Most-cited articles · 2020
The 100 most-cited articles in International Journal of Environmental Research and Public Health, 2020
Ranked by OpenAlex citation count on 29 October 2026, out of 9,489 eligible articles International Journal of Environmental Research and Public Health published in 2020. Ranks are frozen; this page will not change. Number one, with 9,922 citations: Immediate Psychological Responses and Associated Factors during the Initial Stage of the 2019 Coronavirus Disease (COVID-19) Epidemic among the General Population in China.
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The highest cited articles from this journal in 2020 are dominated by three themes: the mental health consequences of the COVID-19 pandemic, environmental toxicology of metals and plastics, and the broader societal impact of the pandemic. The most cited paper is "Immediate Psychological Responses and Associated Factors during the Initial Stage of the 2019 Coronavirus Disease (COVID-19) Epidemic among the General Population in China" by Cuiyan Wang, Riyu Pan, Xiaoyang Wan and colleagues, with 9922 citations. Other leading works address cadmium toxicity, microplastics and human health, and psychological distress during the pandemic in Italy and China.
Readers can use this ranked list to see which topics attracted the most scholarly attention in the journal during 2020. The entries reflect the volume of citation activity recorded by OpenAlex, not a judgment of quality or importance. The list may be useful for identifying influential papers, understanding research trends, or locating sources for further study.
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Immediate Psychological Responses and Associated Factors during the Initial Stage of the 2019 Coronavirus Disease (COVID-19) Epidemic among the General Population in China
Cuiyan Wang, Riyu Pan, Xiaoyang Wan, Yilin Tan, Linkang Xu and 2 more
9,922 citationsOpen access (CC-BY)doi:10.3390/ijerph17051729OpenAlex
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Background: The 2019 coronavirus disease (COVID-19) epidemic is a public health emergency of international concern and poses a challenge to psychological resilience. Research data are needed to develop evidence-driven strategies to reduce adverse psychological impacts and psychiatric symptoms during the epidemic. The aim of this study was to survey the general public in China to better understand their levels of psychological impact, anxiety, depression, and stress during the initial stage of the COVID-19 outbreak. The data will be used for future reference. Methods: From 31 January to 2 February 2020, we conducted an online survey using snowball sampling techniques. The online survey collected information on demographic data, physical symptoms in the past 14 days, contact history with COVID-19, knowledge and concerns about COVID-19, precautionary measures against COVID-19, and additional information required with respect to COVID-19. Psychological impact was assessed by the Impact of Event Scale-Revised (IES-R), and mental health status was assessed by the Depression, Anxiety and…
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The Effects of Cadmium Toxicity
Giuseppe Genchi, Maria Stefania Sinicropi, Graziantonio Lauria, Alessia Carocci, Alessia Anna Catalano
2,722 citationsOpen access (CC-BY)doi:10.3390/ijerph17113782OpenAlex
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Cadmium (Cd) is a toxic non-essential transition metal that poses a health risk for both humans and animals. It is naturally occurring in the environment as a pollutant that is derived from agricultural and industrial sources. Exposure to cadmium primarily occurs through the ingestion of contaminated food and water and, to a significant extent, through inhalation and cigarette smoking. Cadmium accumulates in plants and animals with a long half-life of about 25–30 years. Epidemiological data suggest that occupational and environmental cadmium exposure may be related to various types of cancer, including breast, lung, prostate, nasopharynx, pancreas, and kidney cancers. It has been also demonstrated that environmental cadmium may be a risk factor for osteoporosis. The liver and kidneys are extremely sensitive to cadmium’s toxic effects. This may be due to the ability of these tissues to synthesize metallothioneins (MT), which are Cd-inducible proteins that protect the cell by tightly binding the toxic cadmium ions. The oxidative stress induced by this xenobiotic may be one of the…
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A Detailed Review Study on Potential Effects of Microplastics and Additives of Concern on Human Health
Claudia Campanale, Carmine Massarelli, Ilaria Savino, Vito Locaputo, Vito Felice Uricchio
1,974 citationsOpen access (CC-BY)doi:10.3390/ijerph17041212OpenAlex
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The distribution and abundance of microplastics into the world are so extensive that many scientists use them as key indicators of the recent and contemporary period defining a new historical epoch: The Plasticene. However, the implications of microplastics are not yet thoroughly understood. There is considerable complexity involved to understand their impact due to different physical-chemical properties that make microplastics multifaceted stressors. If, on the one hand, microplastics carry toxic chemicals in the ecosystems, thus serving as vectors of transport, they are themselves, on the other hand, a cocktail of hazardous chemicals that are added voluntarily during their production as additives to increase polymer properties and prolong their life. To date, there is a considerable lack of knowledge on the major additives of concern that are used in the plastic industry, on their fate once microplastics dispose into the environment, and on their consequent effects on human health when associated with micro and nanoplastics. The present study emphasizes the most toxic and…
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A Nationwide Survey of Psychological Distress among Italian People during the COVID-19 Pandemic: Immediate Psychological Responses and Associated Factors
Cristina Mazza, Eleonora Ricci, Silvia Biondi, Marco Colasanti, Stefano Ferracuti and 2 more
1,899 citationsOpen access (CC-BY)doi:10.3390/ijerph17093165OpenAlex
