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Int. J. Environ. Res. Public Health, Volume 19, Issue 4 (February-2 2022) – 580 articles

Cover Story (view full-size image): What information is hidden in road connections when predicting COVID-19 transmission? How soon would the first case of COVID-19 appear for a particular suburb, and how severe could this suburb be? A novel road-network-based approach is employed to answer these questions. In a road network, nodes represent suburbs, and edges represent the roads between suburbs. Four centrality measures are considered, and degree centrality stands out, which is proved to be statistically significant in predicting COVID-19 vulnerability and severity. Closeness centrality is also substantial in assessing vulnerability, and so is eigenvector centrality in determining severity. This study closely looks at the Delta variant of COVID-19 and hopefully could also aid in highly infectious diseases in the future. View this paper.
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12 pages, 474 KiB  
Article
New Method of Avoiding Underestimation of Caries Incidence and Its Association with Possible Risk Factors in Japanese University Students: A Prospective Cohort Study
by Daisuke Ekuni, Naoki Toyama, Yoshiaki Iwasaki and Manabu Morita
Int. J. Environ. Res. Public Health 2022, 19(4), 2490; https://doi.org/10.3390/ijerph19042490 - 21 Feb 2022
Cited by 2 | Viewed by 2559
Abstract
The objective of this three-year prospective cohort study was to investigate the association between a new definition of an increase in dental caries and risk factors in Japanese young adults. Data of Okayama University students who volunteered to undergo oral examinations and answer [...] Read more.
The objective of this three-year prospective cohort study was to investigate the association between a new definition of an increase in dental caries and risk factors in Japanese young adults. Data of Okayama University students who volunteered to undergo oral examinations and answer questionnaires in 2015 and 2018 were analyzed. The status of filled teeth and the status of occlusal/proximal surfaces of filled or decayed teeth were recorded. An increase in dental caries was defined as a change in the status of filled teeth and/or an increase in dental caries of occlusal and proximal surfaces. A total of 393 participants (18.2 ± 0.8 years) were analyzed. First and second molars showed a high prevalence of dental caries. Of the participants, 144 (36.6%) showed an increase in dental caries. In all the participants and in the females, the decayed, missing, and filled teeth (DMFT) score and history of orthodontic treatment at baseline were significantly associated with an increase in dental caries (p < 0.05) in logistic regression analyses. In the males, the DMFT score and the daily frequency of snacking (≥2) at baseline were significantly associated with an increase in dental caries (p = 0.04). The DMFT score and history of orthodontic treatment at baseline can be risk factors for an increase in dental caries using the new definition in young adults. Full article
(This article belongs to the Special Issue Advances in Oral Health and Health Promotion Research)
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9 pages, 313 KiB  
Brief Report
Pain Evaluation in the Paediatric Emergency Department: Differences in Ratings by Patients, Parents and Nurses
by Beata Rybojad, Daniel Sieniawski, Paweł Rybojad, Marzena Samardakiewicz and Anna Aftyka
Int. J. Environ. Res. Public Health 2022, 19(4), 2489; https://doi.org/10.3390/ijerph19042489 - 21 Feb 2022
Cited by 6 | Viewed by 3344
Abstract
The pain experienced by paediatric patients is rarely evaluated in emergency departments. The aim of the present study was to compare the degree of conformity in patients’ pain severity when assessed by themselves (if possible), their parents and a triage nurse trained in [...] Read more.
The pain experienced by paediatric patients is rarely evaluated in emergency departments. The aim of the present study was to compare the degree of conformity in patients’ pain severity when assessed by themselves (if possible), their parents and a triage nurse trained in pain evaluation. Methods: A cross-sectional observational study was conducted at a tertiary paediatric emergency department in Eastern Poland involving children (aged six months to eighteen years), their parents and nurses. The patients had their pain assessed while collecting a medical history. For children ≥ four years of age, the Numerical Rate Scale was used by patients, parents and nurses to evaluate pain. Patients under four years of age were evaluated by parents and nurses using the FLACC scale. Results: Eighty patients and their parents were enrolled in the study. For children ≥ four years, patients rated their pain significantly higher than both their parents (p = 0.03) and nurses (p < 0.001), with the latter group producing the lowest scores. For children under four years of age, parental pain assessments did not significantly differ from those of nurses. Conclusion: Compared to the patients themselves and their parents, nurses tended to assign lower pain scores for children. Pain should be assessed on admission to the ED and, whenever possible, by the patients themselves. Full article
(This article belongs to the Section Nursing)
10 pages, 335 KiB  
Article
Mental Health Status before and during the COVID-19 Pandemic in Patients First Visiting a Psychosomatic Internal Medicine Clinic in Tokyo, Japan
by Fumio Shaku, Motoko Ishiburo, Masako Miwa and Shuichiro Maruoka
Int. J. Environ. Res. Public Health 2022, 19(4), 2488; https://doi.org/10.3390/ijerph19042488 - 21 Feb 2022
Cited by 3 | Viewed by 2380
Abstract
The coronavirus disease (COVID-19) pandemic has aggravated anxiety and depression worldwide, particularly in patients with chronic illnesses and mental disorders. Using validated questionnaires, in this paper, we examine the psychological effects of the pandemic in Japan in detail. The General Mental Health Scale [...] Read more.
The coronavirus disease (COVID-19) pandemic has aggravated anxiety and depression worldwide, particularly in patients with chronic illnesses and mental disorders. Using validated questionnaires, in this paper, we examine the psychological effects of the pandemic in Japan in detail. The General Mental Health Scale (GHQ), the State–Trait Anxiety Inventory (STAI), and the Center for Epidemiologic Studies Depression Scale (CES-D) were used to assess mental health, state and trait anxiety, and depression, respectively. The survey was completed during the patients’ first visits to the clinic of Psychosomatic Internal Medicine from November 2018 to April 2021. The Mann–Whitney U test was used to compare data from 226 participants before and during the COVID-19 pandemic. The GHQ total, GHQ subscales of “social dysfunction” and “anxiety and dysphoria”, and state anxiety scores were significantly higher during than before the pandemic. The GHQ total, some GHQ subscales, and state anxiety scores were significantly higher among male than female participants during the pandemic. The GHQ total, some GHQ subscales, CES-D, and state anxiety scores in those aged 10–39 years were significantly higher. Thus, the COVID-19 pandemic may have caused mental health changes in many individuals based on their gender, age, and with time. Full article
12 pages, 485 KiB  
Article
Profiles of Health-Related Patient Activation and Their Determinants: The Results of a Cluster Analysis of Older Adults—Conclusions for Patient Counselling
by Dorota Włodarczyk and Joanna Chylińska
Int. J. Environ. Res. Public Health 2022, 19(4), 2487; https://doi.org/10.3390/ijerph19042487 - 21 Feb 2022
Cited by 2 | Viewed by 2086
Abstract
Health-related proactivity in older adults may significantly increase medication handling, adherence and patient safety. Deficiencies in training in critical characteristics and diversity of older patients may lead to medical errors in diagnosis and drug administration. This study investigated the profiles of health proactivity [...] Read more.
