Most-cited articles · 2019

The 100 most-cited articles in International Journal of Environmental Research and Public Health, 2019

Ranked by OpenAlex citation count on 29 October 2026, out of 5,322 eligible articles International Journal of Environmental Research and Public Health published in 2019. Ranks are frozen; this page will not change. Number one, with 2,284 citations: Waste Mismanagement in Developing Countries: A Review of Global Issues.

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5,322 articles
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2026-10-29

The most-cited articles from this journal in 2019 cluster around a few broad areas. Environmental health and pollution attract substantial attention, led by “Waste Mismanagement in Developing Countries: A Review of Global Issues” by Navarro Ferronato and Vincenzo Torretta with 2284 citations. Other prominent themes include mental health and well-being, particularly among students and workers, and the health effects of environmental contaminants such as plastics, cadmium, lead, and persistent organic pollutants.

For readers, this ranked list offers a view of the subjects that drew the most citations in this journal for 2019, drawn from 5322 eligible articles. It shows which reviews, meta-analyses, and empirical studies were most frequently referenced, and it allows comparison across topics ranging from waste and wastewater treatment to anxiety, burnout, and social cohesion.

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  1. 1
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    Waste Mismanagement in Developing Countries: A Review of Global Issues

    Navarro Ferronato, Vincenzo Torretta

    2,284 citationsOpen access (CC-BY)doi:10.3390/ijerph16061060OpenAlex

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    Environmental contamination due to solid waste mismanagement is a global issue. Open dumping and open burning are the main implemented waste treatment and final disposal systems, mainly visible in low-income countries. This paper reviews the main impacts due to waste mismanagement in developing countries, focusing on environmental contamination and social issues. The activity of the informal sector in developing cities was also reviewed, focusing on the main health risks due to waste scavenging. Results reported that the environmental impacts are pervasive worldwide: marine litter, air, soil and water contamination, and the direct interaction of waste pickers with hazardous waste are the most important issues. Many reviews were published in the scientific literature about specific waste streams, in order to quantify its effect on the environment. This narrative literature review assessed global issues due to different waste fractions showing how several sources of pollution are affecting the environment, population health, and sustainable development. The results and case studies…

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    The Relationship between Social Cohesion and Urban Green Space: An Avenue for Health Promotion

    Viniece L. Jennings, Omoshalewa Bamkole

    1,027 citationsOpen access (CC-BY)doi:10.3390/ijerph16030452OpenAlex

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    Social cohesion involves the interpersonal dynamics and sense of connection among people. Increased social cohesion can be associated with various physical and psychological health benefits. The presence of urban green spaces can encourage positive social interactions that cultivate social cohesion in ways that enhance health and well-being. Urban green spaces have also been linked to positive health behaviors and outcomes including increased physical activity and social engagement. Understanding the relationship between social cohesion and urban green space is important for informing holistic approaches to health. In this article, we discuss how positive interactions in urban green space can catalyze social cohesion, social capital and critical health-promoting behaviors that may enhance psychological health and well-being. We also summarize the strengths and limitations of previous studies and suggest directions for future research.

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    The Global Prevalence of Anxiety Among Medical Students: A Meta-Analysis

    Travis T. C. Quek, Wilson Tam, Bach Xuan Tran, Min Zhang, Zhisong Zhang and 2 more

    991 citationsOpen access (CC-BY)doi:10.3390/ijerph16152735OpenAlex

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    Anxiety, although as common and arguably as debilitating as depression, has garnered less attention, and is often undetected and undertreated in the general population. Similarly, anxiety among medical students warrants greater attention due to its significant implications. We aimed to study the global prevalence of anxiety among medical students and the associated factors predisposing medical students to anxiety. In February 2019, we carried out a systematic search for cross-sectional studies that examined the prevalence of anxiety among medical students. We computed the aggregate prevalence and pooled odds ratio (OR) using the random-effects model and used meta-regression analyses to explore the sources of heterogeneity. We pooled and analyzed data from sixty-nine studies comprising 40,348 medical students. The global prevalence rate of anxiety among medical students was 33.8% (95% Confidence Interval: 29.2-38.7%). Anxiety was most prevalent among medical students from the Middle East and Asia. Subgroup analyses by gender and year of study found no statistically significant…

  4. 4
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    Crop Residue Burning in India: Policy Challenges and Potential Solutions

    S. Bhuvaneshwari, Hiroshan Hettiarachchi, Jay N. Meegoda

    818 citationsOpen access (CC-BY)doi:10.3390/ijerph16050832OpenAlex

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    India, the second largest agro-based economy with year-round crop cultivation, generates a large amount of agricultural waste, including crop residues. In the absence of adequate sustainable management practices, approximately 92 seems a very small number of metric tons of crop waste is burned every year in India, causing excessive particulate matter emissions and air pollution. Crop residue burning has become a major environmental problem causing health issues as well as contributing to global warming. Composting, biochar production and mechanization are a few effective sustainable techniques that can help to curtail the issue while retaining the nutrients present in the crop residue in the soil. The government of India has attempted to curtail this problem, through numerous measures and campaigns designed to promote sustainable management methods such as converting crop residue into energy. However, the alarming rise of air pollution levels caused by crop residue burning in the city of Delhi and other northern areas in India observed in recent years, especially in and after the…

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    Global Lifetime and 12-Month Prevalence of Suicidal Behavior, Deliberate Self-Harm and Non-Suicidal Self-Injury in Children and Adolescents between 1989 and 2018: A Meta-Analysis

    Kim-San Lim, Celine Hsia Jia Wong, Roger S. McIntyre, Jiayun Wang, Zhisong Zhang and 4 more

    592 citationsOpen access (CC-BY)doi:10.3390/ijerph16224581OpenAlex

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    Objective: This meta-analysis aimed to estimate the global lifetime and 12-month prevalence of suicidal behavior, deliberate self-harm and non-suicidal self-injury in children and adolescents. Methods: A systematic search for relevant articles published between 1989 to 2018 was performed in multiple electronic databases. The aggregate 12-month and lifetime prevalence of suicidal behavior, deliberate self-harm, and non-suicidal self-injury were calculated based on the random-effects model. Subgroup analyses were performed to compare the prevalence according to school attendance and geographical regions. Results: A total of 686,672 children and adolescents were included. The aggregate lifetime and 12-month prevalence of suicide attempts was 6% (95% CI: 4.7–7.7%) and 4.5% (95% CI: 3.4–5.9%) respectively. The aggregate lifetime and 12-month prevalence of suicidal plan was 9.9% (95% CI: 5.5–17%) and 7.5% (95% CI: 4.5–12.1%) respectively. The aggregate lifetime and 12-month prevalence of suicidal ideation was 18% (95% CI: 14.2–22.7%) and 14.2% (95% CI: 11.6–17.3%) respectively. The…

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    Consumer Attitudes Towards Environmental Concerns of Meat Consumption: A Systematic Review

    Rubén Sánchez-Sabaté, Joan Sabaté

    573 citationsOpen access (CC-BY)doi:10.3390/ijerph16071220OpenAlex

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    Meat consumption is a major contributor to global warming. Given the worldwide growing demand of meat, and the severe impact of meat production on the planet, reducing animal protein consumption is a matter of food security and public health. Changing consumer food behavior is a challenge. Taste preferences, culinary traditions and social norms factor into food choices. Since behavioral change cannot occur without the subject's positive attitude based on reasons and motivations, a total of 34 papers on consumer attitudes and behavior towards meat consumption in relation to environmental concerns were examined. The results show that consumers aware of the meat impact on the planet, willing to stop or significantly reduce meat consumption for environmental reasons, and who have already changed their meat intake for ecological concerns are a small minority. However, environmental motives are already appealing significant proportions of Westerners to adopt certain meat curtailment strategies. Those who limit meat intake for environmental reasons are typically female, young, simply…

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    Solutions and Integrated Strategies for the Control and Mitigation of Plastic and Microplastic Pollution

    Joana C. Prata, Ana L. Patrício Silva, João Pinto da Costa, Catherine Mouneyrac, Tony Robert Walker and 2 more

    553 citationsOpen access (CC-BY)doi:10.3390/ijerph16132411OpenAlex

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    Plastic pollution is generated by the unsustainable use and disposal of plastic products in modern society, threatening economies, ecosystems, and human health. Current clean-up strategies have attempted to mitigate the negative effects of plastic pollution but are unable to compete with increasing quantities of plastic entering the environment. Thus, reducing inputs of plastic to the environment must be prioritized through a global multidisciplinary approach. Mismanaged waste is a major land-based source of plastic pollution that can be reduced through improvements in the life-cycle of plastics, especially in production, consumption, and disposal, through an Integrated Waste Management System. In this review paper, we discuss current practices to improve life cycle and waste management of plastics that can be implemented to reduce health and environmental impacts of plastics and reduce plastics pollution. Ten recommendations for stakeholders to reduce plastic pollution include (1) regulation of production and consumption; (2) eco-design; (3) increasing the demand for recycled…

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    Wastewater Treatment by Advanced Oxidation Process and Their Worldwide Research Trends

    José Antonio Garrido-Cárdenas, Belén Esteban-García, Ana Agüera, José Antonio Sánchez Pérez, Francisco Rogelio Manzano-Agugliaro

    481 citationsOpen access (CC-BY)doi:10.3390/ijerph17010170OpenAlex

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    Background: Water is a scarce resource and is considered a fundamental pillar of sustainable development. The modern development of society requires more and more drinking water. For this cleaner wastewater, treatments are key factors. Among those that exist, advanced oxidation processes are being researched as one of the sustainable solutions. The main objective of this manuscript is to show the scientific advances in this field. Methods: In this paper, a systematic analysis of all the existing scientific works was carried out to verify the evolution of this line of research. Results: It was observed that the three main countries researching this field are China, Spain, and the USA. Regarding the scientific collaboration between countries, three clusters were detected—one of Spain, one of China and the USA, and one of Italy and France. The publications are grouped around three types of water: industrial, urban, and drinking. Regarding the research, 15 clusters identified from the keywords analyzed the advanced oxidation process (alone or combined with biological oxidation) with the…

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    Toxic Effect of Acute Cadmium and Lead Exposure in Rat Blood, Liver, and Kidney

    Milena Anđelković, Aleksandra Buha Djordjević, Evica Antonijević Miljaković, Biljana Antonijević, Momcilo Stanic and 6 more

    453 citationsOpen access (CC-BY)doi:10.3390/ijerph16020274OpenAlex

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    Background: Cadmium and lead are widespread and non-biodegradable pollutants of great concern to human health. In real life scenarios, we are exposed to mixtures of chemicals rather than single chemicals, and it is therefore of paramount importance to assess their toxicity. In this study, we investigated the toxicity of Cd and Pb alone and as a mixture in an animal model of acute exposure. Methods: Experimental groups received a single treatment of aqueous solution of Cd-chloride (15 and 30 mg/kg body weight (b.w.) and Pb-acetate (150 mg/kg b.w.), while the mixture group received 15 mg Cd/kg b.w. and 150 mg Pb/kg b.w. Toxic effects of individual metals and their mixture were investigated on hematological and biochemical parameters, and the redox status in the plasma, liver, and kidneys of treated Wistar rats. Results: Tissue-specific changes were recorded in various parameters of oxidative damage, while the accumulation of metals in tissues accompanied the disturbances of both hematological and biochemical parameters. It was observed that the level of toxic metals in tissues had a…

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    Persistent Organic Pollutants in Food: Contamination Sources, Health Effects and Detection Methods

    Wenjing Guo, Bohu Pan, Sugunadevi Sakkiah, Gökhan Yavaş, Weigong Ge and 3 more

    439 citationsOpen access (CC-BY)doi:10.3390/ijerph16224361OpenAlex

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    Persistent organic pollutants (POPs) present in foods have been a major concern for food safety due to their persistence and toxic effects. To ensure food safety and protect human health from POPs, it is critical to achieve a better understanding of POP pathways into food and develop strategies to reduce human exposure. POPs could present in food in the raw stages, transferred from the environment or artificially introduced during food preparation steps. Exposure to these pollutants may cause various health problems such as endocrine disruption, cardiovascular diseases, cancers, diabetes, birth defects, and dysfunctional immune and reproductive systems. This review describes potential sources of POP food contamination, analytical approaches to measure POP levels in food and efforts to control food contamination with POPs.

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    The Effect of Long Working Hours and Overtime on Occupational Health: A Meta-Analysis of Evidence from 1998 to 2018

    Ka Po Wong, Alan H. S. Chan, Shing-Chung Ngan

    427 citationsOpen access (CC-BY)doi:10.3390/ijerph16122102OpenAlex

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    There has been no subsequent meta-analysis examining the effects of long working hours on health or occupational health since 1997. Therefore, this paper aims to conduct a meta-analysis covering studies after 1997 for a comparison. A total of 243 published records were extracted from electronic databases. The effects were measured by five conditions, namely, physiological health (PH), mental health (MH), health behaviours (HB), related health (RH), and nonspecified health (NH). The overall odds ratio between long working hours and occupational health was 1.245 (95% confidence interval (CI): 1.195-1.298). The condition of related health constituted the highest odds ratio value (1.465, 95% CI: 1.332-1.611). The potential moderators were study method, cut-point for long weekly working hours, and country of origin. Long working hours were shown to adversely affect the occupational health of workers. The management on safeguarding the occupational health of workers working long hours should be reinforced.

