International Journal of Environmental Research and Public Health

17 pages, 727 KiB

Open AccessArticle

Do Work Engagement and Transformational Leadership Facilitate Knowledge Sharing? A Perspective of Conservation of Resources Theory

by Wei-Li Wu and Yi-Chih Lee

Int. J. Environ. Res. Public Health 2020, 17(7), 2615; https://doi.org/10.3390/ijerph17072615 - 10 Apr 2020

Cited by 42 | Viewed by 9058

Abstract

Based on the perspective of conservation of resources (COR) theory, this study adopts a multilevel approach to examine the influences of employees’ personal resources (i.e., work engagement and intrinsic motivation) and external resources (i.e., transformational leadership) on knowledge sharing. This study conducts a [...] Read more.

Based on the perspective of conservation of resources (COR) theory, this study adopts a multilevel approach to examine the influences of employees’ personal resources (i.e., work engagement and intrinsic motivation) and external resources (i.e., transformational leadership) on knowledge sharing. This study conducts a survey to explore the interrelationships among transformational leadership, work engagement, intrinsic motivation, and knowledge sharing. The sample includes 33 healthcare work groups consisting of 214 group members. The results show that an individual’s personal and external resources are positive and benefit the promotion of knowledge sharing. As for personal resources, work engagement has a positive impact on knowledge sharing by increasing intrinsic motivation. Regarding external resources, transformational leadership acts as a facilitator for knowledge sharing. Specifically, the conditional indirect effects of work engagement on knowledge sharing through intrinsic motivation are more positive under high levels of transformational leadership, rather than low levels of transformational leadership. Based on the COR theory, this is the first study to argue that knowledge sharing could be considered as an active activity and that individuals could be eager to perform knowledge sharing when they possess significant personal and external resources. The results of this study provide new insights into knowledge sharing. Full article

(This article belongs to the Special Issue Occupational Health Psychology)

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18 pages, 880 KiB

Open AccessFeature PaperReview

A Report on Smoking Detection and Quitting Technologies

by Alessandro Ortis, Pasquale Caponnetto, Riccardo Polosa, Salvatore Urso and Sebastiano Battiato

Int. J. Environ. Res. Public Health 2020, 17(7), 2614; https://doi.org/10.3390/ijerph17072614 - 10 Apr 2020

Cited by 24 | Viewed by 8363

Abstract

Mobile health technologies are being developed for personal lifestyle and medical healthcare support, of which a growing number are designed to assist smokers to quit. The potential impact of these technologies in the fight against smoking addiction and on improving quitting rates must [...] Read more.

Mobile health technologies are being developed for personal lifestyle and medical healthcare support, of which a growing number are designed to assist smokers to quit. The potential impact of these technologies in the fight against smoking addiction and on improving quitting rates must be systematically evaluated. The aim of this report is to identify and appraise the most promising smoking detection and quitting technologies (e.g., smartphone apps, wearable devices) supporting smoking reduction or quitting programs. We searched PubMed and Scopus databases (2008-2019) for studies on mobile health technologies developed to assist smokers to quit using a combination of Medical Subject Headings topics and free text terms. A Google search was also performed to retrieve the most relevant smartphone apps for quitting smoking, considering the average user’s rating and the ranking computed by the search engine algorithms. All included studies were evaluated using consolidated criteria for reporting qualitative research, such as applied methodologies and the performed evaluation protocol. Main outcome measures were usability and effectiveness of smoking detection and quitting technologies supporting smoking reduction or quitting programs. Our search identified 32 smoking detection and quitting technologies (12 smoking detection systems and 20 smoking quitting smartphone apps). Most of the existing apps for quitting smoking require the users to register every smoking event. Moreover, only a restricted group of them have been scientifically evaluated. The works supported by documented experimental evaluation show very high detection scores, however the experimental protocols usually lack in variability (e.g., only right-hand patients, not natural sequence of gestures) and have been conducted with limited numbers of patients as well as under constrained settings quite far from real-life use scenarios. Several recent scientific works show very promising results but, at the same time, present obstacles for the application on real-life daily scenarios. Full article

(This article belongs to the Special Issue Cyber Health Psychology and Psychotherapy: The Use of New Technologies in the Service of Mental Health)

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14 pages, 812 KiB

Open AccessArticle

What Are the Current Audiological Practices for Ototoxicity Assessment and Management in the South African Healthcare Context?

by Katijah Khoza-Shangase and Nothando Masondo

Int. J. Environ. Res. Public Health 2020, 17(7), 2613; https://doi.org/10.3390/ijerph17072613 - 10 Apr 2020

Cited by 12 | Viewed by 4103

Abstract

The study was an initial exploration of the current ototoxicity assessment and management practices by audiologists in South Africa. An exploratory survey research methodology through a cross-sectional research design was adopted where audiologists were recruited from professional associations’ databases in South Africa, using [...] Read more.

The study was an initial exploration of the current ototoxicity assessment and management practices by audiologists in South Africa. An exploratory survey research methodology through a cross-sectional research design was adopted where audiologists were recruited from professional associations’ databases in South Africa, using specific inclusion criteria. The study made use of an 18-item web-based survey guided by the Health Professions Council of South Africa (HPCSA) (2018) guidelines which were developed from reviewing international guidelines such as the American Speech-Language-Hearing Association (ASHA,1994) and the American Academy of Audiology (AAA, 2009). The study surveyed 31 audiologists from across the country. Data were analyzed through descriptive statistics. Findings implied significant gaps between knowledge and translation of this knowledge into practice. Over two thirds of the participants engage with ototoxicity monitoring and management, but the practices adopted by them do not align with international standards nor with the national HPCSA guidelines on assessment and management of patients on ototoxic medications. Most participants do not conduct baseline assessments, and the frequency of monitoring is irregular and reduced from the recommended; thus influencing ability for early detection and intervention of ototoxicity within this context. Non-standard assessment battery is used for assessment and monitoring, raising questions about the reliability and validity of the data used to make preventive treatment decisions. Lack of collaborative work between audiologists and the rest of the clinical team involved in the treatment of patients on ototoxic medications was found to be an important contributing factor to the less than optimal ototoxicity management practices. Of factors potentially influencing adherence to guidelines, the institution of employment, specifically employment in a tuberculosis hospital, seemed to have a positive influence, possibly due to the focused nature of the audiologists’ scope of practice there as well as availability of resources. The level of education appeared to have no influence. Current findings provide contextually relevant evidence on ototoxicity assessment and management within this context. They raise important implications for guidelines adherence and translating knowledge, policies and guidelines into practice, clinical assessment and management protocols followed, appropriate resource allocation per programme, as well as strategic planning for national ototoxicity assessment and management programmes in context. The findings also raise important implications for low- and middle-income countries, in terms of adopting international guidelines without considering context. Full article

(This article belongs to the Special Issue Environmental Exposures and Hearing Loss)

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9 pages, 361 KiB

Open AccessArticle

Infant Cranial Deformity: Cranial Helmet Therapy or Physiotherapy?

by Josefa González-Santos, Jerónimo J. González-Bernal, Raquel De-la-Fuente Anuncibay, Raúl Soto-Cámara, Esther Cubo, José M. Aguilar-Parra, Rubén Trigueros and Remedios López-Liria

Int. J. Environ. Res. Public Health 2020, 17(7), 2612; https://doi.org/10.3390/ijerph17072612 - 10 Apr 2020

Cited by 19 | Viewed by 6617

Abstract

Objective: To compare cranial helmet therapy (CHT) and physiotherapy (PT) for the effective treatment of positional plagiocephaly in infants in terms of improving functional recovery. Methods: This was a prospective cohort study involving 48 infants between 5–10 months of age with cranial [...] Read more.

