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Editor’s Choice articles are based on recommendations by the scientific editors of MDPI journals from around the world. Editors select a small number of articles recently published in the journal that they believe will be particularly interesting to authors, or important in this field. The aim is to provide a snapshot of some of the most exciting work published in the various research areas of the journal.

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Article
Interference and Impact of Dysmenorrhea on the Life of Spanish Nursing Students
Int. J. Environ. Res. Public Health 2020, 17(18), 6473; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph17186473 - 05 Sep 2020
Cited by 4
Abstract
  1. Dysmenorrhea is a cause of absenteeism in universities which, in the context of nursing studies, may affect mandatory attendance. Moreover, presenteeism is associated with medication errors, patient falls, and a reduced quality of patient care. This study sought to identify the degree of
[...] Read more.
  1. Dysmenorrhea is a cause of absenteeism in universities which, in the context of nursing studies, may affect mandatory attendance. Moreover, presenteeism is associated with medication errors, patient falls, and a reduced quality of patient care. This study sought to identify the degree of interference of dysmenorrhea on daily life and its impact on academic performance among Spanish nursing students, and to explore the reasons for presenteeism. A cross-sectional descriptive study was conducted on 261 nursing students. Data were collected using a self-administered questionnaire. The chi square tests, chi-square linear trend, Student’s t-test, one-way analysis of variance of polynomial contrasts, and post hoc tests for the bi-variate analysis were used to compare the participants’ responses regarding their type of dysmenorrhea and pain intensity. In addition, a multivariate regression was performed to predict absenteeism. The answers to the open questions were analyzed using thematic content analysis techniques. We observed 62.8% of absenteeism and 92.7% of presenteeism due to dysmenorrhea. Absenteeism was observed to be 3.079 (confidence interval (CI): 95%1.724–5.499; p < 0.001) times more likely among women with severe menstrual pain, 2.513 (CI 95%1.314–4.807; p = 0.005) times more in those suffering from menstrual nausea and 1.936 (CI 95%1.098–3.411; p = 0.022) times more frequent in those suffering from diarrhea. The reasons for presenteeism were grouped into five categories: the pain was bearable, it is not a reason to be absent, others don’t consider it a reason to be absent, responsibility and guilt, and academic consequences. Dysmenorrhea can have a significant impact on academic performance. The concern among students about the academic repercussions and even feelings of guilt and incomprehension from others leads to high rates of presenteeism with potentially negative consequences for patient care.
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(This article belongs to the Special Issue Assessment of Health-Related Quality of Life (HRQoL) in Public Health)
Article
BCG Vaccination and Mortality of COVID-19 across 173 Countries: An Ecological Study
Int. J. Environ. Res. Public Health 2020, 17(15), 5589; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph17155589 - 03 Aug 2020
Cited by 13
Abstract
Ecological studies have suggested fewer COVID-19 morbidities and mortalities in Bacillus Calmette–Guérin (BCG)-vaccinated countries than BCG-non-vaccinated countries. However, these studies obtained data during the early phase of the pandemic and did not adjust for potential confounders, including PCR-test numbers per population (PCR-tests). Currently—more [...] Read more.
Ecological studies have suggested fewer COVID-19 morbidities and mortalities in Bacillus Calmette–Guérin (BCG)-vaccinated countries than BCG-non-vaccinated countries. However, these studies obtained data during the early phase of the pandemic and did not adjust for potential confounders, including PCR-test numbers per population (PCR-tests). Currently—more than four months after declaration of the pandemic—the BCG-hypothesis needs reexamining. An ecological study was conducted by obtaining data of 61 factors in 173 countries, including BCG vaccine coverage (%), using morbidity and mortality as outcomes, obtained from open resources. ‘Urban population (%)’ and ‘insufficient physical activity (%)’ in each country was positively associated with morbidity, but not mortality, after adjustment for PCR-tests. On the other hand, recent BCG vaccine coverage (%) was negatively associated with mortality, but not morbidity, even with adjustment for percentage of the population ≥ 60 years of age, morbidity, PCR-tests and other factors. The results of this study generated a hypothesis that a national BCG vaccination program seems to be associated with reduced mortality of COVID-19, although this needs to be further examined and proved by randomized clinical trials. Full article
(This article belongs to the Special Issue COVID-19: Prevention, Diagnosis, Therapy and Follow Up)
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Article
Genome-Wide DNA Methylation Profiles in Community Members Exposed to the World Trade Center Disaster
Int. J. Environ. Res. Public Health 2020, 17(15), 5493; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph17155493 - 30 Jul 2020
Cited by 3
Abstract
The primary goal of this pilot study was to assess feasibility of studies among local community members to address the hypothesis that complex exposures to the World Trade Center (WTC) dust and fumes resulted in long-term epigenetic changes. We enrolled 18 WTC-exposed cancer-free [...] Read more.
The primary goal of this pilot study was to assess feasibility of studies among local community members to address the hypothesis that complex exposures to the World Trade Center (WTC) dust and fumes resulted in long-term epigenetic changes. We enrolled 18 WTC-exposed cancer-free women from the WTC Environmental Health Center (WTC EHC) who agreed to donate blood samples during their standard clinical visits. As a reference WTC unexposed group, we randomly selected 24 age-matched cancer-free women from an existing prospective cohort who donated blood samples before 11 September 2001. The global DNA methylation analyses were performed using Illumina Infinium MethylationEpic arrays. Statistical analyses were performed using R Bioconductor package. Functional genomic analyses were done by mapping the top 5000 differentially expressed CpG sites to the Kyoto Encyclopedia of Genes and Genomes (KEGG) Pathway database. Among cancer-free subjects, we observed substantial methylation differences between WTC-exposed and unexposed women. The top 15 differentially methylated gene probes included BCAS2, OSGIN1, BMI1, EEF1A2, SPTBN5, CHD8, CDCA7L, AIDA, DDN, SNORD45C, ZFAND6, ARHGEF7, UBXN8, USF1, and USP12. Several cancer-related pathways were enriched in the WTC-exposed subjects, including endocytosis, mitogen-activated protein kinase (MAPK), viral carcinogenesis, as well as Ras-associated protein-1 (Rap1) and mammalian target of rapamycin (mTOR) signaling. The study provides preliminary data on substantial differences in DNA methylation between WTC-exposed and unexposed populations that require validation in further studies. Full article
(This article belongs to the Special Issue Environmental Factors, Epigenetics, and Cancer)
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Article
Bone Mineral Density of Femur and Lumbar and the Relation between Fat Mass and Lean Mass of Adolescents: Based on Korea National Health and Nutrition Examination Survey (KNHNES) from 2008 to 2011
Int. J. Environ. Res. Public Health 2020, 17(12), 4471; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph17124471 - 22 Jun 2020
Cited by 1
Abstract
It is most important to reach the maximum bone density in the childhood period to prevent developing osteoporosis; it is widely known that increased body weight has a positive correlation with bone density and that even though both the fat mass and lean [...] Read more.