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The uncontrolled spread of the coronavirus disease 2019 (COVID-19) has called for unprecedented measures, to the extent that the Italian government has imposed a quarantine on the entire country. Quarantine has a huge impact and can cause considerable psychological strain. The present study aims to establish the prevalence of psychiatric symptoms and identify risk and protective factors for psychological distress in the general population. An online survey was administered from 18-22 March 2020 to 2766 participants. Multivariate ordinal logistic regression models were constructed to examine the associations between sociodemographic variables; personality traits; depression, anxiety, and stress. Female gender, negative affect, and detachment were associated with higher levels of depression, anxiety, and stress. Having an acquaintance infected was associated with increased levels of both depression and stress, whereas a history of stressful situations and medical problems was associated with higher levels of depression and anxiety. Finally, those with a family member infected and…
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The Impact of COVID-19 Epidemic Declaration on Psychological Consequences: A Study on Active Weibo Users
Sijia Li, Yilin Wang, Jia Xue, Nan Zhao, Tingshao Zhu
1,829 citationsOpen access (CC-BY)doi:10.3390/ijerph17062032OpenAlex
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COVID-19 (Corona Virus Disease 2019) has significantly resulted in a large number of psychological consequences. The aim of this study is to explore the impacts of COVID-19 on people's mental health, to assist policy makers to develop actionable policies, and help clinical practitioners (e.g., social workers, psychiatrists, and psychologists) provide timely services to affected populations. We sample and analyze the Weibo posts from 17,865 active Weibo users using the approach of Online Ecological Recognition (OER) based on several machine-learning predictive models. We calculated word frequency, scores of emotional indicators (e.g., anxiety, depression, indignation, and Oxford happiness) and cognitive indicators (e.g., social risk judgment and life satisfaction) from the collected data. The sentiment analysis and the paired sample t-test were performed to examine the differences in the same group before and after the declaration of COVID-19 on 20 January, 2020. The results showed that negative emotions (e.g., anxiety, depression and indignation) and sensitivity to social risks…
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Nickel: Human Health and Environmental Toxicology
Giuseppe Genchi, Alessia Carocci, Graziantonio Lauria, Maria Stefania Sinicropi, Alessia Anna Catalano
1,602 citationsOpen access (CC-BY)doi:10.3390/ijerph17030679OpenAlex
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Nickel is a transition element extensively distributed in the environment, air, water, and soil. It may derive from natural sources and anthropogenic activity. Although nickel is ubiquitous in the environment, its functional role as a trace element for animals and human beings has not been yet recognized. Environmental pollution from nickel may be due to industry, the use of liquid and solid fuels, as well as municipal and industrial waste. Nickel contact can cause a variety of side effects on human health, such as allergy, cardiovascular and kidney diseases, lung fibrosis, lung and nasal cancer. Although the molecular mechanisms of nickel-induced toxicity are not yet clear, mitochondrial dysfunctions and oxidative stress are thought to have a primary and crucial role in the toxicity of this metal. Recently, researchers, trying to characterize the capability of nickel to induce cancer, have found out that epigenetic alterations induced by nickel exposure can perturb the genome. The purpose of this review is to describe the chemical features of nickel in human beings and the…
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Impact of the COVID-19 Pandemic on Mental Health and Quality of Life among Local Residents in Liaoning Province, China: A Cross-Sectional Study
Yingfei Zhang, Zheng Feei
1,476 citationsOpen access (CC-BY)doi:10.3390/ijerph17072381OpenAlex
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Our study aimed to investigate the immediate impact of the COVID-19 pandemic on mental health and quality of life among local Chinese residents aged ≥18 years in Liaoning Province, mainland China. An online survey was distributed through a social media platform between January and February 2020. Participants completed a modified validated questionnaire that assessed the Impact of Event Scale (IES), indicators of negative mental health impacts, social and family support, and mental health-related lifestyle changes. A total of 263 participants (106 males and 157 females) completed the study. The mean age of the participants was 37.7 ± 14.0 years, and 74.9% had a high level of education. The mean IES score in the participants was 13.6 ± 7.7, reflecting a mild stressful impact. Only 7.6% of participants had an IES score ≥26. The majority of participants (53.3%) did not feel helpless due to the pandemic. On the other hand, 52.1% of participants felt horrified and apprehensive due to the pandemic. Additionally, the majority of participants (57.8-77.9%) received increased support from…
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Depression, Anxiety and Stress during COVID-19: Associations with Changes in Physical Activity, Sleep, Tobacco and Alcohol Use in Australian Adults
Robert Stanton, Quyen Gia To, Saman Khalesi, Susan Lee Williams, Stephanie Alley and 3 more
1,386 citationsOpen access (CC-BY)doi:10.3390/ijerph17114065OpenAlex
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The novel coronavirus (COVID-19) has enforced dramatic changes to daily living including economic and health impacts. Evidence for the impact of these changes on our physical and mental health and health behaviors is limited. We examined the associations between psychological distress and changes in selected health behaviors since the onset of COVID-19 in Australia. An online survey was distributed in April 2020 and included measures of depression, anxiety, stress, physical activity, sleep, alcohol intake and cigarette smoking. The survey was completed by 1491 adults (mean age 50.5 ± 14.9 years, 67% female). Negative change was reported for physical activity (48.9%), sleep (40.7%), alcohol (26.6%) and smoking (6.9%) since the onset of the COVID-19 pandemic. Significantly higher scores in one or more psychological distress states were found for females, and those not in a relationship, in the lowest income category, aged 18-45 years, or with a chronic illness. Negative changes in physical activity, sleep, smoking and alcohol intake were associated with higher depression, anxiety and…