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    Reducing Racial Inequities in Health: Using What We Already Know to Take Action

    David R. Williams, Lisa A. Cooper

    415 citationsOpen access (CC-BY)doi:10.3390/ijerph16040606OpenAlex

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    This paper provides an overview of the scientific evidence pointing to critically needed steps to reduce racial inequities in health. First, it argues that communities of opportunity should be developed to minimize some of the adverse impacts of systemic racism. These are communities that provide early childhood development resources, implement policies to reduce childhood poverty, provide work and income support opportunities for adults, and ensure healthy housing and neighborhood conditions. Second, the healthcare system needs new emphases on ensuring access to high quality care for all, strengthening preventive health care approaches, addressing patients' social needs as part of healthcare delivery, and diversifying the healthcare work force to more closely reflect the demographic composition of the patient population. Finally, new research is needed to identify the optimal strategies to build political will and support to address social inequities in health. This will include initiatives to raise awareness levels of the pervasiveness of inequities in health, build empathy and…

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    Prevalence of Burnout in Medical and Surgical Residents: A Meta-Analysis

    Zhi Xuan Low, Keith A Yeo, Vijay Kumar Sharma, Gkk Leung, Roger S. McIntyre and 8 more

    414 citationsOpen access (CC-BY)doi:10.3390/ijerph16091479OpenAlex

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    The burnout syndrome is characterized by emotional exhaustion, depersonalization, and reduced personal achievement. Uncertainty exists about the prevalence of burnout among medical and surgical residents. Associations between burnout and gender, age, specialty, and geographical location of training are unclear. In this meta-analysis, we aimed to quantitatively summarize the global prevalence rates of burnout among residents, by specialty and its contributing factors. We searched PubMed, PsycINFO, Embase, and Web of Science to identify studies that examined the prevalence of burnout among residents from various specialties and countries. The primary outcome assessed was the aggregate prevalence of burnout among all residents. The random effects model was used to calculate the aggregate prevalence, and heterogeneity was assessed by I2 statistic and Cochran’s Q statistic. We also performed meta-regression and subgroup analysis. The aggregate prevalence of burnout was 51.0% (95% CI: 45.0–57.0%, I2 = 97%) in 22,778 residents. Meta-regression found that the mean age (β = 0.34, 95% CI:…

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    Social Media, Thin-Ideal, Body Dissatisfaction and Disordered Eating Attitudes: An Exploratory Analysis

    Pilar Aparicio Martínez, Alberto-Jesús Perea-Moreno, Pilar Martínez-Jiménez, María Dolores Redel-Macías, Claudia Pagliari and 1 more

    413 citationsOpen access (CC-BY)doi:10.3390/ijerph16214177OpenAlex

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    Disordered eating attitudes are rapidly increasing, especially among young women in their twenties. These disordered behaviours result from the interaction of several factors, including beauty ideals. A significant factor is social media, by which the unrealistic beauty ideals are popularized and may lead to these behaviours. The objectives of this study were, first, to determine the relationship between disordered eating behaviours among female university students and sociocultural factors, such as the use of social network sites, beauty ideals, body satisfaction, body image and the body image desired to achieve and, second, to determine whether there is a sensitive relationship between disordered eating attitudes, addiction to social networks, and testosterone levels as a biological factor. The data (N = 168) was obtained using validated surveys (EAT-26, BSQ, CIPE-a, SNSA) and indirect measures of prenatal testosterone. The data was analysed using chi-square, Student’s t-test, correlation tests and logistic regression tests. The results showed that disordered eating attitudes were…

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    Patient Satisfaction with Health Care Services; An Application of Physician’s Behavior as a Moderator

    Faiza Manzoor, Longbao Wei, Abid Hussain, Muhammad Asif, Syed Irshad Ali Shah

    408 citationsOpen access (CC-BY)doi:10.3390/ijerph16183318OpenAlex

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    Patient satisfaction is a measure of the extent to which a patient is content with the health care they received from their health care provider. Patient satisfaction is one of the most important factors to determine the success of a health care facility. The purpose of this study was to determine patient satisfaction with healthcare services and encompass the physician's behavior as moderation between patient satisfaction and healthcare services. The study seeks to measure the health care services, like a laboratory and diagnostic care, preventive healthcare and prenatal care, to patient satisfaction in the public health sectors of Pakistan. A descriptive survey research design was used for this study. The target population was patients from the out-patient department (OPD) of three public hospitals from Pakistan. By using the convenient sampling technique, 290 sample participants were selected from the target population. The reliability scales were tallied by using Cronbach's Alpha. The findings of the study are gleaned by using regression to explore patient satisfaction with the…

  16. 16
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    Digital Leadership Skills and Associations with Psychological Well-Being

    Sabrina Jasmina Zeike, Katherine J Bradbury, Lara Lindert, Holger Pfaff

    398 citationsOpen access (CC-BY)doi:10.3390/ijerph16142628OpenAlex

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    Due to increasing digitalisation, today's working world is changing rapidly and provides managers with new challenges. Digital leadership is an important factor in managing these challenges and has become a key concept in the discussion about what kinds of skills managers need for digital transformation. The main research question our study explored was if digital leadership is associated with psychological well-being in upper-level managers. Based on a qualitative pilot study and relevant literature, we developed a new scale for digital leadership in managers. We conducted an online survey with a sample of 368 upper-level managers from a large German ICT-company. Using a stepwise logistic regression analysis, potential effects of digital leadership on psychological well-being (WHO-5) were analysed. Logistic regression analyses showed that better skills in digital leadership were significantly associated with higher well-being. Results also showed that gender, age and managerial experience had no effect in our model. Our study provides a valuable insight into the association between…

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    Key Risk Factors Affecting Farmers’ Mental Health: A Systematic Review

    Sahar Daghagh Yazd, Sarah Ann Wheeler, Alec Zuo

    389 citationsOpen access (CC-BY)doi:10.3390/ijerph16234849OpenAlex

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    Recently, concern has increased globally over farmers' mental health issues. We present a systematic review of the outcomes, locations, study designs, and methods of current studies on farmers' mental health. In particular, this review aims to fill an important gap in understanding of the potential key risk factors affecting farmers' mental health around the world. 167 articles on farmer mental health were included in a final systematic review using a standardized electronic literature search strategy and PRISMA guidelines. The four most-cited influences on farmers' mental health in the reviewed literature respectively were pesticide exposure, financial difficulties, climate variabilities/drought, and poor physical health/past injuries. The majority of studies were from developed countries, most specifically from the United States, Australia, and the United Kingdom. Comparative studies on the mental health of farmers and other occupational workers showed mixed results, with a larger portion identifying that psychological health disturbances were more common in farmers and…

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    Addictive Features of Social Media/Messenger Platforms and Freemium Games against the Background of Psychological and Economic Theories

    Christian Montag, Bernd Lachmann, Marc Herrlich, Katharina Anna Zweig

    385 citationsOpen access (CC-BY)doi:10.3390/ijerph16142612OpenAlex

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    Currently about 2.71 billion humans use a smartphone worldwide. Although smartphone technology has brought many advances, a growing number of scientists discuss potential detrimental effects due to excessive smartphone use. Of importance, the likely culprit to understand over-usage is not the smartphone itself, but the excessive use of applications installed on smartphones. As the current business model of many app-developers foresees an exchange of personal data for allowance to use an app, it is not surprising that many design elements can be found in social media apps and Freemium games prolonging app usage. It is the aim of the present work to analyze several prominent smartphone apps to carve out such elements. As a result of the analysis, a total of six different mechanisms are highlighted to illustrate the prevailing business model in smartphone app development. First, these app-elements are described and second linked to classic psychological/economic theories such as the mere-exposure effect, endowment effect, and Zeigarnik effect, but also to psychological mechanisms…

  19. 19
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    The Contribution of Sustainable Tourism to Economic Growth and Employment in Pakistan

    Faiza Manzoor, Longbao Wei, Muhammad Asif, Muhammad Zia Ul Haq, Hafiz ur Rehman

    378 citationsOpen access (CC-BY)doi:10.3390/ijerph16193785OpenAlex

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    In the global economy, tourism is one of the most noticeable and growing sectors. Thissector plays an important role in boosting a nation's economy. An increase in tourism flow canbring positive economic outcomes to the nations, especially in gross domestic product (GDP) andemployment opportunities. In South Asian countries, the tourism industry is an engine ofeconomic development and GDP growth. This study investigates the impact of tourism onPakistan's economic growth and employment. The period under study was from 1990 to 2015. Tocheck whether the variables under study were stationary, augmented Dickey-Fuller andPhillips-Perron unit root tests were applied. A regression technique and Johansen cointegrationapproach were employed for the analysis of data. The key finding of this study shows that there isa positive and significant impact of tourism on Pakistan's economic growth as well as employmentsector and there is also a long-run relationship among the variables under study. This studysuggests that legislators should focus on the policies with special emphasis on the promotion…

  20. 20
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    Wetlands of International Importance: Status, Threats, and Future Protection

    Ting Xu, Baisha Weng, Denghua Yan, Kun Wang, Xiangnan Li and 4 more

    374 citationsOpen access (CC-BY)doi:10.3390/ijerph16101818OpenAlex

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    The 2303 Wetlands of International Importance distribute unevenly in different continents. Europe owns the largest number of sites, while Africa has the largest area of sites. More than half of the sites are affected by three or four impact factors (55%). The most significant impact factors are pollution (54%), biological resources use (53%), natural system modification (53%), and agriculture and aquaculture (42%). The main affected objects are land area and environment of the wetlands, occurred in 75% and 69% of the sites, respectively. The types most affected by land area occupation are river wetlands and lake wetlands, the types with the greatest impact on environment are marine/coastal wetlands and river wetlands, the type with the greatest impact on biodiversity is river wetlands, the types most affected by water resources regulation are marsh wetlands and river wetlands, and the types most affected by climate change are lake wetlands and marine/coastal wetlands. About one-third of the wetland sites have been artificially reconstructed. However, it is found that the proportions…

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    Catalytic Oxidation Process for the Degradation of Synthetic Dyes: An Overview

    Rahat Javaid, Umair Yaqub Qazi

    367 citationsOpen access (CC-BY)doi:10.3390/ijerph16112066OpenAlex

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    Dyes are used in various industries as coloring agents. The discharge of dyes, specifically synthetic dyes, in wastewater represents a serious environmental problem and causes public health concerns. The implementation of regulations for wastewater discharge has forced research towards either the development of new processes or the improvement of available techniques to attain efficient degradation of dyes. Catalytic oxidation is one of the advanced oxidation processes (AOPs), based on the active radicals produced during the reaction in the presence of a catalyst. This paper reviews the problems of dyes and hydroxyl radical-based oxidation processes, including Fenton's process, non-iron metal catalysts, and the application of thin metal catalyst-coated tubular reactors in detail. In addition, the sulfate radical-based catalytic oxidation technique has also been described. This study also includes the effects of various operating parameters such as pH, temperature, the concentration of the oxidant, the initial concentration of dyes, and reaction time on the catalytic decomposition of…

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    Organic Food Purchases in an Emerging Market: The Influence of Consumers’ Personal Factors and Green Marketing Practices of Food Stores

    Hoàng Việt Nguyễn, Ninh Nguyen, Bach Khoa Nguyen, Antonio Lobo, Phuong Anh Vu

    356 citationsOpen access (CC-BY)doi:10.3390/ijerph16061037OpenAlex

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    The consumption of food has a significant impact on the environment, individuals and public health. This study aims to investigate the integrative effects of consumers' personal and situational factors on their attitude and purchase behavior of organic meat. The consumption of this product has been widely regarded as contributing towards sustainable food practices. The study was conducted in an emerging market economy, i.e., Vietnam. Data were collected using a customized and validated survey instrument from a sample of 609 organic meat consumers at four food outlets in Hanoi. The findings suggested that consumers' concerns regarding the environment, health, food safety and their knowledge of organic food, all significantly impacted their attitude towards the purchase behavior of organic meat. Interestingly, their positive attitude did not necessarily translate into their actual purchase of organic meat. Additionally, food stores' green marketing practices significantly enhanced consumers' actual purchase behavior. Conversely, premium prices of organic meat were certainly a…

  23. 23
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    Consumer Understanding of Food Quality, Healthiness, and Environmental Impact: A Cross-National Perspective

    Dacinia Crina Petrescu, Iris Vermeir, Ruxandra Malina Petrescu‐Mag

    353 citationsOpen access (CC-BY)doi:10.3390/ijerph17010169OpenAlex

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    The last few decades testify that consumers' concerns for healthier lifestyles and environment care are driving forces for reshaping food buying intentions and their perspectives on food quality. The present study identifies the importance that consumers attach to quality, health, and environment selected cues of purchased food products. More precisely, to elicit preferences for social, environmental, and qualitative food cues, a survey instrument was developed and applied on 797 Belgian and Romanian consumers. Our findings suggest that investigated consumers most frequently use freshness, taste, and appearance to evaluate food quality. The use frequency of food quality cues related to health is primarily influenced by the attention paid to food quality. The most relevant cues of food healthiness are ingredients, nutrition facts, and additives and for food environmental impact are packaging, food origin, and production type. It is concluded that food quality receives high attention both from Belgian and Romanian consumers and health and environment related cues can be used as a…

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    The Effects of Green Exercise on Physical and Mental Wellbeing: A Systematic Review

    Ian Matthew Lahart, Patricia M. Darcy, Christopher James Gidlow, Giovanna Calogiuri

    352 citationsOpen access (CC-BY)doi:10.3390/ijerph16081352OpenAlex

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    We aimed to examine the evidence for the proposed additive effect of exercise in the presence of nature (green exercise) by systematically reviewing studies that investigated the effects of outdoor or virtual green exercise compared with indoor exercise. Our review updates an earlier review, whose searches were conducted in April 2010. Trials were eligible if: (a) participants in an outdoor or virtual exercise condition were exposed to views of nature (green exercise); (b) green exercise was compared with indoor exercise with no exposure to nature; (c) included an outcome related to physical or mental health; (d) used comparative or crossover trial design. We searched the following databases from 1st January 2010 to 28th June 2018: PubMed, CENTRAL, EMBASE, PsycINFO, GreenFile, and Sports DISCUS. We assessed risk of bias using the Cochrane "risk of bias" tool. Where possible we conducted a meta-analysis using the inverse variance random-effects method, and where this approach was not possible we presented the results qualitatively and in harvest plots. We identified 28 eligible…

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    Effects of Socioeconomic Status on Physical and Psychological Health: Lifestyle as a Mediator

    Jian Wang, Liuna Geng

    349 citationsOpen access (CC-BY)doi:10.3390/ijerph16020281OpenAlex

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    Health is correlated to people's socioeconomic status (SES) and lifestyle. This study examined the impact of SES on respondents' physical and psychological health. Moreover, we explored the potential mediating effect of lifestyle on the relationship between SES and health. The participants were 986 respondents from the 2015 Chinese General Social Survey (CGSS). Structural equation modeling (SEM) was used to test the hypothesized relationship between the variables. The results indicated that SES had a significant impact on people's physical health, but the impact of SES on psychological health was not significant. Lifestyle had significant positive effects on both physical and psychological health. In addition, lifestyle mediated the relationship between SES and health. This research is helpful in gaining a better understanding of the relationship and mediating mechanism between SES, lifestyle, and health. It is recommended that research with longitudinal design and comprehensive indicators be undertaken in the future.