Objective: To compare cranial helmet therapy (CHT) and physiotherapy (PT) for the effective treatment of positional plagiocephaly in infants in terms of improving functional recovery. Methods: This was a prospective cohort study involving 48 infants between 5–10 months of age with cranial deformities. The Cranial Vault Asymmetry Index (CVAI) and the Brunet–Lezine scale were calculated at the initiation of the study and after 40 treatment sessions. Results: The infants’ first assessment showed a delay in overall development areas with a global developmental quotient (DQ) (posture, coordination, sociability, and language) of 80.15. Although developmental improvements were observed in both groups in the Brunet–Lezine scale after treatment, the MANCOVA test showed no significant differences (F(5) = 0.82, p = 0.506, eta² = 0.09). The CVAI reduced to 4.07% during the final evaluation in the cranial helmet group and 5.85% in the physiotherapy group without any significant differences between the two therapies (p = 0.70). Conclusions: No statistically significant differences were found between CHT and PT. After treatment, improvements from baseline measurements were observed in each of the readings of cranial deformity. Full article

(This article belongs to the Section Health Care Sciences & Services)

13 pages, 617 KiB

Open AccessArticle

The Joint Effects of Some Beverages Intake and Smoking on Chronic Obstructive Pulmonary Disease in Korean Adults: Data Analysis of the Korea National Health and Nutrition Examination Survey (KNHANES), 2008–2015

by Ji Eun Min, Da-An Huh and Kyong Whan Moon

Int. J. Environ. Res. Public Health 2020, 17(7), 2611; https://doi.org/10.3390/ijerph17072611 - 10 Apr 2020

Cited by 10 | Viewed by 3459

Abstract

Some beverages and smoking cause an inflammatory response in the lungs and airways in a similar way, ultimately affecting chronic obstructive pulmonary disease (COPD) occurrence. Using a nationally representative health survey database, this study investigates the individual and joint effects of consumption of [...] Read more.

Some beverages and smoking cause an inflammatory response in the lungs and airways in a similar way, ultimately affecting chronic obstructive pulmonary disease (COPD) occurrence. Using a nationally representative health survey database, this study investigates the individual and joint effects of consumption of different beverages and smoking on COPD. This study is a cross-sectional analysis of 15,961 Korean adults in the Korea National Health and Nutritional Examination Survey of 2008–2015. COPD was defined as forced expiratory volume in 1 s (FEV₁) divided by forced vital capacity (FVC) <0.70. We used multiple linear and logistic regression models to examine the association of beverage consumption and smoking with an FEV₁/FVC ratio and odds ratio (OR) for COPD. The mean FEV₁/FVC ratio decreased with increasing soda intake (p = 0.016), coffee intake (p = 0.031), and smoking status; however, the mean FEV₁/FVC ratio increased with increasing green tea intake frequency (p = 0.029). When soda intake increased to 10 times/month, the OR of having COPD increased to 1.04 times (95% CI: 1.01, 1.07). The positive joint effect of soda intake and smoking on COPD was marginally significant (p = 0.058). We found that soda intake, coffee intake, and smoking increased airflow limitation while green tea intake decreased it. In addition, soda intake and smoking had a positive joint effect on COPD in the Korean population. Full article

(This article belongs to the Section Public Health Statistics and Risk Assessment)

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7 pages, 272 KiB

Open AccessEditorial

Substance Abuse and Public Health: A Multilevel Perspective and Multiple Responses

by T. Wing Lo, Jerf W. K. Yeung and Cherry H. L. Tam

Int. J. Environ. Res. Public Health 2020, 17(7), 2610; https://doi.org/10.3390/ijerph17072610 - 10 Apr 2020

Cited by 28 | Viewed by 16929

Abstract

Substance abuse has been a thorny public health concern throughout human history. Manifestly, prevention and treatment are the two main strategies commonly adopted to tackle the problem of substance abuse. They are in fact cross-disciplinary, and they relate to the various domains of [...] Read more.

Substance abuse has been a thorny public health concern throughout human history. Manifestly, prevention and treatment are the two main strategies commonly adopted to tackle the problem of substance abuse. They are in fact cross-disciplinary, and they relate to the various domains of heredity, biology, psychology, cognitive science, family, social development and cultural structures. This special issue, “Substance Abuse, Environment and Public Health,” has published empirical studies from different regions and countries globally to enhance the international exchange of latest views and findings on the etiology, processes and influences of substance abuse across different domains, through which a multilevel perspective is considered more helpful for analyzing its complex nature, courses and consequences. This in turn suggests the possible need to employ multiple responses dynamically and integratively in the prevention and treatment of substance abuse. Full article

(This article belongs to the Special Issue Substance Abuse, Environment and Public Health)

17 pages, 3500 KiB

Open AccessArticle

Regional Aquifer Vulnerability and Pollution Sensitivity Analysis of Drastic Application to Dahomey Basin of Nigeria

by Saheed Adeyinka Oke

Int. J. Environ. Res. Public Health 2020, 17(7), 2609; https://doi.org/10.3390/ijerph17072609 - 10 Apr 2020

Cited by 27 | Viewed by 3830

Abstract

Shallow groundwater vulnerability mapping of the southwestern Nigeria sedimentary basin was assessed in this study with the aim of developing a regional-based vulnerability map for the area based on assessing the intrinsic ability of the aquifer overlying beds to filter and degrade migrating [...] Read more.

Shallow groundwater vulnerability mapping of the southwestern Nigeria sedimentary basin was assessed in this study with the aim of developing a regional-based vulnerability map for the area based on assessing the intrinsic ability of the aquifer overlying beds to filter and degrade migrating pollutant. The mapping includes using the established seven parameter-based DRASTIC vulnerability methodology. Furthermore, the developed vulnerability map was subjected to sensitivity analysis as a validation approach. This approach includes single-parameter sensitivity, map removal sensitivity, and DRASTIC parameter correlation analysis. Of the Dahomey Basin, 21% was classified as high-vulnerability and at risk of pollution, 61% as moderate vulnerability, and 18% as low vulnerability. Low vulnerability areas of the basin are characterised by thick vadose zones, low precipitation, compacted soils, high slopes, and high depth to groundwater. High-vulnerability areas which are prone to pollution are regions closer to the coast with flat slopes and frequent precipitation. Sensitivity of the vulnerability map show the greatest impact with the removal of topography, soil media, and depth to groundwater and least impact with the removal of the vadose zone. Due to the subjectivity of the DRASTIC method, the most important single parameter affecting the rating system of the Dahomey Basin DRASTIC map is the impact of the vadose zone, followed by the net recharge and hydraulic conductivity. The DRASTIC vulnerability map can be useful in planning and siting activities that generate pollutants (e.g., landfill, soak away, automobile workshops, and petrochemical industries) which pollute the environment, groundwater, and eventually impact the environmental health of the Dahomey Basin’s inhabitants. Full article

(This article belongs to the Special Issue Understanding and Responding to Aquifer Vulnerability and Associated Health Risks)

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18 pages, 305 KiB

Open AccessArticle

I Am a Nursing Student but Hate Nursing: The East Asian Perspectives between Social Expectation and Social Context

by Luis Miguel Dos Santos

Int. J. Environ. Res. Public Health 2020, 17(7), 2608; https://doi.org/10.3390/ijerph17072608 - 10 Apr 2020

Cited by 21 | Viewed by 5761

Abstract

From the East Asian social and cultural perspectives and contexts, this study aimed to understand the relationships and behaviors between nursing students’ sense of filial piety and their decision-making behind selecting nursing education as their major. Forty-two traditional-age nursing students (i.e., six men [...] Read more.