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Lead Toxicity: Health Hazards, Influence on Food Chain, and Sustainable Remediation Approaches
Amit Kumar, Amit Kumar, Marina M. S. Cabral-Pinto, Ashish Kumar Chaturvedi, Aftab Ahmad Shabnam and 7 more
1,024 citationsOpen access (CC-BY)doi:10.3390/ijerph17072179OpenAlex
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Lead (Pb) toxicity has been a subject of interest for environmental scientists due to its toxic effect on plants, animals, and humans. An increase in several Pb related industrial activities and use of Pb containing products such as agrochemicals, oil and paint, mining, etc. can lead to Pb contamination in the environment and thereby, can enter the food chain. Being one of the most toxic heavy metals, Pb ingestion via the food chain has proven to be a potential health hazard for plants and humans. The current review aims to summarize the research updates on Pb toxicity and its effects on plants, soil, and human health. Relevant literature from the past 20 years encompassing comprehensive details on Pb toxicity has been considered with key issues such as i) Pb bioavailability in soil, ii) Pb biomagnification, and iii) Pb- remediation, which has been addressed in detail through physical, chemical, and biological lenses. In the review, among different Pb-remediation approaches, we have highlighted certain advanced approaches such as microbial assisted phytoremediation which could…
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The COVID-19 Outbreak and Affected Countries Stock Markets Response
Haiyue Liu, Aqsa Manzoor, Cangyu Wang, Lei Zhang, Zaira Manzoor
916 citationsOpen access (CC-BY)doi:10.3390/ijerph17082800OpenAlex
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This paper evaluates the short-term impact of the coronavirus outbreak on 21 leading stock market indices in major affected countries including Japan, Korea, Singapore, the USA, Germany, Italy, and the UK etc. The consequences of infectious disease are considerable and have been directly affecting stock markets worldwide. Using an event study method, our results indicate that the stock markets in major affected countries and areas fell quickly after the virus outbreak. Countries in Asia experienced more negative abnormal returns as compared to other countries. Further panel fixed effect regressions also support the adverse effect of COVID-19 confirmed cases on stock indices abnormal returns through an effective channel by adding up investors' pessimistic sentiment on future returns and fears of uncertainties.
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Toxicity of Microplastics and Nanoplastics in Mammalian Systems
Cheryl Yong, Suresh Valiyaveettil, Bor Luen Tang
908 citationsOpen access (CC-BY)doi:10.3390/ijerph17051509OpenAlex
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Fragmented or otherwise miniaturized plastic materials in the form of micro- or nanoplastics have been of nagging environmental concern. Perturbation of organismal physiology and behavior by micro- and nanoplastics have been widely documented for marine invertebrates. Some of these effects are also manifested by larger marine vertebrates such as fishes. More recently, possible effects of micro- and nanoplastics on mammalian gut microbiota as well as host cellular and metabolic toxicity have been reported in mouse models. Human exposure to micro- and nanoplastics occurs largely through ingestion, as these are found in food or derived from food packaging, but also in a less well-defined manner though inhalation. The pathophysiological consequences of acute and chronic micro- and nanoplastics exposure in the mammalian system, particularly humans, are yet unclear. In this review, we focus on the recent findings related to the potential toxicity and detrimental effects of micro- and nanoplastics as demonstrated in mouse models as well as human cell lines. The prevailing data suggest that…
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Depression and Anxiety in Hong Kong during COVID-19
Edmond Pui Hang Choi, Bryant P. H. Hui, Eric Yuk Fai Wan
893 citationsOpen access (CC-BY)doi:10.3390/ijerph17103740OpenAlex
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It has been three months since the first confirmed case of coronavirus disease 2019 (COVID-19) in Hong Kong, and people now have a more complete picture of the extent of the pandemic. Therefore, it is time to evaluate the impacts of COVID-19 on mental health. The current population-based study aimed to evaluate the depression and anxiety of people in Hong Kong during the COVID-19 pandemic. Respondents were randomly recruited and asked to complete a structured questionnaire, including the patient health questionnaire-9 (PHQ-9), the generalized anxiety disorder-7 (GAD-7), the global rating of change scale and items related to COVID-19. Of the 500 respondents included in the study, 19% had depression (PHQ-9 score ≥ 10) and 14% had anxiety (GAD score ≥ 10). In addition, 25.4% reported that their mental health had deteriorated since the pandemic. Multiple logistic regression analysis found that not experiencing the SARS outbreak in 2003, being worried about being infected by COVID-19, being bothered by having not enough surgical masks and being bothered by not being able to work from…
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Indoor Air Pollution, Related Human Diseases, and Recent Trends in the Control and Improvement of Indoor Air Quality
Vinh Van Tran, Duckshin Park, Young‐Chul Lee
829 citationsOpen access (CC-BY)doi:10.3390/ijerph17082927OpenAlex
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Indoor air pollution (IAP) is a serious threat to human health, causing millions of deaths each year. A plethora of pollutants can result in IAP; therefore, it is very important to identify their main sources and concentrations and to devise strategies for the control and enhancement of indoor air quality (IAQ). Herein, we provide a critical review and evaluation of the major sources of major pollutant emissions, their health effects, and issues related to IAP-based illnesses, including sick building syndrome (SBS) and building-related illness (BRI). In addition, the strategies and approaches for control and reduction of pollutant concentrations are pointed out, and the recent trends in efforts to resolve and improve IAQ, with their respective advantages and potentials, are summarized. It is predicted that the development of novel materials for sensors, IAQ-monitoring systems, and smart homes is a promising strategy for control and enhancement of IAQ in the future.
