Int. J. Environ. Res. Public Health, Volume 18, Issue 3 (February-1 2021) – 522 articles

Workforce aging is becoming a significant public health problem due to the resulting emergence of age-related diseases, such as osteoporosis. The prevention and early detection of osteoporosis is important to avoid bone fractures and their socio-economic burden. The aim of this study is to evaluate the sustainability of a screening workplace program able to detect workers with osteoporosis. The screening process included a questionnaire-based risk assessment of 1050 healthcare workers followed by measurement of the bone mass density (BMD) with a pulse-echo ultrasound (PEUS) at the proximal tibia in the at-risk subjects. Workers with a BMD value ≤ 0.783 g/cm² were referred to a specialist visit ensuring a diagnosis and the consequent prescriptions. Any possible association between the outcome variable BMD ≤ 0.783 g/cm² and the risk factors was evaluated. The costs were calculated with a full costing method. We identified 60 pathological subjects. We observed increased risks for women, older ages, and menopause (p < 0.01). The yearly cost of our screening program estimated for this study was 8242 euros, and, considering the fragility bone fracture costs, we hypothesize a considerable economic savings, with a possible positive benefits/cost ratio of 2.07. We can say that the margin between the investment and results leads to a preference for this type of screening program. Osteoporosis is an occupational health problem, and a workplace screening program could be a cost-effective intervention. Full article

Seaweed is known to have various health-promoting effects. However, the mechanisms underlying seaweed’s antidiabetic effects remain unclear. We investigated the potential antidiabetic effects of seaweed water extracts and further examined their mechanism(s) using C2C12 mouse skeletal muscle cells. Briefly, we screened the physiochemical properties of seven seaweed extracts by comparing the antioxidant and α-glucosidase inhibitory effects. Among them, three seaweed extracts, Undaria pinnatifida sporophyll (UPS), Codium fragile (CF), and Gracilaria verrucosa (GV), were selected for further testing of their possible antidiabetic effects with underlying mechanisms using C2C12 myotubes. Consistent with the superior α-glucosidase inhibition of the three seaweed extracts, the extracts also enhanced glucose utilization in myotubes compared to the control. The upregulated glucose uptake by the seaweed extracts was reversed by an AMP-activated protein kinase (AMPK) inhibitor, compound C, in the UPS- and CF-treated groups. Furthermore, all three seaweed extracts significantly promoted the phosphorylation of AMPK which was completely blocked by pretreating with compound C. In addition, all three extracts reduced lipopolysaccharide-simulated TNF-α production in C2C12 cells. Our results demonstrated that all three seaweed extracts exhibited antidiabetic properties through not only the inhibition of glucose absorption but also the promotion of glucose utilization. Moreover, the regulation of inflammatory cytokine production by the extracts suggested their potential anti-inflammatory property which might play a critical role in protecting insulin sensitivity in a chronic inflammatory state. Taken together, UPS, CF, and GV are a promising source to modulate the glucose absorption and utilization in muscle cells partially via the AMPK pathway. Full article

This study compared the kinetics, barbell, and joint kinematics and muscle activation patterns between a one-repetition maximum (1-RM) Smith machine squat and isometric squats performed at 10 different heights from the lowest barbell height. The aim was to investigate if force output is lowest in the sticking region, indicating that this is a poor biomechanical region. Twelve resistance trained males (age: 22 ± 5 years, mass: 83.5 ± 39 kg, height: 1.81 ± 0.20 m) were tested. A repeated two-way analysis of variance showed that Force output decreased in the sticking region for the 1-RM trial, while for the isometric trials, force output was lowest between 0–15 cm from the lowest barbell height, data that support the sticking region is a poor biomechanical region. Almost all muscles showed higher activity at 1-RM compared with isometric attempts (p < 0.05). The quadriceps activity decreased, and the gluteus maximus and shank muscle activity increased with increasing height (p ≤ 0.024). Moreover, the vastus muscles decreased only for the 1-RM trial while remaining stable at the same positions in the isometric trials (p = 0.04), indicating that potentiation occurs. Our findings suggest that a co-contraction between the hip and knee extensors, together with potentiation from the vastus muscles during ascent, creates a poor biomechanical region for force output, and thereby the sticking region among recreationally resistance trained males during 1-RM Smith machine squats. Full article