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    Cardiovascular Disease and the Female Disadvantage

    Mark Woodward

    329 citationsOpen access (CC-BY)doi:10.3390/ijerph16071165OpenAlex

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    Age-standardised rates of cardiovascular disease (CVD) are substantially higher in men than women. This explains why CVD has traditionally been seen as a "man's problem". However, CVD is the leading cause of death in women, worldwide, and is one of the most common causes of disability-adjusted life-years lost. In general, this is under-recognised and, in several ways, women are disadvantaged in terms of CVD. Both in primary and secondary prevention, there is evidence that women are undertreated, compared to men. Women often experience heart disease in a different way compared to men, and lack of recognition of this has been shown to have adverse consequences. Female patients of male cardiac physicians have been found to have worse outcomes than their male counterparts, with no such gender differential for female cardiologists. Clinical trials in CVD primarily recruit male patients, yet, it is well recognised that some drugs act differently in women and men. Diabetes and smoking, and perhaps other risk factors, confer a greater proportional excess cardiovascular risk to women than to…

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    Well-Being and Romantic Relationships: A Systematic Review in Adolescence and Emerging Adulthood

    Mercedes Gómez-López, Carmen Viejo, Rosario Ortega Ruiz

    325 citationsOpen access (CC-BY)doi:10.3390/ijerph16132415OpenAlex

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    Adolescence and emerging adulthood are both stages in which romantic relationships play a key role in development and can be a source of both well-being and negative outcomes. However, the limited number of studies prior to adulthood, along with the multiplicity of variables involved in the romantic context and the considerable ambiguity surrounding the construct of well-being, make it difficult to reach conclusions about the relationship between the two phenomena. This systematic review synthesizes the results produced into this topic over the last three decades. A total of 112 studies were included, following the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA-P) guidelines. On the one hand, these works revealed the terminological heterogeneity in research on well-being and the way the absence of symptoms of illness are commonly used to measure it, while on the other hand, they also showed that romantic relationships can be an important source of well-being for both adolescents and emerging adults. The findings underline the importance of…

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    Gender and Psychological Well-Being

    María Pilar Matud Aznar, Marisela López-Curbelo, Demelza Fortes Marichal

    319 citationsOpen access (CC-BY)doi:10.3390/ijerph16193531OpenAlex

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    Background: Research has consistently reported gender differences in mental health, but studies on differences in psychological well-being between women and men have not yielded conclusive results. The aim of this study was to examine the relevance of gender to the psychological well-being of adult individuals. A cross-sectional study with a sample of 1700 men and 1700 women from the general Spanish population was conducted. Their ages ranged from 21 to 64 years, and they were assessed with Ryff’s Psychological Well-Being Scales and the Bem Sex Role Inventory. Results: Men scored higher than women in self-acceptance and autonomy, and women scored higher than men in personal growth and positive relations with others. The most relevant variable in the psychological well-being of both women and men was high masculinity. Other relevant variables in women’s well-being were high femininity, not having a manual occupation, not being homemakers, and professional occupation. Men´s well-being also was higher in professional men and in men with a skilled non-manual occupation, men with high…

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    A Systematic Review of Physiological Measures of Mental Workload

    Da Tao, Haibo Tan, Hailiang Wang, Xu Zhang, Xingda Qu and 1 more

    310 citationsOpen access (CC-BY)doi:10.3390/ijerph16152716OpenAlex

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    Mental workload (MWL) can affect human performance and is considered critical in the design and evaluation of complex human-machine systems. While numerous physiological measures are used to assess MWL, there appears no consensus on their validity as effective agents of MWL. This study was conducted to provide a comprehensive understanding of the use of physiological measures of MWL and to synthesize empirical evidence on the validity of the measures to discriminate changes in MWL. A systematical literature search was conducted with four electronic databases for empirical studies measuring MWL with physiological measures. Ninety-one studies were included for analysis. We identified 78 physiological measures, which were distributed in cardiovascular, eye movement, electroencephalogram (EEG), respiration, electromyogram (EMG) and skin categories. Cardiovascular, eye movement and EEG measures were the most widely used across varied research domains, with 76%, 66%, and 71% of times reported a significant association with MWL, respectively. While most physiological measures were found to…

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    School Green Space and Its Impact on Academic Performance: A Systematic Literature Review

    Matthew H. E. M. Browning, Alessandro Rigolon

    306 citationsOpen access (CC-BY)doi:10.3390/ijerph16030429OpenAlex

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    Background: Scholars and policymakers have criticized public education in developed countries for perpetuating health and income disparities. Several studies have examined the ties between green space and academic performance, hypothesizing that green space can foster performance, and, over time, help reduce such disparities. Although numerous reviews have analyzed the link between nature and child health, none have focused on academic achievement. Methods: We identified 13 peer-reviewed articles that examined associations between academic outcomes, types of green spaces, and distances in which green spaces were measured around schools. Results: Of the 122 findings reported in the 13 articles, 64% were non-significant, 8% were significant and negative, and 28% were significant and positive. Positive findings were limited to greenness, tree cover, and green land cover at distances up to 2000 m around schools. End-of-semester grades and college preparatory exams showed greater shares of positive associations than math or reading test scores. Most findings regarding writing test scores…

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    SGLT2 Inhibitors: A Review of Their Antidiabetic and Cardioprotective Effects

    Anastasios Tentolouris, Panayotis K. Vlachakis, Evangelia Tzeravini, Ioanna Eleftheriadou, Nikolaοs Tentolouris

    300 citationsOpen access (CC-BY)doi:10.3390/ijerph16162965OpenAlex

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    Type 2 diabetes mellitus is a chronic metabolic disease associated with high cardiovascular (CV) risk. Sodium-glucose co-transporter 2 inhibitors (SGLT2i) are the latest class of antidiabetic medication that inhibit the absorption of glucose from the proximal tubule of the kidney and hence cause glycosuria. Four SGLT2i are currently commercially available in many countries: canagliflozin, dapagliflozin, empagliflozin, and ertugliflozin. SGLT2i reduce glycated hemoglobin by 0.5%–1.0% and have shown favorable effects on body weight, blood pressure, lipid profile, arterial stiffness and endothelial function. More importantly, SGLT2i have demonstrated impressive cardioprotective and renoprotective effects. The main mechanisms underlying their cardioprotective effects have been attributed to improvement in cardiac cell metabolism, improvement in ventricular loading conditions, inhibition of the Na+/H+ exchange in the myocardial cells, alteration in adipokines and cytokines production, as well as reduction of cardiac cells necrosis and cardiac fibrosis. The main adverse events of SGLT2i…

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    Mapping the Solastalgia Literature: A Scoping Review Study

    Lindsay P. Galway, Thomas H. Beery, Kelsey Jones-Casey, Kirsti Tasala

    297 citationsOpen access (CC-BY)doi:10.3390/ijerph16152662OpenAlex

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    Solastalgia is a relatively new concept for understanding the links between human and ecosystem health, specifically, the cumulative impacts of climatic and environmental change on mental, emotional, and spiritual health. Given the speed and scale of climate change alongside biodiversity loss, pollution, deforestation, unbridled resource extraction, and other environmental challenges, more and more people will experience solastalgia. This study reviewed 15 years of scholarly literature on solastalgia using a scoping review process. Our goal was to advance conceptual clarity, synthesize the literature, and identify priorities for future research. Four specific questions guided the review process: (1) How is solastalgia conceptualized and applied in the literature?; (2) How is solastalgia experienced and measured in the literature?; (3) How is 'place' understood in the solastalgia literature?; and (4) Does the current body of literature on solastalgia engage with Indigenous worldviews and experiences? Overall, we find there is a need for additional research employing diverse…

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    Workplace-Based Organizational Interventions Promoting Mental Health and Happiness among Healthcare Workers: A Realist Review

    Patricia Gray, Sipho Senabe, Nisha Naicker, Spo M Kgalamono, Annalee Yassi and 1 more

    295 citationsOpen access (CC-BY)doi:10.3390/ijerph16224396OpenAlex

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    Mental illness, deemed globally to account for 32% of years lived with a disability, generates significant impacts on workplaces. In particular, healthcare workers experience high rates of mental ill health such as burnout, stress, and depression due to workplace conditions including excessive workloads, workplace violence and bullying, which also produces negative effects on patients as well as on the happiness and wellbeing of those who remain at work. This review was undertaken to synthesize the evidence on workplace-based interventions at the organizational level promoting mental health and wellbeing among healthcare workers, to identify what has been receiving attention in this area and why, especially considering how such positive effects are produced. A search of three premier health-related databases identified 1290 articles that discussed healthcare workers, workplace interventions, and mental health. Following further examination, 46 articles were ultimately selected as meeting the criteria specifying interventions at the organizational level and combined with similar…

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    Inclusion of Older Adults in the Research and Design of Digital Technology

    Ittay Mannheim, Ella Cohn‐Schwartz, Wanyu Xi, Sandra C. Buttiġieġ, Mary McDonnell‐Naughton and 2 more

    290 citationsOpen access (CC-BY)doi:10.3390/ijerph16193718OpenAlex

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    Digital technology holds a promise to improve older adults' well-being and promote ageing in place. However, there seems to be a discrepancy between digital technologies that are developed and what older adults actually want and need. Ageing is stereotypically framed as a problem needed to be fixed, and older adults are considered to be frail and incompetent. Not surprisingly, many of the technologies developed for the use of older adults focus on care. The exclusion of older adults from the research and design of digital technology is often based on such negative stereotypes. In this opinion article, we argue that the inclusion rather than exclusion of older adults in the design process and research of digital technology is essential if technology is to fulfill the promise of improving well-being. We emphasize why this is important while also providing guidelines, evidence from the literature, and examples on how to do so. We unequivocally state that designers and researchers should make every effort to ensure the involvement of older adults in the design process and research of…

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    Physico-Chemical Analysis of Wastewater Discharge from Selected Paint Industries in Lagos, Nigeria

    Tolulope Elizabeth Aniyikaiye, Temilola O. Oluseyi, John O. Odiyo, Joshua Nosa Edokpayi

    287 citationsOpen access (CC-BY)doi:10.3390/ijerph16071235OpenAlex

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    Effluents from the paint industry have been a major source of environmental pollution. There is a need to investigate the compliance of wastewater discharged from paint industries with regulatory standards. In response, this study evaluates the physicochemical parameters of both raw and treated wastewater, the wastewater treatment plants (WWTPs) efficiencies as well as the compliance level of five selected paint manufacturing companies in Lagos, Nigeria with some regulatory standards: Federal Ministry of Environment (FME) in Nigeria, World Health Organization (WHO) and Department of Water Affairs (DWA) in South Africa. All parameters investigated were analysed using standard methods. The values of pH, electrical conductivity (EC) and total dissolved solids (TDS) levels were in the range of 4⁻12.2, 149.1⁻881.3 mS/m and 1100⁻6510 mg/L, respectively. The range of other parameters include total suspended solids (TSS); 0⁻2470 mg/L, TS; 1920⁻6510 mg/L, chloride; 63.8⁻733.8 mg/L, dissolved oxygen (DO); 0⁻6.7 mg/L, oil and grease (O & G); 44⁻100 mg/L, biochemical oxygen demand (BOD);…

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    Development of Contextually-relevant Sexuality Education: Lessons from a Comprehensive Review of Adolescent Sexuality Education Across Cultures

    Hildie Leung, Daniel T. L. Shek, Edvina Y.K. Leung, Esther Y. W. Shek

    283 citationsOpen access (CC-BY)doi:10.3390/ijerph16040621OpenAlex

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    As reported by the World Health Organization in 2017, there are 2 million+ young people living with HIV worldwide. The World Health Organization also reported that a third of all new HIV infections around the world are estimated to occur among youths (aged 15⁻25). and teen pregnancy rates are on the rise in many places. These worrying trends suggest that existing sexuality education programs and interventions may be inadequate and/or ineffective. Although the 1994 International Conference on Population and Development's (ICPD) Programme of Action highlighted the roles of Governments to offer sex education to young people to promote teenage reproductive health, yet inconsistency exists in the related initiatives in the global context. The present article aims to provide a comprehensive literature review of the existing sexuality programs in selected places in both English-speaking (i.e., the United States of America, the United Kingdom) and Chinese-speaking contexts (i.e., Hong Kong, Mainland China, and Taiwan). Based on the review, observations and implications for sexuality…

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    Loneliness of Older Adults: Social Network and the Living Environment

    Astrid D. A. M. Kemperman, Pauline van den Berg, Minou Weijs-Perrée, Kevin Uijtdewillegen

    282 citationsOpen access (CC-BY)doi:10.3390/ijerph16030406OpenAlex

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    The social participation and integration of older adults are important aspects of healthy aging. However, in general, older adults have smaller social networks than their younger counterparts due to changes in their life cycle stage, such as retirement or age-related losses, along with a declining health and increasing mobility limitations. Consequently, with increasing age, an increasing proportion of older people experience feelings of loneliness and social isolation. Previous studies that have analyzed the relationships between loneliness, social networks, and the living environment have often been based on bivariate relationships or included only a limited number of variables. Therefore, the aim of this study was to analyze multiple relationships in a more comprehensive framework. Data were collected using a survey among 182 adults aged 65 years and over in the Netherlands. A Bayesian belief network (BBN) modeling approach was used that derives all direct and indirect relationships between the variables. The results showed that feelings of loneliness are directly related to…

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    Cyberbullying and Psychological Well-being in Young Adolescence: The Potential Protective Mediation Effects of Social Support from Family, Friends, and Teachers