It is most important to reach the maximum bone density in the childhood period to prevent developing osteoporosis; it is widely known that increased body weight has a positive correlation with bone density and that even though both the fat mass and lean mass have a significant impact on bone density, the latter mass has more importance for adults. Therefore, the study analyzed to identify the relationship between bone density and both fat mass and lean mass of Korean adolescents. Subjects were chosen among 21,303 people from the Korea National Health and Nutrition Examination Survey (KNHNES) between 2008 and 2011 that took a bone density checkup; as a result, 1454 teenagers aged between 12 and 18 were selected. Data analysis was performed in SAS ver. 9.4 (SAS Institute Inc., Cary, NC, USA) following the KNHNES and the weighted complex sample analysis was conducted; body fat mass and lean mass were divided into quintile groups, and to figure out the differences in bone density that were analyzed in six models adjusted by body weight (kg) and walking (yes/no), muscle strengthening exercises (yes/no), nutrition (intake of ca (g), and serum vitamin D (ng/mL)). Then, the generalized linear model (GLM) and trend test were conducted for each gender with a significance level of 0.05. The bone density differences of fat mass and lean mass were analyzed. The result of Model 6 considering all correction variables is as follows; in the case of male adolescents, the total femur and lumbar spine showed a significant difference (F = 13.120, p < 0.001; F = 12.900, p < 0.001) for fat mass, and the trend test showed that the figures significantly decreased (β = −0.030, p < 0.001; −0.035, p < 0.001). Meanwhile, for lean mass, the total femur and lumbar spine had a significant difference (F = 16.740, p < 0.001; F = 20.590, p < 0.001) too, but the trend test showed a significant increase (β = 0.054, p < 0.001; 0.057, p < 0.001). In the case of female adolescents, the lumbar spine (F = 3.600, p < 0.05) for lean mass showed a significant difference, and it also significantly rose in the trend test too (β = 0.020, p < 0.01). To sum up the results, for male adolescents, the bone density differences for fat mass (FM) and lean mass (LM) all had significant differences, but for female adolescents, only the lumbar spine for LM showed such a result. Meanwhile, both genders showed that LM had a more positive impact on bone density than FM. Full article
(This article belongs to the Special Issue Big Data, Decision Models, and Public Health)
Article
Sensitivity of Nutrition Indicators to Measure the Impact of a Multi-Sectoral Intervention: Cross-Sectional, Household, and Individual Level Analysis
Int. J. Environ. Res. Public Health 2020, 17(9), 3121; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph17093121 - 30 Apr 2020
Cited by 2
Abstract
Interventions tackling multiple drivers of child malnutrition have potential, yet the evidence is limited and draws on different analysis and nutrition outcomes, reducing comparability. To better understand the advantages and disadvantages of three different analytical approaches on seven common nutrition indicators, we use [...] Read more.
Interventions tackling multiple drivers of child malnutrition have potential, yet the evidence is limited and draws on different analysis and nutrition outcomes, reducing comparability. To better understand the advantages and disadvantages of three different analytical approaches on seven common nutrition indicators, we use panel data (2012, 2014, 2015) on 1420 households from a randomized control study of a multi-sectoral intervention in Chad. We compare program impact using three types of analysis: a cross-sectional analysis of non-matched children; a panel analysis on longitudinal outcomes following the worst-off child in the household; and a panel analysis on longitudinal outcomes of matched children. We find that the sensitivity of the nutrition outcomes to program impact increases with each subsequent analytical approach, despite the reduction in sample size, as the analysis is able to control for more non-measured child and household characteristics. In the matched child panel analysis, the odds of a child being severely wasted were 76% lower (CI: 0.59–0.86, p = 0.001), the odds of being underweight were 33% lower (CI: 0.15–0.48, p = 0.012), and weight-for-height z-score was 0.19 standard deviations higher (CI: 0.09–0.28, p = 0.022) in the treatment versus control group. The study provides evidence for multi-sectoral interventions to tackle acute malnutrition and recommends the best practice analytical approach. Full article
(This article belongs to the Special Issue Early Influences on Child Health and Wellbeing)
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Article
A New Application of Social Impact in Social Media for Overcoming Fake News in Health
Int. J. Environ. Res. Public Health 2020, 17(7), 2430; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph17072430 - 03 Apr 2020
Cited by 29
Abstract
One of the challenges today is to face fake news (false information) in health due to its potential impact on people’s lives. This article contributes to a new application of social impact in social media (SISM) methodology. This study focuses on the social [...] Read more.
One of the challenges today is to face fake news (false information) in health due to its potential impact on people’s lives. This article contributes to a new application of social impact in social media (SISM) methodology. This study focuses on the social impact of the research to identify what type of health information is false and what type of information is evidence of the social impact shared in social media. The analysis of social media includes Reddit, Facebook, and Twitter. This analysis contributes to identifying how interactions in these forms of social media depend on the type of information shared. The results indicate that messages focused on fake health information are mostly aggressive, those based on evidence of social impact are respectful and transformative, and finally, deliberation contexts promoted in social media overcome false information about health. These results contribute to advancing knowledge in overcoming fake health-related news shared in social media. Full article
(This article belongs to the Special Issue Social Media Intelligence for Public Health Surveillance)
Article
Longitudinal Patterns of Social Problem-Solving Skills in an Ethnically Diverse Sample of Pediatric Patients with Cancer and their Caregivers
Int. J. Environ. Res. Public Health 2020, 17(5), 1581; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph17051581 - 29 Feb 2020
Abstract
Pediatric patients with acute lymphoblastic leukemia and lymphoblastic lymphoma are prescribed a daily oral chemotherapy medication named 6-mercaptopurine. Adherence to this medication is vital for survival and decreased risk for disease relapse. Adaptive problem-solving strategies are important for adhering to this complex regimen. [...] Read more.