Medical tourism is a thriving industry. Many destinations now seek to attract more medical tourists. The United Arab Emirates (UAE) is no exception. As one of the most important pillars of the UAE’s economy, tourism is considered a high priority. However, medical tourism in the UAE is still developing. This paper addresses the main challenges for medical tourism in the UAE and proposes methods to enhance its development. This research utilized qualitative analysis. Twelve professionals in medical tourism were interviewed to provide data. The data were then analyzed using NVivo 12 software. Our results indicate that the key barriers to medical tourism development in the UAE are high costs of medical tourism services, lack of marketing activities, lack of collaboration between medical and tourism service providers, and so forth. Although initiatives from the UAE government are very encouraging, more efficient medical care supply networks, tourism suppliers and intermediaries should be established to ensure its growth. This research could influence national tourism policies in the UAE as well as regional alliances in all Gulf Cooperation Council (GCC) and the Middle East and North Africa (MENA) countries. Full article

Heavy metals in soil are in a high background state in Karst areas, and agricultural activities will affect the bioactivity of heavy metals. The heavy metal (Cd and Cr) bioactivity and their activation effects in rice-rape rotation lands in Karst areas were studied based on field experiments and laboratory analysis, and the influencing factors of heavy metal activity were analyzed based on the physical and chemical properties of soil. The results suggest that the residual fraction was the largest and the exchangeable fraction was the smallest for both Cr and Cd in rice-rape rotation lands in Karst areas. During the rice-rape rotation process, Cd and Cr tended to be released from the residual fraction and transformed into the other four fractions. The fractions with high bioactivity, including the exchangeable fraction and carbonate fraction, increased to different degrees. Rice-rape rotation could activate the activity of soil Cd and Cr in Karst areas. It is also revealed that the activity of soil Cd and Cr in Karst areas was closely associated with soil pH and electric potential (Eh). In the 0–20 cm soil layer, Cr showed a significant negative correlation with pH (r = −0.69, p < 0.05), while both Cr and Cd showed significant negative correlations with Eh, and the correlation coefficients were −0.85 (p < 0.01) and −0.83 (p < 0.01), respectively. In the 20–40 cm soil layer, Cr showed significant negative correlations with Eh, and the correlation coefficient was −0.95 (p < 0.01). No significant correlation between the activity of soil Cd and Cr and soil mechanical composition was observed. This study revealed that special attention should be paid to changes in pH and Eh in consideration of heavy metal activity in the rice-rape rotation process. Full article

The aim of this study was to develop and validate a predictive early tooth loss multivariable model for periodontitis patients before periodontal treatment. A total of 544 patients seeking periodontal care at the university dental hospital were enrolled in the study. Teeth extracted after periodontal diagnosis and due to periodontal reasons were recorded. Clinical and sociodemographic variables were analyzed, considering the risk of short-term tooth loss. This study followed the transparent reporting of a multivariable prediction model for individual prognosis or diagnosis (TRIPOD) guidelines for development and validation, with two cohorts considered as follows: 455 patients in the development phase and 99 in the validation phase. As a result, it was possible to compute a predictive model based on tooth type and clinical attachment loss. The model explained 25.3% of the total variability and correctly ranked 98.9% of the cases. The final reduced model area under the curve (AUC) was 0.809 (95% confidence interval (95% CI): 0.629–0.989) for the validation sample and 0.920 (95% CI: 0.891–0.950) for the development cohort. The established model presented adequate prediction potential of early tooth loss due to periodontitis. This model may have clinical and epidemiologic relevance towards the prediction of tooth loss burden. Full article

The purpose of this study was to determine the influence of perceived helicopter parenting, critical thinking disposition, cognitive ability, and learning motivation on learning behavior in nursing students in South Korea. The participants in this study were 149 sophomore nursing students from two universities using convenience sampling. The two universities were similar in terms of type, curricula, and size. Data were collected from October to November 2017 using self-reported questionnaires. The collected data were analyzed using descriptive statistics, Pearson correlation coefficients, and hierarchical multiple regression with SPSS 22.0. The mean score of perceived helicopter parenting was 3.06 ± 0.65 out of six points. The levels of critical thinking disposition, cognitive ability, learning motivation, and learning behavior were medium. Factors affecting learning behavior were learning motivation (β = 0.40, p < 0.001), cognitive ability (β = 0.26, p = 0.001), and critical thinking disposition (β = 0.25, p = 0.001). These variables explained 32% of the variance in learning behavior (F = 18.21, p < 0.001). Teaching methods are necessary to increase the critical thinking disposition and learning competence of nursing students. In addition, it is important to consider the learning motivation of nursing students for effective learning. Full article

