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A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Health Behavior, Chronic Disease and Health Promotion".

Deadline for manuscript submissions: closed (31 March 2023) | Viewed by 50230

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Prof. Dr. Danila de Vito

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Chief Guest Editor

Department of Basic Medical Sciences, Neurosciences and Sense Organs, University of Bari, 70122 Bari, Italy
Interests: public health; dental hygiene; preventive medicine
Special Issues, Collections and Topics in MDPI journals

Dr. Davide Farronato

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Assistant Guest Editor

Department of Medicine and Technological Innovation, Research Center of Innovative Technology and Engineered Biomaterial, University of Insubria, 21100 Varese, Italy
Interests: implantology; biomechanics; prosthodontic rehabilitation; implant design
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Prof. Dr. Marco Tatullo

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Assistant Guest Editor

Full Professor, Department of Translational Biomedicine and Neuroscience (DiBraiN), University of Bari “Aldo Moro”, 70121 Bari, Italy
Interests: regenerative medicine; regenerative dentistry; stem cells; MSCs; biomaterials; growth factors; PRF; PRP; tissue engineering; biomimetics
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Special Issue Information

Dear Colleagues,

Public health decision making can be a complicated process because of the complex nature of inputs and the need for group decision making. Nevertheless, public health research and practice during the last century have gained many notable achievements and contributed to the 30-year gain in life expectancy. Despite these accomplishments, a greater attention to evidence-based approaches may be helpful. In its most straightforward definition, evidence-based public health (EBPH) means applying the principles of evidence-based medicine/practice (EBM/EBP) to the field of public health. However, randomized clinical trials—the gold standard in EBM/EBP—are not always applicable in investigating public health problems. An evidence-based approach to public health and preventive medicine could potentially have numerous direct and indirect benefits, including access to more and higher-quality information on best practice, a higher likelihood of successful prevention programs and policies, greater workforce productivity, and more efficient use of public and private resources.

This Special Issue seeks research papers on various aspects related to the emerging field of evidence-based public health, covering different aspects of the basics of hygiene in public health and health promotion, that is, from evidence generation and evidence synthesis to evidence communication and policy recommendation.

In particular, we encourage the submission of interdisciplinary work and multicountry collaborative research. We welcome submissions of original research papers using different study designs, critical and relevant reviews, including as systematic reviews and meta-analysis, methodological papers, and manuscripts that emphasize theoretical content.

We welcome original research papers using different study designs as well as systematic reviews and meta-analysis.

Prof. Dr. Danila de Vito
Prof. Dr. Marco Tatullo
Prof. Dr. Davide Farronato
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. International Journal of Environmental Research and Public Health is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2500 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

Health promotion
Preventive medicine
Pandemic diseases
Screening
Dental hygiene
Clinical microbiology
COVID-19
Medicine and dentistry

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Published Papers (11 papers)

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11 pages, 1365 KiB

Open AccessArticle

Relationship between Body Mass Index and Physical Activity among Children from Low-Income Communities in Gqeberha, South Africa: A Cross-Sectional Study

by Danielle Dolley, Rosa Du Randt, Uwe Pühse, Markus Gerber, Jacob Bosma, Ann Aerts, Larissa Adams, Patricia Arnaiz, Nandi Joubert, Ivan Müller, Siphesihle Nqweniso, Harald Seelig, Peter Steinmann, Jürg Utzinger and Cheryl Walter

Int. J. Environ. Res. Public Health 2023, 20(2), 1428; https://doi.org/10.3390/ijerph20021428 - 12 Jan 2023

Cited by 1 | Viewed by 2267

Abstract

This study aimed to establish the prevalence of underweight, overweight and obesity, the level of moderate-to-vigorous physical activity (MVPA) and the association thereof among vulnerable children from low-income communities in South Africa. Cross-sectional data were collected from 916 children (467 boys and 449 [...] Read more.