Pediatric patients with acute lymphoblastic leukemia and lymphoblastic lymphoma are prescribed a daily oral chemotherapy medication named 6-mercaptopurine. Adherence to this medication is vital for survival and decreased risk for disease relapse. Adaptive problem-solving strategies are important for adhering to this complex regimen. This manuscript examined ethnic and racial differences in social problem-solving domains (Social Problem-Solving Inventory) among patients aged 7–19 years old who were diagnosed with cancer; and, their caregivers (N = 139). This was a 15-month longitudinal study. We also examined differences in medication adherence based on behavioral adherence measures. Our study found significant differences between minority and non-minority reporters across multiple social problem-solving domains (p < 0.05). However, there were no significant differences observed for medication adherence. Our findings underscore the importance of implementing culturally sensitive interventions in clinical care that could ultimately positively impact health behaviors, interactions with healthcare providers, and long-term health outcomes. Full article
(This article belongs to the Special Issue Child-Parent Dynamics, Psychosocial Factors, and Health Outcomes)
Article
Internet Gaming Disorder Clustering Based on Personality Traits in Adolescents, and Its Relation with Comorbid Psychological Symptoms
Int. J. Environ. Res. Public Health 2020, 17(5), 1516; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph17051516 - 26 Feb 2020
Cited by 5
Abstract
In recent years, the evidence regarding Internet Gaming Disorder (IGD) suggests that some personality traits are important risk factors for developing this problem. The heterogeneity involved in problematic online gaming and differences found in the literature regarding the comorbid psychopathology associated with the [...] Read more.
In recent years, the evidence regarding Internet Gaming Disorder (IGD) suggests that some personality traits are important risk factors for developing this problem. The heterogeneity involved in problematic online gaming and differences found in the literature regarding the comorbid psychopathology associated with the problem could be explained through different types of gamers. Clustering analysis can allow organization of a collection of personality traits into clusters based on similarity. The objectives of this study were: (1) to obtain an empirical classification of IGD patients according to personality variables and (2) to describe the resultant groups in terms of clinical and sociodemographic variables. The sample included 66 IGD adolescent patients who were consecutive referrals at a mental health center in Barcelona, Spain. A Gaussian mixture model cluster analysis was used in order to classify the subjects based on their personality. Two clusters based on personality traits were detected: type I “higher comorbid symptoms” (n = 24), and type II “lower comorbid symptoms” (n = 42). The type I included higher scores in introversive, inhibited, doleful, unruly, forceful, oppositional, self-demeaning and borderline tendency traits, and lower scores in histrionic, egotistic and conforming traits. The type I obtained higher scores on all the Symptom Check List-90 items-Revised, all the State-Trait Anxiety Index scales, and on the DSM-5 IGD criteria. Differences in personality can be useful in determining clusters with different types of dysfunctionality. Full article
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Article
Geographical Disparities in Screening and Cancer-Related Health Behaviour
Int. J. Environ. Res. Public Health 2020, 17(4), 1246; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph17041246 - 14 Feb 2020
Cited by 1
Abstract
This study aimed to identify whether cancer-related health behaviours including participation in cancer screening vary by geographic location in Australia. Data were obtained from the 2014–2015 Australian National Health Survey, a computer-assisted telephone interview that measured a range of health-related issues in a [...] Read more.
This study aimed to identify whether cancer-related health behaviours including participation in cancer screening vary by geographic location in Australia. Data were obtained from the 2014–2015 Australian National Health Survey, a computer-assisted telephone interview that measured a range of health-related issues in a sample of randomly selected households. Chi-square tests and adjusted odds ratios from logistic regression models were computed to assess the association between residential location and cancer-related health behaviours including cancer screening participation, alcohol consumption, smoking, exercise, and fruit and vegetable intake, controlling for age, socio-economic status (SES), education, and place of birth. The findings show insufficient exercise, risky alcohol intake, meeting vegetable intake guidelines, and participation in cervical screening are more likely for those living in inner regional areas and in outer regional/remote areas compared with those living in major cities. Daily smoking and participation in prostate cancer screening were significantly higher for those living in outer regional/remote areas. While participation in cancer screening in Australia does not appear to be negatively impacted by regional or remote living, lifestyle behaviours associated with cancer incidence and mortality are poorer in regional and remote areas. Population-based interventions targeting health behaviour change may be an appropriate target for reducing geographical disparities in cancer outcomes. Full article
(This article belongs to the Section Global Health)
Article
Predictors Associated with Health-Related Heat Risk Perception of Urban Citizens in Germany
Int. J. Environ. Res. Public Health 2020, 17(3), 874; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph17030874 - 30 Jan 2020
Cited by 5
Abstract
The rising probability of extremely high temperatures and an increasing number of consecutive hot days caused by climate change—combined with the impact of these high temperatures on human health—is widely discussed in the literature. There are calls for the development of heatwave adaptation [...] Read more.
The rising probability of extremely high temperatures and an increasing number of consecutive hot days caused by climate change—combined with the impact of these high temperatures on human health—is widely discussed in the literature. There are calls for the development of heatwave adaptation measures by governmental and scientific institutions. In this research, the predictors of health-related heat risk perception of urban citizens in Augsburg, Germany, were investigated. An online survey was conducted with 468 citizens, asking about their heat risk perception, knowledge about heat risks, and demographic data and health information. Statistical methods (Spearman correlation, unpaired t-test, ANOVA and multiple regression) were used to determine which factors were significant and relevant. The results show that the knowledge of heat risks, heat risk sensitivity and an external locus of control are the most important factors for heat risk perception. The health implication score and chronic disease show significant effects in descriptive statistics. Furthermore, younger people showed the highest heat risk perception of all age groups. Surprisingly, income, education, living alone and gender did not play a role in heat risk perception. The findings imply a need for better and intensified heat risk communication in urban areas—especially among elderly people—and thus are important for creating acceptance towards heat wave risks, which is a prerequisite of willingness to adapt. Full article
(This article belongs to the Special Issue Climate Change Adaptation and Risk Reduction)
Article
Associations of Socioeconomic Status, Parental Smoking and Parental E-Cigarette Use with 10–11-Year-Old Children’s Perceptions of Tobacco Cigarettes and E-Cigarettes: Cross Sectional Analysis of the CHETS Wales 3 Survey
Int. J. Environ. Res. Public Health 2020, 17(3), 683; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph17030683 - 21 Jan 2020
Cited by 2
Abstract
Background: This study examines primary schoolchildren’s perceptions of e-cigarettes and tobacco cigarettes, and associations with parental smoking, vaping and socioeconomic status. Methods: Survey of 2218 10–11-year-old children in 73 schools in Wales. Results: Overall, 36% reported that a parent figure smoked compared to [...] Read more.