From the East Asian social and cultural perspectives and contexts, this study aimed to understand the relationships and behaviors between nursing students’ sense of filial piety and their decision-making behind selecting nursing education as their major. Forty-two traditional-age nursing students (i.e., six men and 36 women) at their final year of a bachelor’s degree program in nursing were invited. The findings indicated that many nursing students disliked their university major and the potential career pathway as a nursing professional, as none of them selected the major based on their choice and interest. The environmental context and family’s recommendations were the major impacts to influence the decision-making process of the participants. The result also indicated that filial piety, parents’ recommendations, and elderly people’s suggestions were the key factors to influence the selections and decisions of university major and career development pathways. The study provided a blueprint for related staff and professionals to create and design career counselling and services for East Asian youths to enable life investment and development. Full article

(This article belongs to the Special Issue Nursing and Society)

18 pages, 4350 KiB

Open AccessArticle

Distribution and Behaviour of Some Trace Elements as a Function of Apple Varieties in Northeastern Romania

by Ionuţ-Mihai Prundeanu, Ciprian Chelariu, Sorin-Ionuț Balaban and Ovidiu-Gabriel Iancu

Int. J. Environ. Res. Public Health 2020, 17(7), 2607; https://doi.org/10.3390/ijerph17072607 - 10 Apr 2020

Cited by 6 | Viewed by 3266

Abstract

The levels and distribution of 9 trace elements in apples from two orchards in north-east (NE) Romania were measured by means of Atomic Absorption Spectroscopy (AAS) on 42 samples of 9 different apple varieties, with average content ranges of 0.909–4.458 mg·kg⁻¹ Zn, [...] Read more.

The levels and distribution of 9 trace elements in apples from two orchards in north-east (NE) Romania were measured by means of Atomic Absorption Spectroscopy (AAS) on 42 samples of 9 different apple varieties, with average content ranges of 0.909–4.458 mg·kg⁻¹ Zn, 0.055–0.409 mg·kg⁻¹ Cu, 0.700–2.476 mg·kg⁻¹ Fe, 0.328–0.695 mg·kg⁻¹ Mn, 0.054–0.257 mg·kg⁻¹ Ni, 0.005–0.101 mg·kg⁻¹ Cr, 0.027–0.420 mg·kg⁻¹ Co, 0.413–1.149 mg·kg⁻¹ Pb, and 0.025–0.127 mg·kg⁻¹ Cd. For some apple varieties, Pb contents are 2 times higher than the maximum contents allowed according to national standards, Cd contents are 6 times higher, and in some cases Zn contents also exceed the national threshold, showing preferential accumulation on specific apple varieties. Whilst some research has been carried out on trace element distribution in apples, this study assessed the areal distribution of toxic trace elements in connection to the adjacent roads. The first apple orchard is located near a county road, with reduced car traffic, while the second orchard shares its southern limit with a high-volume traffic road (E583). The results point towards a proportional increase of Pb and, to some extent, of Cd in the samples close to the E583 road in contrast with the other orchard, where no such observation derived. Along the areal distribution of the selected elements, the preferential accumulation of dietary recommended trace elements in different apple varieties was assessed. In matters of daily nutrients content in trace elements, the best sources of Fe, Cu, and Zn in terms of apple varieties are Golden Delicious, Jonathan, and Kaltherer Böhmer. Full article

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18 pages, 451 KiB

Open AccessArticle

SettleIN: Using a Manualised Intervention to Facilitate the Adjustment of Older Adults with Dementia Following Placement into Residential Care

by Caroline A Saint-Bryant, Judy Murrill, Janine K Hayward, Kayleigh-Marie Nunez and Aimee Spector

Int. J. Environ. Res. Public Health 2020, 17(7), 2606; https://doi.org/10.3390/ijerph17072606 - 10 Apr 2020

Cited by 6 | Viewed by 2962

Abstract

The authors examined the feasibility of delivering an adapted version of SettleIN, a manualised staff-led programme designed to facilitate adjustment to care for new residents with dementia. The effects of SettleIN on resident adjustment, mood and quality of life were also investigated. A [...] Read more.

The authors examined the feasibility of delivering an adapted version of SettleIN, a manualised staff-led programme designed to facilitate adjustment to care for new residents with dementia. The effects of SettleIN on resident adjustment, mood and quality of life were also investigated. A pilot randomised controlled trial was conducted. Nineteen new residents with dementia and 21 staff participants were recruited. Residents were randomly assigned to receive the SettleIN programme or residential care as usual. Resident quality of life, mood and overall adjustment were measured at baseline and post-intervention, in week seven. Interviews were conducted with staff in week seven to explore intervention feasibility. Despite medium to large effect sizes, there was no significant difference in mean change scores between the two conditions, with regards to quality of life, psychological wellbeing or overall adjustment outcomes. Qualitative feedback indicated that SettleIN was not feasible across all areas, with problems around recruitment and practicality. However, SettleIN was deemed feasible in terms of retention and acceptability among staff. The majority of staff felt that SettleIN was beneficial for residents but that organisational and programme factors impacted upon intervention feasibility. Further exploration of organisational barriers is needed in order to reduce the impact of such factors on care home research. Full article

(This article belongs to the Special Issue Enhancing the Quality of Care in Long-Term Care Settings)

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11 pages, 960 KiB

Open AccessArticle

Placement of Outdoor Exercise Equipment and Physical Activity: A Quasi-Experimental Study in Two Parks in Southern California

by Mojgan Sami, Megan Smith and Oladele A. Ogunseitan

Int. J. Environ. Res. Public Health 2020, 17(7), 2605; https://doi.org/10.3390/ijerph17072605 - 10 Apr 2020

Cited by 10 | Viewed by 4966

Abstract

To reduce the burden of chronic disease, the Centers for Disease Control and Prevention (CDC) funded the Orange County Partnerships to Improve Health (OC-PICH) project in Orange County, California. One of the strategies included adding outdoor exercise equipment (OEE) in two parks in [...] Read more.

To reduce the burden of chronic disease, the Centers for Disease Control and Prevention (CDC) funded the Orange County Partnerships to Improve Health (OC-PICH) project in Orange County, California. One of the strategies included adding outdoor exercise equipment (OEE) in two parks in Garden Grove and Anaheim. Using a quasi-experimental pre-post design, we evaluated park users’ physical activity levels before and after OEE installation using the System for Observing Play and Recreation in Communities (SOPARC). The OEE was installed along a walking path in Edison Park (Anaheim) and grouped within a single area (a “fitness zone”) in Garden Grove Park. In both parks, there were significantly greater odds of high-intensity physical activity overall after the installation—19% higher odds in Anaheim, and 23% higher odds in Garden Grove. However, the fitness zone area in Garden Grove had substantially higher odds of increased physical activity post-intervention (OR = 5.29, CI: 3.76–7.44, p < 0.001). While the increases in physical activity levels are consistent with past studies that link OEE to higher levels of physical activity among park users, our findings also suggest that the location and placement of equipment within a park may be an important factor to consider when improving park amenities for physical activity. Full article

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8 pages, 454 KiB

Open AccessArticle

Selected Physicochemical Properties of Saliva in Menopausal Women—A Pilot Study

by Aleksandra Cydejko, Aida Kusiak, Magdalena Emilia Grzybowska, Barbara Kochańska, Jolanta Ochocińska, Adrian Maj and Dariusz Świetlik

Int. J. Environ. Res. Public Health 2020, 17(7), 2604; https://doi.org/10.3390/ijerph17072604 - 10 Apr 2020

Cited by 8 | Viewed by 3213

Abstract

The aim of this study was to estimate differences in selected physicochemical properties of saliva between menopausal and premenopausal women. Methods: The study population consisted of 9 menopausal women and 15 women of the control group. Laboratory tests included the determination of pH [...] Read more.