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= 10.4 ± 1.2 years) attending eight low-income schools in Gqeberha, South Africa. Measured outcomes included accelerometery-measured physical activity (PA), weight, height and body mass index (BMI). Analysis of variance was used to determine the mean difference of total MVPA stratified by sex and BMI classification. Overall, 13% of the cohort were underweight, 19% were overweight/obese and 64% engaged in 60 min of MVPA per day. Girls presented nearly twice the odds of being overweight or obese than boys (95% CI: 1.40–2.77). Underweight to normal-weight children (boys: OR = 3.89, 95% CI: 2.18–6.93; girls: OR = 1.78, 95% CI: 1.13–2.80) were more likely to engage in 60 min/day of MVPA than overweight to obese children. There is an inverse association between BMI categories and theduration of MVPA achieved per day. Special attention should be aimed at increasing awareness of healthy nutrition and promoting a variety of PA, especially among girls and children with excess weight. Full article

(This article belongs to the Special Issue Basics of Hygiene in Public Health and Health Promotion)

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9 pages, 1010 KiB

Open AccessArticle

SARS-CoV-2 Vaccines and Adverse Effects in Gynecology and Obstetrics: The First Italian Retrospective Study

by Miriam Dellino, Bruno Lamanna, Marina Vinciguerra, Silvio Tafuri, Pasquale Stefanizzi, Antonio Malvasi, Giovanni Di Vagno, Gennaro Cormio, Vera Loizzi, Gerardo Cazzato, Raffaele Tinelli, Ettore Cicinelli, Vincenzo Pinto, Antonella Daniele, Eugenio Maiorano, Leonardo Resta, Danila De Vito, Salvatore Scacco and Eliano Cascardi

Int. J. Environ. Res. Public Health 2022, 19(20), 13167; https://doi.org/10.3390/ijerph192013167 - 13 Oct 2022

Cited by 26 | Viewed by 2973

Abstract

The most common effects reported by the Italian Medicine Agency following administration of SARS-CoV-2 vaccine are myalgia, soreness to the arm of inoculation, fever, and asthenia. To date, there are no specific and official reports registered by the Italian Medicine Agency on possible alterations of the menstrual cycle, or of the female reproductive system, following the vaccine. Actually, clinical experience showed a spread of transient adverse drug reactions of the menstrual cycle, following the administration of all COVID-19 vaccine types, both mRNA and Adenovirus vectored ones. In this work, we conducted the first retrospective study on Italian patients vaccinated for SARS-CoV-2 in the period between April 2021 and April 2022, to report the onset of menstrual changes after the vaccine in order to understand: etiology, duration of possible adverse effects, and the extent of the phenomenon. We recruited 100 women aged 18–45, vaccinated for SARS-CoV-2, who were asked to complete a questionnaire consisting of 12 multiple choice questions about the effects of the vaccine on the reproductive system. Thirty-seven of them received three doses of the vaccine, while the remaining 63 received two doses. Symptoms such as delayed menstruation and abnormal uterine bleeding (metrorrhagia, menometrorrhagia, and menorrhagia) were generally reported within the first three weeks of vaccination, especially after the second dose, with a percentage of 23% and 77%, respectively. These preliminary data suggest that this problem may be broader and deserving of further investigation in the future. Full article

(This article belongs to the Special Issue Basics of Hygiene in Public Health and Health Promotion)

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11 pages, 348 KiB

Open AccessArticle

Adherence to Hand Hygiene among Nurses and Clinicians at Chiradzulu District Hospital, Southern Malawi

by Monica Nzanga, Mindy Panulo, Tracy Morse and Kondwani Chidziwisano

Int. J. Environ. Res. Public Health 2022, 19(17), 10981; https://doi.org/10.3390/ijerph191710981 - 2 Sep 2022