Background: This study examines primary schoolchildren’s perceptions of e-cigarettes and tobacco cigarettes, and associations with parental smoking, vaping and socioeconomic status. Methods: Survey of 2218 10–11-year-old children in 73 schools in Wales. Results: Overall, 36% reported that a parent figure smoked compared to 21% for vaping, with parental smoking lower in affluent families (OR = 0.72; 95% CI = 0.68 to 0.76). Overall, 1% had tried a cigarette, while 5% had tried an e-cigarette. Most said they would not smoke or vape in 2 years’ time; susceptibility to vaping (20%) was higher than smoking (12%). Exposure to and perceptions of tobacco cigarettes were more positive for children of smokers. Having a parent who vaped was associated with exposure to and positive perceptions of e-cigarettes, but not smoking. Most children perceived e-cigarettes as used by adults to stop smoking (64%). Susceptibility to smoking (OR = 0.57; 95% CI = 0.41 to 0.79) and vaping (OR = 0.78; 95% CI = 0.62 to 0.99) were lower among children who perceived e-cigarettes as cessation aids. Conclusions: Parental smoking continues to be concentrated in poorer families. This study provides no evidence that parental vaping in the absence of smoking is associated with more positive perceptions of tobacco cigarettes. Communicating to children the role of e-cigarettes as cessation devices for smokers may help to limit their appeal to young people. Full article
(This article belongs to the Collection Feature Papers in Children's Health)
Article
Effect of Information Disclosure Policy on Control of Infectious Disease: MERS-CoV Outbreak in South Korea
Int. J. Environ. Res. Public Health 2020, 17(1), 305; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph17010305 - 01 Jan 2020
Cited by 8
Abstract
This study examined the effect of disclosing a list of hospitals with Middle East respiratory syndrome coronavirus (MERS-CoV) patients on the number of laboratory-confirmed MERS-CoV cases in South Korea. MERS-CoV data from 20 May 2015 to 5 July 2015 were from the Korean [...] Read more.
This study examined the effect of disclosing a list of hospitals with Middle East respiratory syndrome coronavirus (MERS-CoV) patients on the number of laboratory-confirmed MERS-CoV cases in South Korea. MERS-CoV data from 20 May 2015 to 5 July 2015 were from the Korean Ministry of Health & Welfare website and analyzed using segmented linear autoregressive error models for interrupted time series. This study showed that the number of laboratory-confirmed cases was increased by 9.632 on 5 June (p < 0.001). However, this number was significantly decreased following disclosure of a list of hospitals with MERS-CoV cases (Estimate = −0.699; p < 0.001). Disclosing the list of hospitals exposed to MERS-CoV was critical to the prevention of further infection. It reduced the number of confirmed MERS-CoV cases. Thus, providing accurate and timely information is a key to critical care response. Full article
(This article belongs to the Section Public Health Statistics and Risk Assessment)
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Article
Reliability of a Virtual Prosthodontic Project Realized through a 2D and 3D Photographic Acquisition: An Experimental Study on the Accuracy of Different Digital Systems
Int. J. Environ. Res. Public Health 2019, 16(24), 5139; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph16245139 - 16 Dec 2019
Cited by 23
Abstract
Aims: The study aims to assess the accuracy of digital planning in dentistry, evaluating the characteristics of different intraoral 3D scanners and comparing it with traditional imaging 2D recording methods. Specifically, using computer aided design (CAD) software and measuring inside CAD software, authors [...] Read more.
Aims: The study aims to assess the accuracy of digital planning in dentistry, evaluating the characteristics of different intraoral 3D scanners and comparing it with traditional imaging 2D recording methods. Specifically, using computer aided design (CAD) software and measuring inside CAD software, authors want to verify the reliability of different models obtained with different techniques and machines. Methods: 12 patients that needed aesthetic restorative treatment were enrolled in the study. All the patients underwent recording data of the height and width dental elements 1.1, 1.2, and 1.3 size using different technologies and comparing 2D with 3D methods. A T test was then applied in order to verify whether there was a statistically significant difference between the measurements obtained, comparing the different tools data (Emerald, TRIOS, Photogrammetry and DSS (Digital Smile System)) with the reference values. Results: No significant differences emerged in the measurements made with the different scanners (Trios 3Shape ®, Planmeca Emerald ®) and photogrammetry. Therefore, what should be underlined regarding the 2D measurements is the speed and simplicity compared to all 3D techniques, so this work can help to better define the field of application and the limits connected to 2D techniques, giving a good window of the technique. Conclusions: The low number of patients is not sufficient to provide statistically significant results, but the digital planning future prospects seem to be promising. This study results highlighted how a photogrammetric scanner for dental arches would only have a much smaller shooting field size and greater accuracy. Despite these considerations, the photogrammetric facial scanner provided excellent results for the measurement of individual teeth, showing a great versatility of use. Full article
(This article belongs to the Special Issue Digital Dentistry for Oral Health)
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Article
Impact of a Telemedicine Program on the Reduction in the Emission of Atmospheric Pollutants and Journeys by Road
Int. J. Environ. Res. Public Health 2019, 16(22), 4366; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph16224366 - 08 Nov 2019
Cited by 10
Abstract
This retrospective study evaluates the effect of a telemedicine program developed in the central Catalan region in lowering the environmental footprint by reducing the emission of atmospheric pollutants, thanks to a reduction in the number of hospital visits involving journeys by road. Between [...] Read more.
This retrospective study evaluates the effect of a telemedicine program developed in the central Catalan region in lowering the environmental footprint by reducing the emission of atmospheric pollutants, thanks to a reduction in the number of hospital visits involving journeys by road. Between January 2018 and June 2019, a total of 12,322 referrals were made to telemedicine services in the primary care centers, avoiding a total of 9034 face-to-face visits. In total, the distance saved was 192,682 km, with a total travel time saving of 3779 h and a total fuel reduction of 11,754 L with an associated cost of €15,664. This represents an average reduction of 3248.3 g of carbon dioxide, 4.05 g of carbon monoxide, 4.86 g of nitric oxide and 3.2 g of sulphur dioxide. This study confirms that telemedicine reduces the environmental impact of atmospheric pollutants emitted by vehicles by reducing the number of journeys made for face-to-face visits, and thus contributing to environmental sustainability. Full article
(This article belongs to the Special Issue Social Media and Public Health: Opportunities and Challenges)
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Article
Stability of Differences in Weight-Related Characteristics of Mothers across Economic, Cultural, Social, and Environmental-Health Indicators of Socioeconomic Status
Int. J. Environ. Res. Public Health 2019, 16(20), 3866; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph16203866 - 12 Oct 2019
Cited by 3
Abstract
This study explored the differences in weight-related characteristics when socioeconomic status (SES) was assessed by economic, cultural, social, and environmental-health capital individually and as a composite with the goal of determining the stability of differences across types of capital and to ascertain whether [...] Read more.