The aim of this study was to estimate differences in selected physicochemical properties of saliva between menopausal and premenopausal women. Methods: The study population consisted of 9 menopausal women and 15 women of the control group. Laboratory tests included the determination of pH saliva, salivary flow rate, and concentrations of lactoferrin, lysozyme, immunoglobulin A, and ionized calcium. Results: Among menopausal women, statistically significant differences were observed in values of salivary flow rate and lysozyme and ionized calcium concentrations; however, no statistically significant differences for pH and concentrations of lactoferrin and immunoglobulin A were found. The salivary flow rate in the study group was significantly lower compared to that in premenopausal women. In relation to lysozyme, statistically significant differences were found between control group and menopausal women to the disadvantage of the latter. However, the concentration of ionized calcium in the saliva of menopausal women was distinctly higher than in the saliva of the control group. Conclusion: The saliva of menopausal women appeared significantly different from that of the control group. Differences in physicochemical parameters such as salivary flow rate and lysozyme and ionized calcium concentrations were observed. These differences in saliva properties observed in menopause can potentially affect the oral environment of women in this particular period, possibly increasing the risk of some pathological changes in the oral cavity and consequently indicating the need to take special care of this group of female patients in order to help them maintain proper oral health. Dentists and gynecologists should be aware of the problems associated with menopause and need to provide these women complete health care, including dental care as an integral part. Full article

(This article belongs to the Section Oral Health)

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14 pages, 317 KiB

Open AccessArticle

Using the Health Literacy Questionnaire (HLQ) with Providers in the Early Intervention Setting: A Qualitative Validity Testing Study

by Catherine J. Leslie, Melanie Hawkins and Diane L. Smith

Int. J. Environ. Res. Public Health 2020, 17(7), 2603; https://doi.org/10.3390/ijerph17072603 - 10 Apr 2020

Cited by 9 | Viewed by 7160

Abstract

More than one in four parents in the United States of America (USA) have low health literacy, which is associated with reduced health equity and negatively impacts child health outcomes. Early intervention (EI) programs are optimally placed to build the health literacy capacity [...] Read more.

More than one in four parents in the United States of America (USA) have low health literacy, which is associated with reduced health equity and negatively impacts child health outcomes. Early intervention (EI) programs are optimally placed to build the health literacy capacity of caregivers, which could improve health equity. The health literacy of interdisciplinary EI providers has not previously been measured. This study used the Health Literacy Questionnaire (HLQ) with EI providers (n = 10) to investigate evidence based on response (cognitive) processes. Narratives from cognitive interviews gave reasons for HLQ score choices, and concordance and discordance between HLQ item intent descriptions and narrative data were assessed using thematic analysis. Results found scales with highest concordance for Scales 3, 6, and 9 (each 96%, n = 24). Concordance was lowest on Scale 5 (88%, n = 22), although still strong with only 12% discordance. Three themes reflecting discordance were identified: (1) Differences between Australian and USA culture/health systems; (2) Healthcare provider perspective; and (3) Participants with no health problems to manage. Results show strong concordance between EI providers’ narrative responses and item intents. Study results contribute validity evidence for the use of HLQ data to inform interventions that build health literacy capacity of EI providers to then empower and build the health literacy of EI parents. Full article

(This article belongs to the Special Issue Health Literacy and Equity – Interdisciplinary Perspectives and Recent Trends in Health Literacy Research and Action around the World)

14 pages, 355 KiB

Open AccessArticle

Factors Associated with Utilization of Primary and Specialist Healthcare Services by Elderly Cardiovascular Patients in the Republic of Serbia: A Cross-Sectional Study from the National Health Survey 2013

by Andrija Grustam, Aleksandra Jovic Vranes, Ivan Soldatovic, Predrag Stojicic and Zorana Jovanovic Andersen

Int. J. Environ. Res. Public Health 2020, 17(7), 2602; https://doi.org/10.3390/ijerph17072602 - 10 Apr 2020

Cited by 6 | Viewed by 3020

Abstract

The European Health Interview Survey (EHIS) is run every 5 years to examine how people experience and rank their health, how they care about their health, and to what extent they use the healthcare services. We identified the sub-population of special interest, i.e., [...] Read more.

The European Health Interview Survey (EHIS) is run every 5 years to examine how people experience and rank their health, how they care about their health, and to what extent they use the healthcare services. We identified the sub-population of special interest, i.e., cardiovascular disease (CVD) patients older than 65 years, in this cross-sectional study from the Serbian national survey of population health (2568 persons from a total of 15,999 subjects surveyed). We performed univariable and multivariable logistic regression analysis to assess the correlation between the healthcare system utilization and identified demographic, geographic, socio-economic, and self-rated factors. The most important factor for the utilization of the primary and the specialist healthcare services by elderly CVD patients is the region where one lives (Southern and Eastern Serbia OR = 2.44, 95% CI = 1.58–3.77/Belgrade OR = 1.75, 95% CI = 1.32–2.30). Age is another factor, where the 65 to 74 years old CVD patients utilize healthcare services the most. Higher education (OR = 1.80, 95% CI = 1.31–2.47), being a part of the highest Wealth Index group (OR = 1.62, 95% CI = 1.10–2.40), having very poor health status (OR = 3.02, 95% CI = 1.41–6.47), and presence of long-term illness (OR = 1.49, 95% CI = 1.16–1.92), play an important role in the utilization of the specialist care only. Full article

12 pages, 1027 KiB

Open AccessArticle

Effects of Aerobic-, Anaerobic- and Combined-Based Exercises on Plasma Oxidative Stress Biomarkers in Healthy Untrained Young Adults

by Achraf Ammar, Khaled Trabelsi, Omar Boukhris, Jordan M Glenn, Nick Bott, Liwa Masmoudi, Ahmed Hakim, Hamdi Chtourou, Tarak Driss, Anita Hoekelmann and Kais El Abed

Int. J. Environ. Res. Public Health 2020, 17(7), 2601; https://doi.org/10.3390/ijerph17072601 - 10 Apr 2020

Cited by 35 | Viewed by 6137

Abstract

Currently, it is well accepted that physical exercise-induced oxidative stress may damage biological structures and impair cellular functions. However, it is still unclear which type of exercise results in the greatest oxidative stress responses among a healthy untrained population. The aim of the [...] Read more.

Currently, it is well accepted that physical exercise-induced oxidative stress may damage biological structures and impair cellular functions. However, it is still unclear which type of exercise results in the greatest oxidative stress responses among a healthy untrained population. The aim of the present study was to compare the acute oxidative stress response (i.e., 0 to 20 min) following different types of exercise (anaerobic, aerobic, and combined). Ten healthy, untrained males (19.5 ± 1.7 years) performed three randomized exercise bouts: anaerobic (30 s Wingate test), aerobic (30 min at 60% maximal aerobic power (MAP)) or combined (anaerobic and aerobic). Venous blood samples were collected before, as well as at 0 (P0), 5 (P5), 10 (P10), and 20 (P20) min after each session. Rates of malondialdehyde (MDA) and antioxidant activities (i.e., glutathione peroxidase (GPX), superoxide dismutase (SOD), glutathione reductase (GR), α-tocopherol, and total antioxidant status (TAS)) were assessed. Independent of exercise type, plasma MDA, GPX, SOD, and GR contents increased above baseline, whereas plasma α-tocopherol decreased under baseline after the test sessions (p < 0.05). Aerobic and anaerobic exercises generated faster responses (at P0) when compared to the combined exercise (P5 to P10) for the majority of the tested parameters. Plasma TAS content only increased following the aerobic exercise at P10 (p = 0.03). Five to twenty-minutes post exercise, the highest MDA response was registered in the aerobic condition, and the highest GPX and SOD responses were recorded in the anaerobic (at P5) and aerobic (at P20) conditions (p < 0.05). In conclusion, aerobic, anaerobic, or combined exercises have the potential to acutely increase oxidative stress and antioxidant activities, but with different responses magnitude. These findings confirm that oxidative stress response seems to be dependent on the intensity and the duration of the physical exercise and may help in understanding how varying exercise bouts influence the degree of oxidative stress among healthy untrained young adults. Full article