Cited by 5 | Viewed by 3329

Abstract

Healthcare associated infections (HAIs) are a burden in many countries especially low-income countries due to poor hand hygiene practices in the healthcare settings. Proper hand hygiene in the healthcare setting is an effective way of preventing and reducing HAIs, and is an integral component of infection prevention and control. The objective of this study was to determine adherence to hand hygiene guidelines and associated factors among nurses and clinicians. A quantitative cross-sectional study was conducted at Chiradzulu District Hospital (Malawi) where stratified random sampling was used to obtain the sample of 75 nurses and clinicians. Data were collected using self-administered questionnaires (n = 75), observation checklists (n = 7) and structured observations (n = 566). The study findings confirmed low adherence to hand hygiene practice among healthcare workers (HCWs) in Malawi. Overall, higher hand hygiene practices were reported than observed among nurses and clinicians in all the World Health Organization’s (WHO) five critical moments of hand hygiene. This calls on the need for a combination of infrastructure, consumables (e.g., soap) and theory driven behavior change interventions to influence adoption of the recommended hand hygiene behaviors. However, such interventions should not include demographic factors (i.e., age, profession and ward) as they have been proven not to influence hand hygiene performance. Full article

(This article belongs to the Special Issue Basics of Hygiene in Public Health and Health Promotion)

11 pages, 4383 KiB

Open AccessArticle

Innovative Application of Diathermy in Orthodontics: A Case Report

by Nunzio Cirulli, Alessio Danilo Inchingolo, Assunta Patano, Sabino Ceci, Grazia Marinelli, Giuseppina Malcangi, Giovanni Coloccia, Valentina Montenegro, Chiara Di Pede, Anna Maria Ciocia, Giuseppe Barile, Antonio Mancini, Giulia Palmieri, Daniela Azzollini, Biagio Rapone, Ludovica Nucci, Ioana Roxana Bordea, Antonio Scarano, Felice Lorusso, Gianluca Martino Tartaglia, Cinzia Maspero, Manuel Nuzzolese, Filippo Cardarelli, Daniela Di Venere, Angelo Michele Inchingolo, Gianna Dipalma and Francesco Inchingolo Show full author list Hide full author list

Int. J. Environ. Res. Public Health 2022, 19(12), 7448; https://doi.org/10.3390/ijerph19127448 - 17 Jun 2022

Cited by 8 | Viewed by 4771

Abstract

Introduction: Several strategies have been proposed in the literature to accelerate tooth movement, many of which are invasive and have numerous side effects, such as surgical techniques (corticotomy and piezocision technique). This research investigates to what extent diathermy can accelerate the orthodontic alignment phase. Materials and Methods: A patient with lower teeth crowding index of the same magnitude was selected. The orthodontic treatment with Nickel–Titanium (NiTi) thermal arc 0.015 in the lower arch was performed, associated with a weekly application of diathermy using the intraoral handpiece. The total duration of treatment was three weeks. During each session, an intraoral transducer was employed to stimulate the hard and soft tissues of the left dental hemiarch, which was also orthodontically aligned like the right one. Results: Comparing the tooth movements of four elements of the two hemiarchies, it was found that, overall, the two teeth examined on the treated side underwent a more significant number of changes than on the untreated side, although not by a significant amount. Conclusions: The use of diathermy, according to the authors, is a non-invasive approach that may speed up the orthodontic alignment phase and reduce treatment duration, resulting in a lower risk of caries, gingival recessions, root resorptions, and patient compliance improvement, without side effects. Further studies and an adequate sample size will be needed to confirm the findings. Full article

(This article belongs to the Special Issue Basics of Hygiene in Public Health and Health Promotion)

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10 pages, 455 KiB

Open AccessArticle

Development and Validation of a Knowledge, Attitudes and Practices Questionnaire on COVID-19 (KAP COVID-19)

by Da-In Park

Int. J. Environ. Res. Public Health 2021, 18(14), 7493; https://doi.org/10.3390/ijerph18147493 - 14 Jul 2021