This study explored the differences in weight-related characteristics when socioeconomic status (SES) was assessed by economic, cultural, social, and environmental-health capital individually and as a composite with the goal of determining the stability of differences across types of capital and to ascertain whether single or a combination of capital indicators of SES should be used in nutrition and public health studies. Mothers (n = 557) of young children completed a survey assessing capital and weight-related characteristics. Mothers with higher economic, cultural, and social capital and composite SES had fewer sugar-sweetened beverage servings, fewer meals in front of the TV, more food security, and greater neighborhood space/supports for physical activity than comparators. Few differences occurred among environmental-health capital groups. Composite SES performed similarly to individual economic, cultural, and social capital measures. Findings suggest single SES indicators may be sufficiently stable to capture differences in weight-related characteristics. Each capital type captures a unique aspect of SES; thus, assessing an array of capital types could advance understanding of SES aspects on weight-related characteristics. Full article
Article
Facebook Groups on Chronic Obstructive Pulmonary Disease: Social Media Content Analysis
Int. J. Environ. Res. Public Health 2019, 16(20), 3789; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph16203789 - 09 Oct 2019
Cited by 9
Abstract
Facebook Groups facilitate information exchange and engagement for patients with chronic conditions, including those living with Chronic Obstructive Pulmonary Disease (COPD); however, little is known about how knowledge is diffused throughout these communities. This study aimed to evaluate the content that is available [...] Read more.
Facebook Groups facilitate information exchange and engagement for patients with chronic conditions, including those living with Chronic Obstructive Pulmonary Disease (COPD); however, little is known about how knowledge is diffused throughout these communities. This study aimed to evaluate the content that is available on COPD-related Facebook Groups, as well as the communication (self-disclosures, social support) and engagement (agreement, emotional reaction) strategies used by members to facilitate these resources. Two researchers independently searched the “Groups” category using the terms “COPD”, “emphysema”, and “chronic bronchitis”. Twenty-six closed (n = 23) and public (n = 3) COPD Facebook Groups were identified with 87,082 total members. The vast majority of Group members belonged to closed (n = 84,684; 97.25%) as compared to open (n = 2398; 2.75%) groups. Medications were the most commonly addressed self-management topic (n = 48; 26.7%). While overall engagement with wall posts was low, the number of “likes” (an indicator of agreement) was significantly greater for wall posts that demonstrated social support as compared to posts that did not (p < 0.001). Findings from this study showed that COPD Facebook group members share specific disease-related experiences and request information about select self-management topics. This information can be used to improve the quality of self-management support provided to members of popular COPD Facebook groups. Full article
(This article belongs to the Special Issue Exploring the Role of Social Media in Health Promotion)
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Impact of Wildfire Smoke on Adverse Pregnancy Outcomes in Colorado, 2007–2015
Int. J. Environ. Res. Public Health 2019, 16(19), 3720; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph16193720 - 02 Oct 2019
Cited by 23
Abstract
Colorado is regularly impacted by long-range transport of wildfire smoke from upwind regions. This smoke is a major source of ambient PM2.5. Maternal exposure to total PM2.5 during pregnancy has been linked to decreased birth weight and other adverse outcomes, [...] Read more.
Colorado is regularly impacted by long-range transport of wildfire smoke from upwind regions. This smoke is a major source of ambient PM2.5. Maternal exposure to total PM2.5 during pregnancy has been linked to decreased birth weight and other adverse outcomes, although the impact of wildfire smoke contribution has only recently been investigated. The objective of this study was to estimate associations between adverse pregnancy outcomes and ambient wildfire smoke PM2.5. Wildfire smoke PM2.5 exposures were estimated using a previously published method incorporating ground-based monitors and remote sensing data. Logistic regression models stratified by ZIP code and mixed models with random intercept by ZIP code were used to test for associations. The primary outcomes of interest were preterm birth and birth weight. Secondary outcomes included gestational hypertension, gestational diabetes, neonatal intensive care unit admission, assisted ventilation, small for gestational age, and low birth weight. Exposure to wildfire smoke PM2.5 over the full gestation and during the second trimester were positively associated with pre-term birth (OR = 1.076 (μg/m3)−1 [95% CI = 1.016, 1.139; p = 0.013] and 1.132 (μg/m3)−1 [95% CI = 1.088, 1.178]; p < 0.0001, respectively), while exposure during the first trimester was associated with decreased birth weight (−5.7 g/(μg/m3) [95% CI: −11.1, −0.4; p = 0.036]). Secondary outcomes were mixed. Full article
(This article belongs to the Special Issue Impacts of Climate Change on Women's Health)
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Article
Use of Wearable Technology and Social Media to Improve Physical Activity and Dietary Behaviors among College Students: A 12-Week Randomized Pilot Study
Int. J. Environ. Res. Public Health 2019, 16(19), 3579; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph16193579 - 25 Sep 2019
Cited by 11
Abstract
College students demonstrate poor physical activity (PA) and dietary behaviors. We evaluated the feasibility of a combined smartwatch and theoretically based, social media-delivered health education intervention versus a comparison on improving college students’ health behaviors/outcomes. Thirty-eight students (28 female; Xage = 21.5 [...] Read more.