Major depression is one of the most prevalent mental health problems in the penitentiary context and has been related to different undesirable outcomes. The aim of the current research was to evaluate the utility of screening tools for major depression brief assessment in the jail context. We interviewed 203 male inmates and complimented the MCMI-III, the SCL-90-R, and the CES-D-7 self-informed scales. Major depression syndrome and disorder were determined based on MCMI-III criteria and the capability of SCL-90-R and CES-D-7 to identify true positives and true negatives when tested. SCL-90-R and CES-D-7 showed good sensitivity for major depression syndrome and disorder. The specificity of SCL-90-R was poor in all cases, but CES-D-7 showed good specificity depending on the cut-off score. Rigorous interviews are needed for better evaluation of major depression in jails, but screening tools like CES-D-7 are useful for rapid assessment considering the work overload of penitentiary psychologists. Full article

Although simultaneous supplementation of iron and folic acid is justified, the potential interactions between these micronutrients and other elements are poorly known. In this study, we aimed to investigate the effect of iron and folic acid supplementation on the levels of selected essential and toxic elements in the serum of micronutrient-deficient young women. A total of 40 women participated in this study and were divided into two groups: study group (n = 23) (with iron and folate deficiency) and control group (n = 17). The study group received iron and folic acid supplements for 3 months. Blood samples were collected at baseline and after the completion of the study period. Women completed a 3-day food intake record. We calculated the body mass index (BMI) of all the participants. Cellular morphology was analyzed in whole blood, and biochemical parameters were determined in serum. Elements were measured in serum by inductively coupled plasma mass spectrometry (ICP-MS). According to our results, in the case of the study group, the supplementation of iron and folic acid restored their levels; however, it caused a significant decrease in the level of zinc, calcium, and magnesium. In the case of the control group, at the end of the study period, there was a marked decrease in the level of iron. Interestingly, there was an increase in the level of arsenic and vanadium in both groups. In conclusion, simultaneous supplementation of iron and folic acid impairs the level of zinc, calcium, and magnesium in women of childbearing age. Full article

We assessed the health risks of fine particulate matter (PM_2.5) ambient air pollution and its trace elemental components in a rural South African community. Air pollution is the largest environmental cause of disease and disproportionately affects low- and middle-income countries. PM_2.5 samples were previously collected, April 2017 to April 2018, and PM_2.5 mass determined. The filters were analyzed for chemical composition. The United States Environmental Protection Agency’s (US EPA) health risk assessment method was applied. Reference doses were calculated from the World Health Organization (WHO) guidelines, South African National Ambient Air Quality Standards (NAAQS), and US EPA reference concentrations. Despite relatively moderate levels of PM_2.5 the health risks were substantial, especially for infants and children. The average annual PM_2.5 concentration was 11 µg/m³, which is above WHO guidelines, but below South African NAAQS. Adults were exposed to health risks from PM_2.5 during May to October, whereas infants and children were exposed to risk throughout the year. Particle-bound nickel posed both non-cancer and cancer risks. We conclude that PM_2.5 poses health risks in Thohoyandou, despite levels being compliant with yearly South African NAAQS. The results indicate that air quality standards need to be tightened and PM_2.5 levels lowered in South Africa. Full article