    Karin Hellfeldt, Laura López‐Romero, Henrik Andershed

    278 citationsOpen access (CC-BY)doi:10.3390/ijerph17010045OpenAlex

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    In the current study, we tested the relations between cyberbullying roles and several psychological well-being outcomes, as well as the potential mediation effect of perceived social support from family, friends, and teachers in school. This was investigated in a cross-sectional sample of 1707 young adolescents (47.5% girls, aged 10-13 years, self-reporting via a web questionnaire) attending community and private schools in a mid-sized municipality in Sweden. We concluded from our results that the Cyberbully-victim group has the highest levels of depressive symptoms, and the lowest of subjective well-being and family support. We also observed higher levels of anxiety symptoms in both the Cyber-victims and the Cyberbully-victims. Moreover, we conclude that some types of social support seem protective in the way that it mediates the relationship between cyberbullying and psychological well-being. More specifically, perceived social support from family and from teachers reduce the probability of depressive and anxiety symptoms, and higher levels of social support from the family…

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    Food Insecurity and Hunger in Rich Countries—It Is Time for Action against Inequality

    Christina Mary Pollard, Sue Booth

    278 citationsOpen access (CC-BY)doi:10.3390/ijerph16101804OpenAlex

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    Household food insecurity is a serious public health concern in rich countries with developed economies closely associated with inequality. The prevalence of household food insecurity is relatively high in some developed countries, ranging from 8 to 20% of the population. Human rights approaches have the potential to address the structural causes, not just the symptoms of food insecurity. Despite most developed countries ratifying the Covenant on Economic, Social and Cultural Rights over 40 years ago, food insecurity rates suggest current social protections are inadequate. The contemporary framing of the solution to food insecurity in developed countries is that of diverting food waste to the hungry to meet the United Nations Sustainable Development Goals agenda (Goals 2 and 12.3). An estimated 60 million people or 7.2% of the population in high income countries used food banks in 2013. Although providing food assistance to those who are hungry is an important strategy, the current focus distracts attention away from the ineffectiveness of government policies in addressing the…

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    It’s Time to Replace the Term “Heavy Metals” with “Potentially Toxic Elements” When Reporting Environmental Research

    Olivier Pourret, Andrew S. Hursthouse

    270 citationsOpen access (CC-BY)doi:10.3390/ijerph16224446OpenAlex

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    Even if the Periodic Table of Chemical Elements is relatively well defined, some controversial terms are still in use. Indeed, the term "heavy metal" is a common term used for decades in the natural sciences, and even more in environmental sciences, particularly in studies of pollution impacts. As the use of the term appears to have increased, we highlight the relevance of the use of the term "Potentially Toxic Element(s)", which needs more explicit endorsement, and we illustrate the chemical elements that need to be considered.

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    Psycho-Physiological Stress Recovery in Outdoor Nature-Based Interventions: A Systematic Review of the Past Eight Years of Research

    Sus Sola Corazon, Ulrik Sidenius, Dorthe Varning Poulsen, Marie Christoffersen Gramkow, Ulrika Karlsson Stigsdotter

    268 citationsOpen access (CC-BY)doi:10.3390/ijerph16101711OpenAlex

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    BACKGROUND: In modern, urban daily life, natural environments are increasingly recognized as an important resource for stress recovery and general well-being. AIM: the present review aims to provide an overview and synthesis of the past eight years' research into the psycho-physiological effects of outdoor nature-based interventions, related to stress recovery. METHOD: a structured search was performed in seven databases, returning 5618 articles. Removal of duplicates and initial screening gave a total of 95 studies. After full text reading, 36 studies were included in the assessment. RESULTS: most of the psychological outcomes were related to different emotional measures. The synthesis of the results points towards outdoor, nature-based exposure having a positive effect on different emotional parameters, related to stress relief. The studies into physiological measures showed more equivocal results. CONCLUSION: the research, conducted over the past eight years, into outdoor, nature-based exposure has now attained a sound evidence base for psychological and especially emotional…

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    Maximizing Muscle Hypertrophy: A Systematic Review of Advanced Resistance Training Techniques and Methods

    Michał Krzysztofik, Michał Wilk, Grzegorz Wojdała, Artur Gołaś

    265 citationsOpen access (CC-BY)doi:10.3390/ijerph16244897OpenAlex

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    BACKGROUND: Effective hypertrophy-oriented resistance training (RT) should comprise a combination of mechanical tension and metabolic stress. Regarding training variables, the most effective values are widely described in the literature. However, there is still a lack of consensus regarding the efficiency of advanced RT techniques and methods in comparison to traditional approaches. METHODS: MEDLINE and SPORTDiscus databases were searched from 1996 to September 2019 for all studies investigating the effects of advanced RT techniques and methods on muscle hypertrophy and training variables. Thirty articles met the inclusion criteria and were consequently included for the quality assessment and data extraction. RESULTS: Concerning the time-efficiency of training, the use of agonist-antagonist, upper-lower body supersets, drop and cluster sets, sarcoplasma stimulating training, employment of fast, but controlled duration of eccentric contractions (~2s), and high-load RT supplemented with low-load RT under blood flow restriction may provide an additional stimulus and an advantage to…

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    A Deep Learning Model for Automated Sleep Stages Classification Using PSG Signals

    Özal Yıldırım, Ulaş Baran Baloğlu, U. Rajendra Acharya

    265 citationsOpen access (CC-BY)doi:10.3390/ijerph16040599OpenAlex

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    Sleep disorder is a symptom of many neurological diseases that may significantly affect the quality of daily life. Traditional methods are time-consuming and involve the manual scoring of polysomnogram (PSG) signals obtained in a laboratory environment. However, the automated monitoring of sleep stages can help detect neurological disorders accurately as well. In this study, a flexible deep learning model is proposed using raw PSG signals. A one-dimensional convolutional neural network (1D-CNN) is developed using electroencephalogram (EEG) and electrooculogram (EOG) signals for the classification of sleep stages. The performance of the system is evaluated using two public databases (sleep-edf and sleep-edfx). The developed model yielded the highest accuracies of 98.06%, 94.64%, 92.36%, 91.22%, and 91.00% for two to six sleep classes, respectively, using the sleep-edf database. Further, the proposed model obtained the highest accuracies of 97.62%, 94.34%, 92.33%, 90.98%, and 89.54%, respectively for the same two to six sleep classes using the sleep-edfx dataset. The developed deep…

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    Overview of Stigma against Psychiatric Illnesses and Advancements of Anti-Stigma Activities in Six Asian Societies

    Zhisong Zhang, Kai Sing Sun, Chonnakarn Jatchavala, John Koh, Yimian Chia and 8 more

    263 citationsOpen access (CC-BY)doi:10.3390/ijerph17010280OpenAlex

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    Background: In psychiatry, stigma is an attitude of disapproval towards people with mental illnesses. Psychiatric disorders are common in Asia but some Asians receive inadequate treatment. Previous review found that Asians with mental illness were perceived to be dangerous and aggressive. There is a need for renewed efforts to understand stigma and strategies which can effectively reduce stigma in specific Asian societies. The objective of this systematic review was to provide an up-to-date overview of existing research and status on stigma experienced by psychiatric patients and anti-stigma campaigns in China, Hong Kong, Japan, Singapore, Korea, and Thailand. Methods: A systematic literature search was conducted in the following databases, including PubMed, PsycINFO, Embase, Web of Science, and local databases. Studies published in English and the official language of included countries/territories were considered for inclusion in the systematic review. Any article on stigma related to any form of psychiatric illness in the six Asian societies was included. Results: One hundred and…

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    Changes in Undergraduate Students’ Psychological Well-Being as They Experience University Life

    Xinqiao Liu, Siqing Ping, Wenjuan Gao

    261 citationsOpen access (CC-BY)doi:10.3390/ijerph16162864OpenAlex

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    The onset of most lifetime mental disorders occurs during adolescence, and the years in college, as the final stage of adolescence in a broad sense, deserve attention in this respect. The psychological well-being of undergraduate students can influence not only their academic and professional success, but also the development of society as a whole. Although previous studies suggested psychiatric disorders are common in the adult population, there was little consistent information available about undergraduate students' mental health problems. This research aimed to describe the changes in depression, anxiety, and stress of Chinese full-time undergraduate students as they experienced university life using the Depression Anxiety Stress Scales-21 (DASS-21). The main conclusions of our study were as follows: (1) on average, students' severity scores of depression during the four academic years varied between 7.22 and 7.79, while stress scores ranged from 9.53 to 11.68. However, the anxiety scores of college students in the first three years turned out to be 7.40, 7.24 and 7.10,…

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    Health and Environmental Risks of Residents Living Close to a Landfill: A Case Study of Thohoyandou Landfill, Limpopo Province, South Africa

    Prince Obinna Njoku, Joshua Nosa Edokpayi, John O. Odiyo

    259 citationsOpen access (CC-BY)doi:10.3390/ijerph16122125OpenAlex

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    The by-products of solid waste deposited in a landfill has adverse effects on the surrounding environment and humans living closer to landfill sites. This study sought to test the hypothesis that the deposition of waste on landfill has an impact on the surrounding environment and residents living closer to it. This was achieved by evaluating the perception of the respondents drawn from people living close (100-500 m) and far (1-2 km) from the landfill site, concerning environmental issues, health problems, and life satisfaction. Results from the study showed that 78% of participants living closer to the landfill site indicated serious contamination of air quality evident from bad odours linked to the landfill site. Illnesses such as flu, eye irritation and weakness of the body were frequently reported by participants living closer to the landfill than those living far from the landfill. More than half of the participants (56%) living closer to the landfill indicated fear of their health in the future. Thus, the participants living closer to the landfill site were less satisfied with…

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    Sociodemographic Factors Influencing the Use of eHealth in People with Chronic Diseases

    F. Reiners, Janienke Sturm, Lisette J.W. Bouw, Eveline Wouters

    258 citationsOpen access (CC-BY)doi:10.3390/ijerph16040645OpenAlex

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    Alongside the growing number of older persons, the prevalence of chronic diseases is increasing, leading to higher pressure on health care services. eHealth is considered a solution for better and more efficient health care. However, not every patient is able to use eHealth, for several reasons. This study aims to provide an overview of: (1) sociodemographic factors that influence the use of eHealth; and (2) suggest directions for interventions that will improve the use of eHealth in patients with chronic disease. A structured literature review of PubMed, ScienceDirect, Association for Computing Machinery Digital Library (ACMDL), and Cumulative Index to Nursing and Allied Health Literature (CINAHL) was conducted using four sets of keywords: "chronic disease", "eHealth", "factors", and "suggested interventions". Qualitative, quantitative, and mixed-method studies were included. Four researchers each assessed quality and extracted data. Twenty-two out of 1639 articles were included. Higher age and lower income, lower education, living alone, and living in rural areas were found to be…

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    Benefits of Outdoor Sports for Society. A Systematic Literature Review and Reflections on Evidence

    Barbara Eigenschenk, Andreas Thomann, Mike McClure, Larissa E. Davies, Maxine Gregory and 2 more

    255 citationsOpen access (CC-BY)doi:10.3390/ijerph16060937OpenAlex

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    The combination of physical activity and being in nature is recognized as providing a range of significant benefits. The objective of this literature review was to compile an overview of the social benefits and costs associated with outdoor sports within the academic literature and to reflect on the quality of underlying evidence that supports the relationship. A systematic review was carried out with seven partners from different European countries, including Bulgaria, France, Germany, United Kingdom, Italy, Portugal, and Spain. From a total of 17,560 studies identified, 133 studies were selected with relevant data extracted to standardized forms. The selected studies have been analyzed with qualitative research methods. A meta-analysis could not be conducted due to the heterogeneity of the study designs and outcome measures. As a result, the review gives an overview of the social impacts associated with outdoor sports which have been clustered to six broad categories: physical health, mental health and wellbeing, education and lifelong learning, active citizenship, crime…

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    Impact of Job Demands and Resources on Nurses’ Burnout and Occupational Turnover Intention Towards an Age-Moderated Mediation Model for the Nursing Profession

    BEATRICE I. J. M. VAN DER HEIJDEN, Christine Brown Mahoney, Yingzi Xu

    253 citationsOpen access (CC-BY)doi:10.3390/ijerph16112011OpenAlex

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    This longitudinal study among Registered Nurses has four purposes: (1) to investigate whether emotional, quantitative and physical demands, and family-work conflict have a negative impact on nurses' perceived effort; (2) to investigate whether quality of leadership, developmental opportunities, and social support from supervisors and colleagues have a positive impact on meaning of work; (3) to investigate whether burnout from the combined impact of perceived effort and meaning of work mediates the relationship with occupational turnover intention; and (4) whether the relationships in our overall hypothesized framework are moderated by age (nurses categorized under 40 years versus ≥ 40 years old). In line with our expectations, emotional, quantitative, and physical demands, plus family-work conflict appeared to increase levels of perceived effort. Quality of leadership, developmental opportunities, and social support from supervisors and colleagues increased the meaning of work levels. In addition, increased perceived stress resulted in higher burnout levels, while increased meaning…

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    Biodegradation of Polyethylene by Enterobacter sp. D1 from the Guts of Wax Moth Galleria mellonella

    Liu Ren, Lina Men, Zhiwei Zhang, Feifei Guan, Jian Tian and 4 more

    248 citationsOpen access (CC-BY)doi:10.3390/ijerph16111941OpenAlex

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    Plastic polymers are widely used in agriculture, industry, and our daily life because of their convenient and economic properties. However, pollution caused by plastic polymers, especially polyethylene (PE), affects both animal and human health when they aggregate in the environment, as they are not easily degraded under natural conditions. In this study, Enterobacter sp. D1 was isolated from the guts of wax moth (Galleria mellonella). Microbial colonies formed around a PE film after 14 days of cultivation with D1. Roughness, depressions, and cracks were detected on the surface of the PE film by scanning electron microscopy (SEM) and atomic force microscopy (AFM). Fourier transform infrared spectroscopy (FTIR) showed the presence of carbonyl functional groups and ether groups on the PE film that was treated with D1. Liquid chromatography-tandem mass spectrometry (LC-MS) also revealed that the contents of certain alcohols, esters, and acids were increased as a result of the D1 treatment, indicating that oxidation reaction occurred on the surface of the PE film treated with D1…

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    Overview of Existing Heat-Health Warning Systems in Europe

    Ana Casanueva, Annkatrin Burgstall, Sven Kotlarski, Alessandro Messeri, Marco Morabito and 4 more