College students demonstrate poor physical activity (PA) and dietary behaviors. We evaluated the feasibility of a combined smartwatch and theoretically based, social media-delivered health education intervention versus a comparison on improving college students’ health behaviors/outcomes. Thirty-eight students (28 female; Xage = 21.5 ± 3.4 years) participated in this two-arm, randomized 12-week pilot trial (2017–2018). Participants were randomized into: (a) experimental: Polar M400 use and twice-weekly social cognitive theory- and self-determination theory-based Facebook-delivered health education intervention; or (b) comparison: enrollment only in separate, but content-identical, Facebook intervention. Primary outcomes pertained to intervention feasibility. Secondary outcomes included accelerometer-estimated PA, physiological/psychosocial outcomes, and dietary behaviors. Intervention adherence was high (~86%), with a retention of 92.1%. Participants implemented health education tips 1–3 times per week. We observed experimental and comparison groups to have 4.2- and 1.6-min/day increases in moderate-to-vigorous PA (MVPA), respectively, at six weeks—partially maintained at 12 weeks. In both groups, similarly decreased body weight (experimental = −0.6 kg; comparison = −0.5 kg) and increased self-efficacy, social support, and intrinsic motivation were observed pre- and post-intervention. Finally, we observed small decreases in daily caloric consumption over time (experimental = −41.0 calories; comparison = −143.3). Both interventions were feasible/of interest to college students and demonstrated initial effectiveness at improving health behaviors/outcomes. However, smartwatch provision may not result in an additional benefit. Full article
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Article
Flood- and Weather-Damaged Homes and Mental Health: An Analysis Using England’s Mental Health Survey
Int. J. Environ. Res. Public Health 2019, 16(18), 3256; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph16183256 - 05 Sep 2019
Cited by 9
Abstract
There is increasing evidence that exposure to weather-related hazards like storms and floods adversely affects mental health. However, evidence of treated and untreated mental disorders based on diagnostic criteria for the general population is limited. We analysed the Adult Psychiatric Morbidity Survey, a [...] Read more.
There is increasing evidence that exposure to weather-related hazards like storms and floods adversely affects mental health. However, evidence of treated and untreated mental disorders based on diagnostic criteria for the general population is limited. We analysed the Adult Psychiatric Morbidity Survey, a large probability sample survey of adults in England (n = 7525), that provides the only national data on the prevalence of mental disorders assessed to diagnostic criteria. The most recent survey (2014–2015) asked participants if they had experienced damage to their home (due to wind, rain, snow or flood) in the six months prior to interview, a period that included months of unprecedented population exposure to flooding, particularly in Southern England. One in twenty (4.5%) reported living in a storm- or flood-damaged home in the previous six months. Social advantage (home ownership, higher household income) increased the odds of exposure to storm or flood damage. Exposure predicted having a common mental disorder over and above the effects of other known predictors of poor mental health. With climate change increasing the frequency and severity of storms and flooding, improving community resilience and disaster preparedness is a priority. Evidence on the mental health of exposed populations is key to building this capacity. Full article
(This article belongs to the Section Climate Change and Health)
Article
Adolescent Smoking in Secondary Schools that Have Implemented Smoke-Free Policies: In-Depth Exploration of Shared Smoking Patterns
Int. J. Environ. Res. Public Health 2019, 16(12), 2100; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph16122100 - 13 Jun 2019
Cited by 8
Abstract
Large numbers of adolescents smoke during school hours, despite the implementation of smoke-free school policies (SFSPs). Studies about SFSPs predominantly analyse smoking as individual behaviour, yet there is increasing recognition that smoking should be understood as social behaviour. We explored shared smoking patterns [...] Read more.
Large numbers of adolescents smoke during school hours, despite the implementation of smoke-free school policies (SFSPs). Studies about SFSPs predominantly analyse smoking as individual behaviour, yet there is increasing recognition that smoking should be understood as social behaviour. We explored shared smoking patterns specifying where, when, and with whom, and social meanings about why groups of adolescents smoke in two Dutch schools that have implemented SFSPs. Surveys among adolescents were held to obtain contextual information about the schools. Four focus group discussions and fourteen individual interviews were held with adolescents to identify shared smoking patterns in each school. Two shared patterns were identified at a school where 17% of students smoked daily: Dependent smoking and Rebellious smoking. Both built on pro-smoking norms and underscored the benefits of smoking. Three shared patterns were identified at a school where 3% of students smoked daily: Social bonding smoking, Low-profile smoking and Smoking-friendly event smoking. These built on anti-smoking norms and helped smokers cope with negative social judgements related to smoking. We conclude that adolescent smoking during school hours is embedded in diverse shared smoking patterns. Future studies should develop more understanding about how to deal with adolescents’ shared smoking patterns that decrease the effectiveness of tobacco policies. Full article
(This article belongs to the Special Issue School Health and Wellbeing)

Review

Jump to: Research

Review
Stigma and Discrimination (SAD) at the Time of the SARS-CoV-2 Pandemic
Int. J. Environ. Res. Public Health 2020, 17(17), 6341; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph17176341 - 31 Aug 2020
Cited by 31
Abstract
Infectious disease control is a crucial public health issue. Although it is important to urgently perform public health measures in order to reduce the risk of spread, it could end up stigmatizing entire groups of people rather than offering control measures based on [...] Read more.
Infectious disease control is a crucial public health issue. Although it is important to urgently perform public health measures in order to reduce the risk of spread, it could end up stigmatizing entire groups of people rather than offering control measures based on sound scientific principles. This “us” versus “them” dynamic is common in stigmatization, in general, and indicates a way in which disease stigma can be viewed as a proxy for other types of fears, especially xenophobia and general fear of outsiders. The pandemic risk associated with SARS-CoV-2 infection led us to consider, among other related issues, how stigma and discrimination remain serious barriers to care for people suspected of being infected, even more if they are assisting professions, such as health workers, employed in emergency response. The purpose of this review is to evaluate and promote the importance of psychological aspects of the stigma and social discrimination (SAD) in pandemic realities and, more specifically, nowadays, in the context of SARS-CoV-2/COVID-19. Just as it happened with HIV, HCV, tuberculosis, and Zika, stigma and discrimination undermine the social fabric compromising the ethics and principles of civilization to which each individual in entitled. Recognizing disease stigma history can give us insight into how, exactly, stigmatizing attitudes are formed, and how they are disbanded. Instead of simply blaming the ignorance of people espousing stigmatizing attitudes about certain diseases, we should try to understand precisely how these attitudes are formed so that we can intervene in their dissemination. We should also look at history to see what sorts of interventions against stigma may have worked in the past. Ongoing research into stigma should evaluate what has worked in the past, as above-mentioned, providing us with some clues as to what might work in the current pandemic emergency, to reduce devastating discrimination that keeps people from getting the care they need. We propose a systematic and historical review, in order to create a scientific and solid base for the following SAD analysis. The aim is to propose a coping strategy to face stigma and discrimination (SAD) related to SARS-CoV-2/COVID-19 pandemic outbreak, borrowing coping strategy tools and solutions from other common contagious diseases. Furthermore, our study observes how knowledge, education level, and socioeconomic status (SES) can influence perception of SARS-CoV-2/ COVID-19 risk in a digital world, based on previous research, best practices, and evidence-based research. Full article
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Review
Key Guidelines in Developing a Pre-Emptive COVID-19 Vaccination Uptake Promotion Strategy
Int. J. Environ. Res. Public Health 2020, 17(16), 5893; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph17165893 - 13 Aug 2020
Cited by 27
Abstract
This paper makes the case for immediate planning for a COVID-19 vaccination uptake strategy in advance of vaccine availability for two reasons: first, the need to build a consensus about the order in which groups of the population will get access to the [...] Read more.