Background: Race/ethnicity, toxic stress (TS), resilience-promoting factors (RPFs), and their interactions were investigated in relationship to neurocognitive impairment (NI) in a nationally representative sample of adult Americans ≥50 years enrolled in the Health and Retirement Study (HRS) between 2012 and 2014. Methods: NI was defined as physician diagnosis of Alzheimer’s disease/dementia or HRS total cognition score ≤ 10. Race/ethnicity (i.e., African American, White, or Other), TS (i.e., everyday discrimination and chronic stressors), and mastery (as indicator of RPF) were self-reported. Multivariable logistic regression models estimated race-, TS-, RPF-associated odds ratios (ORs), and 95% confidence intervals (CI) for NI adjusting for socio-demographic confounders. Results: 6317 respondents interviewed between the years 2012 and 2014, age range 55–104 years old, 83% White, 13% Black and 4% Other race were included in the study. Chronic stress (OR = 1.88, 95% CI: 1.42–2.48), discrimination (OR = 3.31, 95% CI: 2.12–5.19) and low mastery (OR = 1.85, 95% CI: 1.38–2.48) were each associated with higher NI risk while low mastery was associated with higher NI risk in discrimination and race/ethnicity dependent manner. Specifically, low mastery-associated risk for NI was evident among adults that denied experiencing discrimination (OR = 2.01, 95% CI: 1.51–2.68), but absent among those that experienced discrimination (OR = 0.72, 95% CI: 0.32–1.62). Further, AA race was associated with NI risk but only among adults with high mastery (OR = 2.00, 95% CI: 1.20–3.35). Conclusions: Discrimination, chronic stress, and low mastery were associated with worse cognition. Persisting cognitive disadvantage for AA vs. White/Other race only among high mastery adults suggests that adverse social experiences may counteract mastery-associated cognitive benefits among AA population. TS reduction through policies that promote equal treatment by race/ethnicity in social life, health, justice, and economic systems may promote successful cognitive aging. Full article

Cultural competence is an essential component in providing effective and culturally responsive healthcare services, reducing health inequalities, challenging racism in health care and improving patient safety, satisfaction and health outcomes. It is thus reasonable that undergraduate nursing students can develop cultural competency through education and training. The aim of this paper was to investigate nursing lecturers’ perception and experience of teaching cultural competence in four undergraduate nursing programs. A phenomenological approach was selected to illicit nursing lecturers’ perception of culture and experience of teaching cultural competence. Semi-structured personal interviews were held with a sample of 24 lecturers from four European universities. The anonymized transcripts were analyzed qualitatively following Braun and Clark’s phases for thematic analysis. Six themes and fifteen subthemes emerged from thematic analysis of the transcripts. Cultural competence was not explicitly integrated in the nursing curricula. Instead, the lecturers used mainly examples and case studies to illustrate the theory. The integration of cultural content in the modules was unplanned and not based on a specific model. Nursing programs should be examined to establish how cultural content is integrated in the curricula; clear guidelines and standards for a systematic integration of cultural content in the nursing curriculum should be developed. Full article

Background: While the number of retail interventions with impacts on diet- and/or health-related outcomes is increasing, the economic evaluation literature is limited. This review investigated (i) the cost-effectiveness of health-promoting food retail interventions and (ii) key assumptions adopted in these evaluations. Methods: A systematic review of published academic studies was undertaken (CRD42020153763). Fourteen databases were searched. Eligible studies were identified, analysed, and reported following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. Results: Eight studies that evaluated 30 retail interventions were included in the review. Common outcomes reported were cost per healthy food item purchased/served or cost per disability-adjusted life year (DALY) averted. Four studies undertook cost-utility analyses and half of these studies concluded that retail interventions were cost-effective in improving health outcomes. Most studies did not state any assumptions regarding compensatory behaviour (i.e., purchases/consumption of non-intervention foods or food purchases/consumption from non-intervention settings) and presumed that sales data were indicative of consumption. Conclusion: The cost-effectiveness of retail-based health-promoting interventions is inconclusive. Future health-promoting retail interventions should regularly include an economic evaluation which addresses key assumptions related to compensatory behaviour and the use of sales data as a proxy for consumption. Full article

The collaborative project between the University of Las Palmas de Gran Canaria and the public University of Mozambique, UniZambeze, aims to strengthen the institutional and training capacities of its Faculty of Medicine located in Tete to provide new medical graduates. The essence of the program, training doctors, has the objective of improving the healthcare system and making it sustainable for the integration of new graduates into the staff of the faculty. In this work, we determine the cost of education for a new doctor and we evaluate the social benefit of the program in terms of the human capital. The program has led to the training of 199 new doctors in the 11 years of operation and is leading the way for 100 more in the next four years. The incorporation of some of them into the faculty’s staff will generate new doctor graduates in the near future with a cost below 6000 EUR each in normal circumstances. These results can help to determine how much traditional international aid healthcare programs can save when investing in the education of new doctors. This program is an alternative policy for the international aid financing budgets of donor countries. Supporting teachers and native doctors in the future with private and public patronage programs can raise the efficiency per EUR spent. Full article