    247 citationsOpen access (CC-BY)doi:10.3390/ijerph16152657OpenAlex

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    The frequency of extreme heat events, such as the summer of 2003 in Europe, and their corresponding consequences for human beings are expected to increase under a warmer climate. The joint collaboration of institutional agencies and multidisciplinary approaches is essential for a successful development of heat-health warning systems and action plans which can reduce the impacts of extreme heat on the population. The present work constitutes a state-of-the-art review of 16 European heat-health warning systems and heat-health action plans, based on the existing literature, web search (over the National Meteorological Services websites) and questionnaires. The aim of this study is to pave the way for future heat-health warning systems, such as the one currently under development in the framework of the Horizon 2020 HEAT-SHIELD project. Some aspects are highlighted among the variety of examined European warning systems. The meteorological variables that trigger the warnings should present a clear link with the impact under consideration and should be chosen depending on the purpose and…

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    Synergistic Effects of Climate Change and Marine Pollution: An Overlooked Interaction in Coastal and Estuarine Areas

    Henrique N. Cabral, Vanessa F. Fonseca, Tânia Sousa, Miguel Costa Leal

    243 citationsOpen access (CC-BY)doi:10.3390/ijerph16152737OpenAlex

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    Coastal areas have been increasingly affected by human activities, marine pollution and climate change are among the most important pressures affecting these environments. Human-induced pressures occur in a cumulative way and generate additive, antagonistic or synergistic effects. Knowledge on synergistic effects is crucial to coastal zone management, since they may imply a change in human uses of these systems, as well as dedicated action plans in order to reduce hazards and environmental risks. In this work, we provide an overview of the available literature on synergistic effects between climate change and chemical pollution, and discuss current knowledge, methodological approaches, and research gaps and needs. Interactions between these two pressures may be climate change dominant (climate change leads to an increase in contaminant exposure or toxicity) or contaminant-dominant (chemical exposure leads to an increase in climate change susceptibility), but the mechanistic drivers of such processes are not well known. Results from a few meta-analyses studies and reviews showed that…

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    How Health Communication via Tik Tok Makes a Difference: A Content Analysis of Tik Tok Accounts Run by Chinese Provincial Health Committees

    Chengyan Zhu, Xiaolin Xu, Wei Zhang, Jianmin Chen, Richard David Evans

    242 citationsOpen access (CC-BY)doi:10.3390/ijerph17010192OpenAlex

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    During the last two decades, social media has immersed itself into all facets of our personal and professional lives. The healthcare sector is no exception, with public health departments now capitalizing on the benefits that social media offers when delivering healthcare education and communication with citizens. Provincial Health Committees (PHCs) in China have begun to adopt the micro-video sharing platform, Tik Tok, to engage with local residents and communicate health-related information. This study investigates the status quo of official Tik Tok accounts managed by PHCs in mainland China. In total, 31 PHC accounts were analyzed during August 2019, while the top 100 most liked micro-videos were examined using content analysis. Coding included three major aspects: Quantified Impact, Video Content, and Video Form. 45.2% (n = 14) of PHCs had official Tik Tok accounts. A limited number of accounts (n = 2) were yet to upload a micro-video, while most (n = 9) had uploaded their first micro-video during 2019. For the top 100 most liked micro-videos, a sharp difference was observed in…

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    Reliability and Concurrent Validity of Global Physical Activity Questionnaire (GPAQ): A Systematic Review

    Xiaofen Deng Keating, Ke Zhou, Xiaolu Liu, Michael Hodges, Jingwen Liu and 3 more

    240 citationsOpen access (CC-BY)doi:10.3390/ijerph16214128OpenAlex

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    = 26) using the online EBSCOHost databases, PubMed, Web of Science, and Google Scholar up to September 2019. A previously developed coding sheet was used to collect the data. The Modified Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies was employed to assess risk of bias and study quality. It was found that GPAQ was primarily revalidated in adult populations in Asian and European countries. The sample size ranged from 43 to 2657 with a wide age range (i.e., 15-79 years old). Different populations yielded inconsistent results concerning the reliability and validity of the GPAQ. Short term (i.e., one- to two-week interval) and long-term (i.e., two- to three-month apart) test-retest reliability was good to very good. The concurrent validity using accelerometers, pedometers, and physical activity (PA) log was poor to fair. The GPAQ data and accelerometer/pedometer/PA log data were not compared using the same measurements in some validation studies. Studies with more rigorous research designs are needed before any conclusions concerning the concurrent…

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    Mapping Geospatial Processes Affecting the Environmental Fate of Agricultural Pesticides in Africa

    Chantal Mechtildis Johanna Hendriks, Harry S. Gibson, Anna Trett, André Python, Daniel J. Weiss and 5 more

    238 citationsOpen access (CC-BY)doi:10.3390/ijerph16193523OpenAlex

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    The application of agricultural pesticides in Africa can have negative effects on human health and the environment. The aim of this study was to identify African environments that are vulnerable to the accumulation of pesticides by mapping geospatial processes affecting pesticide fate. The study modelled processes associated with the environmental fate of agricultural pesticides using publicly available geospatial datasets. Key geospatial processes affecting the environmental fate of agricultural pesticides were selected after a review of pesticide fate models and maps for leaching, surface runoff, sedimentation, soil storage and filtering capacity, and volatilization were created. The potential and limitations of these maps are discussed. We then compiled a database of studies that measured pesticide residues in Africa. The database contains 10,076 observations, but only a limited number of observations remained when a standard dataset for one compound was extracted for validation. Despite the need for more in-situ data on pesticide residues and application, this study provides a…

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    A Systematic Literature Review of Green and Sustainable Logistics: Bibliometric Analysis, Research Trend and Knowledge Taxonomy

    Rui Chen Ren, Wanjie Hu, Jianjun Dong, Bo Sun, Yicun Chen and 1 more

    237 citationsOpen access (CC-BY)doi:10.3390/ijerph17010261OpenAlex

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    Ever-growing globalization and industrialization put forward impending requirements for green and sustainable logistics (G&SL). Over the past decades, G&SL initiatives triggered worldwide deliberations, aiming at easing negative transport externalities and improving supply chain performance. This review-based paper attempts to offer a joint quantitative and qualitative understanding for the overall evolutionary trend, knowledge structure, and literature gaps of the G&SL research field. Employing the science mapping approach, a total of 306 major paper published from 1999 to 2019 were retrieved, elaborated on, and synthesized. Visualized statistics regarding publication years, journal allocation/co-citation, inter-country/institution collaboration, influential articles, co-occurred keywords, and time view clusters of research themes were analyzed bibliographically. On this basis, a total of 50 sub-branches of G&SL knowledge were classified and thematically discussed based on five alignments, namely (i) social-environmental-economic research, (ii) planning, policy and management,…

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    Ecological and Health Effects of Lubricant Oils Emitted into the Environment

    Paulina Nowak, Karolina Kucharska, Marian Kamiński

    236 citationsOpen access (CC-BY)doi:10.3390/ijerph16163002OpenAlex

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    Lubricating oils used in machines with an open cutting system, such as a saw or harvester, are applied in forest areas, gardening, in the household, and in urban greenery. During the operation of the device with an open cutting system, the lubricating oil is emitted into the environment. Therefore, the use of an oil base and refining additives of petroleum origin in the content of lubricants is associated with a negative impact on health and the environment. The current legal regulations concerning lubricants applicable in the European Union (EU) assess the degree of biodegradability. Legislation permits the use of biodegradable oils at 60% for a period of 28 days. This means that, in practice, lubricating oil considered to be biodegradable can contain up to 50% of the so-called petroleum oil base. The paper aims to draw public attention to the need to reduce the toxicity and harmful effects, due to their composition, of lubricating oils emitted into the environment on health. The authors discuss the impact of petroleum oil lubricants on soils, groundwater, vegetation, and animals,…

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    Active and Passive Use of Green Space, Health, and Well-Being amongst University Students

    Elizabeth W. Holt, Quinn K. Lombard, Noelle Best, Sara Smiley-Smith, John E. Quinn

    236 citationsOpen access (CC-BY)doi:10.3390/ijerph16030424OpenAlex

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    Frequent exposure to green space has been linked to positive health and well-being in varying populations. Yet, there is still limited research exploring the restorative benefits associated with differing types of green space use among students living in the university setting. To address this gap, we explored green space use amongst a population of undergraduate students (n = 207) attending a university with abundant opportunities to access the restorative properties of nature. The purpose of this study was to examine the type and frequency of green space interactions that are most strongly associated with indicators of health and well-being, and investigate student characteristics associated with frequent use of green space. Results revealed that students who frequently engage with green spaces in active ways report higher quality of life, better overall mood, and lower perceived stress. Passive green space interactions were not strongly associated with indicators of health and well-being. Having had daily interactions with green space in childhood was associated with frequent…

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    Physiological Benefits of Viewing Nature: A Systematic Review of Indoor Experiments

    Hyunju Jo, Chorong Song, Yoshifumi Miyazaki

    234 citationsOpen access (CC-BY)doi:10.3390/ijerph16234739OpenAlex

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    Contact with nature has been proposed as a solution to achieve physiological relaxation and stress recovery, and a number of scientific verification outcomes have been shown. Compared with studies of the other senses, studies investigating the visual effects of nature have been at the forefront of this research field. A variety of physiological indicators adopted for use in indoor experiments have shown the benefits of viewing nature. In this systematic review, we examined current peer-reviewed articles regarding the physiological effects of visual stimulation from elements or representations of nature in an indoor setting. The articles were analyzed for their stimulation method, physiological measures applied, groups of participants, and outcomes. Thirty-seven articles presenting evidence of the physiological effects of viewing nature were selected. The majority of the studies that used display stimuli, such as photos, 3D images, virtual reality, and videos of natural landscapes, confirmed that viewing natural scenery led to more relaxed body responses than viewing the control.…

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    Urban Green Space: Creating a Triple Win for Environmental Sustainability, Health, and Health Equity through Behavior Change

    Hanneke Kruize, Nina van der Vliet, Brigit A.M. Staatsen, Ruth Bell, Aline Chiabai and 12 more

    233 citationsOpen access (CC-BY)doi:10.3390/ijerph16224403OpenAlex

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    Urbanization, costs of green space maintenance, and diminishing connection between people and nature all exert pressures on urban green space. This is regrettable as green space has the potential to create wins for environmental sustainability, health, and health equity. This paper explores this potential triple win and investigates how to increase the use of urban green space through behavior change. A narrative literature review was conducted and was supplemented with literature suggested by experts. Results show that creating well-designed green spaces and stimulating people to use them can indeed deliver this triple win. Providing accessible, attractive, well-maintained green space with room for socialization, and where people feel safe, may increase the opportunity and motivation of people to use it more often. Informing and educating people and organizing activities may increase capability (and motivation) to use green space. Since the use of green space depends on life stage, lifestyle factors and individual values, it is important to involve potential users in its design. We…

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    Assessment of Heavy Metal Pollution and Potential Ecological Risk in Sewage Sludge from Municipal Wastewater Treatment Plant Located in the Most Industrialized Region in Poland—Case Study

    Malwina Tytła

    233 citationsOpen access (CC-BY)doi:10.3390/ijerph16132430OpenAlex

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    This study aimed to assess the pollution and potential ecological risk of seven heavy metals (Cd, Cr, Cu, Hg, Ni, Pb, and Zn) in the sewage sludge collected from a wastewater treatment plant (WWTP), located in the most industrialized region of Poland (Silesian Voivodeship). The concentrations of heavy metals were determined using inductively coupled plasma optical spectrometry (ICP-OES) and cold vapor atomic absorption spectrometry (CVAAS). The chemical forms (chemical speciation) of heavy metals were determined using the three-step chemical sequential extraction procedure, developed by the Community Bureau of Reference (BCR). To assess the pollution level and potential ecological risk, the following indices were used: Geoaccumulation Index (Igeo), Potential Ecological Risk Factor (ER), Individual Contamination Factor (ICF), modified Risk Assessment Code (RACm), and Ecological Risk Factor (ERF)—the author’s index. Sludge samples were collected at successive stages of processing. The results revealed that the activated sludge process and sludge thickening have a significant impact on…

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    Is It Possible to Change from a Linear to a Circular Economy? An Overview of Opportunities and Barriers for European Small and Medium-Sized Enterprise Companies

    Concepción Garcés‐Ayerbe, Pilar Rivera Torres, Inés Suárez‐Perales, Dante I. Leyva‐de la Hiz

    226 citationsOpen access (CC-BY)doi:10.3390/ijerph16050851OpenAlex

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    The Circular Economy is a paradigm shift attempting to replace the end-of-life concept with reducing, reusing, recycling and recovering materials and to slow down, close and narrow material and power loops. This concept is much discussed in the academic literature, but limited progress has been accomplished so far regarding its empirical analysis. The objective of this work is to study circular economy practices and analyze in depth the circular economy behavior in European firms. We find that firms' circular economy behavior is a gradual process where measures are implemented gradually, starting with activities involving control measures and ending with putting preventive practices in place. We discovered also that the most proactive companies in implementing circular economy measures generally come across certain common barriers such as administrative processes, regulations and a lack of human resources to perform these practices, while firms that have not implemented circular economy measures view financing, investment and cost⁻benefit barriers as the most significant.…

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    Falls in Parkinson’s Disease Subtypes: Risk Factors, Locations and Circumstances

    Paulo Henrique Silva Pelicioni, Jasmine C. Menant, Mark D. Latt, Stephen R. Lord

    225 citationsOpen access (CC-BY)doi:10.3390/ijerph16122216OpenAlex

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    People with Parkinson's disease (PD) can be classified into those with postural instability and gait difficulty (PIGD subtype) and those manifesting tremor as the main symptoms (non-PIGD subtype). In a prospective cohort study of 113 people with PD we aimed to contrast fall rates and circumstances as well as a range of disease-related, clinical, and functional measures between the PD subtypes. Compared with non-PIGD participants, PIGD participants were significantly more likely to suffer more falls overall as well as more falls due to freezing of gait, balance-related falls and falls at home. The PIGD group also performed significantly worse in a range of fall-related clinical and functional measures including general cognitive status, executive function, quadriceps muscle strength, postural sway and the timed up and go test. These findings document the extent to which people with the PIGD subtype are at increased risk of falls, the circumstances in which they fall and their disease-related, clinical and functional impairments.