Health-related proactivity in older adults may significantly increase medication handling, adherence and patient safety. Deficiencies in training in critical characteristics and diversity of older patients may lead to medical errors in diagnosis and drug administration. This study investigated the profiles of health proactivity in older adults and the factors differentiating them, like sociodemographic factors, health status, visit characteristics, and patients’ visit-related expectations, actual experiences, and satisfaction with the visit. Before and after visits, 3391 patients aged 65–95 filled in two sets of questionnaires, that allowed to measure aforementioned factors. Three distinct proactivity profiles emerged from a cluster analysis: high (43%), medium (25%), and low proactivity (32%). Highly proactive patients had the highest expectations, but their visits provided better opportunities to meet them than in other groups. Higher proactivity was related to a longer attendance time, frequent contact with and easier access to the doctor, or a longer time spent with a patient. The findings highlight the need to detect and respond to patients’ expectations regarding psychosocial aspects of care, as well as to improve organizational aspects of care, in order to enhance health proactivity in older adults. The resulting good practice recommendations may significantly improve healthcare workers’ effectiveness in both primary and secondary care. Full article
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16 pages, 370 KiB  
Article
Research on the Effect of Rural Inclusive Financial Ecological Environment on Rural Household Income in China
by Heping Ge, Lianzhen Tang, Xiaojun Zhou, Decai Tang and Valentina Boamah
Int. J. Environ. Res. Public Health 2022, 19(4), 2486; https://doi.org/10.3390/ijerph19042486 - 21 Feb 2022
Cited by 21 | Viewed by 4071
Abstract
After a long struggle against poverty, the problem of absolute poverty among Chinese rural residents has been solved, but the problem of relative poverty still exists. With digitalization, the ecological environment of rural inclusive finance has been optimized. This paper empirically tests the [...] Read more.
After a long struggle against poverty, the problem of absolute poverty among Chinese rural residents has been solved, but the problem of relative poverty still exists. With digitalization, the ecological environment of rural inclusive finance has been optimized. This paper empirically tests the individual fixed-effect model and finds that digital inclusive finance has a positive income-increasing effect on rural residents. Wage income, operating income, and transfer income among the income types undergo a certain degree of promotion, while property income is affected to the contrary. In addition, digital inclusive finance has the same effect on farmers’ income increases in the east and central regions of China. However, it has a slightly smaller impact on farmers in the west. This paper uses a spatial econometric model and finds that promoting the development of local digital inclusive finance will enhance the income level of local farmers and increase the income of neighboring farmers. Therefore, this paper proposes to speed up the development of digital inclusive finance, optimize the rural financial ecological environment, strengthen government supervision and other recommendations, further enhance farmers’ income, and achieve common prosperity. Full article
11 pages, 1920 KiB  
Article
Epidemiology of Fungal Colonization in Children Treated at the Department of Oncology and Hematology: Single-Center Experience
by Joanna Klepacka, Zuzanna Zakrzewska, Małgorzata Czogała, Magdalena Wojtaszek-Główka, Emil Krzysztofik, Wojciech Czogała and Szymon Skoczeń
Int. J. Environ. Res. Public Health 2022, 19(4), 2485; https://doi.org/10.3390/ijerph19042485 - 21 Feb 2022
Cited by 1 | Viewed by 2277
Abstract
Oncological patients are especially predisposed to fungal infections due to multiple risk factors and immunocompromising treatment. Epidemiological research regarding pediatric oncologic patients is still insufficient, and existing data are difficult to generalize on different populations. Therefore, we aimed to analyze fungal infections and [...] Read more.
Oncological patients are especially predisposed to fungal infections due to multiple risk factors and immunocompromising treatment. Epidemiological research regarding pediatric oncologic patients is still insufficient, and existing data are difficult to generalize on different populations. Therefore, we aimed to analyze fungal infections and fungal epidemiology in the Department of Oncology and Hematology of the University Children’s Hospital in Krakow with help from the Clinical Microbiology Department. During the chosen period of 2005 and 2015–2020, 2342 tests were performed in our ward on 847 patients. Analyzed samples were divided into five source groups. The amount of patients with positive test results was 62.5%. The year with the highest detection level was 2005. The most frequent pathogen was Candida albicans, with a significant decrease in tendency. An increase in non-albicans species was observed. Candida parapsilosis was not frequently observed compared to similar studies. We noticed an increase in positive results from the urinary tract material. Our results confirmed that fungal infections are still an issue, and they may indicate the efficacy of prophylaxis. The majority of our results are consistent with the literature, yet we managed to emphasize data unique to our patients’ population. Our findings are helpful in clinical work and for further studies in our center. Full article
(This article belongs to the Special Issue Epidemiology and Outcome of Invasive Fungal Disease in Children)
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21 pages, 38171 KiB  
Article
Spatiotemporal Differentiation and Driving Force Analysis of the High-Quality Development of Urban Agglomerations along the Yellow River Basin
by Yu Chen, Qianqian Miao and Qian Zhou
Int. J. Environ. Res. Public Health 2022, 19(4), 2484; https://doi.org/10.3390/ijerph19042484 - 21 Feb 2022
Cited by 42 | Viewed by 3201
Abstract
The ecological protection and high-quality development (HQD) of the Yellow River Basin (YRB) have been promoted as national strategies. An urban agglomeration is the basic unit of the YRB used to participate in international competitions. Taking seven urban agglomerations covering 70 cities along [...] Read more.
The ecological protection and high-quality development (HQD) of the Yellow River Basin (YRB) have been promoted as national strategies. An urban agglomeration is the basic unit of the YRB used to participate in international competitions. Taking seven urban agglomerations covering 70 cities along the YRB as the sample, this paper establishes a high-quality evaluation system and uses the entropy method and exploratory spatial data analysis (ESDA) to analyze the HQD levels of the seven urban agglomerations along the YRB from 2009 to 2018. In addition, geographically-weighted regression (GWR) is adopted to analyze the influencing factors. The results show that: (1) the gap in the HQD of the seven urban agglomerations gradually narrows, showing a spatial pattern of “high in the east, low in the west, and depression in the middle”; (2) the HQD levels of the seven urban agglomerations have a strong spatial correlation, and the patterns of cold and hot spots have not changed substantially, showing the spatial distribution of “hot in the east, cold in the west”; (3) the degree of influence of each driving factor on the HQD differs among the seven urban agglomerations. The order is as follows: industrial structure upgrading index > proportion of R&D expenditure > urbanization rate > internet penetration rate > proportion of urban construction area > proportion of days reaching the air standard. These findings show that advanced industrial structure and technology are the two core driving forces for the HQD of the urban agglomerations along the YRB. Full article
(This article belongs to the Special Issue Healthy Lifestyle: Health Promotion and Prevention)
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16 pages, 753 KiB  
Article
Quantification and Analysis of Micro-Level Activities Data from Children Aged 1–12 Years Old for Use in the Assessments of Exposure to Recycled Tire on Turf and Playgrounds
by Nicolas Lopez-Galvez, Jocelyn Claude, Patty Wong, Asa Bradman, Carly Hyland, Rosemary Castorina, Robert A. Canales, Dean Billheimer, Elmira Torabzadeh, James O. Leckie and Paloma I. Beamer
Int. J. Environ. Res. Public Health 2022, 19(4), 2483; https://doi.org/10.3390/ijerph19042483 - 21 Feb 2022
Cited by 1 | Viewed by 3021
Abstract
Background: There are growing health concerns about exposure to toxicants released from recycled tire rubber, which is commonly used in synthetic turf and playground mats. To better estimate children’s exposure and risk from recycled tire rubber used in synthetic turf and playground mats, [...] Read more.