The risk assessment of hazardous substances has become increasingly important for the efficient prevention and management of various diseases or accidents caused by increased amounts of hazardous substances in the workplace. In this study, risk assessment was conducted for 36 kinds of hazardous substances requiring management by using qualitative and quantitative risk assessments. Qualitative risk assessment was performed by multiplying the exposure level class by the hazard class according to the Korea Occupational Safety and Health Agency’s (KOSHA) Chemical Hazard Risk Management (CHARM). The quantitative risk assessment was followed by a four-step risk assessment system presented in the Guidelines for Hazard Risk Assessment of Chemicals (KOSHA GUIDE W-6-2016). In the quantitative assessments, we presented a new method of classifying risk levels into four steps, much like qualitative assessments. In this study, the quantitative risk assessment was considered difficult to predict through qualitative risk assessment. Therefore, it is necessary to perform a quantitative risk assessment after a qualitative risk assessment for a higher level of risk assessment. Full article

The contribution ratio of autotrophic and heterotrophic metabolism in the mixotrophic culture of Chlorella sorokiniana (C. sorokiniana) was investigated. At the early stage of mixotrophic growth (day 0–1), autotrophy contributed over 70% of the total metabolism; however, heterotrophy contributed more than autotrophy after day 1 due to the rapid increase in cell density, which had a shading effect in the photo-bioreactor. Heterotrophy continued to have a higher contribution until the available organic carbon was depleted at which point autotrophy became dominant again. Overall, the increase in algal biomass and light conditions in the photo-bioreactor are important factors in determining the contribution of autotrophy and heterotrophy during a mixotrophic culture. Full article

One of the requirements of EU-BSS (European Basic Safety Standards) is the design and implementation of a National Radon Action Plan in the member states. This should define, as accurately as possible, areas of risk for the presence of radon gas (²²²Rn) in homes and workplaces. The concept used by the Spanish Nuclear Safety Council (CSN), the body responsible for nuclear safety and radiation protection in Spain, to identify “radon priority areas” is that of radon potential. This paper establishes a different methodology from that used by the CSN, using the same study variables (indoor radon measurements, gamma radiation exposure data, and geological information) to prepare a radon potential map that improves the definition of the areas potentially exposed to radon in Spain. The main advantage of this methodology is that by using simple data processing the definition of these areas is improved. In addition, the application of this methodology can improve the delimitation of radon priority areas and can be applied within the cartographic system used by the European Commission-Joint Research Center (EC-JRC) in the representation of different environmental parameters. Full article

Self-help organizations (SHOs) enable patients with chronic health conditions (PCHCs) to overcome common difficulties through the exchange of knowledge and mutual assistance, which serves as the basis for promoting the self-reliance and well-being of PCHCs. Nevertheless, practical challenges persist because little is known about what and how to evaluate for the developmental outcomes of SHOs. To address this knowledge gap, the present study seeks to develop and validate the Self-Help Organization Development Scale (SHODS). A total of 232 core members from 54 SHOs in Hong Kong participated in our study. The SHODS structure was validated by confirmatory factor analysis. This analysis derived five factors: citizen support, business support, member recovery and mutual aid, organizational health, and functional sustainability. The five-factor structure demonstrated stability across various types of SHOs, as validated by the subgroup analysis based on two criteria: duration of SHO establishment and organization affiliation. Good concurrent validity was supported by significant correlations between the SHODS factors and organizational variables, including staff supervision, staff understanding, networking, advocating, and educating the public and patients. The SHODS also showed excellent internal consistency. In conclusion, the SHODS is a psychometrically sound instrument for measuring the developmental outcomes of SHOs. Full article