(This article belongs to the Special Issue Sports and Health)

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10 pages, 1638 KiB

Open AccessArticle

Predicted Future Mortality Attributed to Increases in Temperature and PM₁₀ Concentration under Representative Concentration Pathway Scenarios

by Jiyun Jung, Jae Young Lee, Hyewon Lee and Ho Kim

Int. J. Environ. Res. Public Health 2020, 17(7), 2600; https://doi.org/10.3390/ijerph17072600 - 10 Apr 2020

Cited by 6 | Viewed by 2702

Abstract

As climate change progresses, understanding the impact on human health associated with the temperature and air pollutants has been paramount. However, the predicted effect on temperature associated with particulate matter (PM₁₀) is not well understood due to the difficulty in predicting [...] Read more.

As climate change progresses, understanding the impact on human health associated with the temperature and air pollutants has been paramount. However, the predicted effect on temperature associated with particulate matter (PM₁₀) is not well understood due to the difficulty in predicting the local and regional PM₁₀. We compared temperature-attributable mortality for the baseline (2003–2012), 2030s (2026–2035), 2050s (2046–2055), and 2080s (2076–2085) based on a distributed lag non-linear model by simultaneously considering assumed levels of PM₁₀ on historical and projected temperatures under representative concentration pathway (RCP) scenarios. The considered projected PM₁₀ concentrations of 35, 50, 65, 80, and 95 μg/m³ were based on historical concentration quantiles. Our findings confirmed greater temperature-attributable risks at PM₁₀ concentrations above 65 μg/m³ due to the modification effect of the pollutants on temperature. In addition, this association between temperature and PM₁₀ was higher under RCP8.5 than RCP4.5. We also confirmed regional heterogeneity in temperature-attributable deaths by considering PM₁₀ concentrations in South Korea with higher risks in heavily populated areas. These results demonstrated that the modification association of air pollutants on health burdens attributable to increasing temperatures should be considered by researchers and policy makers. Full article

(This article belongs to the Section Climate Change)

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11 pages, 899 KiB

Open AccessArticle

Effectiveness of a Flexible and Continuous Case Management Program for Suicide Attempters

by Min-Hyuk Kim, Jinhee Lee, Hyunjean Noh, Jin-Pyo Hong, Hyun Kim, Yong Sung Cha, Joung-Sook Ahn, Sei-Jin Chang and Seongho Min

Int. J. Environ. Res. Public Health 2020, 17(7), 2599; https://doi.org/10.3390/ijerph17072599 - 10 Apr 2020

Cited by 2 | Viewed by 3480

Abstract

The purpose of this study was to investigate the effect of continuous case management with a flexible approach on the prevention of suicide by suicide reattempt in a real clinical setting. The subjects in this study were 526 suicide attempters who visited emergency [...] Read more.

The purpose of this study was to investigate the effect of continuous case management with a flexible approach on the prevention of suicide by suicide reattempt in a real clinical setting. The subjects in this study were 526 suicide attempters who visited emergency rooms in a teaching hospital in South Korea. Subjects were provided a continuous case management program with a flexible approach according to the severity of their suicide risk and needs. During the entire observation period (from 182 days to 855 days, mean = 572 ± 254), 18 patients (3.7%) died by suicide reattempt: Eight patients (2.27%) in the case management group and 10 patients (7.35%) in the no-case management group. The Cox regression analysis showed that the case management group had a 75% lower risk of death from suicide attempts than the no-case management group (HR = 0.34, 95% CI = 0.13–0.87). This result was shown to be more robust after adjusting for confounding factors such as gender, age, psychiatric treatment, suicide attempts, and family history of suicide (adjusted HR = 0.27, 95% CI = 0.09–0.83). This study was conducted in a single teaching hospital and not a randomized controlled one. A flexible and continuous case management program for suicide attempters is effective for preventing death by suicide reattempts. Full article

(This article belongs to the Special Issue Hospital and Primary Care-Presenting Self-Harm: Incidence, Management and Outcomes)

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8 pages, 265 KiB

Open AccessArticle

Survey Methods of the 2018 International Tobacco Control (ITC) Japan Survey

by Mary E. Thompson, Christian Boudreau, Anne C.K. Quah, Janine Ouimet, Grace Li, Mi Yan, Yumiko Mochizuki, Itsuro Yoshimi and Geoffrey T. Fong

Int. J. Environ. Res. Public Health 2020, 17(7), 2598; https://doi.org/10.3390/ijerph17072598 - 10 Apr 2020

Cited by 7 | Viewed by 4851

Abstract

This paper describes the methods of the Wave 1 (2018) International Tobacco Control (ITC) Japan Survey. The respondents were adults aged 20 years and older in one of four user groups: (1) cigarette-only smokers who smoked at least monthly and used heated tobacco [...] Read more.

This paper describes the methods of the Wave 1 (2018) International Tobacco Control (ITC) Japan Survey. The respondents were adults aged 20 years and older in one of four user groups: (1) cigarette-only smokers who smoked at least monthly and used heated tobacco products (HTPs) not at all or less than weekly, (2) HTP-only users who used HTPs at least weekly and smoked cigarettes not at all or less than monthly, (3) cigarette-HTP dual users who smoked at least monthly and used HTPs at least weekly, and (4) non-users who had never smoked or who smoked less than monthly and used HTPs less than weekly. Eligible respondents were recruited by a commercial survey firm from its online panel. Respondents were allocated proportionally to sample strata based on demographic, geographic, and user type specifications benchmarked to a national reference. Survey weights, accounting for smoking/HTP use status, sex, age, education, and geography, were calibrated to benchmarks from a nationally representative survey in Japan. Response rate was 45.1% and cooperation rate was 96.3%. The total sample size was 4615 (3288 cigarette smokers, 164 exclusive HTP users, 549 cigarette-HTP dual users, and 614 non-users). The 2018 ITC Japan Survey sampling design and survey data collection methods will allow analyses to examine prospectively the use of cigarettes and HTPs in Japan and factors associated with the use of both products and of transitions between them. Full article

(This article belongs to the Special Issue Japan: Evaluating the Effectiveness of Tobacco Control Policies and the Use of Heated Tobacco Products)

18 pages, 1947 KiB

Open AccessArticle

Effects of Changes in Acoustic and Non-Acoustic Factors on Public Health and Reactions: Follow-Up Surveys in the Vicinity of the Hanoi Noi Bai International Airport

by Thu Lan Nguyen, Bach Lien Trieu, Yasuhiro Hiraguri, Makoto Morinaga, Takashi Morihara and Takashi Yano

Int. J. Environ. Res. Public Health 2020, 17(7), 2597; https://doi.org/10.3390/ijerph17072597 - 10 Apr 2020

Cited by 13 | Viewed by 4130

Abstract

Herein, the effects of changes in acoustic and non-acoustic factors on public health and reactions were assessed using two follow-up investigations; this was achieved after three surveys were conducted on the impact of the step change in noise caused by the increased number [...] Read more.