Background: There are growing health concerns about exposure to toxicants released from recycled tire rubber, which is commonly used in synthetic turf and playground mats. To better estimate children’s exposure and risk from recycled tire rubber used in synthetic turf and playground mats, there is a need to collect detailed accurate information on mouthing activity and dermal contact behaviors. The objective of this study was to quantify and analyze micro-level activity time series (MLATS) data from children aged 1–12 years old while playing (non-sport-related games) at turf-like locations and playgrounds. Another objective was to estimate the incidental ingestion rate of rubber crumb among children. Methods: Hand and mouth contact frequency, hourly duration, and median contact duration with different objects were calculated for children playing on turf (i.e., parks, lawns, and gardens) (n = 56) and for children playing on playground structures (n = 24). Statistically significant differences between males and females as well as children’s age groups were evaluated. The daily incidental ingestion rate of rubber crumb was calculated. Results: For children playing on turf, there were significant differences between younger (1–6 y) and older (7–12 y) children for the mouthing median duration with non-dietary objects and all objects. For children playing on playground structures, we found significant mouthing frequency differences between younger (1–6 y) and older children (7–12 y) with all objects, and for mouthing median duration with non-dietary objects. There were no significant differences between males and females playing on artificial turf-like surfaces or playground mats. Our estimated mean incidental ingestion rate was 0.08, 0.07, and 0.08 g rubber crumb/day for children <2, 2–6, and 6–11 years old, respectively. Discussion: our results suggest that age and contact duration should be considered in risk assessment models to evaluate mouthing activities when children are playing on artificial turf surfaces or playground mats. Full article
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18 pages, 1204 KiB  
Article
Correlation between Positive Orientation and Control of Anger, Anxiety and Depression in Nursing Students in Poland, Spain and Slovakia during the COVID-19 Pandemic
by Ewa Kupcewicz, Marzena Mikla, Helena Kadučáková, Elżbieta Grochans, Maria Dolores Roldán Valcarcel and Anna Maria Cybulska
Int. J. Environ. Res. Public Health 2022, 19(4), 2482; https://doi.org/10.3390/ijerph19042482 - 21 Feb 2022
Cited by 10 | Viewed by 3450
Abstract
(1) This study analysed the relationship between positive orientation and subjective control of anger, anxiety and depression in nursing students in Poland, Spain and Slovakia during the pandemic. (2) The survey was carried out by the diagnostic survey method in a group of [...] Read more.
(1) This study analysed the relationship between positive orientation and subjective control of anger, anxiety and depression in nursing students in Poland, Spain and Slovakia during the pandemic. (2) The survey was carried out by the diagnostic survey method in a group of 756 nursing students in Poland, Spain and Slovakia. The empirical data were gathered using an original survey questionnaire, the Positive Orientation Scale and the Courtauld Emotional Control Scale. (3) It was shown that the positive orientation level in Polish students was significantly lower than in students in Spain (p < 0.0001) and Slovakia (p < 0.0001). Low results for positive orientation were obtained in nearly half (47.18%) of the respondents in the Polish sample, whereas it was 34.18% and 31.18% in the Spanish and Slovak samples, respectively (p < 0.0001). A positive orientation was the most important predictor of emotional control among the nursing students at all the sites (p < 0.0001). (4) Positive orientation has been shown to have a significant impact on emotional control in nursing students during the pandemic. Therefore, it is important to carefully monitor students’ mental health during the pandemic to determine the demand for psychological and emotional support. Full article
(This article belongs to the Special Issue New Advances in Nursing Care)
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16 pages, 1137 KiB  
Article
An Investigation on the Academic Burden of Chinese Students Ranging from Primary Schools to Universities Based on a Word Association Test in Guangdong Province
by Ruixiang Gao, Tingxin He, Yu Liao, Xiaoqin Liu, Yinqing Fan, Yingting Su, Huang Zuo and Lei Mo
Int. J. Environ. Res. Public Health 2022, 19(4), 2481; https://doi.org/10.3390/ijerph19042481 - 21 Feb 2022
Cited by 20 | Viewed by 4971
Abstract
China’s basic education and higher education are currently facing policies aimed at reducing and increasing the academic burden, respectively. In this context, we first review and assess the methods of measuring students’ academic burden and then apply the implicit association test for the [...] Read more.
China’s basic education and higher education are currently facing policies aimed at reducing and increasing the academic burden, respectively. In this context, we first review and assess the methods of measuring students’ academic burden and then apply the implicit association test for the first time to the academic burden of Chinese students from primary school to university under a unified framework. The results demonstrates that students’ academic burden increases with the school stage, and thus university students face a greater burden than primary and high school students, and that learning attitude fully mediates the relationship between objective and subjective views of academic burden. These results suggest the three policy approaches of implementing a management system for classifying academic burden, considering how to improve students’ learning quality, and developing their mental health education, thus providing a reference and inspiration for research and practice in the field of academic burden. Full article
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16 pages, 2689 KiB  
Article
The Phenomenon of Social and Pastoral Service in Eastern Slovakia and Northwestern Czech Republic during the COVID-19 Pandemic: Comparison of Two Selected Units of Former Czechoslovakia in the Context of the Perspective of Positive Solutions
by Patrik Maturkanič, Ivana Tomanová Čergeťová, Roman Králik, Ľubomír Hlad, Marie Roubalová, Jose Garcia Martin, Viliam Judák, Amantius Akimjak and Lucia Petrikovičová
Int. J. Environ. Res. Public Health 2022, 19(4), 2480; https://doi.org/10.3390/ijerph19042480 - 21 Feb 2022
Cited by 18 | Viewed by 3642
Abstract
This study seeks to explain the differences in the perception of social and pastoral service after the first and second wave pandemic in 2020 among the inhabitants of two neighbouring states, both parts of the former unified Czechoslovakia. Our research study compares subjective [...] Read more.
This study seeks to explain the differences in the perception of social and pastoral service after the first and second wave pandemic in 2020 among the inhabitants of two neighbouring states, both parts of the former unified Czechoslovakia. Our research study compares subjective perception, needs, and participation among inhabitants of eastern Slovakia and north-western Czech Republic in social and pastoral service during the COVID-19 pandemic. The research sample consisted of a healthy population from the Czech Republic (n = 496) and Slovakia (n = 484) over 16 years of age, of which 63% (n = 617) were women and 37% (n = 363) men. The level of education ranged from primary to postgraduate. The research sample consisted of 623 (63.6%) participants with religious affiliation and 357 (36.4%) without religion. The level of perception, needs, and participation of the participants in social and pastoral service was obtained based on a non-standardised questionnaire. The results of our study confirmed several differences in the areas studied. Full article
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14 pages, 825 KiB  
Review
How to Educate the Public about Dental Trauma—A Scoping Review
by Magdalena Nowosielska, Joanna Bagińska, Agnieszka Kobus and Anna Kierklo
Int. J. Environ. Res. Public Health 2022, 19(4), 2479; https://doi.org/10.3390/ijerph19042479 - 21 Feb 2022
Cited by 7 | Viewed by 3018
Abstract
Educating the general population about dental trauma is of public health interest. The aim of this scoping review was to map research on traumatic dental injuries (TDIs) education in the general population and to identify the most relevant methods of knowledge transfer. PubMed, [...] Read more.