This paper makes the case for immediate planning for a COVID-19 vaccination uptake strategy in advance of vaccine availability for two reasons: first, the need to build a consensus about the order in which groups of the population will get access to the vaccine; second, to reduce any fear and concerns that exist in relation to vaccination and to create demand for vaccines. A key part of this strategy is to counter the anti-vaccination movement that is already promoting hesitancy and resistance. Since the beginning of the COVID-19 pandemic there has been a tsunami of misinformation and conspiracy theories that have the potential to reduce vaccine uptake. To make matters worse, sections of populations in many countries display low trust in governments and official information about the pandemic and how the officials are tackling it. This paper aims to set out in short form critical guidelines that governments and regional bodies should take to enhance the impact of a COVID-19 vaccination strategy. We base our recommendations on a review of existing best practice guidance. This paper aims to assist those responsible for promoting COVID-19 vaccine uptake to digest the mass of guidance that exists and formulate an effective locally relevant strategy. A summary of key guidelines is presented based on best practice guidance. Full article
(This article belongs to the Section Health Communication)
Review
Secular Trends in Physical Fitness of Children and Adolescents: A Review of Large-Scale Epidemiological Studies Published after 2006
Int. J. Environ. Res. Public Health 2020, 17(16), 5671; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph17165671 - 05 Aug 2020
Cited by 6
Abstract
Physical fitness (PF) of children and adolescents is an important resource for their future health. Population-based studies, however, rarely report secular changes of PF, although monitoring of these is crucial to deriving information for adequate interventions. This review aims to report trends in [...] Read more.
Physical fitness (PF) of children and adolescents is an important resource for their future health. Population-based studies, however, rarely report secular changes of PF, although monitoring of these is crucial to deriving information for adequate interventions. This review aims to report trends in PF of children and adolescents. A literature search was conducted in PubMed in July 2019. Cohort studies published in English allowing statements to be made on trends in PF by comparing youth between the ages of four and 18 years were included. The review identified 24 studies from 16 countries meeting the inclusion criteria, with an overall sample size of more than 860,000 children and adolescents. Through a standardized quality assessment tool, we classified two studies as strong, 21 as moderate, and only one as weak. We analyzed specific secular trends separately for the five different dimensions: endurance, strength, speed, flexibility, and coordination. The majority of studies report a decline of PF over time; however, a few studies report conflicting results. Performance in endurance, strength, and flexibility decreased over time, whereas there was no consistent trend reported for speed and coordination. Overall, there is no international standard on examining and reporting changes or secular trends in PF of children and adolescents, and comparability of studies is limited due to heterogeneous conditions of conducting and analyzing PF tests. Consequently, standardized and consistent international monitoring should be implemented. Full article
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Review
Air Pollution and COVID-19: The Role of Particulate Matter in the Spread and Increase of COVID-19’s Morbidity and Mortality
Int. J. Environ. Res. Public Health 2020, 17(12), 4487; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph17124487 - 22 Jun 2020
Cited by 88
Abstract
Sars-Cov-2 virus (COVID-19) is a member of the coronavirus family and is responsible for the pandemic recently declared by the World Health Organization. A positive correlation has been observed between the spread of the virus and air pollution, one of the greatest challenges [...] Read more.
Sars-Cov-2 virus (COVID-19) is a member of the coronavirus family and is responsible for the pandemic recently declared by the World Health Organization. A positive correlation has been observed between the spread of the virus and air pollution, one of the greatest challenges of our millennium. COVID-19 could have an air transmission and atmospheric particulate matter (PM) could create a suitable environment for transporting the virus at greater distances than those considered for close contact. Moreover, PM induces inflammation in lung cells and exposure to PM could increase the susceptibility and severity of the COVID-19 patient symptoms. The new coronavirus has been shown to trigger an inflammatory storm that would be sustained in the case of pre-exposure to polluting agents. In this review, we highlight the potential role of PM in the spread of COVID-19, focusing on Italian cities whose PM daily concentrations were found to be higher than the annual average allowed during the months preceding the epidemic. Furthermore, we analyze the positive correlation between the virus spread, PM, and angiotensin-converting enzyme 2 (ACE2), a receptor involved in the entry of the virus into pulmonary cells and inflammation. Full article
(This article belongs to the Section Environmental Health)
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Review
The Need for the Right Socio-Economic and Cultural Fit in the COVID-19 Response in Sub-Saharan Africa: Examining Demographic, Economic Political, Health, and Socio-Cultural Differentials in COVID-19 Morbidity and Mortality
Int. J. Environ. Res. Public Health 2020, 17(10), 3445; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph17103445 - 15 May 2020
Cited by 26
Abstract
The coronavirus disease (COVID-19) has spread quickly across the globe with devastating effects on the global economy as well as the regional and societies’ socio-economic fabrics and the way of life for vast populations. The nonhomogeneous continent faces local contextual complexities that require [...] Read more.