Herein, the effects of changes in acoustic and non-acoustic factors on public health and reactions were assessed using two follow-up investigations; this was achieved after three surveys were conducted on the impact of the step change in noise caused by the increased number of flights at the Noi Bai International Airport in Hanoi (Vietnam) after the new terminal building was opened to the public. Exposure-response relationships established in the follow-up studies were less in number than those established in 2015 after the step change had occurred, and were almost similar to the relationship established in the survey conducted before the step change; however, these relationships were significantly greater than those established in the European Union position paper. Comparisons between respondents with high blood pressure and insomnia ratios at different noise level ranges showed that there is no significant association between ratios of high blood pressure and day-evening-night noise levels; however, an exposure-response relationship was discovered between insomnia and night-time noise levels. Non-acoustic factors such as noise sensitivity, sound insulation capacity of houses, and length of residence were found to curb the respondents’ annoyance, insomnia, and high blood pressure. Thus, an improvement in residence quality and a restriction on nighttime flight operation is necessitated. Full article

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13 pages, 867 KiB

Open AccessArticle

Strength plus Endurance Training and Individualized Diet Reduce Fat Mass in Overweight Subjects: A Randomized Clinical Trial

by Pedro J. Benito, Bricia López-Plaza, Laura M. Bermejo, Ana B. Peinado, Rocío Cupeiro, Javier Butragueño, Miguel A. Rojo-Tirado, Domingo González-Lamuño, Carmen Gómez-Candela and on behalf of the PRONAF Study Group

Int. J. Environ. Res. Public Health 2020, 17(7), 2596; https://doi.org/10.3390/ijerph17072596 - 10 Apr 2020

Cited by 6 | Viewed by 10573

Abstract

Studies with overweight people are a priority in order to observe the effect of the timing of intervention on pre-obesity people. The aim was to compare different physical activity programs plus an individualized hypocaloric diet on body composition in overweight subjects. A randomized [...] Read more.

Studies with overweight people are a priority in order to observe the effect of the timing of intervention on pre-obesity people. The aim was to compare different physical activity programs plus an individualized hypocaloric diet on body composition in overweight subjects. A randomized controlled clinical trial was carried out in overweight adults with no history of relevant illness. Primary outcome was total fat mass (TFM). Participants were allocated into four activity programs with equal intensity and volume of exercise for 22 weeks: strength training (S), endurance training (E), strength + endurance training (SE), and ‘adhering to physical activity recommendations’ (C). Participants followed a diet with 25% less energy (50%–55% carbohydrates, 30%–35% fat) measured by accelerometer. Variables were assessed at baseline and at the end of the intervention. Body composition was measured by dual-energy X-ray absorptiometry. One hundred nineteen from 205 subjects were randomized in the four exercise groups (S = 30/E = 30/SE = 30/C = 29) and 84 participants (36 men/48 women) ended the intervention (S = 19/E = 25/SE = 22/C = 18). At the end of the experiment, all groups except C increased their total physical activity (S = 1159 ± 1740; E = 1625 ± 1790; SE = 1699 ± 2516; C = 724 ± 1979 MET-min/week). Using an ANOVA-test, improvements were observed in body weight (S = −4.6 ± 4.5; E = −6.6 ± 4.6; SE = −8.5 ± 2.8; C = −6.1 ± 5.6 kg, p = 0.059) and TFM (S = −4.24 ± 2.02; E = −4.74 ± 2.96; SE = −6.74 ± 3.27; C = −3.94 ± 4.18%; p < 0.05). The main conclusion was that there were no adverse events. Strength and endurance training with a balanced, individualized hypocaloric diet was the most effective at reducing weight loss and fat mass in overweight subjects. Trial registration: NCT01116856. Full article

(This article belongs to the Special Issue Advances in Community Nutrition and Physical Exercise)

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13 pages, 2859 KiB

Open AccessArticle

Comparison of Bioelectrical Impedance Analysis and Dual Energy X-ray Absorptiometry for Total and Segmental Bone Mineral Content with a Three-Compartment Model

by Yu-San Liao, Hung-Chou Li, Hsueh-Kuan Lu, Chung-Liang Lai, Yue-Sheng Wang and Kuen-Chang Hsieh

Int. J. Environ. Res. Public Health 2020, 17(7), 2595; https://doi.org/10.3390/ijerph17072595 - 10 Apr 2020

Cited by 31 | Viewed by 4603

Abstract

Modern bioelectrical impedance analysis (BIA) provides a wide range of body composition estimates such as fat mass (FM), lean body mass (LBM), and body water, using specific algorithms. Assuming that the fat free mass (FFM) and LBM can be accurately estimated by the [...] Read more.

Modern bioelectrical impedance analysis (BIA) provides a wide range of body composition estimates such as fat mass (FM), lean body mass (LBM), and body water, using specific algorithms. Assuming that the fat free mass (FFM) and LBM can be accurately estimated by the 8-electrode BIA analyzer (BIA_8MF; InBody230, Biospace), the bone mineral content (BMC) may be calculated by subtracting the LBM from the FFM estimates based on the three-compartment (3C) model. In this cross-sectional study, 239 healthy Taiwanese adults (106 male and 133 female) aged 20–45 years were recruited for BIA and dual-energy X-ray absorptiometry (DXA) measurements of the whole body and body segments, with DXA as the reference. The results showed a high correlation between BIA_8MF and DXA in estimating total and segmental LBM, FM and percentage body fat (r = 0.909–0.986, 0.757–0.964, and 0.837–0.936, respectively). For BMC estimates, moderate to high correlations (r = 0.425–0.829) between the two methods were noted. The percentage errors and pure errors for BMC estimates between the methods ranged from 33.9% to 93.0% and from 0.159 kg to 0.969 kg, respectively. This study validated that BIA_8MF can accurately assesses LBM, FM and body fat percentage (BF%). However, the estimation of segmental BMC based on the difference between FFM and LBM in body segments may not be reliable by BIA_8MF. Full article

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14 pages, 1362 KiB

Open AccessArticle

Is the Random Forest Algorithm Suitable for Predicting Parkinson’s Disease with Mild Cognitive Impairment out of Parkinson’s Disease with Normal Cognition?

by Haewon Byeon

Int. J. Environ. Res. Public Health 2020, 17(7), 2594; https://doi.org/10.3390/ijerph17072594 - 10 Apr 2020

Cited by 34 | Viewed by 4765

Abstract

Because it is possible to delay the progression of dementia if it is detected and treated in an early stage, identifying mild cognitive impairment (MCI) is an important primary goal of dementia treatment. The objectives of this study were to develop a random [...] Read more.

Because it is possible to delay the progression of dementia if it is detected and treated in an early stage, identifying mild cognitive impairment (MCI) is an important primary goal of dementia treatment. The objectives of this study were to develop a random forest-based Parkinson’s disease with mild cognitive impairment (PD-MCI) prediction model considering health behaviors, environmental factors, medical history, physical functions, depression, and cognitive functions using the Parkinson’s Dementia Clinical Epidemiology Data (a national survey conducted by the Korea Centers for Disease Control and Prevention) and to compare the prediction accuracy of our model with those of decision tree and multiple logistic regression models. We analyzed 96 subjects (PD-MCI = 45; Parkinson’s disease with normal cognition (PD-NC) = 51 subjects). The prediction accuracy of the model was calculated using the overall accuracy, sensitivity, and specificity. Based on the random forest analysis, the major risk factors of PD-MCI were, in descending order of magnitude, Clinical Dementia Rating (CDR) sum of boxes, Untitled Parkinson’s Disease Rating (UPDRS) motor score, the Korean Mini Mental State Examination (K-MMSE) total score, and the K- Korean Montreal Cognitive Assessment (K-MoCA) total score. The random forest method achieved a higher sensitivity than the decision tree model. Thus, it is advisable to develop a protocol to easily identify early stage PDD based on the PD-MCI prediction model developed in this study, in order to establish individualized monitoring to track high-risk groups. Full article

(This article belongs to the Special Issue Prevention and Management of Frailty)

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20 pages, 2430 KiB

Open AccessArticle

Census Demographics and Chlorpyrifos Use in California’s Central Valley, 2011–15: A Distributional Environmental Justice Analysis

by Daniel J. Hicks

Int. J. Environ. Res. Public Health 2020, 17(7), 2593; https://doi.org/10.3390/ijerph17072593 - 10 Apr 2020

Cited by 7 | Viewed by 4005

Abstract

Chlorpyrifos, an acetylcholinesterase inhibitor (ACI), is one of the most widely used insecticides in the world, and is generally recognized to be a moderate human neurotoxin. This paper reports a distributional environmental justice (dEJ) analysis of chlorpyrifos use in California’s Central Valley, examining [...] Read more.