Educating the general population about dental trauma is of public health interest. The aim of this scoping review was to map research on traumatic dental injuries (TDIs) education in the general population and to identify the most relevant methods of knowledge transfer. PubMed, Scopus, Web of Science All Databases, reference lists, and grey literature were searched. Articles in English published between 2000 and 2020 were included. A total of 32 articles fulfilled inclusion criteria. The most frequently tested modality was lecture/seminar/workshop. Studies focused mainly on teachers and medical staff as target groups. Post-intervention evaluation showed an increase in knowledge. In long-term follow-up, a decrease in knowledge was found. The effectiveness of different modalities varied. Studies comparing single-modal and multimodal approaches did not confirm the effect of combined methods. Printed materials are a practical mode for laypeople. Lectures should be reserved for professions with high probability of coming into contact with a TDI victim. The Internet can be a promising tool to educate people. Educators have to choose the method of communication most appropriate for the target population. The education should include topics related to dental trauma prevention. Further research is needed to investigate the effectiveness of multimodal TDI education. Full article
(This article belongs to the Special Issue Oral Health: The First Step to Well-Being)
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18 pages, 8182 KiB  
Article
The Use of the Bolk Model for Positive Health and Living Environment in the Development of an Integrated Health Promotion Approach: A Case Study in a Socioeconomically Deprived Neighborhood in The Netherlands
by Herman A. van Wietmarschen, Sjef Staps, Judith Meijer, J. Francisca Flinterman and Miek C. Jong
Int. J. Environ. Res. Public Health 2022, 19(4), 2478; https://doi.org/10.3390/ijerph19042478 - 21 Feb 2022
Cited by 4 | Viewed by 3462
Abstract
Background. Despite considerable efforts, health disparities between people with high and low socioeconomic status (SES) have not changed over the past decades in The Netherlands. To create a culture of health and an environment in which all people can flourish, a shift in [...] Read more.
Background. Despite considerable efforts, health disparities between people with high and low socioeconomic status (SES) have not changed over the past decades in The Netherlands. To create a culture of health and an environment in which all people can flourish, a shift in focus is needed from disease management towards health promotion. The Bolk model for Positive Health and Living Environment was used as a tool to guide this shift. This study aimed to describe how this model was used and perceived by stakeholders in a case study on an integrated health promotion approach for residents with low SES. Methods. An instrumental case study was undertaken in Venserpolder, a neighborhood in Amsterdam South East of approximately 8500 residents. A participatory action approach was used that allowed continuous interaction between the residents, health care professionals, researchers, and other stakeholders. The Bolk model is a tool, based on the conceptual framework of positive health, that was developed to guide health promotion practice. Its use in the case study was evaluated by means of semistructured interviews with stakeholders, using qualitative directed content analyses. Results. The Bolk model was found to be a useful tool to identify and map the needs and strengths of residents with low SES. The model facilitated the development and implementation of eight health promotion pilots by transforming the needs and strengths of residents into concrete actions carried out by responsible actors in the neighborhood. Although the Bolk model seemed to be accepted by all stakeholders, the shift towards positive health thinking appeared to be more embodied by local professionals than by residents. Adjustments were proposed to enhance the applicability of the model in a multicultural setting, to increase its cultural sensitivity and to use language more familiar to residents. Conclusions. The Bolk model for positive health and living environment seems to be promising in the guidance of health promotion practices in Amsterdam South East. Further research and development are needed to improve its cultural sensitivity and to investigate its applicability in a broader range of public health settings. Full article
(This article belongs to the Collection Health Behaviors, Risk Factors, NCDs and Health Promotion)
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20 pages, 787 KiB  
Article
“Well, I Signed Up to Be a Soldier; I Have Been Trained and Equipped Well”: Exploring Healthcare Workers’ Experiences during COVID-19 Organizational Changes in Singapore, from the First Wave to the Path towards Endemicity
by Celene Ting, Alyssa Yenyi Chan, Lai Gwen Chan and Zoe Jane-Lara Hildon
Int. J. Environ. Res. Public Health 2022, 19(4), 2477; https://doi.org/10.3390/ijerph19042477 - 21 Feb 2022
Cited by 4 | Viewed by 4360
Abstract
(1) Background: As COVID-19 transmission continues despite vaccination programs, healthcare workers (HCWs) face an ongoing pandemic response. We explore the effects of this on (1) Heartware, by which we refer to morale and commitment of HCWs; and identify how to improve (2) Hardware, [...] Read more.
(1) Background: As COVID-19 transmission continues despite vaccination programs, healthcare workers (HCWs) face an ongoing pandemic response. We explore the effects of this on (1) Heartware, by which we refer to morale and commitment of HCWs; and identify how to improve (2) Hardware, or ways of enabling operational safety and functioning. (2) Methods: Qualitative e-diary entries were shared by HCWs during the early phases of the outbreak in Singapore from June to August 2020. Data were collected via an online survey of n = 3616 HCWs of all cadres. Nine institutions—restructured hospitals (n = 5), affiliated primary partners (n = 2) and hospices (n = 2)—participated. Applied thematic analysis was undertaken and organized according to Heartware and Hardware. Major themes are in italics (3) Results: n = 663 (18%) HCWs submitted a qualitative entry. Dominant themes undermining (1) Heartware consisted of burnout from being overworked and emotional exhaustion and at times feeling a lack of appreciation or support at work. The most common themes overriding morale breakers were a stoic acceptance to fight, adjust and hold the line, coupled with motivation from engaging leadership and supportive colleagues. The biggest barrier in (2) Hardware analysis related to sub-optimal segregation strategies within wards and designing better protocols for case detection, triage, and admissions criteria. Overall, the most cited enabler was the timely and well-planned provision of Personal Protective Equipment (PPE) for front-liners, though scope for scale-up was called for by those not considered frontline. Analysis maps internal organizational functioning to wider external public and policy-related narratives. (4) Conclusions: COVID-19 surges are becoming endemic rather than exceptional events. System elasticity needs to build on known pillars coupling improving safety and care delivery with improving HCW morale. Accordingly, a model capturing such facets of Adaptive Pandemic Response derived from our data analyses is described. HCW burnout must be urgently addressed, and health systems moved away from reactive “wartime” response configurations. Full article
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7 pages, 2404 KiB  
Brief Report
Cadaveric and Ultrasound Validation of Percutaneous Electrolysis Approaches at the Arcade of Frohse: A Potential Treatment for Radial Tunnel Syndrome
by Pedro Belón-Pérez, Laura Calderón-Díez, José Luis Sánchez-Sánchez, Miguel Robles-García, Gustavo Plaza-Manzano and César Fernández-de-las-Peñas
Int. J. Environ. Res. Public Health 2022, 19(4), 2476; https://doi.org/10.3390/ijerph19042476 - 21 Feb 2022
Cited by 1 | Viewed by 2910
Abstract
Entrapment of the radial nerve at the arcade of Frohse could contribute to symptoms in patients with lateral epicondylalgia or radial tunnel syndrome. Our aim was to determine the validity of applying percutaneous electrolysis, targeting the supinator muscle at the Frohse’s arcade with [...] Read more.