Cited by 31 | Viewed by 6657

Abstract

Given its highly contagious nature and an absence of a specific antiviral agent to this date, the key to controlling the spread of coronavirus disease 2019 (COVID-19) and decreasing the infection rate is adherence to preventive measures. It is essential to understand an individual’s knowledge, attitudes and practices toward COVID-19 since public adherence to health guidelines relies heavily on these aspects. However, there is no validated instrument that evaluates knowledge, attitudes and practices toward COVID-19. Thus, this study aimed to develop and validate such tool. A questionnaire was developed based on international and national guidelines and a review of the literature. Initial items were evaluated by 10 experts to determine content validity. Exploratory factor analysis and reliability testing were conducted with a convenience sample of 229 nursing students. Based on the content, face validity and factor analysis, 34 items were selected. The Kaiser-Meyer-Olkin value of 0.735 indicated a highly acceptable score with a significant Bartlett’s test of sphericity (p < 0.0001). The internal consistency coefficients indicated acceptable reliability of the tool (Cronbach’s α = 0.75). The KAP COVID-19 is a valid instrument that can be used to evaluate knowledge, attitudes and practices toward COVID-19. Full article

(This article belongs to the Special Issue Basics of Hygiene in Public Health and Health Promotion)

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9 pages, 609 KiB

Open AccessArticle

Diagnostic Accuracy of a New Antigen Test for SARS-CoV-2 Detection

by Marina Di Domenico, Alfredo De Rosa, Francesca Di Gaudio, Pietro Internicola, Cinzia Bettini, Nicola Salzano, Davide Castrianni, Andrea Marotta and Mariarosaria Boccellino

Int. J. Environ. Res. Public Health 2021, 18(12), 6310; https://doi.org/10.3390/ijerph18126310 - 10 Jun 2021

Cited by 15 | Viewed by 7695

Abstract

Background and aims: Quick and reliable diagnostic tools play an important role in controlling the spread of the SARS-Cov-2 pandemic. The aim of this study was to evaluate the diagnostic accuracy of a new cyto-salivary antigen test aimed at detecting the presence of antigens for SARS-CoV-2, as compared by the gold standard RT-PCR and a lateral flow test. Methods: A total of 433 healthy volunteers were enrolled in the study and the sensitivity and specificity of the new cyto-salivary antigen test were calculated, as compared to the RT-PCR nasopharyngeal swab and to the lateral flow test. Results: A total of 433 samples were collected and tested at the Mediterranean Fair in Palermo from February 2021 until April 2021. The new cyto-salivary antigen had a sensitivity of 100% and a specificity of 94.2%. The sensitivity and the specificity of the lateral flow test were 55% and 100%, respectively. Conclusions: The new cyto-salivary antigen test detected more positive cases than the RT-PCR in a sample of asymptomatic subjects, demonstrating to be a promising tool for a more sensitive diagnosis of COVID-19. Further studies are warranted to better characterize its diagnostic accuracy. Full article

(This article belongs to the Special Issue Basics of Hygiene in Public Health and Health Promotion)

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12 pages, 661 KiB

Open AccessArticle

Serological Profile of Children and Young Adults with at Least One SARS-CoV-2 Positive Cohabitant: An Observational Study

by Marco Farronato, Carolina Dolci, Elisa Boccalari, Sara Izadi, Luis Hernan Salvatierra Rios, Maurizio Festa, Valentina Panetta, Danila De Vito and Gianluca Martino Tartaglia

Int. J. Environ. Res. Public Health 2021, 18(4), 1488; https://doi.org/10.3390/ijerph18041488 - 4 Feb 2021

Cited by 7 | Viewed by 3213

Abstract

At the end of 2019, a new disease caused by the novel coronavirus SARS-CoV-2 appeared in Wuhan Province in China. Children seemed to be infected less frequently than adults, and family clusters seemed to play an important role in the spread of the pandemic. The aim of this study is to evaluate the serological profile of children and young adults between 4 and 16 years of age in order to assess the transmission patterns of COVID-19 between cohabitants. The subjects lived with at least one cohabitant who tested positive for the disease using a nasopharyngeal swab. To avoid contact with the disease, families were interviewed by telephone. Forty-nine children and adolescents with a mean age of 11 years were then subjected to a rapid lateral flow chromatographic test. Of them, seven (14.3%) were immunoglobulin G (IgG)-positive, and four (8.2%) were immunoglobulin M (IgM)-positive. In total, 16.3% of the tested sample had antibodies against SARS-CoV-2: this may confirm the lower vulnerability of children to COVID-19, despite the small sample size. The time from the negativization of the cohabitant until the test day may have influenced the results, especially when this timeframe is wide. Full article