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Coronavirus Diseases (COVID-19) Current Status and Future Perspectives: A Narrative Review
Francesco Di Gennaro, Damiano Pizzol, Claudia Marotta, Mario Antunes, Vincenzo Racalbuto and 2 more
822 citationsOpen access (CC-BY)doi:10.3390/ijerph17082690OpenAlex
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At the end of 2019 a novel virus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), causing severe acute respiratory syndrome expanded globally from Wuhan, China. In March 2020 the World Health Organization declared the SARS-Cov-2 virus a global pandemic. We performed a narrative review to describe existing literature with regard to Corona Virus Disease 2019 (COVID-19) epidemiology, pathophysiology, diagnosis, management and future perspective. MEDLINE, EMBASE and Scopus databases were searched for relevant articles. Although only when the pandemic ends it will be possible to assess the full health, social and economic impact of this global disaster, this review represents a picture of the current state of the art. In particular, we focus on public health impact, pathophysiology and clinical manifestations, diagnosis, case management, emergency response and preparedness.
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Symptoms of Posttraumatic Stress, Anxiety, Depression, Levels of Resilience and Burnout in Spanish Health Personnel during the COVID-19 Pandemic
Lourdes Moreno, Beatriz Talavera‐Velasco, Yolanda García-Albuerne, Jesús Martín‐García
813 citationsOpen access (CC-BY)doi:10.3390/ijerph17155514OpenAlex
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The number of health workers infected with COVID-19 in Spain is one of the highest in the world. The aim of this study is to analyse posttraumatic stress, anxiety and depression during the COVID-19 pandemic. Associations between burnout, resilience, demographic, work and COVID-19 variables are analysed. Cross-sectional data on 1422 health workers were analysed. A total of 56.6% of health workers present symptoms of posttraumatic stress disorder, 58.6% anxiety disorder, 46% depressive disorder and 41.1% feel emotionally drained. The profile of a health worker with greater posttraumatic stress symptoms would be a person who works in the Autonomous Community of Madrid, in a hospital, is a woman, is concerned that a person he/she lives with may be infected, and thinks that he/she is very likely to be infected. The risk variables for anxiety and depression would be a person that is a woman, working 12- or 24-h shifts, and being worried that a family member could be infected. High scores on emotional exhaustion and depersonalization are risk factors for mental health, with resilience and…
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COVID-19-Related Mental Health Effects in the Workplace: A Narrative Review
Gabriele Giorgi, Luigi Isaia Lecca, Federico Alessio, Georgia Libera Finstad, Giorgia Bondanini and 3 more
810 citationsOpen access (CC-BY)doi:10.3390/ijerph17217857OpenAlex
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The Coronavirus Disease 2019 (COVID-19) pandemic has deeply altered social and working environments in several ways. Social distancing policies, mandatory lockdowns, isolation periods, and anxiety of getting sick, along with the suspension of productive activity, loss of income, and fear of the future, jointly influence the mental health of citizens and workers. Workplace aspects can play a crucial role on moderating or worsening mental health of people facing this pandemic scenario. The purpose of this literature review is to deepen the psychological aspects linked to workplace factors, following the epidemic rise of COVID-19, in order to address upcoming psychological critical issues in the workplaces. We performed a literature search using Google Scholar, PubMed, and Scopus, selecting papers focusing on workers' psychological problems that can be related to the workplace during the pandemic. Thirty-five articles were included. Mental issues related to the health emergency, such as anxiety, depression, post-traumatic stress disorder (PTSD), and sleep disorders are more likely to…
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The Impact of COVID-19 on Physical Activity Behavior and Well-Being of Canadians
Iris Lesser, Carl P. Nienhuis
783 citationsOpen access (CC-BY)doi:10.3390/ijerph17113899OpenAlex
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A global pandemic caused by the novel coronavirus (COVID-19) resulted in restrictions to daily living for Canadians, including social distancing and closure of city and provincial recreation facilities, national parks and playgrounds. The objective of this study was to assess how these preemptive measures impacted physical activity behaviour and well-being of Canadians. An online survey was utilized to measure participant physical activity behavior, nature exposure, well-being and anxiety levels. Results indicate that while 40.5% of inactive individuals became less active, only 22.4% of active individuals became less active. Comparatively, 33% of inactive individuals became more active while 40.3% of active individuals became more active. There were significant differences in well-being outcomes in the inactive population between those who were more active, the same or less active (p < 0.001) but this was not seen in the active population. Inactive participants who spent more time engaged in outdoor physical activity had lower anxiety than those who spent less time in outdoor…