Entrapment of the radial nerve at the arcade of Frohse could contribute to symptoms in patients with lateral epicondylalgia or radial tunnel syndrome. Our aim was to determine the validity of applying percutaneous electrolysis, targeting the supinator muscle at the Frohse’s arcade with ultrasound imaging and in a Thiel-embalmed cadaver model (not ultrasound-guiding). Percutaneous electrolysis targeting the supinator muscle was conducted in five healthy volunteers (ultrasound study) and three Thiel-embalmed cadaver forearms. Two approaches, one with the forearm supinated and other with the forearm pronated were conducted. The needle was inserted until the tip reached the interphase of both bellies of the supinator muscle. Accurate needle penetration of the supinator muscle was observed in 100% in both US-imaging and cadaveric studies. No neurovascular bundle of the radial-nerve deep branch was pierced in any insertion. The distance from the tip of the needle to the neurovascular bundle was 15.3 ± 0.6 mm with the forearm supinated, and 11.2 ± 0.6 mm with the forearm pronated. The results of the current study support that percutaneous electrolysis can properly target the supinator muscle with either the forearm in supination or in pronation. In fact, penetration of the neurovascular bundle was not observed in any approach when percutaneous needling electrolysis was performed by an experienced clinician. Full article
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7 pages, 312 KiB  
Editorial
New Insights in Prevention and Treatment of Cardiovascular Disease
by Domenico Di Raimondo, Gaia Musiari, Giuliana Rizzo, Edoardo Pirera and Salvatore Santo Signorelli
Int. J. Environ. Res. Public Health 2022, 19(4), 2475; https://doi.org/10.3390/ijerph19042475 - 21 Feb 2022
Cited by 3 | Viewed by 2424
Abstract
Cardiovascular (CV) disease (CVD) is still a major cause of morbidity and mortality in many countries in Europe although considerable efforts have been made in recent decades to address this disease in an even more “comprehensive” approach [...] Full article
(This article belongs to the Special Issue New Insights in Prevention and Treatment of Cardiovascular Disease)
10 pages, 324 KiB  
Article
Mixed-Methods Survey of Healthcare Workers’ Experiences of Personal Protective Equipment during the COVID-19 Pandemic in Aotearoa/New Zealand
by Cervantée E. K. Wild, Hailey Wells, Nicolene Coetzee, Cameron C. Grant, Trudy A. Sullivan, José G. B. Derraik and Yvonne C. Anderson
Int. J. Environ. Res. Public Health 2022, 19(4), 2474; https://doi.org/10.3390/ijerph19042474 - 21 Feb 2022
Cited by 3 | Viewed by 3174
Abstract
There have been widespread issues with the supply and distribution of personal protective equipment (PPE) globally throughout the COVID-19 pandemic, raising considerable public concern. We aimed to understand the experiences of healthcare workers using PPE during the first COVID-19 surge (February–June 2020) in [...] Read more.
There have been widespread issues with the supply and distribution of personal protective equipment (PPE) globally throughout the COVID-19 pandemic, raising considerable public concern. We aimed to understand the experiences of healthcare workers using PPE during the first COVID-19 surge (February–June 2020) in Aotearoa/New Zealand (NZ). This study consisted of an online, voluntary, and anonymous survey, distributed nationwide via multimodal recruitment. Reported domains included PPE supply, sourcing and procurement, fit-testing and fit-checking, perceived protection, trust and confidence in the workplace, mental health, and the likelihood of remaining in the profession. Differences according to demographic variables (e.g., profession and workplace) were examined. We undertook a descriptive analysis of responses to open-text questions to provide explanation and context to the quantitative data. The survey was completed in October–November 2020 by 1411 healthcare workers. Reported PPE shortages were common (26.8%) among healthcare workers during surge one in NZ. This led to respondents personally saving both new (31.2%) and used (25.2%) PPE, purchasing their own PPE (28.2%), and engaging in extended wear practices. More respondents in the public system reported being told not to wear PPE by their organisation compared with respondents in the private sector. Relatively low numbers of respondents who were required to undertake aerosol-generating procedures reported being fit-tested annually (3.8%), a legal requirement in NZ. Healthcare workers in NZ reported a concerning level of unsafe PPE practices during surge one, as well as a high prevalence of reported mental health concerns. As NZ and other countries transition from COVID-19 elimination to suppression strategies, healthcare worker safety should be paramount, with clear communication regarding PPE use and supply being a key priority. Full article
6 pages, 599 KiB  
Case Report
An Atypical Case of Late-Onset Wolfram Syndrome 1 without Diabetes Insipidus
by Luciana Rigoli, Valerio Caruso, Concetta Aloi, Alessandro Salina, Mohamad Maghnie, Giuseppe d'Annunzio, Olga Lamacchia, Giuseppina Salzano, Fortunato Lombardo and Giuseppe Picca
Int. J. Environ. Res. Public Health 2022, 19(4), 2473; https://doi.org/10.3390/ijerph19042473 - 21 Feb 2022
Cited by 2 | Viewed by 2719
Abstract
Wolfram syndrome 1, a rare autosomal recessive neurodegenerative disease, is caused by mutations in the WFS1 gene. It is characterized by diabetes insipidus, diabetes mellitus, optic atrophy, and deafness (DIDMOAD), and other clinical manifestations such as urological and neurological disorders. Here we described [...] Read more.
Wolfram syndrome 1, a rare autosomal recessive neurodegenerative disease, is caused by mutations in the WFS1 gene. It is characterized by diabetes insipidus, diabetes mellitus, optic atrophy, and deafness (DIDMOAD), and other clinical manifestations such as urological and neurological disorders. Here we described the case of a patient with an atypical late-onset Wolfram syndrome 1 without DI. Our WS1 patient was a c.1620_1622delGTG (p.Trp540del)/c.124 C > T (p.Arg42*) heterozygous compound. The p.Arg42* nonsense mutation was also found in heterozygosity in his sister and niece, both suffering from psychiatric disorders. The p.Arg42* nonsense mutation has never been found in WS1 and its pathogenicity is unclear so far. Our study underlined the need to study a greater number of WS1 cases in order to better understand the clinical significance of many WFS1 variants. Full article
(This article belongs to the Special Issue Wolfram Syndrome in Pediatric Age)
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9 pages, 321 KiB  
Article
Spirituality, Community Belonging, and Mental Health Outcomes of Indigenous Peoples during the COVID-19 Pandemic
by Chantal Burnett, Eva Purkey, Colleen M. Davison, Autumn Watson, Jennifer Kehoe, Sheldon Traviss, Dionne Nolan and Imaan Bayoumi
Int. J. Environ. Res. Public Health 2022, 19(4), 2472; https://doi.org/10.3390/ijerph19042472 - 21 Feb 2022
Cited by 6 | Viewed by 4805
Abstract
We aimed to assess the association between community belonging, spirituality, and mental health outcomes among Indigenous Peoples during the COVID-19 pandemic. This cross-sectional observational study used online survey distribution and targeted outreach to the local Indigenous community to collect a convenience sample between [...] Read more.