(This article belongs to the Special Issue Basics of Hygiene in Public Health and Health Promotion)

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Review

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11 pages, 699 KiB

Open AccessReview

The Mechanistic Pathways of Periodontal Pathogens Entering the Brain: The Potential Role of Treponema denticola in Tracing Alzheimer’s Disease Pathology

by Flavio Pisani, Valerio Pisani, Francesca Arcangeli, Alice Harding and Simarjit Kaur Singhrao

Int. J. Environ. Res. Public Health 2022, 19(15), 9386; https://doi.org/10.3390/ijerph19159386 - 31 Jul 2022

Cited by 17 | Viewed by 3458

Abstract

Alzheimer’s Disease (AD) is a complex neurodegenerative disease and remains the most common form of dementia. The pathological features include amyloid (Aβ) accumulation, neurofibrillary tangles (NFTs), neural and synaptic loss, microglial cell activation, and an increased blood–brain barrier permeability. One longstanding hypothesis suggests that a microbial etiology is key to AD initiation. Among the various periodontal microorganisms, Porphyromonas gingivalis has been considered the keystone agent to potentially correlate with AD, due to its influence on systemic inflammation. P. gingivalis together with Treponema denticola and Tannerella forsythia belong to the red complex consortium of bacteria advocated to sustain periodontitis within a local dysbiosis and a host response alteration. Since the implication of P. gingivalis in the pathogenesis of AD, evidence has emerged of T. denticola clusters in some AD brain tissue sections. This narrative review explored the potential mode of spirochetes entry into the AD brain for tracing pathology. Spirochetes are slow-growing bacteria, which can hide within ganglia for many years. It is this feature in combination with the ability of these bacteria to evade the hosts’ immune responses that may account for a long lag phase between infection and plausible AD disease symptoms. As the locus coeruleus has direct connection between the trigeminal nuclei to periodontal free nerve endings and proprioceptors with the central nervous system, it is plausible that they could initiate AD pathology from this anatomical region. Full article

(This article belongs to the Special Issue Basics of Hygiene in Public Health and Health Promotion)

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17 pages, 1041 KiB

Open AccessReview

Encountering Parents Who Are Hesitant or Reluctant to Vaccinate Their Children: A Meta-Ethnography

by Sara Fernández-Basanta, Manuel Lagoa-Millarengo and María-Jesús Movilla-Fernández

Int. J. Environ. Res. Public Health 2021, 18(14), 7584; https://doi.org/10.3390/ijerph18147584 - 16 Jul 2021

Cited by 7 | Viewed by 4408

Abstract

(1) Background: Health professionals play an important role in addressing parents who are hesitant or reluctant to immunise their children. Despite the importance of this topic, gaps remain in the literature about these experiences. This meta-ethnography aimed to synthesise the available body of qualitative work about the care experiences of community and hospital health professionals in encounters with parents hesitant or reluctant to vaccinate their children. The aim is to provide key information for the creation of strategies that address vaccine hesitancy or refusal and ensure public trust in vaccination programs, which are required in a pandemic context such as the current one. (2) Methods: Noblit and Hare’s interpretive meta-ethnography of 12 studies was followed. A line of argument synthesis based on a metaphor was developed. (3) Results: The metaphor “The stone that refuses to be sculpted”, accompanied by three themes, symbolises the care experiences of health professionals in their encounters with parents that hesitate or refuse to vaccinate their children. (4) Conclusions: The creation of clearer communication strategies, the establishment of a therapeutic alliance, health literacy and the empowerment of parents are recommended. The incorporation of health professionals in decision making and the strengthening of multidisciplinary teams interacting with such parents are also included. Full article

(This article belongs to the Special Issue Basics of Hygiene in Public Health and Health Promotion)