Socially, economically, politically and emotionally (SEPE) disadvantaged children are shorter than children from affluent background. In view of previous work on the lack of association between nutrition and child growth, we performed a study in urban schoolchildren. We measured 723 children (5.83 to 13.83 years); Kupang, Indonesia; three schools with different social background. We investigated anthropometric data, clinical signs of malnutrition, physical fitness, parental education, and household equipment. Subjective self-confidence was assessed by the MacArthur test. The prevalence of stunting was between 8.5% and 46.8%. Clinical signs of under- or malnutrition were absent even in the most underprivileged children. There was no delay in tooth eruption. Underprivileged children are physically fitter than the wealthy. The correlation between height and state of nutrition (BMI_SDS, skinfold_SDS, MUAC_SDS) ranged between r = 0.69 (p < 0.01) and r = 0.43 (p < 0.01) in private school children, and between r = 0.07 (ns) and r = 0.32 (p < 0.01) in the underprivileged children. Maternal education interacted with height in affluent (r = 0.20, p < 0.01) and in underprivileged children (r = 0.20, p < 0.01). The shortness of SEPE disadvantaged children was not associated with anthropometric and clinical signs of malnutrition, nor with delay in physical development. Stunting is a complex phenomenon and may be considered a synonym of social disadvantage and poor parental education. Full article

Community mapping projects have been studied as important contributions to the field of environmental justice and Public Participation Geographic Information Systems (PPGIS). As a collaborative project between the Colectivo Salud y Justicia Ambiental and Red de Ciudadanos por el Mejoramiento de las Comunidades (RECIMEC), the “Mapeo Comunitario de la Zona Alamar” was created as a mechanism for community participation in the urban planning process in Tijuana, México. This paper outlines the project’s community mapping process, including planning, data collection, priority identification, and data submission. Results from this community mapping project are analyzed including the (1) particular environmental risks and goods in this border region, (2) the influence that the project data had on the urban planning process, and (3) the impact that the community mapping process had on community organizing capacity. Our findings point to particular environmental challenges in this border city including clandestine trash dumps, and contaminated water runoff points. The mapping project influenced the land use planning process by identifying the key environmental risks and goods to prioritize in the zoning and ground truthing urban planning data. The community mapping project also had a key impact on community organizing through the fomenting of knowledge and relationships between community members and government representatives at the city’s urban planning agency. Full article

(1) Background: The purpose of this study was to validate a Korean version of the disaster preparedness evaluation tool (DPET-K) for nurses and to verify its validity and reliability for use in community healthcare centers and hospitals in South Korea; (2) Methods: In total, 497 nurses (248 for exploratory factor analysis and 249 for confirmatory factor analysis) at public health centers, public health sub-centers, public health clinics, and general hospitals in Seoul and Gyeonggi, Chungcheong, and Gangwon Provinces participated in this study. The tool went through translation and back-translation, content validity verification, a pilot survey, and validity and reliability testing; (3) Results: The DPET-K had 28 items with five factors (disaster education and training, disaster knowledge and information, bioterrorism and emergency response, disaster response, and disaster evaluation). The Cronbach’s α values for internal consistency were 0.766–0.953 for the five subscales of the DPET-K. A structural equation model was built through confirmatory factor analysis for goodness of fit (χ²/df = 2.193, SRMR = 0.060, RMSEA = 0.069, GFI = 0.831, CFI = 0.927, NFI = 0.875); (4) Conclusions: The DPET-K was confirmed to be a useful tool for assessing the disaster preparedness of nurses in Korea. Full article

The contribution of ill-health to labour market participation in relation to vocational training is unclear. Using nationally representative Finnish register data on 42,691 vocational labour market trainees in 2008–2010, we constructed latent trajectory groups of work participation in the open labour market three years before and after training, identifying groups called “High–High”, “High–Low”, “Low–High”, and “Low–Low”. We plotted further patterns of labour market participation within these trajectory groups and, using multinomial logistic regression, examined assignment to these groups focusing on previous work disability status. Those with compared to those without previous work disability had previous employment more often and spent less time in economic inactivity within the two trajectory groups with low pre-training levels of work participation. Having a previous work disability was associated with assignment to the “High–Low” trajectory group of work participation instead of the “High–High” comparison group. The associations of other background factors with the assignment to the different trajectory groups were relatively similar amongst those with and without previous work disability. However, some of these associations were weaker amongst the former. Along with other key background factors, previous work disability should be accounted for when assessing the effects of vocational training. Full article