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    Oral Health and Its Associated Factors Among Older Institutionalized Residents—A Systematic Review

    Florence Mei Fung Wong, Yannies T. Y. Ng, Wai Keung Leung

    223 citationsOpen access (CC-BY)doi:10.3390/ijerph16214132OpenAlex

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    The oral health of an ageing population, especially that of the institutionalized elderly population, constitutes a significant concern because it is closely linked to general health and the quality of life. Shared common risk factors drive the development and worsening of poor oral health and non-communicable diseases, which eventually lead to self-care inability. Several studies have reported on the poor oral health of the institutionalized elderly population. However, few comprehensive reports exist regarding the relationship between poor oral health, the oral health-related quality of life (OHRQoL) and the associated factors in this specific population. Objective: The objective is to describe recently reported oral health levels, the OHRQoL and the associated factors among older institutional residents. Methods: Studies published between July 2009 and June 2019 in MEDLINE, EMBASE and CINAHL were searched. The population, intervention, comparison and outcome (PICO) strategy was used as a guide. The reported factors related to poor oral health were identified (i.e., age, gender,…

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    Exploring Psychophysiological Restoration and Individual Preference in the Different Environments Based on Virtual Reality

    Tian Gao, Tian Zhang, Ling Zhu, Yanan Gao, Ling Qiu

    223 citationsOpen access (CC-BY)doi:10.3390/ijerph16173102OpenAlex

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    Accumulated evidence claims that urban green spaces (UGS) have a positive impact on the physical and mental health of humans. However, little information is available to clearly reveal what the most important driving factors are for human psychophysiological restoration. In order to unveil this uncertainty, this study employed virtual reality (VR) technology to investigate the physiological (electroencephalogram, EEG), and psychological (attention, positive mood, negative mood) responses and individual preferences for different urban environments. Participants (120) were recruited and randomly assigned to experience six different types of environments varying in land use and vegetation structures, which were: Grey space, blue space, open green space, partly open green space, partly closed green space, and closed green space. The results showed that the experience of the six environmental types through VR devices had positive restorative effects on the individuals' attentional fatigue and negative mood; however, all the participants obtained the highest levels of physiological stress…

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    Role Stress, Job Burnout, and Job Performance in Construction Project Managers: The Moderating Role of Career Calling

    Guangdong Wu, Zhibin Hu, Junwei Zheng

    223 citationsOpen access (CC-BY)doi:10.3390/ijerph16132394OpenAlex

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    This study aims to explore the influence of role stress (role ambiguity and role conflict) on job burnout and job performance in construction project managers in the Chinese construction industry. Based on the JD-R (Job Demands Resources) model, this study introduces career calling as the moderating variable, in order to develop a theoretical model. The theoretical model is then tested with structural equation modeling. This work uses data from 191 owners, contractors, subcontractors, and supervisors in the Chinese construction industry. The results indicate that: (i) role ambiguity has a negative and significant effect on job burnout and job performance; (ii) role conflict has a negative effect on job burnout, but has a non-significant influence on job performance; (iii) job burnout has a negative impact on job performance; (iv) career calling negatively moderates the relationship between role ambiguity and job burnout, and positively moderates the relationship between role conflict and job performance. Furthermore, the results also show that career calling can positively moderate…

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    Changes in Cognitive Function and Risk Factors for Cognitive Impairment of the Elderly in China: 2005–2014

    Qilin Zhang, Y. H. Wu, Tiankuo Han, Erpeng Liu

    221 citationsOpen access (CC-BY)doi:10.3390/ijerph16162847OpenAlex

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    Background: The cognitive function of the elderly has become a focus of public health research. Little is known about the changes of cognitive function and the risk factors for cognitive impairment in the Chinese elderly; thus, the purposes of this study are as follows: (1) to describe changes in cognitive function in the Chinese elderly from 2005–2014 and (2) to explore risk factors for cognitive impairment of the Chinese elderly. Design and setting: A total of 2603 participants aged 64 years and above participated in the Chinese Longitudinal Healthy Longevity Survey (CLHLS) and were followed up from 2005 to 2014. Cognitive function and cognitive impairment were assessed using the Chinese version of the Mini-Mental State Examination (MMSE). Binary logistic regression analysis was used to estimate the odds ratio (OR) and 95% confidence intervals (CI) of cognitive impairment. Results: Results revealed that the cognitive function of the Chinese elderly shows diversified changes: deterioration (55.09%), unchanged (17.21%) and improvement (27.70%). In addition, there are significant…

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    The Role of DPP-4 Inhibitors in the Treatment Algorithm of Type 2 Diabetes Mellitus: When to Select, What to Expect

    Konstantinos Makrilakis

    220 citationsOpen access (CC-BY)doi:10.3390/ijerph16152720OpenAlex

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    Type 2 diabetes mellitus is a growing global public health problem, the prevalence of which is projected to increase in the succeeding decades. It is potentially associated with many complications, affecting multiple organs and causing a huge burden to the society. Due to its multi-factorial pathophysiology, its treatment is varied and based upon a multitude of pharmacologic agents aiming to tackle the many aspects of the disease pathophysiology (increasing insulin availability [either through direct insulin administration or through agents that promote insulin secretion], improving sensitivity to insulin, delaying the delivery and absorption of carbohydrates from the gastrointestinal tract, or increasing urinary glucose excretion). DPP-4 (dipeptidyl peptidase-4) inhibitors (or "gliptins") represent a class of oral anti-hyperglycemic agents that inhibit the enzyme DPP-4, thus augmenting the biological activity of the "incretin" hormones (glucagon-like peptide-1 [GLP-1] and glucose-dependent insulinotropic polypeptide [GIP]) and restoring many of the pathophysiological problems of…

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    Water, Sanitation and Hygiene (WASH) in Schools in Low-Income Countries: A Review of Evidence of Impact

    Celia McMichael

    220 citationsOpen access (CC-BY)doi:10.3390/ijerph16030359OpenAlex

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    Many schools in low-income countries have inadequate access to water facilities, sanitation and hygiene promotion. A systematic review of literature was carried out that aimed to identify and analyse the impact of water, sanitation and hygiene interventions (WASH) in schools in low-income countries. Published peer reviewed literature was systematically screened during March to June 2018 using the databases PubMed, Embase, Web of Science, the Cochrane Library, Science Direct, and Google Scholar. There were no publication date restrictions. Thirty-eight peer reviewed papers were identified that met the inclusion criteria. The papers were analysed in groups, based on four categories of reported outcomes: (i) reduction of diarrhoeal disease and other hygiene-related diseases in school students; (ii) improved WASH knowledge, attitudes and hygiene behaviours among students; (iii) reduced disease burden and improved hygiene behaviours in students' households and communities; (iv) improved student enrolment and attendance. The typically unmeasured and unreported 'output' and/or 'exposure'…

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    Quality of Work Life and Organizational Performance: Workers’ Feelings of Contributing, or Not, to the Organization’s Productivity

    João Carlos Correia Leitão, Dina Batista Pereira, Ângela Gonçalves

    219 citationsOpen access (CC-BY)doi:10.3390/ijerph16203803OpenAlex

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    This is a pioneering study on the relationship between quality of work life and the employee's perception of their contribution to organizational performance. It unveils the importance of subjective and behavioral components of quality of work life and their influence on the formation of the collaborator's individual desire to contribute to strengthening the organization's productivity. The results obtained indicate that for workers: feeling their supervisors' support through listening to their concerns and by sensing they take them on board; being integrated in a good work environment; and feeling respected both as professionals and as people; positively influence their feeling of contributing to organizational performance. The results are particularly relevant given the increased weight of services in the labor market, together with intensified automation and digitalization of collaborators' functions. The findings also contribute to the ongoing debate about the need for more work on the subjective and behavioral components of so-called smart and learning organizations, rather…

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    Impact of Wildfire Smoke on Adverse Pregnancy Outcomes in Colorado, 2007–2015

    Mona Abdo, Isabella Ward, Katelyn O’Dell, Bonne Ford, Jeffrey R. Pierce and 2 more

    218 citationsOpen access (CC-BY)doi:10.3390/ijerph16193720OpenAlex

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    Colorado is regularly impacted by long-range transport of wildfire smoke from upwind regions. This smoke is a major source of ambient PM2.5. Maternal exposure to total PM2.5 during pregnancy has been linked to decreased birth weight and other adverse outcomes, although the impact of wildfire smoke contribution has only recently been investigated. The objective of this study was to estimate associations between adverse pregnancy outcomes and ambient wildfire smoke PM2.5. Wildfire smoke PM2.5 exposures were estimated using a previously published method incorporating ground-based monitors and remote sensing data. Logistic regression models stratified by ZIP code and mixed models with random intercept by ZIP code were used to test for associations. The primary outcomes of interest were preterm birth and birth weight. Secondary outcomes included gestational hypertension, gestational diabetes, neonatal intensive care unit admission, assisted ventilation, small for gestational age, and low birth weight. Exposure to wildfire smoke PM2.5 over the full gestation and during the second…

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    Risk Factors for Obstructive Sleep Apnea Syndrome in Children: State of the Art

    Giampiero Gulotta, Giannicola Iannella, Claudio Vicini, Antonella Polimeni, Antonio Greco and 12 more

    218 citationsOpen access (CC-BY)doi:10.3390/ijerph16183235OpenAlex

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    The obstructive sleep apnea syndrome (OSAS) represents only part of a large group of pathologies of variable entity called respiratory sleep disorders (RSD) which include simple snoring and increased upper airway resistance syndrome (UARS). Although the etiopathogenesis of adult OSAS is well known, many aspects of this syndrome in children are still debated. Its prevalence is about 2% in children from 2 to 8 years of age, mostly related to the size of the upper airways adenoid tissue. Several risk factors linked to the development of OSAS are typical of the pediatric age. The object of this paper is to analyze the state of the art on this specific topic, discussing its implications in terms of diagnosis and management.

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    Application of the Theory of Planned Behavior in Environmental Science: A Comprehensive Bibliometric Analysis

    Hongyun Si, Jiangang Shi, Daizhong Tang, Shiping Wen, Wei Miao and 1 more

    215 citationsOpen access (CC-BY)doi:10.3390/ijerph16152788OpenAlex

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    Since the theory of planned behavior (TPB) was proposed by Ajzen in 1985, it has attracted extensive interest and been widely applied worldwide. Although an increasing number of studies have employed the TPB in the domain of environmental science, there have been no attempts to retrospectively analyze existing articles. The current study aimed to holistically understand the application status of the TPB in environmental science from a knowledge domain visualization perspective. A total of 531 journal articles were obtained through the Scopus database to perform a bibliometric analysis and content analysis. The results showed that waste management, green consumption, climate and environment, saving and conservation, and sustainable transportation are the primary research topics; the United States (U.S.), Mainland China, the United Kingdom (UK), and Malaysia are the most productive countries/regions. Moreover, the cross-disciplinary situations, main source journals, and key articles were revealed. Furthermore, the extended factors, integrated theories, major methods, specific groups,…

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    Chromium Monitoring in Water by Colorimetry Using Optimised 1,5-Diphenylcarbazide Method

    Annija Lace, David Ryan, Mark Bowkett, John Cleary

    212 citationsOpen access (CC-BY)doi:10.3390/ijerph16101803OpenAlex

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    Chromium contamination of drinking water has become a global problem due to its extensive use in industry. The most commonly used methods for chromium detection in water are laboratory-based methods, such as atomic absorption spectroscopy and mass spectroscopy. Although these methods are highly selective and sensitive, they require expensive maintenance and highly trained staff. Therefore, there is a growing demand for cost effective and portable detection methods that would meet the demand for mass monitoring. Microfluidic detection systems based on optical detection have great potential for onsite monitoring applications. Furthermore, their small size enables rapid sample throughput and minimises both reagent consumption and waste generation. In contrast to standard laboratory methods, there is also no requirement for sample transport and storage. The aim of this study is to optimise a colorimetric method based on 1,5-diphenylcarbazide dye for incorporation into a microfluidic detection system. Rapid colour development was observed after the addition of the dye and samples were…

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    5G Wireless Communication and Health Effects—A Pragmatic Review Based on Available Studies Regarding 6 to 100 GHz

    Myrtill Simkó, Mats‐Olof Mattsson

    209 citationsOpen access (CC-BY)doi:10.3390/ijerph16183406OpenAlex

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    The introduction of the fifth generation (5G) of wireless communication will increase the number of high-frequency-powered base stations and other devices. The question is if such higher frequencies (in this review, 6-100 GHz, millimeter waves, MMW) can have a health impact. This review analyzed 94 relevant publications performing in vivo or in vitro investigations. Each study was characterized for: study type (in vivo, in vitro), biological material (species, cell type, etc.), biological endpoint, exposure (frequency, exposure duration, power density), results, and certain quality criteria. Eighty percent of the in vivo studies showed responses to exposure, while 58% of the in vitro studies demonstrated effects. The responses affected all biological endpoints studied. There was no consistent relationship between power density, exposure duration, or frequency, and exposure effects. The available studies do not provide adequate and sufficient information for a meaningful safety assessment, or for the question about non-thermal effects. There is a need for research regarding local…

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    Effectiveness of Lifestyle Health Promotion Interventions for Nurses: A Systematic Review

    Natalia Stanulewicz, Emily Caitlin Lily Knox, Melanie Jay Narayanasamy, Noureen Asif Shivji, Kamlesh K. Khunti and 1 more

    206 citationsOpen access (CC-BY)doi:10.3390/ijerph17010017OpenAlex

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    BACKGROUND: Prior research has investigated various strategies to improve health, wellbeing and the job-related outcomes of nurses. However, the scope of this evidence is not clear and the types of intervention most likely to have positive outcomes are unknown. OBJECTIVE: To provide an overview and synthesis of the effectiveness of interventions conducted with the goal of improving health, wellbeing and the job-related outcomes of nurses. METHODS: A systematic database search was conducted from January 2000 to December 2018, with pre-defined criteria (Cochrane Central Register of Controlled Trials; MEDLINE and PubMed; EMBASE; CINAHL; PsycINFO; and BioMed Central). In total, 136 intervention studies with a total sample of 16,129 participants (range 9-3381) were included and evaluated. Data extraction, quality assessment and risk of bias analyses were performed. RESULTS: Studies included randomised controlled trials (RCTs; n = 52, 38%), randomised crossover design studies (n = 2, 1.5%) and non-randomised pre-post studies with a control group (n = 31, 23%) and without a control group…