Chlorpyrifos, an acetylcholinesterase inhibitor (ACI), is one of the most widely used insecticides in the world, and is generally recognized to be a moderate human neurotoxin. This paper reports a distributional environmental justice (dEJ) analysis of chlorpyrifos use in California’s Central Valley, examining the way distributions of environmental risks are associated with race, ethnicity, class, gender, and other systems of structural oppression. Spatial data on chlorpyrifos use were retrieved from California’s Department of Pesticide Registration public pesticide use records for 2011–2015. These data were combined with demographic data for the Central Valley from the American Community Survey (ACS). Spatial regression models were used to estimate effects of demographic covariates on local chlorpyrifos use. A novel bootstrap method was used to account for measurement error in the ACS estimates. This study finds consistent evidence that Hispanic population proportion is associated with increased local chlorpyrifos use. A 10-point increase in Hispanic proportion is associated with an estimated 1.05–1.4-fold increase in local chlorpyrifos use across Census tract models. By contrast, effects of agricultural employment and poverty on local chlorpyrifos use are ambiguous and inconsistent between Census tracts and Census-designated places. Full article

(This article belongs to the Section Public Health Statistics and Risk Assessment)

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18 pages, 1980 KiB

Open AccessArticle

Effects of Using Immersive Media on the Effectiveness of Training to Prevent Ergonomics Risks

by Jose Antonio Diego-Mas, Jorge Alcaide-Marzal and Rocio Poveda-Bautista

Int. J. Environ. Res. Public Health 2020, 17(7), 2592; https://doi.org/10.3390/ijerph17072592 - 10 Apr 2020

Cited by 13 | Viewed by 4004

Abstract

In this work, the effects of using immersive media such as virtual reality on the performance of training programs to avoid ergonomics risks are analyzed. The advance of technology has made it possible to use low-cost portable devices able to generate highly immersive [...] Read more.

In this work, the effects of using immersive media such as virtual reality on the performance of training programs to avoid ergonomics risks are analyzed. The advance of technology has made it possible to use low-cost portable devices able to generate highly immersive experiences in training programs. The effects of using this kind of device in training programs have been studied in several fields such as industrial security, medicine and surgery, rehabilitation, or construction. However, there is very little research on the effects of using immersive media in training workers to avoid ergonomics risk factors. In this study, we compare the effects of using traditional and immersive media in a training program to avoid three common ergonomics risk factors in industrial environments. Our results showed that using immersive media increases the participant’s engagement during the training. In the same way, the learning contents are perceived as more interesting and useful and are better remembered over time, leading to an increased perception of the ergonomics risks among workers. However, we found that little training was finally transferred to the workplace three months after the training session. Full article

(This article belongs to the Special Issue Promotion of Healthy Work)

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12 pages, 1470 KiB

Open AccessReview

Is Heart Rate a Confounding Factor for Photoplethysmography Markers? A Systematic Review

by Md Rizman Md Lazin Md Lazim, Amilia Aminuddin, Kalaivani Chellappan, Azizah Ugusman, Adila A Hamid, Wan Amir Nizam Wan Ahmad and Mohd Shawal Faizal Mohamad

Int. J. Environ. Res. Public Health 2020, 17(7), 2591; https://doi.org/10.3390/ijerph17072591 - 10 Apr 2020

Cited by 11 | Viewed by 3909

Abstract

Finger photoplethysmography (PPG) waveform is blood volume change of finger microcirculation that reflects vascular function. Reflection index (RI), stiffness index (SI) and second derivative of photoplethysmogram (SDPPG) are derived from PPG waveforms proposed as cardiovascular disease (CVD) markers. Heart rate (HR) is a [...] Read more.

Finger photoplethysmography (PPG) waveform is blood volume change of finger microcirculation that reflects vascular function. Reflection index (RI), stiffness index (SI) and second derivative of photoplethysmogram (SDPPG) are derived from PPG waveforms proposed as cardiovascular disease (CVD) markers. Heart rate (HR) is a known factor that affects vascular function. Individual resting HR variation may affect RI, SI and SDPPG. This review aims to identify studies about the relationship between HR with RI, SI and SDPPG among humans. A literature search was conducted in Medline via the Ebscohost and Scopus databases to find relevant articles published within 11 years. The main inclusion criteria were articles in the English language that discuss the relationship between HR with RI, SI and SDPPG using PPG among humans. The search found 1960 relevant articles but only six articles that met the inclusion criteria. SI and RI showed an association with HR. SDPPG (SDPPG-b/SDPPG-a ratio, SDPPG-d/SDPPG-a ratio, aging index (AGI) and revised aging index (RAGI)) also had an association with HR. Only RI had a considerable association with HR, the association between SI and HR was non-considerable and the association between HR and SDPPG was inconclusive. Further interventional studies should be conducted to investigate this issue, as a variation in resting HR may challenge the validity of PPG-based CVD markers. Full article

(This article belongs to the Section Health Behavior, Chronic Disease and Health Promotion)

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19 pages, 946 KiB

Open AccessArticle

The Effect of Active Plus, a Computer-Tailored Physical Activity Intervention, on the Physical Activity of Older Adults with Chronic Illness(es)—A Cluster Randomized Controlled Trial

by Esmee Volders, Catherine A. W. Bolman, Renate H. M. de Groot, Peter Verboon and Lilian Lechner

Int. J. Environ. Res. Public Health 2020, 17(7), 2590; https://doi.org/10.3390/ijerph17072590 - 10 Apr 2020

Cited by 16 | Viewed by 4563

Abstract

eHealth interventions aimed at improving physical activity (PA) can reach large populations with few resources and demands on the population as opposed to centre-based interventions. Active Plus is a proven effective computer-tailored PA intervention for the older adult population focusing on PA in [...] Read more.

eHealth interventions aimed at improving physical activity (PA) can reach large populations with few resources and demands on the population as opposed to centre-based interventions. Active Plus is a proven effective computer-tailored PA intervention for the older adult population focusing on PA in daily life. This manuscript describes the effects of the Active Plus intervention (N = 260) on PA of older adults with chronic illnesses (OACI), compared to a waiting list control group (N = 325). It was part of a larger randomized controlled trial (RCT) on the effects of the Active Plus intervention on cognitive functioning. OACI (≥65 years) with at least one chronic illness were allocated to one of the conditions. Intervention group participants received PA advice. Baseline and follow-up measurements were assessed after 6 and 12 months. Intervention effects on objectively measured light PA (LPA) and moderate-to-vigorous PA (MVPA) min/week were analysed with multilevel linear mixed-effects models adjusted for the clustered design. Intervention effects on self-reported MVPA min/week on common types of PA were analysed with two-part generalized linear mixed-effects models adjusted for the clustered design. The dropout rate was 19.1% after 6 months and 25.1% after 12 months. Analyses showed no effects on objectively measured PA. Active Plus increased the likelihood to perform self-reported cycling and gardening at six months and participants who cycled increased their MVPA min/week of cycling. Twelve months after baseline the intervention increased the likelihood to perform self-reported walking and participants who cycled at 12 months increased their MVPA min/week of cycling. Subgroup analyses showed that more vulnerable participants (higher degree of impairment, age or body mass index) benefitted more from the intervention on especially the lower intensity PA outcomes. In conclusion, Active Plus only increased PA behaviour to a limited extent in OACI 6 and 12 months after baseline measurements. The Active Plus intervention may yet be not effective enough by itself in OACI. A blended approach, where this eHealth intervention and face-to-face contact are combined, is advised to improve the effects of Active Plus on PA in this target group. Full article