The popularity of social media use among adolescents has raised concerns about the potentially harmful effects of social media use on adolescents’ sleep. Since longitudinal research considering this relationship is scarce, the present two-wave longitudinal study of 2021 secondary school students (M_age = 13.86, SD = 1.25) examined whether frequency of social media use and problematic social media use predicted adolescents’ bedtime and quality of sleep. Moreover, the protective role of parental rules regarding Internet and smartphone use one hour before sleep was examined. The findings indicated that strict parental rules about Internet and smartphone use before sleep might prevent negative consequences of social media use on bedtime and sleep quality, but only among less engaged social media users. Once adolescents are highly engaged social media users, strict parental rules do not seem to prevent negative media influences on sleep. This implies that limiting Internet accessibility before bedtime can help prevent adolescents’ sleep problems, but that regulation is less effective for adolescents who are already highly involved in social media use. Full article

Users provide and share information with a broad audience on different forms of social media; however, information accuracy is questionable. Currently, the health information field is severely affected by misinformation. Thus, addressing health misinformation is integral for enhancing public health. This research can help relevant practitioners (i.e., government officials, medical and health service personnel, and educators) find the most effective correctional interventions for governing health misinformation. We constructed a theoretical model for credibility-oriented determinants refuting misinformation based on the elaboration likelihood model. We aggregated 415 pieces of valid data through a questionnaire survey. A partial least squares structural equation model evaluated this research model. The results indicated that both perceived information quality and perceived source credibility can enhance perceived information credibility. Under some circumstances, the influence of information quality on information credibility may be more important than that of the information source. However, the cognitive conflict and knowledge self-confidence of information receivers weaken the influence of information quality on information credibility. In contrast, cognitive conflict can strengthen the influence of source credibility on information credibility. Further, perceived information quality can be affected by information usefulness, understandability, and relevance, while perceived source reliability can be affected by source expertise and authority. Full article

The present study analyses the influence of family, specifically parents, on the career decisions of their children, and how gender and socioeconomic status influence this choice. Research was carried out using data obtained from a questionnaire administered to a representative sample of students who took the university entrance examination (PEvAU, its Spanish acronym) in Spanish North Africa. A quantitative research design was adopted in which multivariate analysis (MANOVA) was applied anda decision tree, which was also used for graphical and analytical analysis. The main results indicated a significant influence of parents on their children’s choices, this being the best predictor regarding the decision to take the said examination. It was also verified that their choice of Spanish Baccalaureate programme was significantly associated with their selected career path, and gender and socioeconomic status had a significant impact on that decision. These results lead to the need for further research on guidance from secondary education onwards. It would be interesting to analyse factors neglected thus far, such as those related to the cultural environment of students. Full article

The aim of this study was to evaluate the test–retest reliability of a conventional gait model (CGM), the Plug-in Gait model, to calculate the angles of the hip, knee, and ankle during initial contact (IC) and toe-off (TO). Gait analysis was performed using the Vicon Motion System^® (Oxford Metrics, Oxford, UK). The study group consisted of 50 healthy subjects. To evaluate the test–retest reliability, the intraclass correlation coefficient (ICC), the standard error of measurement (SEM), the minimal detectable change (MDC), and the Bland–Altman analysis with 95% limits of agreement were calculated. The ICC for the joint angles of the hip, knee, and ankle was higher than 0.80. However, the ankle angle at IC had an ICC lower than 0.80. The SEM was <5° for all parameters. The MDC was large (>5°) for the hip angle at IC. The Bland–Altman analysis indicated that the magnitude of divergence was between ±5° and ±9° at IC and around ±7° at TO. In conclusion, the ICC for the plug-in gait model was good for the hip, knee, and ankle angles during IC and TO. The plots revealed a disagreement between measurements that should be considered in patients’ clinical assessments. Full article

Strong and healthy futures for Aboriginal and Torres Strait Islander people requires engagement in meaningful decision making which is supported by evidence-based approaches. While a significant number of research publications state the research is co-designed, few describe the research process in relation to Indigenous ethical values. Improving the health and wellbeing of Aboriginal and Torres Strait Islander mothers and babies is crucial to the continuation of the oldest living culture in the world. Developing meaningful supports to empower Aboriginal and Torres Strait Islander mothers to quit smoking during pregnancy is paramount to addressing a range of health and wellbeing outcomes. Aboriginal and Torres Strait Islander women have called for non-pharmacological approaches to smoking cessation during pregnancy. We describe a culturally responsive research protocol that has been co-designed and is co-owned with urban and regional Aboriginal communities in New South Wales. The project has been developed in line with the AH&MRC’s (Aboriginal Health & Medical Research Council) updated guidelines for ethical research with Aboriginal and Torres Strait Islander communities. Ethics approvals have been granted by AH&MRC #14541662 University of Newcastle HREC H-2020-0092 and the Local Health District ethics committee 2020/ETH02095. Results will be disseminated through peer reviewed articles, community reports, infographics, and online social media content. Full article