We aimed to assess the association between community belonging, spirituality, and mental health outcomes among Indigenous Peoples during the COVID-19 pandemic. This cross-sectional observational study used online survey distribution and targeted outreach to the local Indigenous community to collect a convenience sample between 23 April 2020 and 20 November 2020. The surveys included demographic information, self-reported symptoms of depression (PHQ-2) and anxiety (GAD-2), and measures of the sense of community belonging and the importance of spirituality. Multivariate logistic regression was used to model the association between the sense of community belonging and spirituality, and symptoms of anxiety and depression. Of the 263 self-identified Indigenous people who participated, 246 participants had complete outcome data, including 99 (40%) who reported symptoms of depression and 110 (45%) who reported symptoms of anxiety. Compared to Indigenous participants with a strong sense of community belonging, those with weak community belonging had 2.42 (95% CI: 1.12–5.24)-times greater odds of reporting symptoms of anxiety, and 4.40 (95% CI: 1.95–9.89)-times greater odds of reporting symptoms of depression. While spirituality was not associated with anxiety or depression in the adjusted models, 76% of Indigenous participants agreed that spirituality was important to them pre-pandemic, and 56% agreed that it had become more important since the pandemic began. Community belonging was associated with positive mental health outcomes. Indigenous-led cultural programs that foster community belonging may promote the mental health of Indigenous Peoples. Full article
17 pages, 4527 KiB  
Article
Detecting Airborne Pollen Using an Automatic, Real-Time Monitoring System: Evidence from Two Sites
by Maria Pilar Plaza, Franziska Kolek, Vivien Leier-Wirtz, Jens Otto Brunner, Claudia Traidl-Hoffmann and Athanasios Damialis
Int. J. Environ. Res. Public Health 2022, 19(4), 2471; https://doi.org/10.3390/ijerph19042471 - 21 Feb 2022
Cited by 18 | Viewed by 3814
Abstract
Airborne pollen monitoring has been an arduous task, making ecological applications and allergy management virtually disconnected from everyday practice. Over the last decade, intensive research has been conducted worldwide to automate this task and to obtain real-time measurements. The aim of this study [...] Read more.
Airborne pollen monitoring has been an arduous task, making ecological applications and allergy management virtually disconnected from everyday practice. Over the last decade, intensive research has been conducted worldwide to automate this task and to obtain real-time measurements. The aim of this study was to evaluate such an automated biomonitoring system vs. the conventional ‘gold-standard’ Hirst-type technique, attempting to assess which may more accurately provide the genuine exposure to airborne pollen. Airborne pollen was monitored in Augsburg since 2015 with two different methods, a novel automatic Bio-Aerosol Analyser, and with the conventional 7-day recording Hirst-type volumetric trap, in two different sites. The reliability, performance, accuracy, and comparability of the BAA500 Pollen Monitor (PoMo) vs. the conventional device were investigated, by use of approximately 2.5 million particles sampled during the study period. The observations made by the automated PoMo showed an average accuracy of approximately 85%. However, it also exhibited reliability problems, with information gaps within the main pollen season of between 17 to 19 days. The PoMo automated algorithm had identification issues, mainly confusing the taxa of Populus, Salix and Tilia. Hirst-type measurements consistently exhibited lower pollen abundances (median of annual pollen integral: 2080), however, seasonal traits were more comparable, with the PoMo pollen season starting slightly later (median: 3 days), peaking later (median: 5 days) but also ending later (median: 14 days). Daily pollen concentrations reported by Hirst-type traps vs. PoMo were significantly, but not closely, correlated (r = 0.53–0.55), even after manual classification. Automatic pollen monitoring has already shown signs of efficiency and accuracy, despite its young age; here it is suggested that automatic pollen monitoring systems may be more effective in capturing a larger proportion of the airborne pollen diversity. Even though reliability issues still exist, we expect that this new generation of automated bioaerosol monitoring will eventually change the aerobiological era, as known for almost 70 years now. Full article
(This article belongs to the Section Air)
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14 pages, 538 KiB  
Article
Organizational Commitment and Intention to Leave of Nurses in Portuguese Hospitals
by Teresa Neves, Pedro Parreira, Vitor Rodrigues and João Graveto
Int. J. Environ. Res. Public Health 2022, 19(4), 2470; https://doi.org/10.3390/ijerph19042470 - 21 Feb 2022
Cited by 15 | Viewed by 3946
Abstract
Intention to leave is influenced by the commitment and individual and structural factors. It is a critical dimension in health systems due to the shortage of professionals and the potential impact on the quality of care. The present paper: (i) characterizes organizational commitment [...] Read more.
Intention to leave is influenced by the commitment and individual and structural factors. It is a critical dimension in health systems due to the shortage of professionals and the potential impact on the quality of care. The present paper: (i) characterizes organizational commitment and intention to leave; (ii) analyzes the relationship between structural factors (such as, work environment and nurse staffing), individual factors (age), and nurses’ organizational commitments and intention to leave; and (iii) analyzes the differences in the intention to leave and in the organizational commitment according to service specialty, nurses’ specialization, and contractual relationship in Portuguese public hospitals. A cross-sectional study was conducted with a sample of 850 nurses from 12 public hospitals units. The results show a high affective and continuance commitment of nurses with the hospital, and a reduced tendency of the intention to leave. A significant positive association was also found between the intent to leave and individual/structural factors. Organizational commitment and intention to leave levels are satisfactory, despite the influence of several factors, such as nurse staffing, work environment, or other opportunities for professional development. The results identify particularly sensitive areas that, through adequate health and management policies, can reduce nurses’ intentions to leave and promote the sustainability of the health system. Full article
(This article belongs to the Section Nursing)
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21 pages, 5022 KiB  
Article
Optimizing the Water Ecological Environment of Mining Cities in the Yangtze River Economic Belt Using the Cloud Model, CV-TOPSIS, and Coupling Coordination Degree
by Ran Wang, Hao Lin, Jinhua Cheng, Zixi Xu, Haoying Feng and Yameng Tang
Int. J. Environ. Res. Public Health 2022, 19(4), 2469; https://doi.org/10.3390/ijerph19042469 - 21 Feb 2022
Cited by 2 | Viewed by 2567
Abstract
The Yangtze River Economic Belt (YREB) is the core region for the security of mineral resources in China and is a strategic water source containing rich water resources. Coordinating the security of mineral resources and water resources in the YREB is a key [...] Read more.
