
Int. J. Environ. Res. Public Health 2021, 18(22), 12242; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph182212242 - 22 Nov 2021
Cited by 14 | Viewed by 1922
Abstract
With the acceleration of industrialization and urbanization, the Yangtze River Economic Belt (YREB) is facing many environmental problems that need to be solved in the process of development. This paper aims to analyze the environmental governance effects of nine provinces and two municipalities [...] Read more.
With the acceleration of industrialization and urbanization, the Yangtze River Economic Belt (YREB) is facing many environmental problems that need to be solved in the process of development. This paper aims to analyze the environmental governance effects of nine provinces and two municipalities in the Yangtze River Economic Belt from 2009 to 2018. Firstly, based on the input-output index, the slacks-based measure (SBM) undesirable model and Malmquist (ML) index were used to measure the green total factor productivity (GTFP) of the YREB from 2009 to 2018. The results showed that the technological progress index contributed the most to the GTFP of the YREB, followed by the pure technical efficiency index and the scale efficiency index. Environmental regulation has no significant impact on the GTFP of the YREB. Secondly, by analyzing the effect of environmental governance in the YREB, the results show that the main reasons for the ineffective environmental governance in the YREB are the redundant input of environmental resources, excessive unwanted output, and low harmless treatment rate of municipal solid waste, rather than the low level of urban environmental management. Finally, this paper provides recommendations for the ineffective provinces and municipalities of the YREB to further optimize the input-output factors of environmental governance. Full article
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11 pages, 323 KiB  
Article
Perspectives of Local Community Leaders, Health Care Workers, Volunteers, Policy Makers and Academia on Climate Change Related Health Risks in Mukuru Informal Settlement in Nairobi, Kenya—A Qualitative Study
by Johanne Greibe Andersen, Catherine Karekezi, Zipporah Ali, Gerald Yonga, Per Kallestrup and Christian Kraef
Int. J. Environ. Res. Public Health 2021, 18(22), 12241; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph182212241 - 22 Nov 2021
Cited by 5 | Viewed by 2775
Abstract
Sub-Saharan Africa has been identified as one of the most vulnerable regions to climate change. The objective of this study was to explore knowledge and perspectives on climate change and health-related issues, with a particular focus on non-communicable diseases, in the informal settlement [...] Read more.
Sub-Saharan Africa has been identified as one of the most vulnerable regions to climate change. The objective of this study was to explore knowledge and perspectives on climate change and health-related issues, with a particular focus on non-communicable diseases, in the informal settlement (urban slum) of Mukuru in Nairobi, Kenya. Three focus group discussions and five in-depth interviews were conducted with total of 28 participants representing local community leaders, health care workers, volunteers, policy makers and academia. Data were collected using semi-structured interview guides and analyzed using grounded theory. Seven main themes emerged: climate change related diseases, nutrition and access to clean water, environmental risk factors, urban planning and public infrastructure, economic risk factors, vulnerable groups, and adaptation strategies. All participants were conscious of a link between climate change and health. This is the first qualitative study on climate change and health in an informal settlement in Africa. The study provides important information on perceived health risks, risk factors and adaptation strategies related to climate change. This can inform policy making, urban planning and health care, and guide future research. One important strategy to adapt to climate change-associated health risks is to provide training of local communities, thus ensuring adaptation strategies and climate change advocacy. Full article
(This article belongs to the Section Climate Change)
12 pages, 843 KiB  
Article
Development and Validation of a Graded Motor Imagery Intervention for Phantom Limb Pain in Patients with Amputations (GraMI Protocol): A Delphi Study
by Sandra Rierola-Fochs, Luz Adriana Varela-Vásquez, Jose Antonio Merchán-Baeza and Eduard Minobes-Molina
Int. J. Environ. Res. Public Health 2021, 18(22), 12240; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph182212240 - 22 Nov 2021
Cited by 7 | Viewed by 3174
Abstract
Background: Phantom limb pain can be defined as discomfort or pain in a missing part of the limb. The aims of this study were to develop and validate, through a Delphi methodology, a graded motor imagery protocol in order to reduce phantom limb [...] Read more.
Background: Phantom limb pain can be defined as discomfort or pain in a missing part of the limb. The aims of this study were to develop and validate, through a Delphi methodology, a graded motor imagery protocol in order to reduce phantom limb pain. Method: Physiotherapists and/or occupational therapists with experience in research and a minimum clinical experience of five years in the field of neurorehabilitation and/or pain were recruited by part of a group of experts to assess the intervention. The study was conducted through an online questionnaire, where experts assessed each aspect of the intervention through a Likert scale. As many rounds as necessary were carried out until consensus was reached among experts. Results: A total of two rounds were required to fully validate the intervention. During the second round, the relative interquartile range of all aspects to be assessed was less than 15%, thus showing a consensus among experts and with good concordance (Kappa index of 0.76). Conclusion: Experts validated a graded motor imagery intervention of phantom limb pain in patients with amputations (GraMi protocol). This intervention can help to homogenize the use of graded motor imagery in future studies and in clinical practice. Full article
(This article belongs to the Section Disabilities)
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18 pages, 1823 KiB  
Article
The Association between Endogenous Hair Steroid Hormones and Social Environmental Factors in a Group of Conscripts during Basic Military Training
by Asta Mažeikienė, Svajone Bekesiene, Dovilė Karčiauskaitė, Eglė Mazgelytė, Gerry Larsson, Tomas Petrėnas, Andrius Kaminskas, Jurgita Songailienė, Algirdas Utkus, Ramutė Vaičaitienė and Rasa Smaliukienė
Int. J. Environ. Res. Public Health 2021, 18(22), 12239; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph182212239 - 22 Nov 2021
Cited by 6 | Viewed by 1813
Abstract
This study aimed to analyse the association between endogenous hair steroid hormones as reliable biological indicators of an individual’s stress level and the social environmental factors experienced during military training that are manifested at the beginning of compulsory military service. Hair steroid hormone [...] Read more.
This study aimed to analyse the association between endogenous hair steroid hormones as reliable biological indicators of an individual’s stress level and the social environmental factors experienced during military training that are manifested at the beginning of compulsory military service. Hair steroid hormone concentrations—cortisol, cortisone, dehydroepiandrosterone (DHEA), and testosterone—in a group of 185 conscripts were measured using the ultra-high performance liquid chromatography-tandem mass spectrometry method. Six subjective social environmental factors in the military—attitude towards the military and military service, adaptation to the military environment, team, task, and norm cohesion, as well as psychological (un)safety in the group—were evaluated using military-specific research questionnaires. Weak but significant negative correlations were identified between cortisol and adaptation (r = −0.176, p < 0.05), attitude (r = −0.147, p < 0.05) as well as between testosterone and task cohesion (r = −0.230, p < 0.01) levels. Additionally, a multiple forward stepwise regression analysis highlighted that cortisone variation might be partially explained by task cohesion; the DHEA—determined by psychological (un)safety in the group, attitude towards the military and military service, and norm cohesion; and the testosterone—determined by task cohesion and adaptation to the new military environment. The results of this study suggest that subjective measures of social factors can be used to predict hair steroid hormone levels as objective measures of the chronic stress perceived by conscripts during their basic military training. Full article
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