(This article belongs to the Special Issue Physical Exercise and Chronic Diseases Prevention)

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22 pages, 3774 KiB

Open AccessArticle

The Role of Green Building Materials in Reducing Environmental and Human Health Impacts

by Seyed Meysam Khoshnava, Raheleh Rostami, Rosli Mohamad Zin, Dalia Štreimikienė, Abbas Mardani and Mohammad Ismail

Int. J. Environ. Res. Public Health 2020, 17(7), 2589; https://doi.org/10.3390/ijerph17072589 - 10 Apr 2020

Cited by 74 | Viewed by 10052

Abstract

Conventional building materials (CBMs) made from non-renewable resources are the main source of indoor air contaminants, whose impact can extend from indoors to outdoors. Given their sustainable development (SD) prospect, green building materials (GBMs) with non-toxic, natural, and organic compounds have the potential [...] Read more.

Conventional building materials (CBMs) made from non-renewable resources are the main source of indoor air contaminants, whose impact can extend from indoors to outdoors. Given their sustainable development (SD) prospect, green building materials (GBMs) with non-toxic, natural, and organic compounds have the potential to reduce their overall impacts on environmental and human health. In this regard, biocomposites as GBMs are environmentally friendly, safe, and recyclable materials and their replacement of CBMs reduces environmental impacts and human health concerns. This study aims to develop a model of fully hybrid bio-based biocomposite as non-structural GBMs and compare it with fully petroleum-based composite in terms of volatile organic compound (VOC) emissions and human health impacts. Using a small chamber test (American Society for Testing and Materials (ASTM)-D5116) for VOC investigation and SimaPro software modeling with the ReCiPe method for evaluating human health impacts. Life cycle assessment (LCA) methodology is used, and the results indicate that switching the fully hybrid bio-based biocomposite with the fully petroleum-based composite could reduce more than 50% impacts on human health in terms of indoor and outdoor. Our results indicate that the usage of biocomposite as GBMs can be an environmentally friendly solution for reducing the total indoor and outdoor impacts on human health. Full article

(This article belongs to the Special Issue Indoor Air Quality and Health Outcomes in Energy-Efficient Buildings)

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19 pages, 777 KiB

Open AccessArticle

Cooperation as the Secret Ingredient in the Recipe to Foster Internal Technological Eco-Innovation in the Agri-Food Industry

by Adrián Rabadán, Ángela Triguero and Ángela Gonzalez-Moreno

Int. J. Environ. Res. Public Health 2020, 17(7), 2588; https://doi.org/10.3390/ijerph17072588 - 10 Apr 2020

Cited by 20 | Viewed by 4249

Abstract

Although eco-innovation in the agri-food sector is receiving increasing amounts of attention, there is a lack of information about the specific conditions that encourage firms to develop eco-innovation strategies internally. Our empirical method relies on the data of Spanish firms operating in the [...] Read more.

Although eco-innovation in the agri-food sector is receiving increasing amounts of attention, there is a lack of information about the specific conditions that encourage firms to develop eco-innovation strategies internally. Our empirical method relies on the data of Spanish firms operating in the agri-food sector, and uses the Qualitative Comparative Analysis (QCA). Specifically, we identify the recipes of antecedent conditions that effectively foster the internal development of technological eco-innovation, and then we analyze whether differences exist in the internal development of product and process eco-innovations. The results show that different combinations of conditions can yield internally developed eco-innovation, but all of them indicate that cooperation with stakeholders is the key to fostering technological eco-innovation in this industry. This conclusion encourages the creation of policies and incentives to promote cooperation in order to improve the sustainability of the sector. Full article

(This article belongs to the Special Issue Environmental Innovation in the Agri-Food Sector)

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12 pages, 451 KiB

Open AccessArticle

Accumulated Long-Term Exposure to Workplace Bullying Impairs Psychological Hardiness: A Five-Year Longitudinal Study among Nurses

by Kristina Vaktskjold Hamre, Ståle Valvatne Einarsen, Øystein Løvik Hoprekstad, Ståle Pallesen, Bjørn Bjorvatn, Siri Waage, Bente E. Moen and Anette Harris

Int. J. Environ. Res. Public Health 2020, 17(7), 2587; https://doi.org/10.3390/ijerph17072587 - 10 Apr 2020

Cited by 17 | Viewed by 6171

Abstract

Personality has been hypothesized to act as antecedent as well as an outcome of workplace bullying. Still, investigations on the longitudinal relationship between bullying and personality are scarce. We investigated the relationship between accumulated exposure to bullying at work and subsequent changes in [...] Read more.

Personality has been hypothesized to act as antecedent as well as an outcome of workplace bullying. Still, investigations on the longitudinal relationship between bullying and personality are scarce. We investigated the relationship between accumulated exposure to bullying at work and subsequent changes in psychological hardiness. Additionally, we examined whether hardiness predicted subsequent exposure to bullying. The data were based on the Survey of Shiftwork, Sleep, and Health (SUSSH), a cohort study with annual surveys among Norwegian nurses. The participants who completed standardized instruments measuring exposure to bullying behavior at T1 (2008/09) to T4 (2012) and psychological hardiness at T1 (2008/09) and T5 (2012) were included (n = 938). The results showed that accumulated exposure to bullying (sum of exposure from T1–T4) was associated with reduced psychological hardiness at T5, adjusted for age, sex, and hardiness at baseline (β = –0.16, t = –5.70, p < 0.001). Accumulated exposure to bullying behaviors explained 2.3% of the change in hardiness. Less hardy individuals experienced higher levels of subsequent exposure to bullying behaviors, adjusted for age, sex, and bullying at baseline (β = –0.04, t = –2.21 p < 0.05). Long-term accumulated exposure to bullying behaviors seemed to be a stronger predictor for changes in hardiness as compared to hardiness in predicting exposure to bullying. Full article

(This article belongs to the Special Issue Well-being, Mental Health and Prevention of Psychosocial Risks in Contemporary Working Life)

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11 pages, 613 KiB

Open AccessArticle

A Surrogate Model Based on Artificial Neural Network for RF Radiation Modelling with High-Dimensional Data

by Xi Cheng, Clément Henry, Francesco P. Andriulli, Christian Person and Joe Wiart

Int. J. Environ. Res. Public Health 2020, 17(7), 2586; https://doi.org/10.3390/ijerph17072586 - 9 Apr 2020

Cited by 5 | Viewed by 3898

Abstract

This paper focuses on quantifying the uncertainty in the specific absorption rate values of the brain induced by the uncertain positions of the electroencephalography electrodes placed on the patient’s scalp. To avoid running a large number of simulations, an artificial neural network architecture [...] Read more.

This paper focuses on quantifying the uncertainty in the specific absorption rate values of the brain induced by the uncertain positions of the electroencephalography electrodes placed on the patient’s scalp. To avoid running a large number of simulations, an artificial neural network architecture for uncertainty quantification involving high-dimensional data is proposed in this paper. The proposed method is demonstrated to be an attractive alternative to conventional uncertainty quantification methods because of its considerable advantage in the computational expense and speed. Full article

(This article belongs to the Special Issue Machine Learning, Stochastic Modelling and Applied Statistics for EMF Exposure Assessment)

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