The Yangtze River Economic Belt (YREB) is the core region for the security of mineral resources in China and is a strategic water source containing rich water resources. Coordinating the security of mineral resources and water resources in the YREB is a key problem. Establishing and optimizing the water ecological environment (WEE) is crucial for addressing this problem in mining cities, which are the main bases for the supply of mineral resources. This study applies the cloud model, CV-TOPSIS, the standard deviation ellipse, and the coupling coordination degree model to evaluate the WEE and the coordinated development state, and to optimize the WEE. The results show that: (1) the WEE of mining cities in the YREB is generally good; (2) the protection of WEE in most mining cities has achieved significant results recently, and the results in the downstream are more remarkable than those in the mid-upstream; (3) the coordinated development of WEE in regenerative mining cities is better than that of mature and declining cities; and (4) most mining cities still belong to the lagging type of water environment (heavy metal pollution has been better treated and the threat of water ecological security caused by heavy metal pollution is low). This study suggests improvements to the sewer system, promotes WEE management in the mid-upstream, and propels the transformational development of mature and declining mining cities in advance. Full article
(This article belongs to the Topic Energy Efficiency, Environment and Health)
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10 pages, 1050 KiB  
Article
Patellar and Achilles Tendon Thickness Differences among Athletes with Different Numbers of Meals per Day: A Cross-Sectional Study
by Santiago Navarro-Ledesma, Gabriel Gijon-Nogueron, Inmaculada Reina-Martín, Ana Belen Ortega-Avila and Leo Pruimboom
Int. J. Environ. Res. Public Health 2022, 19(4), 2468; https://doi.org/10.3390/ijerph19042468 - 21 Feb 2022
Cited by 3 | Viewed by 3762
Abstract
The objective of this study is to analyse differences in the thickness of the patellar (PT) and Achilles tendons (AT) among athletes with different number of meals per day. The design is a cross-sectional, observational study. A total of thirty-six male athletes (with [...] Read more.
The objective of this study is to analyse differences in the thickness of the patellar (PT) and Achilles tendons (AT) among athletes with different number of meals per day. The design is a cross-sectional, observational study. A total of thirty-six male athletes (with mean age groups ranging from 31 to 40) were recruited and divided into three groups based on the number of daily meals they had (3, 4 or 5 meals). PT and AT were assessed by ultrasound. There were statistically significant differences in PT when comparing groups 1 and 3, at both longitudinal (p < 0.03) and transversal (p < 0.002) planes. There were no differences when comparing groups 1 and 2 or groups 2 and 3. There was a negative correlation between the number of meals per day and tendon thicknesses in both PT (longitudinal plane: r = −0.384; p = 0.02/transversal plane: r = −0.406; p = 0.01) and AT (transversal plane: r = −0.386; p = 0.02). In conclusion, there were patellar tendon thickness differences between participants and the number of daily meals could play a key role in tendon thickness, healing and performance. Full article
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24 pages, 6705 KiB  
Article
Identification of the Visually Prominent Gait Parameters for Forensic Gait Analysis
by Daewook Lee, Jiman Soon, Gyuri Choi, Kijoon Kim and Sangwoo Bahn
Int. J. Environ. Res. Public Health 2022, 19(4), 2467; https://doi.org/10.3390/ijerph19042467 - 21 Feb 2022
Cited by 2 | Viewed by 2411
Abstract
Walking patterns can be used as a key parameter in identifying individuals, as it varies visually depending on one’s body size as well as their habits, gender, and age group. In this study, we measure the gait characteristics of a large number of [...] Read more.
Walking patterns can be used as a key parameter in identifying individuals, as it varies visually depending on one’s body size as well as their habits, gender, and age group. In this study, we measure the gait characteristics of a large number of subjects using 34 visual parameters to identify significant parameters that can be used to distinguish individual walking features. We recorded 291 subjects’ walking on a constructed footpath using four video cameras, and data on parameters was calculated at the points of double support, toe-off, and heel-strike. K-means Clustering Analysis and ANOVA were conducted to determine the difference between age, gender, and BMI. As a result, we confirm that parameters related to the spine, neck, and feet are useful for identifying individuals. In the comparative analysis between age groups, the older the age, the more significant variables appeared in the upper body. The difference between genders showed significant parameters in both the upper and lower bodies of males. Similarly, among the large BMI groups, we also derived significant results in the upper and lower bodies. The key parameters derived from this study can be used more effectively in the real-world visual analysis of gait, as the walking characteristics of a large number of subjects have been measured with a similar view as real-world CCTV. This study will be effectively utilized as a foundation for future research attempting to identify people through their gait by distinguishing major gait characteristic differences. Full article
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14 pages, 2281 KiB  
Article
Interface Design for Products for Users with Advanced Age and Cognitive Impairment
by Li-Hao Chen and Yi-Chien Liu
Int. J. Environ. Res. Public Health 2022, 19(4), 2466; https://doi.org/10.3390/ijerph19042466 - 21 Feb 2022
Viewed by 2142
Abstract
The aim of this study is to investigate the problems and needs of users with advanced age and cognitive impairment regarding the design and operation of daily living products. Television remote controls and an electric rice cooker were applied as the research tools, [...] Read more.
The aim of this study is to investigate the problems and needs of users with advanced age and cognitive impairment regarding the design and operation of daily living products. Television remote controls and an electric rice cooker were applied as the research tools, and focus group interviews with control older adults and interviews with individuals with MCI or mild dementia were conducted regarding the operation of the products. The control participants stressed that the operating procedures should not be excessively complex, the number of functions and buttons should not be overly high, and buttons and text should be enlarged. For those with MCI or mild dementia, in addition to the size and number of buttons, text size, and functions, their operation of product interfaces was affected by the complexity of the operating procedures. The solutions recommended by the participants included interface design involving direct operation and voice control. Full article
(This article belongs to the Special Issue The Lived Experience of People Living with Dementia and Caregivers)
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13 pages, 2223 KiB  
Case Report
Quantitative Electroencephalography (QEEG) as an Innovative Diagnostic Tool in Mental Disorders
by Marta Kopańska, Danuta Ochojska, Agnieszka Dejnowicz-Velitchkov and Agnieszka Banaś-Ząbczyk
Int. J. Environ. Res. Public Health 2022, 19(4), 2465; https://doi.org/10.3390/ijerph19042465 - 21 Feb 2022
Cited by 8 | Viewed by 4943
Abstract
Quantitative electroencephalography (QEEG) is becoming an increasingly common method of diagnosing neurological disorders and, following the recommendations of The American Academy of Neurology (AAN) and the American Clinical Neurophysiology Society (ACNS), it can be used as a complementary method in the diagnosis of [...] Read more.