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    Assessment of Agricultural Carbon Emissions and Their Spatiotemporal Changes in China, 1997–2016

    Xiuquan Huang, Xiaocang Xu, Qingqing Wang, Lu Zhang, Xin Gao and 1 more

    204 citationsOpen access (CC-BY)doi:10.3390/ijerph16173105OpenAlex

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    Despite achieving remarkable development, China’s agricultural economy has been under severe environmental pressure. Based on previous studies, the present study further considers the sources of agricultural carbon emissions in depth, estimates China’s agricultural carbon emissions from 1997 to 2016, and analyzes the agricultural pollution faced by China and its provinces. The study estimates the amount and intensity of agricultural carbon emissions in China from five carbon sources—agricultural materials, rice planting, soil N2O, livestock and poultry farming, and straw burning—and analyzes their spatial and temporal characteristics. The following results were obtained: (1) between 1997 and 2016, the amount of agricultural carbon emissions in China generally increased, while the intensity of agricultural carbon emissions decreased; (2) in the same period, the amount of carbon emissions from each category of carbon source generally increased, with the exception of rice planting; however, the amount of emissions fluctuated; (3) the amount and intensity of carbon emissions varied…

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    Emotional Intelligence and Psychological Well-Being in Adolescents

    Joan Guerra Bustamante, Benito León del Barco, Rocío Yuste Tosina, Víctor-María López-Ramos, Santiago Mendo-Lázaro

    204 citationsOpen access (CC-BY)doi:10.3390/ijerph16101720OpenAlex

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    The present study aimed to analyze the association between of the dimensions of emotional intelligence (attention, clarity, and repair) and different levels of perceived happiness (low, medium, and high) in adolescents. The sample consists of 646 students in the first, second, third, and fourth years of Secondary Education, 47.5% females and 52.5% males, between 12 and 17 years of age. The instruments used were the Spanish version of the Trait Meta Mood Scale-24 Questionnaire to measure perceived emotional intelligence and the Oxford Happiness Questionnaire. Multinomial logistic regression analysis and receiver operating characteristic (ROC) curve analysis were performed. The results suggest that as the capacity of understanding and regulation of emotional intelligence increases, happiness also increases. Adolescence is seen as an ideal time in life to encourage the development of emotional capacities that contribute to the greater happiness of individuals. In this way, the present study stresses the need to carry out practices leading to improvements in the adolescents' emotional…

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    Osteoarthritis in the Middle-Aged and Elderly in China: Prevalence and Influencing Factors

    Xueshan Sun, Xuemei Zhen, Xiaoqian Hu, Yuanyuan Li, Shuyan Gu and 2 more

    200 citationsOpen access (CC-BY)doi:10.3390/ijerph16234701OpenAlex

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    Background: Osteoarthritis is a common joint disease, with the acceleration of the aging process in China, it has troubled the middle-aged and elderly. There have been some epidemiological studies of osteoarthritis conducted in one single site, and most of them were on knee osteoarthritis. The results varied greatly between different surveys. There was still a lack of large-scale and multicenter epidemiological studies of osteoarthritis. This paper aimed to estimate the overall prevalence of lumbar osteoarthritis, cervical osteoarthritis, hand osteoarthritis, knee osteoarthritis, and hip osteoarthritis in the middle-aged and elderly in China by summarizing the existing publications. Methods: We comprehensively searched publications on 1 January 2019 in PubMed, Web of Science, Embase, Cochrane Library, CBM, CNNI, VIP, and Wan Fang. Epidemiological publications on osteoarthritis in the middle-aged and elderly Chinese published from 2000 to 2018 were summarized and analyzed by means of systematic review and meta-analysis. Data of prevalence of osteoarthritis in five joints were…

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    Serratia marcescens Infections in Neonatal Intensive Care Units (NICUs)

    Maria Luisa Cristina, Marina Sartini, Anna Maria Spagnolo

    200 citationsOpen access (CC-BY)doi:10.3390/ijerph16040610OpenAlex

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    Serratia marcescens belongs to the family Enterobacteriaceae, which is commonly found in water, soil, animals, insects, plants. Although S. marcescens displays relatively low virulence, it causes nosocomial infections and outbreaks in severely immunocompromised or critically ill patients, particularly in settings such as intensive care units (ICUs), especially neonatal units (NICUs). This microorganism gives rise to a wide range of clinical manifestations in newborns: from asymptomatic colonization to keratitis, conjunctivitis, urinary tract infections, pneumonia, surgical wound infections, sepsis, bloodstream infection and meningitis. The most frequent site of infection is the bloodstream, followed by the respiratory apparatus and the gastrointestinal tract. Strains of S. marcescens involved in epidemic events have frequently proved to be multi-resistant. Indeed, this species displays intrinsic resistance to several classes of antibiotics. Often, the specific source of the infection cannot be identified. However, the contaminated hands of healthcare workers are believed to be a…

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    Preharvest Transmission Routes of Fresh Produce Associated Bacterial Pathogens with Outbreak Potentials: A Review

    Chidozie Declan Iwu, Anthony Ifeanyi Okoh

    199 citationsOpen access (CC-BY)doi:10.3390/ijerph16224407OpenAlex

    Show abstract

    Disease outbreaks caused by the ingestion of contaminated vegetables and fruits pose a significant problem to human health. The sources of contamination of these food products at the preharvest level of agricultural production, most importantly, agricultural soil and irrigation water, serve as potential reservoirs of some clinically significant foodborne pathogenic bacteria. These clinically important bacteria include: Klebsiella spp., Salmonella spp., Citrobacter spp., Shigella spp., Enterobacter spp., Listeria monocytogenes and pathogenic E. coli (and E. coli O157:H7) all of which have the potential to cause disease outbreaks. Most of these pathogens acquire antimicrobial resistance (AR) determinants due to AR selective pressure within the agroecosystem and become resistant against most available treatment options, further aggravating risks to human and environmental health, and food safety. This review critically outlines the following issues with regards to fresh produce; the global burden of fresh produce-related foodborne diseases, contamination between the continuum of farm…

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    The Association between Chronotype and Dietary Pattern among Adults: A Scoping Review

    Fatin Hanani Mazri, Zahara Abdul Manaf, Suzana Shahar, Arimi Fitri Mat Ludin

    198 citationsOpen access (CC-BY)doi:10.3390/ijerph17010068OpenAlex

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    Chronotype reflects an individual’s preferred time of the day for an activity/rest cycle and individuals can be classified as a morning, intermediate, or evening type. A growing number of studies have examined the relationship between chronotype and general health. This review aimed to map current evidence of the association between chronotype and dietary intake among the adult population. A systematic search was conducted across five databases: EBSCO Host, Medline & Ovid, Pubmed, Scopus, and The Cochrane Library. The inclusion criteria were adult subjects (more than 18 years old), and included an assessment of (i) chronotype, (ii) dietary behaviour/nutrient intake/food group intake, and (iii) an analysis of the association between chronotype and dietary behaviour/nutrient intake/food group intake. A total of 36 studies were included in the review. This review incorporated studies from various study designs, however, the majority of these studies were based on a cross-sectional design (n = 29). Dietary outcomes were categorized into three main groups, namely dietary behaviour,…

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    Social Inequalities in Exposure to Ambient Air Pollution: A Systematic Review in the WHO European Region

    Jon Fairburn, Steffen Andreas Schüle, Stefanie Dreger, Lisa Karla Hilz, Gabriele Bolte

    198 citationsOpen access (CC-BY)doi:10.3390/ijerph16173127OpenAlex

    Show abstract

    Ambient air pollution is a long-standing and significant public health issue. The aim of this review is to systematically examine the peer-reviewed evidence on social inequalities and ambient air pollution in the World Health Organization European Region. Articles published between 2010 and 2017 were analyzed in the review. In total 31 articles were included in the review. There is good evidence from ecological studies that higher deprivation indices and low economic position are usually linked with higher levels of pollutants such as particulate matter (particulate matter under 2.5 and 10 microns in diameter, PM2.5, PM10) and oxides of nitrogen (e.g., NO2, and NOx). There is also evidence that ethnic minorities experience a mixed exposure in comparison to the majority population being sometimes higher and sometimes lower depending on the ethnic minority under consideration. The studies using data at the individual level in this review are mainly focused on pregnant women or new mothers, in these studies deprivation and ethnicity are more likely to be linked to higher exposures of…

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    The Water–Energy–Food Nexus as a Tool to Transform Rural Livelihoods and Well-Being in Southern Africa

    Tafadzwanashe Mabhaudhi, Luxon Nhamo, Sylvester Mpandeli, Charles Nhemachena, Aidan Senzanje and 6 more

    195 citationsOpen access (CC-BY)doi:10.3390/ijerph16162970OpenAlex

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    About 60% of southern Africa's population lives in rural areas with limited access to basic services and amenities such as clean and safe water, affordable and clean energy, and balanced and nutritious diets. Resource scarcity has direct and indirect impacts on nutrition, human health, and well-being of mostly poor rural communities. Climate change impacts in the region are manifesting through low crop yields, upsurge of vector borne diseases (malaria and dengue fever), and water and food-borne diseases (cholera and diarrhoea). This study applied a water-energy-food (WEF) nexus analytical livelihoods model with complex systems understanding to assess rural livelihoods, health, and well-being in southern Africa, recommending tailor-made adaptation strategies for the region aimed at building resilient rural communities. The WEF nexus is a decision support tool that improves rural livelihoods through integrated resource distribution, planning, and management, and ensures inclusive socio-economic transformation and development, and addresses related sustainable development goals,…

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    A Meta-Analysis of Job Insecurity and Employee Performance: Testing Temporal Aspects, Rating Source, Welfare Regime, and Union Density as Moderators

    Magnus Sverke, Lena Låstad, Johnny Hellgren, Anne Richter, Katharina Näswall

    195 citationsOpen access (CC-BY)doi:10.3390/ijerph16142536OpenAlex

    Show abstract

    Previous research has shown that job insecurity is linked to a range of performance outcomes, but the number of studies exploring this relationship is still limited and the results are somewhat mixed. The first aim of this study was to meta-analytically investigate how job insecurity is related to task performance, contextual performance, counterproductive work behavior, creativity, and safety compliance. The second aim was to test two method-related factors (cross-sectional vs. longitudinal associations and self- vs. supervisor-ratings of performance) and two macro-level indicators of social protection (social welfare regime and union density) as moderators of these associations. The results show that job insecurity was generally associated with impaired employee performance. These findings were generally similar both cross-sectionally and longitudinally and irrespective of rater. Overall, the associations between job insecurity and negative performance outcomes were weaker in welfare regimes characterized by strong social protection, whereas the results concerning union density…

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    Microalgae Brewery Wastewater Treatment: Potentials, Benefits and the Challenges

    David Kwame Amenorfenyo, Xianghu Huang, Yulei Zhang, Qitao Zeng, Ning Zhang and 2 more

    195 citationsOpen access (CC-BY)doi:10.3390/ijerph16111910OpenAlex

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    Concerns about environmental safety have led to strict regulations on the discharge of final brewery effluents into water bodies. Brewery wastewater contains huge amounts of organic compounds that can cause environmental pollution. The microalgae wastewater treatment method is an emerging environmentally friendly biotechnological process. Microalgae grow well in nutrient-rich wastewater by absorbing organic nutrients and converting them into useful biomass. The harvested biomass can be used as animal feed, as an alternative energy source for biodiesel production and as biofertilizer. This review discusses conventional and current brewery wastewater treatment methods, and the application and potential of microalgae in brewery wastewater treatment. This study also discusses the benefits as well as challenges associated with microalgae brewery and other industrial wastewater treatments.

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    How Safe is Chicken Litter for Land Application as an Organic Fertilizer?: A Review

    Margaret Kyakuwaire, Giregon Olupot, Alice Amoding, Peter Nkedi‐Kizza, Twaha Ali Ateenyi Basamba

    194 citationsOpen access (CC-BY)doi:10.3390/ijerph16193521OpenAlex

    Show abstract

    Chicken litter application on land as an organic fertilizer is the cheapest and most environmentally safe method of disposing of the volume generated from the rapidly expanding poultry industry worldwide. However, little is known about the safety of chicken litter for land application and general release into the environment. Bridging this knowledge gap is crucial for maximizing the benefits of chicken litter as an organic fertilizer and mitigating negative impacts on human and environmental health. The key safety concerns of chicken litter are its contamination with pathogens, including bacteria, fungi, helminthes, parasitic protozoa, and viruses; antibiotics and antibiotic-resistant genes; growth hormones such as egg and meat boosters; heavy metals; and pesticides. Despite the paucity of literature about chicken litter safety for land application, the existing information was scattered and disjointed in various sources, thus making them not easily accessible and difficult to interpret. We consolidated scattered pieces of information about known contaminants found in chicken litter…

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    Parenting Styles and Internalizing Symptoms in Adolescence: A Systematic Literature Review

    Arantxa Gorostiaga, Jone Aliri, Nekane Balluerka, Joanes Lameirinhas

    194 citationsOpen access (CC-BY)doi:10.3390/ijerph16173192OpenAlex

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    A growing body of recent research has identified associations between various parenting practices and styles and internalizing problems among adolescents. However, the reported findings are inconsistent and the studies in question have been conducted from different theoretical backgrounds. The aim of this systematic review was to synthesize the literature on the association of parental socialization styles with depression, anxiety, and suicidal ideation. To this end, we conducted a systematic search of the PsycInfo, Scopus, Pubmed, and Web of Science databases, covering literature published from 2010 to 2019. The search was restricted to peer-reviewed studies in English or Spanish. The results show that parental warmth, behavioural control, and autonomy granting are inversely related to internalizing symptoms in adolescents. Conversely, psychological control and harsh control by parents are positively associated with adolescent anxiety, depression, and suicidal ideation. Although the associated effect sizes are only small or moderate, the results suggest that these variables should…

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    Hydrogeochemical Characterization and Irrigation Quality Assessment of Shallow Groundwater in the Central-Western Guanzhong Basin, China