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The Gut Microbiota and Inflammation: An Overview
Zahraa Al Bander, Marloes Dekker Nitert, Aya Mousa, Negar Naderpoor
763 citationsOpen access (CC-BY)doi:10.3390/ijerph17207618OpenAlex
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The gut microbiota encompasses a diverse community of bacteria that carry out various functions influencing the overall health of the host. These comprise nutrient metabolism, immune system regulation and natural defence against infection. The presence of certain bacteria is associated with inflammatory molecules that may bring about inflammation in various body tissues. Inflammation underlies many chronic multisystem conditions including obesity, atherosclerosis, type 2 diabetes mellitus and inflammatory bowel disease. Inflammation may be triggered by structural components of the bacteria which can result in a cascade of inflammatory pathways involving interleukins and other cytokines. Similarly, by-products of metabolic processes in bacteria, including some short-chain fatty acids, can play a role in inhibiting inflammatory processes. In this review, we aimed to provide an overview of the relationship between the gut microbiota and inflammatory molecules and to highlight relevant knowledge gaps in this field. Based on the current literature, it appears that as the gut microbiota…
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Burnout Assessment Tool (BAT)—Development, Validity, and Reliability
Wilmar B. Schaufeli, Steffie Desart, Hans De Witte
758 citationsOpen access (CC-BY)doi:10.3390/ijerph17249495OpenAlex
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This paper introduces a new definition for burnout and investigates the psychometric properties of the Burnout Assessment Tool (BAT). In a prior qualitative study, 49 practitioners were interviewed about their conceptualization of burnout (part 1). Using a dialectical approach, four core dimensions-exhaustion, mental distance, and impaired emotional and cognitive impairment-and three secondary dimensions-depressed mood, psychological distress, and psychosomatic complaints-emerged, which constitute the basis of the BAT. In the second study, the psychometric characteristics of the BAT were investigated in a representative sample of 1500 Flemish employees, focusing on factorial validity, reliability, and construct validity, respectively. Results demonstrate the assumed four-factor structure for the core dimensions, which is best represented by one general burnout factor. Contrary to expectations, instead of a three-factor structure, a two-factor structure was found for the secondary dimensions. Furthermore, the BAT and its subscales show adequate reliability. Convergent validity and…
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Psychological Impact of COVID-19 and Lockdown among University Students in Malaysia: Implications and Policy Recommendations
Sheela Sundarasen, Karuthan Chinna, Kamilah Kamaludin, Mohammad Nurunnabi, Gul Baloch and 3 more
742 citationsOpen access (CC-BY)doi:10.3390/ijerph17176206OpenAlex
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The COVID-19 pandemic and the lockdown has taken the world by storm. This study examines its impact on the anxiety level of university students in Malaysia during the peak of the crisis and the pertinent characteristics affecting their anxiety. A cross-sectional online survey, using Zung’s self-rating anxiety questionnaire was conducted during the COVID-19 pandemic and lockdown. Out of the 983 respondents, 20.4%, 6.6%, and 2.8% experienced minimal to moderate, marked to severe, and most extreme levels of anxiety. Female gender (OR = 21.456, 95% CI = 1.061, 1.998, p = 0.020), age below 18 years (OR = 4.147, 95% CI = 1.331, 12.918, p = 0.014), age 19 to 25 (OR = 3.398, 95% CI = 1.431, 8.066, p = 0.006), pre-university level of education (OR = 2.882, 95% CI = 1.212, 6.854, p = 0.017), management studies (OR = 2.278, 95% CI = 1.526, 3.399, p < 0.001), and staying alone (OR = 2.208, 95% CI = 1.127, 4.325, p = 0.021) were significantly associated with higher levels of anxiety. The main stressors include financial constraints, remote online teaching and uncertainty about the future with…
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Changes in Physical Activity and Sedentary Behavior in Response to COVID-19 and Their Associations with Mental Health in 3052 US Adults
Jacob D. Meyer, Cillian P. McDowell, Jeni E. Lansing, Cassandra Sue Brower, Lee Smith and 2 more
718 citationsOpen access (CC-BY)doi:10.3390/ijerph17186469OpenAlex