The coronavirus disease (COVID-19) has spread quickly across the globe with devastating effects on the global economy as well as the regional and societies’ socio-economic fabrics and the way of life for vast populations. The nonhomogeneous continent faces local contextual complexities that require locally relevant and culturally appropriate COVID-19 interventions. This paper examines demographic, economic, political, health, and socio-cultural differentials in COVID-19 morbidity and mortality. The health systems need to be strengthened through extending the health workforce by mobilizing and engaging the diaspora, and implementing the International Health Regulations (2005) core capacities. In the absence of adequate social protection and welfare programs targeting the poor during the pandemic, sub-Saharan African countries need to put in place flexible but effective policies and legislation approaches that harness and formalise the informal trade and remove supply chain barriers. This could include strengthening cross-border trade facilities such as adequate pro-poor, gender-sensitive, and streamlined cross-border customs, tax regimes, and information flow. The emphasis should be on cross-border infrastructure that not only facilitates trade through efficient border administration but can also effectively manage cross-border health threats. There is an urgent need to strengthen social protection systems to make them responsive to crises, and embed them within human rights-based approaches to better support vulnerable populations and enact health and social security benefits. The COVI-19 response needs to adhere to the well-established ‘do no harm’ principle to prevent further damage or suffering as a result of the pandemic and examined through local lenses to inform peace-building initiatives that may yield long-term gains in the post-COVID-19 recovery efforts. Full article
(This article belongs to the Collection Outbreak of a Novel Coronavirus: A Global Health Threat)
Review
Five Challenges When Managing Mass Casualty or Disaster Situations: A Review Study
Int. J. Environ. Res. Public Health 2020, 17(9), 3068; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph17093068 - 28 Apr 2020
Cited by 3
Abstract
Background: Managing mass casualty or disaster incidents is challenging to any person or organisation. Therefore, this paper identifies and describes common challenges to managing such situations, using case and lessons learned reports. It focuses on sudden onset, man-made or technologically caused mass [...] Read more.
Background: Managing mass casualty or disaster incidents is challenging to any person or organisation. Therefore, this paper identifies and describes common challenges to managing such situations, using case and lessons learned reports. It focuses on sudden onset, man-made or technologically caused mass casualty or disaster situations. Methods: A management review was conducted based on a structured search in the PubMed and Web of Science databases. Results: The review included 20 case—and lessons learned reports covering natural disasters, man-made events, and accidents across Europe, the United States of Amerika (USA), Asia and the Middle East. Five common challenges were identified: (1) to identify the situation and deal with uncertainty, (2) to balance the mismatch between the contingency plan and the reality, (3) to establish a functional crisis organization, (4) to adapt the medical response to the actual and overall situation and (5) to ensure a resilient response. Conclusions: The challenges when managing mass casualty or disaster events involved were mainly related to the ability to manage uncertainty and surprising situations, using structured processes to respond. The ability to change mind set, organization and procedures, both from an organizational- and individual perspective, was essential. Non-medical factors and internal factors influenced the medical management. In order to respond in an effective, timely and resilient way, all these factors should be taken into consideration. Full article
(This article belongs to the Special Issue Prehospital and Disaster Medicine and Crises Management)
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Review
Internet Addiction in the Web of Science Database: A Review of the Literature with Scientific Mapping
Int. J. Environ. Res. Public Health 2020, 17(8), 2753; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph17082753 - 16 Apr 2020
Cited by 20
Abstract
Information and communication technologies (ICT) is a major element of today’s society with great potential that can offer both advantages and disadvantages. Addiction to the Internet and social networks is a growing problem in all age groups. Education is the context in which [...] Read more.
Information and communication technologies (ICT) is a major element of today’s society with great potential that can offer both advantages and disadvantages. Addiction to the Internet and social networks is a growing problem in all age groups. Education is the context in which to work and train in the correct use of these media. The objective of the study focuses on knowing the scientific production and the performance of the concepts “addiction” and “internet” (ADIN). A bibliometric methodology complemented with the scientific mapping technique was followed. Different processes related to the quantification, analysis, evaluation, and estimation of scientific documents were carried out. The literature was analyzed by specific programs such as SciMAT, Analyze Results, and Creation Citation Report. The unit of analysis was specified in 5644 scientific publications extracted from Web of Science (WoS), belonging to the period of years between 1996 and 2019. The results showed that the evolution in the study of the addiction to the Internet is constant and continuous, with articles in English being the most used means to present the information on the part of the investigators. In addition, the subject of study was based on time, given that the coincidence of key words between the periods analyzed was high. In conclusion, the importance of promoting healthy living habits that include responsible use of the Internet are discussed. Full article
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Review
Regulatory Policies for Alcohol, other Psychoactive Substances and Addictive Behaviours: The Role of Level of Use and Potency. A Systematic Review
Int. J. Environ. Res. Public Health 2019, 16(19), 3749; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph16193749 - 04 Oct 2019
Cited by 12
Abstract
The object of this contribution based on a systematic review of the literature is to examine to what degree the level of use and potency play a role in regulatory policies for alcohol, other psychoactive substances and gambling, and whether there is an [...] Read more.
The object of this contribution based on a systematic review of the literature is to examine to what degree the level of use and potency play a role in regulatory policies for alcohol, other psychoactive substances and gambling, and whether there is an evidence base for this role. Level of use is usually defined around a behavioural pattern of the user (for example, cigarettes smoked per day, or average ethanol use in grams per day), while potency is defined as a property or characteristic of the substance. For all substances examined (alcohol, tobacco, opioids, cannabis) and gambling, both dimensions were taken into consideration in the formulation of most regulatory policies. However, the associations between both dimensions and regulatory policies were not systematic, and not always based on evidence. Future improvements are suggested. Full article
(This article belongs to the Special Issue Alcohol Control Policy and Health in Europe)
Review
A Scoping Review Mapping Research on Green Space and Associated Mental Health Benefits
Int. J. Environ. Res. Public Health 2019, 16(12), 2081; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph16122081 - 12 Jun 2019
Cited by 27
Abstract
Background: There is a growing interest in research investigating the association between green space (GS) and mental health and wellbeing (HWB), in order to understand the underlying mechanisms. Accordingly, there is a need to map the literature and create an overview of the [...] Read more.
Background: There is a growing interest in research investigating the association between green space (GS) and mental health and wellbeing (HWB), in order to understand the underlying mechanisms. Accordingly, there is a need to map the literature and create an overview of the research. Methods: A scoping review approach was used to map literature on GS, including context and co-exposures (the GS exposome), and their associations with mental HWB. The review considers mental HWB definitions and measurements and how GS is characterized. Furthermore, the review aims to identify knowledge gaps and make recommendations for future research. Results: We identified a great diversity in study designs, definitions, outcome measures, consideration of the totality of the GS exposome, and reporting of results. Around 70% of the 263 reviewed studies reported a positive association between some aspect of GS and HWB. However, there is a limited amount of research using randomized controlled crossover trails (RCTs) and mixed methods and an abundance of qualitative subjective research. Conclusions: The discords between study designs, definitions, and the reporting of results makes it difficult to aggregate the evidence and identify any potential causal mechanisms. We propose key points to consider when defining and quantifying GS and make recommendations for reporting on research investigating GS and mental HWB. This review highlights a need for large well-designed RCTs that reliably measure the GS exposome in relation to mental HWB. Full article
(This article belongs to the Section Environmental Health)
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