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14 pages, 1352 KiB

Open AccessSystematic Review

Tooth Complications after Orthodontic Miniscrews Insertion

by Angelo Michele Inchingolo, Giuseppina Malcangi, Stefania Costa, Maria Celeste Fatone, Pasquale Avantario, Merigrazia Campanelli, Fabio Piras, Assunta Patano, Irene Ferrara, Chiara Di Pede, Anna Netti, Elisabetta de Ruvo, Giulia Palmieri, Vito Settanni, Vincenzo Carpentiere, Gianluca Martino Tartaglia, Ioana Roxana Bordea, Felice Lorusso, Salvatore Sauro, Daniela Di Venere, Francesco Inchingolo, Alessio Danilo Inchingolo and Gianna Dipalma Show full author list Hide full author list

Int. J. Environ. Res. Public Health 2023, 20(2), 1562; https://doi.org/10.3390/ijerph20021562 - 14 Jan 2023

Cited by 16 | Viewed by 3389

Abstract

Orthodontic miniscrews (OM) are widely used in modern orthodontic clinical practice to improve skeletal anchorage and have a high safety profile. A complication at the time of OM insertion is tooth root perforation or periodontal ligament trauma. Rarely, OM injury can cause permanent damage, such as ankylosis, osteosclerosis, and loss of tooth vitality. The aim of this work was to analyze potential risks and dental complications associated with the use of OMs. A search of the PubMed, Cochrane, Web of Science, and Scopus databases was conducted without a time limit using the keywords “orthodontic mini-screw” and “dental damage”, resulting in 99 studies. After screening and eligibility, including articles obtained through a citation search, 13 articles were selected. Four studies revealed accidental injuries caused by OM. Most of the damage was localized at the root level and resolved spontaneously with restorative cement formation after prompt removal of the OM, while the pain disappeared. In some cases, irreversible nerve damage, extensive lesions to the dentin–pulp complex, and refractory periapical periodontitis occurred, requiring endodontic and/or surgical treatment. The choice of insertion site was the most important element to be evaluated during the application of OMs. Full article

(This article belongs to the Special Issue Basics of Hygiene in Public Health and Health Promotion)

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12 pages, 2160 KiB

Open AccessSystematic Review

Laser Surgical Approach of Upper Labial Frenulum: A Systematic Review

by Angelo Michele Inchingolo, Giuseppina Malcangi, Irene Ferrara, Fabio Viapiano, Anna Netti, Silvio Buongiorno, Giulia Latini, Daniela Azzollini, Nicole De Leonardis, Elisabetta de Ruvo, Antonio Mancini, Biagio Rapone, Daniela Di Venere, Assunta Patano, Pasquale Avantario, Gianluca Martino Tartaglia, Felice Lorusso, Antonio Scarano, Salvatore Sauro, Maria Celeste Fatone, Ioana Roxana Bordea, Francesco Inchingolo, Alessio Danilo Inchingolo and Gianna Dipalma Show full author list Hide full author list

Int. J. Environ. Res. Public Health 2023, 20(2), 1302; https://doi.org/10.3390/ijerph20021302 - 11 Jan 2023

Cited by 13 | Viewed by 6018

Abstract

An abnormal and hypertrophied upper labial frenulum (ULF) can cause diastemas, gingival recession, eruption abnormalities, and the onset of carious and periodontal problems in the upper central incisors, as well as aesthetic and functional disorders of the upper lip. The goal of this investigation is to review the evidence on the surgical techniques that are currently available for treating ULF in order to identify the best approach. PubMed, Scopus, Cochrane Library, and Embase were searched for papers that matched our topic from 13 November 2012 up to 22 November 2022 using the following Boolean keywords: “frenulum” and “surgery*”. A total of eight articles were selected for the purpose of the review. ULF can be surgically treated using either traditional scalpel surgery or laser surgery. The latter is the better option due to its intra- and post-operative benefits for both the patients and the clinicians, in terms of faster healing, fewer side effects and discomfort, and greater patient compliance. However, a higher learning curve is required for this technique, especially to calibrate the appropriate power of the laser. To date, it is not possible to identify which type of laser achieves the best clinical results for the treatment of ULF. Full article

(This article belongs to the Special Issue Basics of Hygiene in Public Health and Health Promotion)

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