    Panpan Xu, Wenwen Feng, Hui Qian, Qiying Zhang

    193 citationsOpen access (CC-BY)doi:10.3390/ijerph16091492OpenAlex

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    Groundwater is the major water resource for the agricultural development of the Guanzhong Basin, China. In this study, a total of 97 groundwater samples (51 from the North Bank of the Wei River (NBWR) and 46 from the South Bank of the Wei River (SBWR)) were collected from the central-western Guanzhong Basin. The aim of this study was to investigate the hydrogeochemical characteristics of the basin and to determine the suitability of shallow groundwater for irrigation. The groundwater of the entire study area is alkaline. The groundwater of the SBWR is fresh water, and the NBWR groundwater is either freshwater or brackish water. The average concentration of ions (except for Ca2+) in SBWR samples is lower than in NBWR samples. HCO3− is dominant in the groundwater of the study area. Ca2+ is dominant in the SBWR while Na+ is dominant in the NBWR. The SBWR groundwater is mainly of the HCO3-Ca·Mg type, and has undergone the main hydrogeochemical processes of rock weathering-leaching. The hydrochemical facies of the majority of the NBWR groundwater samples are the HCO3-Na type with several…

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    Cardiovascular Risk in Non-Alcoholic Fatty Liver Disease: Mechanisms and Therapeutic Implications

    Claudio Tana, Stefano Ballestri, Fabrizio Ricci, Angelo Di Vincenzo, Andrea Ticinesi and 7 more

    191 citationsOpen access (CC-BY)doi:10.3390/ijerph16173104OpenAlex

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    New evidence suggests that non-alcoholic fatty liver disease (NAFLD) has a strong multifaceted relationship with diabetes and metabolic syndrome, and is associated with increased risk of cardiovascular events, regardless of traditional risk factors, such as hypertension, diabetes, dyslipidemia, and obesity. Given the pandemic-level rise of NAFLD-in parallel with the increasing prevalence of obesity and other components of the metabolic syndrome-and its association with poor cardiovascular outcomes, the question of how to manage NAFLD properly, in order to reduce the burden of associated incident cardiovascular events, is both timely and highly relevant. This review aims to summarize the current knowledge of the association between NAFLD and cardiovascular disease, and also to discuss possible clinical strategies for cardiovascular risk assessment, as well as the spectrum of available therapeutic strategies for the prevention and treatment of NAFLD and its downstream events.

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    A Machine Learning Ensemble Approach Based on Random Forest and Radial Basis Function Neural Network for Risk Evaluation of Regional Flood Disaster: A Case Study of the Yangtze River Delta, China

    Junfei Chen, Qian Li, Huimin Wang, Menghua Deng

    189 citationsOpen access (CC-BY)doi:10.3390/ijerph17010049OpenAlex

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    The Yangtze River Delta (YRD) is one of the most developed regions in China. This is also a flood-prone area where flood disasters are frequently experienced; the situations between the people-land nexus and the people-water nexus are very complicated. Therefore, the accurate assessment of flood risk is of great significance to regional development. The paper took the YRD urban agglomeration as the research case. The driving force, pressure, state, impact and response (DPSIR) conceptual framework was established to analyze the indexes of flood disasters. The random forest (RF) algorithm was used to screen important indexes of floods risk, and a risk assessment model based on the radial basis function (RBF) neural network was constructed to evaluate the flood risk level in this region from 2009 to 2018. The risk map showed the I-V level of flood risk in the YRD urban agglomeration from 2016 to 2018 by using the geographic information system (GIS). Further analysis indicated that the indexes such as flood season rainfall, urban impervious area ratio, gross domestic product (GDP) per…

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    Potential Ecological Risk and Human Health Risk Assessment of Heavy Metal Pollution in Industrial Affected Soils by Coal Mining and Metallurgy in Ostrava, Czech Republic

    Helena Doležalová Weissmannová, Silvie Mihočová, Petr Chovanec, Jiří Pavlovský

    189 citationsOpen access (CC-BY)doi:10.3390/ijerph16224495OpenAlex

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    The heavy metal pollution of soils has become serious environmental problem, mainly in localities with high industrialization and rapid growth. The purpose of this detailed research was to determine the actual status of heavy metal pollution of soils and an assessment of heavy metal pollution in a highly industrialized city, Ostrava, with a history of long-term impacts from the metallurgy industry and mining. The ecological risks to the area was subsequently also assessed. The heavy metals Cd, Hg, Cu, Mn, Pb, V, Zn, Cr and Fe were determined in top-soils (0–20 cm) using atomic absorption spectrometry (F AAS, GF AAS) from three areas with different anthropogenic loads. The obtained data expressed as mean metal concentrations were very varied among the sampled soils and values of all analyzed metal concentrations were higher than its background levels. To identify the ecological risk and assessment of soil pollution, various pollution indices were calculated, such as single pollution indices (Igeo, CF, EF, PI) and total complex indices (IPI, PLI, PINemerow, Cdeg, mCdeg, Er and PERI).…

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    The Impact of Green Space on Violent Crime in Urban Environments: An Evidence Synthesis

    Mardelle McCuskey Shepley, Naomi A. Sachs, Hessam Sadatsafavi, Christine Fournier, Kati Peditto

    187 citationsOpen access (CC-BY)doi:10.3390/ijerph16245119OpenAlex

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    Can the presence of green space in urban environments reduce the frequency of violent crime? To ascertain the evidence on this topic, we conducted an in-depth literature review using the PRISMA checklist. The search parameters included US articles written in English and published since 2000. More than 30,000 potential paper titles were identified and ultimately, 45 papers were selected for inclusion. Green spaces typically comprised tree cover, parks and ground cover. Criminal behaviors typically included murder, assault, and theft. The majority of the research reviewed involved quantitative methods (e.g., comparison of green space area to crime data). We extracted multiple mechanisms from the literature that may account for the impact of green space on crime including social interaction and recreation, community perception, biophilic stress reduction, climate modulation, and spaces expressing territorial definition. Recommendations are made for future research, such as meta-analysis of existing data and the development of grounded theory through qualitative data-gathering methods.…

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    Artificial Stone Associated Silicosis: A Systematic Review

    Veruscka Leso, Luca Fontana, Rosaria Romano, Paola Gervetti, Ivo Iavicoli

    186 citationsOpen access (CC-BY)doi:10.3390/ijerph16040568OpenAlex

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    Silicosis is a progressive fibrotic lung disease that is caused by the inhalation of respirable crystalline silica. Due to its high silica content, artificial stone (AS) can become a possible source of hazardous dust exposure for workers that are employed in the manufacturing, finishing, and installing of AS countertops. Therefore, the aim of this review was to verify the association between AS derived silica exposure and silicosis development, and also then define the pathological characteristics of the disease in relation to specific work practices and preventive and protective measures that were adopted in the workplace. A systematic review of articles available on Pubmed, Scopus, and Isi Web of Knowledge databases was performed. Although the characteristics of AS-associated silicosis were comparable to those that were reported for the disease in traditional silica exposure settings, some critical issues emerged concerning the general lack of suitable strategies for assessing/managing silica risks in these innovative occupational fields. Further research that is designed to…

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    Evaluation of an Ultraviolet C (UVC) Light-Emitting Device for Disinfection of High Touch Surfaces in Hospital Critical Areas

    Beatrice Casini, Benedetta Tuvo, Maria Luisa Cristina, Anna Maria Spagnolo, Michele Totaro and 2 more

    185 citationsOpen access (CC-BY)doi:10.3390/ijerph16193572OpenAlex

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    Implementation of environmental cleaning and disinfection has been shown to reduce the incidences of healthcare-associated infections. The effect of an enhanced strategy for terminal room disinfection, applying the pulsed xenon-based ultraviolet light no-touch disinfection systems (PX-UVC) after the current standard operating protocol (SOP) was evaluated. In a teaching hospital, the effectiveness in reducing the total bacterial count (TBC) and in eliminating high-concern microorganisms was assessed on five high-touch surfaces in different critical areas, immediately pre- and post-cleaning and disinfection procedures (345 sampling sites). PX-UVC showed only 18% (15/85) of positive samples after treatment compared to 63% (72/115) after SOP. The effectiveness of PX-UVC was also observed in the absence of manual cleaning and application of a chemical disinfectant. According to the hygienic standards proposed by the Italian Workers Compensation Authority, 9 of 80 (11%) surfaces in operating rooms showed TBC ≥15 CFU/24 cm2 after the SOP, while all samples were compliant applying the SOP…

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    Role of Emerging Environmental Risk Factors in Thyroid Cancer: A Brief Review

    Maria Fiore, Gea Oliveri Conti, Rosario Caltabiano, Antonino Buffone, Pietro Zuccarello and 3 more

    183 citationsOpen access (CC-BY)doi:10.3390/ijerph16071185OpenAlex

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    Environmental factors are recognized as risk factors of thyroid cancer in humans. Exposure to radiation, both from nuclear weapon or fallout or medical radiation, and to some organic and inorganic chemical toxicants represent a worldwide public health issue for their proven carcinogenicity. Halogenated compounds, such as organochlorines and pesticides, are able to disrupt thyroid function. Polychlorinated biphenyls and their metabolites and polybrominated diethyl ethers bind to thyroid, transport proteins, replace thyroxin, and disrupt thyroid function as phthalates and bisphenolates do, highly mimicking thyroid hormones. A better knowledge of environmental risks represents a very important tool for cancer prevention through true risks prevention and management. This approach is very important because of the epigenetic origin's theory of cancer. Therefore, the aim of this review was study the association between environmental agents and thyroid cancer promotion.

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    A Molecular Docking Approach to Evaluate the Pharmacological Properties of Natural and Synthetic Treatment Candidates for Use against Hypertension

    Syed Awais Attique, Muhammad Shahzaib Hassan, Muhammad Usman, Rana Muhammad Atif, Shahid Mahboob and 3 more

    183 citationsOpen access (CC-BY)doi:10.3390/ijerph16060923OpenAlex

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    Cardiovascular diseases (CVDs) have become the leading cause of disability and death worldwide, particularly in low- and middle-income countries. Hypertension, a major cause of CVD progression, is widely attributable to genetic, behavioral, and environmental risk factors. Among the genetic reasons, angiotensin II enzyme, produced as a result of abnormal functioning of the renin⁻angiotensin system, is reported as the foremost cause of hypertension. A cascade of genes, including those encoding for WNK kinases (WNK1 and WNK4), Bp1, Bp2, angiotensinogen, and other enzymes, is involved in the conversion of angiotensin I to angiotensin II. However, the angiotensin-converting enzyme (ACE) plays a crucial role in this pathway. Therefore, ACE could be a potential therapeutic target in regulating the conversion of angiotensin I to angiotensin II and eventually controlling hypertension. In this study, a molecular docking-based approach was utilized for identifying and evaluating potential inhibitors of ACE present in herbs, other natural sources, and synthetic sources, on the basis of these…

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    Implementation of 3D Printing Technology in the Field of Prosthetics: Past, Present, and Future

    Albert C. Manero, PETER A. S. SMITH, John Sparkman, Matt Dombrowski, Dominique Courbin and 3 more

    182 citationsOpen access (CC-BY)doi:10.3390/ijerph16091641OpenAlex

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    There is an interesting and long history of prostheses designed for those with upper-limb difference, and yet issues still persist that have not yet been solved. Prosthesis needs for children are particularly complex, due in part to their growth rates. Access to a device can have a significant impact on a child's psychosocial development. Often, devices supporting both cosmetic form and user function are not accessible to children due to high costs, insurance policies, medical availability, and their perceived durability and complexity of control. These challenges have encouraged a grassroots effort globally to offer a viable solution for the millions of people living with limb difference around the world. The innovative application of 3D printing for customizable and user-specific hardware has led to open-source Do It Yourself "DIY" production of assistive devices, having an incredible impact globally for families with little recourse. This paper examines new research and development of prostheses by the maker community and nonprofit organizations, as well as a novel case study…

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    Social Determinants of Rural Health Workforce Retention: A Scoping Review

    Catherine Cosgrave, Christina Amelia Rosa Malatzky, Judy Gillespie

    182 citationsOpen access (CC-BY)doi:10.3390/ijerph16030314OpenAlex

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    Residents of rural and remote Australia have poorer health outcomes than their metropolitan counterparts. A major contributor to these health disparities is chronic and severe health workforce shortages outside of metropolitan areas-a global phenomenon. Despite emerging recognition of the important influence of place-based social processes on retention, much of the political attention and research is directed elsewhere. A structured scoping review was undertaken to describe the range of research addressing the influence of place-based social processes on turnover or retention of rural health professionals, to identify current gaps in the literature, and to formulate a guide for future rural health workforce retention research. A systematic search of the literature was performed. In total, 21 articles were included, and a thematic analysis was undertaken. The themes identified were (1) rural familiarity and/or interest, (2) social connection and place integration, (3) community participation and satisfaction, and (4) fulfillment of life aspirations. Findings suggest place-based…

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    Social Support—A Protective Factor for Depressed Perinatal Women?

    Jeannette Milgrom, Yafit Hirshler, John Reece, Charlene Holt, Alan W. Gemmill

    181 citationsOpen access (CC-BY)doi:10.3390/ijerph16081426OpenAlex

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    Social support before and after childbirth is a possible protective factor for perinatal depression. Currently, there is a lack of longitudinal studies beyond the first year postpartum exploring the relationship of social support with depression and anxiety. Social support is also a possible protective factor for adverse child development, which is a known consequence of perinatal depression. The present study followed up a cohort of depressed women (n = 54) from a randomised controlled trial of psychological treatment for antenatal depression. We examined the trajectory of the relationships between perceived social support (Social Provisions Scale), depression (Beck Depression Inventory), and anxiety (Beck Anxiety Inventory) twice in pregnancy and twice postpartum up to two years. The influence of social support on child development and parenting-related stress was also explored. Two aspects of social support, Reassurance of Worth and Reliable Alliance, were strongly related to perinatal depression and anxiety, particularly when predicting symptoms in late pregnancy. However, the…

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The cohort is every article, review and book chapter OpenAlex attributes to International Journal of Environmental Research and Public Health with publication year 2019, excluding retracted works and paratext such as editorials and errata. The top 100 by citation count are listed; the percentile is the rank divided by the cohort size. 100 of the 100 entries have an abstract in OpenAlex. Counts were read on 29 October 2026 and will not be updated on this page, so a quoted rank stays verifiable. Full rules on the methodology page.

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