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The COVID-19 pandemic altered many facets of life. We aimed to evaluate the impact of COVID-19-related public health guidelines on physical activity (PA), sedentary behavior, mental health, and their interrelations. Cross-sectional data were collected from 3052 US adults 3–8 April 2020 (from all 50 states). Participants self-reported pre- and post-COVID-19 levels of moderate and vigorous PA, sitting, and screen time. Currently-followed public health guidelines, stress, loneliness, positive mental health (PMH), social connectedness, and depressive and anxiety symptoms were self-reported. Participants were grouped by meeting US PA guidelines, reporting ≥8 h/day of sitting, or ≥8 h/day of screen time, pre- and post-COVID-19. Overall, 62% of participants were female, with age ranging from 18–24 (16.6% of sample) to 75+ (9.3%). Self-reported PA was lower post-COVID among participants reporting being previously active (mean change: −32.3% [95% CI: −36.3%, −28.1%]) but largely unchanged among previously inactive participants (+2.3% [−3.5%, +8.1%]). No longer meeting PA guidelines and…
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Fear and Practice Modifications among Dentists to Combat Novel Coronavirus Disease (COVID-19) Outbreak
Muhammad Adeel Ahmed, Rizwan Jouhar, Naseer Ahmed, Samira Adnan, Marziya Aftab and 2 more
683 citationsOpen access (CC-BY)doi:10.3390/ijerph17082821OpenAlex
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An outbreak of novel coronavirus disease (COVID-19) in China has influenced every aspect of life. Healthcare professionals, especially dentists, are exposed to a higher risk of getting infected due to close contact with infected patients. The current study was conducted to assess anxiety and fear of getting infected among dentists while working during the current novel coronavirus diseases (COVID-19) outbreak. In addition, dentists' knowledge about various practice modifications to combat COVID-19 has been evaluated. A cross-sectional study was conducted using an online survey from 10th to 17th March 2020. The well-constructed questionnaire was designed and registered at online website (Kwiksurveys) and validated. A total of 669 participants from 30 different countries across the world responded. After scrutiny, completed questionnaires (n = 650) were included in the study. Statistical analysis was performed using SPSS version 25. Chi-Square and Spearman correlation tests were applied to control confounders and assess the relation of dentists' response with respect to gender and…
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Airborne Transmission Route of COVID-19: Why 2 Meters/6 Feet of Inter-Personal Distance Could Not Be Enough
Leonardo Setti, Fabrizio Passarini, Gianluigi de Gennaro, Pierluigi Barbieri, Maria Grazia Perrone and 5 more
671 citationsOpen access (CC-BY)doi:10.3390/ijerph17082932OpenAlex
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The COVID-19 pandemic caused the shutdown of entire nations all over the world. In addition to mobility restrictions of people, the World Health Organization and the Governments have prescribed maintaining an inter-personal distance of 1.5 or 2 m (about 6 feet) from each other in order to minimize the risk of contagion through the droplets that we usually disseminate around us from nose and mouth. However, recently published studies support the hypothesis of virus transmission over a distance of 2 m from an infected person. Researchers have proved the higher aerosol and surface stability of SARS-COV-2 as compared with SARS-COV-1 (with the virus remaining viable and infectious in aerosol for hours) and that airborne transmission of SARS-CoV can occur besides close-distance contacts. Indeed, there is reasonable evidence about the possibility of SARS-COV-2 airborne transmission due to its persistence into aerosol droplets in a viable and infectious form. Based on the available knowledge and epidemiological observations, it is plausible that small particles containing the virus may…
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Mitigating the Psychological Impact of COVID-19 on Healthcare Workers: A Digital Learning Package
Holly Blake, Fiona Bermingham, Graham David Johnson, Andrew John Tabner
656 citationsOpen access (CC-BY)doi:10.3390/ijerph17092997OpenAlex
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The coronavirus pandemic (COVID-19) will undoubtedly have psychological impacts for healthcare workers, which could be sustained; frontline workers will be particularly at risk. Actions are needed to mitigate the impacts of COVID-19 on mental health by protecting and promoting the psychological wellbeing of healthcare workers during and after the outbreak. We developed and evaluated a digital learning package using Agile methodology within the first three weeks of UK outbreak. This e-package includes evidence-based guidance, support and signposting relating to psychological wellbeing for all UK healthcare employees. A three-step rapid development process included public involvement activities (PPIs) (STEP 1), content and technical development with iterative peer review (STEP 2), and delivery and evaluation (STEP 3). The package outlines the actions that team leaders can take to provide psychologically safe spaces for staff, together with guidance on communication and reducing social stigma, peer and family support, signposting others through psychological first aid (PFA), self-care…
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Effects of Covid-19 Lockdown on Mental Health and Sleep Disturbances in Italy
Maria Rosaria Gualano, Giuseppina Lo Moro, Gianluca Voglino, Fabrizio Bert, Roberta Siliquini