In Australia, 1.5 generation migrants (those who migrated as children) often enter a new cultural and religious environment, with its own set of constructs of sexual and reproductive health (SRH), at a crucial time in their psychosexual development—puberty/adolescence. Therefore, 1.5 generation migrants may thus have to contend with constructions of SRH from at least two cultures which may be at conflict on the matter. This study was designed to investigate the role of culture and religion on sexual and reproductive health indicators and help-seeking amongst 1.5 generation migrants. An online survey was completed by 111 participants who answered questions about their cultural connectedness, religion, sexual and reproductive health and help-seeking. Kruskall-Wallis tests were used to analyse the data. There was no significant difference between ethnocultural groups or levels of cultural connectedness in relation to sexual and reproductive health help-seeking attitudes. The results do suggest differences between religious groups in regard to seeking help specifically from participants’ parents. Notably, participants who reported having ‘no religion’ were more likely to seek help with sexual and reproductive health matters from their parent(s). Managing cross-cultural experiences is often noted in the extant literature as a barrier to sexual and reproductive health help-seeking. However, while cultural norms of migrants’ country of origin can remain strong, it is religion that seems to have more of an impact on how 1.5 generation migrants seek help for SRH issues. The findings suggest that 1.5 generation migrants may not need to adapt their religious beliefs or practices, despite entering a new ethnocultural environment. Given that religion can play a role in the participants’ sexual and reproductive health, religious organizations are well-placed to encourage young migrants to adopt help-seeking attitudes. Full article

Nutrition plays a critical role in health and job performance in physically demanding roles. Studies have shown Australian military personnel do not consume diets suited to their roles. A range of foods are provided in military dining facilities; however, personnel still need to make appropriate choices for healthier eating and to optimise performance. This study explored the effect of a labelling scheme based on military-specific nutrition guidance, over a one-month period. Food choices were evaluated in a pre-post design using plate photography (pre n = 190; post n = 159 plates); with satisfaction and behavioural influences assessed through a survey (pre n = 79; post n = 67). The results indicate the scheme had a small effect on food choice—potato and hot vegetable choices increased post-campaign for the dinner meal. On average, choices were heathier at lunch post-campaign, and less healthy at dinner. Satisfaction with the meal experience was higher after the campaign, and no difference was observed in behavioural influences (e.g., self-efficacy and other perceptions). These results are in alignment with other point-of-service labelling studies showing the limited capacity labelling schemes have on guiding consumer choices. Rather than using point-of-service labelling in isolation, additional individual and/or environmental strategies may be needed to more effectively encourage nutritious food choices by personnel. Full article

This study aimed to assess the feasibility of an educational intervention on hydration behavior in adolescent soccer players. A pilot study of a two-arm, non-randomized controlled cluster trial was conducted. A total of 316 players aged 13–16 agreed to participate. The response variables were the players’ participation in the intervention, their perception of the knowledge acquired, the usefulness and the overall assessment of the intervention. Hydration patterns and acquisition of knowledge on hydration behavior were also assessed. The intervention involved two elements: posters and a web app. A total of 259 adolescents completed the study (intervention group (IG) = 131; control group (CG) = 128). 80.6% of the players responded to the survey assessing the feasibility of the intervention. The mean number of correct answers regarding behavior was significantly higher in the IG (3.54; SD = 1.162) than in the CG (2.64; SD = 1.174) (p < 0.001). The water consumption pattern at all the clubs was ad libitum. Of the players, 10% did not drink any water at all during the game. In conclusion, this intervention has been shown to be feasible for implementation with adolescent soccer players. It suggests that hydration guidelines should be informed by personal factors and that ad libitum water consumption should be avoided. Full article