Quantitative electroencephalography (QEEG) is becoming an increasingly common method of diagnosing neurological disorders and, following the recommendations of The American Academy of Neurology (AAN) and the American Clinical Neurophysiology Society (ACNS), it can be used as a complementary method in the diagnosis of epilepsy, vascular diseases, dementia, and encephalopathy. However, few studies are confirming the importance of QEEG in the diagnosis of mental disorders and changes occurring as a result of therapy; hence, there is a need for analyses in this area. The aim of the study is analysis of the usefulness of QEEG in the diagnosis of people with generalized anxiety disorders. Our research takes the form of case studies. The paper presents an in-depth analysis of the QEEG results of five recently studied people with a psychiatric diagnosis: generalized anxiety disorder. The results show specific pattern amplitudes at C3 and C4. In all of the examined patients, two dependencies are repeated: low contribution of the sensorimotor rhythm (SMR) wave amplitudes and high beta2 wave amplitudes, higher or equal to the alpha amplitudes. The QEEG study provides important information about the specificity of brain waves of people with generalized anxiety disorder; therefore, it enables the preliminary and quick diagnosis of dysfunction. It is also possible to monitor changes due to QEEG, occurring as a result of psychotherapy, pharmacological therapy and EEG-biofeedback. Full article
(This article belongs to the Section Mental Health)
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15 pages, 2139 KiB  
Article
Effect of Urbanization on the River Network Structure in Zhengzhou City, China
by Hongxiang Wang, Lintong Huang, Jianwen Hu, Huan Yang and Wenxian Guo
Int. J. Environ. Res. Public Health 2022, 19(4), 2464; https://doi.org/10.3390/ijerph19042464 - 21 Feb 2022
Cited by 13 | Viewed by 2566
Abstract
Hydrological problems, such as flood disasters, can be caused by the influence of urbanization on river network structures in plain areas. Taking the main urban region of Zhengzhou city as the research area, based on six remote sensing images from 1992 to 2015, [...] Read more.
Hydrological problems, such as flood disasters, can be caused by the influence of urbanization on river network structures in plain areas. Taking the main urban region of Zhengzhou city as the research area, based on six remote sensing images from 1992 to 2015, the modified normalized difference water index method and a land-use transfer matrix were used to reconstruct river network data to study the temporal and spatial changes in the river system. In addition, the analytic hierarchy process and the entropy weight method were used to construct pattern indexes of the river system to quantitatively evaluate the inner relationship between the urbanization process and the river network structure in the plain area. The results showed that the percentages of arable land, forest and grassland, water, and unused land in Zhengzhou that was transferred to construction land from 1992 to 2015 were 59.10%, 51.05%, 29.83%, and 58.76%, respectively. In the past 34 years, the morphological indices, structural indices, and connectivity indices of the river system experienced a trend of high to low, and then increased, with the structural indices being significantly correlated with construction land use (p < 0.05). The regression equation R2 between urbanization level and river length, water area, river network density, water surface rate, connection rate, and connectivity ranged from 0.677 to 0.966, which could well reflect the response relationship between urbanization and the river network. In addition, the outflow was greater than the inflow, which has destroyed the natural structure of the channel. Full article
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19 pages, 438 KiB  
Article
Marathon Performance Depends on Pacing Oscillations between Non Symmetric Extreme Values
by Jean-Renaud Pycke and Véronique Billat
Int. J. Environ. Res. Public Health 2022, 19(4), 2463; https://doi.org/10.3390/ijerph19042463 - 21 Feb 2022
Cited by 7 | Viewed by 2992
Abstract
A marathon was recently run in less than 2 h by a man who ran the three fastest marathons ever recorded in a span of three years—Eliud Kipchoge—in the Tokyo Olympic games. Here, we demonstrate that the best marathons were run according to [...] Read more.
A marathon was recently run in less than 2 h by a man who ran the three fastest marathons ever recorded in a span of three years—Eliud Kipchoge—in the Tokyo Olympic games. Here, we demonstrate that the best marathons were run according to a pace distribution that is statistically not constant and with negative asymmetry. The concept of mirror race enables us to show that the sign of asymmetry is not due to sampling fluctuations. We show that marathon performance depends on pacing oscillations between extreme values, and that even the best marathons ever run differ and can be improved upon. The utilization of extreme values and oscillations allows for recovery and optimization of the complementary aerobic and anaerobic metabolisms. Our findings suggest new ways to approach the pacing for optimizing endurance performance. Full article
(This article belongs to the Special Issue The Marathon: Environmental and Public Health Aspects)
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12 pages, 728 KiB  
Article
Health-Seeking Behaviors in Mozambique: A Mini-Study of Ethnonursing
by Naoko Takeyama, Basilua Andre Muzembo, Yasmin Jahan and Michiko Moriyama
Int. J. Environ. Res. Public Health 2022, 19(4), 2462; https://doi.org/10.3390/ijerph19042462 - 21 Feb 2022
Cited by 3 | Viewed by 2839
Abstract
In settings where traditional medicine is a crucial part of the healthcare system, providing culturally competent healthcare services is vital to improving patient satisfaction and health outcomes. Therefore, this study sought to gain insight into how cultural beliefs influence health-seeking behaviors (HSBs) among [...] Read more.
In settings where traditional medicine is a crucial part of the healthcare system, providing culturally competent healthcare services is vital to improving patient satisfaction and health outcomes. Therefore, this study sought to gain insight into how cultural beliefs influence health-seeking behaviors (HSBs) among Mozambicans. Participant observation and in-depth interviews (IDIs) were undertaken using the ethnonursing method to investigate beliefs and views that Mozambicans (living in Pemba City) often take into account to meet their health needs. Data were analyzed in accordance with Leininger’s ethnonursing guidelines. Twenty-seven IDIs were carried out with 12 informants from the Makonde and Makuwa tribes. The choice of health service was influenced by perceptions of health and illness through a spiritual lens, belief in supernatural forces, dissatisfaction with and dislike of the public medical system on grounds of having received poor-quality treatment, perceived poor communication skills of health professionals, and trust in the indigenous medical system. This study confirmed the need for health professionals to carefully take cultural influences into consideration when providing care for their patients. We recommend an educational intervention that emphasizes communication skills training for healthcare workers to ensure successful physician/nurse–patient relationships. Full article
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17 pages, 519 KiB  
Article
Identifying Types of Eco-Anxiety, Eco-Guilt, Eco-Grief, and Eco-Coping in a Climate-Sensitive Population: A Qualitative Study
by Csilla Ágoston, Benedek Csaba, Bence Nagy, Zoltán Kőváry, Andrea Dúll, József Rácz and Zsolt Demetrovics
Int. J. Environ. Res. Public Health 2022, 19(4), 2461; https://doi.org/10.3390/ijerph19042461 - 21 Feb 2022
Cited by 79 | Viewed by 20621
Abstract
Background: Climate change is one of the greatest challenges of the 21st century and it can affect mental health either directly through the experience of environmental traumas or indirectly through the experience of emotional distress and anxiety about the future. However, it is [...] Read more.
Background: Climate change is one of the greatest challenges of the 21st century and it can affect mental health either directly through the experience of environmental traumas or indirectly through the experience of emotional distress and anxiety about the future. However, it is not clear what possible subtypes of the emerging “psychoterratic” syndromes such as eco-anxiety, eco-guilt, and eco-grief exist, how much distress they may cause, and to what extent they facilitate ecofriendly behavior. Methods: We analyzed semi-structured interviews (N = 17) focusing on the thoughts, emotions, and behaviors related to climate change by using a combination of inductive and deductive qualitative methods. Results and conclusions: The interviews revealed six eco-anxiety components, eight types of eco-guilt, and two types of eco-grief that help to understand the multifactorial nature of these phenomena. The six categories of coping strategies are in line with traditional coping models, and they are linked in various ways to pro-environmental behavior and the management of negative emotions. The results can help practitioners to gain a deeper understanding of emotions related to climate change and how to cope with them, and researchers to develop comprehensive measurement tools to assess these emotions. Full article
(This article belongs to the Special Issue The Psychological Impacts of Global Climate Change)
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