653 citationsOpen access (CC-BY)doi:10.3390/ijerph17134779OpenAlex
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Italy was the first European country that entered a nationwide lockdown during the COVID-19 pandemic. Since quarantine can impact on mental health, this study aimed to estimate the prevalence of depressive symptoms, anxiety symptoms and sleeping disturbances in the Italian population during lockdown. The factors that might influence such outcomes were explored. A national cross-sectional survey was performed during the last 14 days of the Italian lockdown. Questionnaires assessed socio-demographics characteristic, behaviors and healthcare access. The outcomes were assessed using Patient Health Questionnaire-2 and Generalized Anxiety Disorder-2. Participants with sleep disturbances completed the Insomnia Severity Index. The sample size was 1515. Depression and anxiety symptom prevalence was 24.7% and 23.2%; 42.2% had sleep disturbances and, among them, 17.4% reported moderate/severe insomnia. Being female, an increased time spent on the internet and an avoidance of activities through peer pressure increased the likelihood of at least one mental health outcome. Increasing age, an…
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Toxicities of Polycyclic Aromatic Hydrocarbons for Aquatic Animals
Masato Honda, Nobuo Suzuki
642 citationsOpen access (CC-BY)doi:10.3390/ijerph17041363OpenAlex
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Polycyclic aromatic hydrocarbons (PAHs) are organic compounds that are widely distributed in the air, water, and soil. Recently, the amount of PAHs derived from fuels and from incomplete combustion processes is increasing. In the aquatic environment, oil spills directly cause PAH pollution and affect marine organisms. Oil spills correlate very well with the major shipping routes. Furthermore, accidental oil spills can seriously impact the marine environment toxicologically. Here, we describe PAH toxicities and related bioaccumulation properties in aquatic animals, including invertebrates. Recent studies have revealed the toxicity of PAHs, including endocrine disruption and tissue-specific toxicity, although researchers have mainly focused on the carcinogenic toxicity of PAHs. We summarize the toxicity of PAHs regarding these aspects. Additionally, the bioaccumulation properties of PAHs for organisms, including invertebrates, are important factors when considering PAH toxicity. In this review, we describe the bioaccumulation properties of PAHs in aquatic animals. Recently,…
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The Prevalence of Depression, Anxiety and Stress and Their Associated Factors in College Students
Enrique Ramón Arbués, Vicente Gea-Caballero, José Manuel Granada-López, Raúl Juárez‐Vela, Begoña Pellicer-García and 1 more
634 citationsOpen access (CC-BY)doi:10.3390/ijerph17197001OpenAlex
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AIM: To estimate the prevalence of symptoms of depression, anxiety, stress and associated factors in a population of college students. METHOD: Cross-sectional study of psychological distress measured through the Depression, Anxiety and Stress Scale (DASS-21) in a sample of 1074 college students. RESULTS: We found a moderate prevalence of depression (18.4%), anxiety (23.6%) and stress (34.5%) symptoms in our study population. Being <21, having problematic Internet use behavior, smoking, presenting insomnia and having a low self-esteem were independently associated with symptoms of depression, anxiety and stress. Being a woman, living with their family, having a stable partner, consuming alcohol frequently and having poor nutritional habits were significantly associated with symptoms of stress; lacking a stable partner was significantly associated with depressive symptoms; and frequent consumption of alcohol was significantly associated with symptoms of anxiety. CONCLUSION: We found a moderate prevalence of depression, anxiety and stress symptoms in our population. Interventions aimed…
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The Characteristic of Virulence, Biofilm and Antibiotic Resistance of Klebsiella pneumoniae
Guoying Wang, Zhao Guo, Xiaoyu Chao, Longxiang Xie, Hongju Wang
595 citationsOpen access (CC-BY)doi:10.3390/ijerph17176278OpenAlex
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Klebsiella pneumoniae is an important gram-negative opportunistic pathogen that causes a variety of infectious diseases, including urinary tract infections, bacteremia, pneumonia, and liver abscesses. With the emergence of multidrug-resistant (MDR) and hypervirulent K. pneumoniae (hvKP) strains, the rapid spread of these clinical strains in geography is particularly worrying. However, the detailed mechanisms of virulence and antibiotic resistance in K. pneumoniae are still not very clear. Therefore, studying and elucidating the pathogenic mechanisms and drug resistance mechanism of K. pneumoniae infection are important parts of current medical research. In this paper, we systematically summarized the virulence, biofilm, and antibiotic tolerance mechanisms of K. pneumoniae, and explored the application of whole genome sequencing and global proteomics, which will provide new clues for clinical treatment of K. pneumoniae.
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Physical Activity Change during COVID-19 Confinement
Arkaitz Castañeda-Babarro, Ane Arbillaga Etxarri, Borja Gutiérrez-Santamaría, Aitor Coca
594 citationsOpen access (CC-BY)doi:10.3390/ijerph17186878OpenAlex
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Background: The lockdown and social distancing caused by COVID-19 may influence common health behavior. The unprecedent worldwide confinement, in which Spain has been one of the most affected—with severe rules governing confinement—may have changed physical activity (PA) and sedentary habits due to prolonged stays at home. Purpose: The aim of this study is to evaluate how self-reported PA and sedentary time (ST) have changed during confinement in the Spanish population. Methods: 3800 healthy adults (age 18–64 years) residing in Spain answered the international physical activity questionnaire short (IPAQ-S) twice between 23 March and 1 April (confinement). Data analysis was carried out taking into consideration meeting general PA recommendations before confinement, age and gender. Results: Self-reported PA decreased significantly during confinement in our sample. Vigorous physical activities (VPA) and walking time decreased by 16.8% (p < 0.001) and 58.2% (p < 0.001), respectively, whereas ST increased by 23.8% (p < 0.001). The percent of people fulfilling the 75 min/week of VPA…
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Chromium Pollution in European Water, Sources, Health Risk, and Remediation Strategies: An Overview
Marina Tumolo, Valeria Ancona, Domenico De Paola, Daniela Losacco, Claudia Campanale and 2 more
591 citationsOpen access (CC-BY)doi:10.3390/ijerph17155438OpenAlex
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Chromium is a potentially toxic metal occurring in water and groundwater as a result of natural and anthropogenic sources. Microbial interaction with mafic and ultramafic rocks together with geogenic processes release Cr (VI) in natural environment by chromite oxidation. Moreover, Cr (VI) pollution is largely related to several Cr (VI) industrial applications in the field of energy production, manufacturing of metals and chemicals, and subsequent waste and wastewater management. Chromium discharge in European Union (EU) waters is subjected to nationwide recommendations, which vary depending on the type of industry and receiving water body. Once in water, chromium mainly occurs in two oxidation states Cr (III) and Cr (VI) and related ion forms depending on pH values, redox potential, and presence of natural reducing agents. Public concerns with chromium are primarily related to hexavalent compounds owing to their toxic effects on humans, animals, plants, and microorganisms. Risks for human health range from skin irritation to DNA damages and cancer development, depending on dose,…
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Prevalence and Predictors of Anxiety and Depression Symptoms during the COVID-19 Pandemic and Compliance with Precautionary Measures: Age and Sex Matter
Ioulia Solomou, Fofi Constantinidou
591 citationsOpen access (CC-BY)doi:10.3390/ijerph17144924OpenAlex
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Effective management of the global pandemic caused by Severe Acute Respiratory Syndrome Coronavirus 2 (also known as COVID-19), resulted in the implementation of severe restrictions in movement and enforcement of social distancing measures. This study aimed to understand and characterize the psychosocial effects of the COVID-19 pandemic in the general population and to identify risks and protective factors that predict changes in mental health status. In addition, the study investigated compliance with precautionary measures (PM) to halt the spread of the virus. The online anonymous survey collected information on sociodemographic data, compliance with PM, quality of life (QOL), and mental health via the Generalized Anxiety Disorder-7 (GAD-7) and Patient Health Questionnaire-9 (PHQ-9). A total of 1642 adult participants (71.6% women, 28.4% men) completed the survey in the European island country, Cyprus. A large percentage (48%) reported significant financial concerns and 66.7% significant changes in their QOL. About 41% reported symptoms associated with mild anxiety; 23.1% reported…
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Exploring the Impact of COVID-19 on Mental Health Outcomes in Children and Adolescents: A Systematic Review
Finiki Nearchou, Clodagh Flinn, Rachel Niland, Sheena Siva Subramaniam, Eilis Hennessy
577 citationsOpen access (CC-BY)doi:10.3390/ijerph17228479OpenAlex
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The psychological impact of the COVID-19 pandemic has been widely discussed during the past few months, with scholars expressing concern about its potential debilitating consequences on youth mental health. Hence, this research aimed to provide a systematic review of the evidence on the COVID-19 pandemic’s impact on youth mental health. We conducted a mixed methods integrated review to identify any empirical study that focused on young people ≤ 18 years old. Eight databases were systematically searched to identify studies of any type of research design. The selection procedure followed the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) guidelines. The protocol of this systematic review was registered with PROSPERO (protocol ID: CRD4202019375). Twelve studies deemed eligible for data extraction (n = 12,262). The findings show that COVID-19 has an impact on youth mental health and is particularly associated with depression and anxiety in adolescent cohorts. The quality appraisal indicated that all studies were of low or moderate methodological quality. The…
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Toxic Metal Implications on Agricultural Soils, Plants, Animals, Aquatic life and Human Health
Godwin Uchenna Okereafor, Mamookho Elizabeth Makhatha, Lukhanyo Mekuto, Nkemdinma C. Uche-Okereafor, Tendani Edith Sebola and 1 more
577 citationsOpen access (CC-BY)doi:10.3390/ijerph17072204OpenAlex
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The problem of environmental pollution is a global concern as it affects the entire ecosystem. There is a cyclic revolution of pollutants from industrial waste or anthropogenic sources into the environment, farmlands, plants, livestock and subsequently humans through the food chain. Most of the toxic metal cases in Africa and other developing nations are a result of industrialization coupled with poor effluent disposal and management. Due to widespread mining activities in South Africa, pollution is a common site with devastating consequences on the health of animals and humans likewise. In recent years, talks on toxic metal pollution had taken center stage in most scientific symposiums as a serious health concern. Very high levels of toxic metals have been reported in most parts of South African soils, plants, animals and water bodies due to pollution. Toxic metals such as Zinc (Zn), Lead (Pb), Aluminium (Al), Cadmium (Cd), Nickel (Ni), Iron (Fe), Manganese (Mn) and Arsenic (As) are major mining effluents from tailings which contaminate both the surface and underground water, soil…
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Corona Virus (COVID-19) “Infodemic” and Emerging Issues through a Data Lens: The Case of China
Jinling Hua, Rajib Shaw
575 citationsOpen access (CC-BY)doi:10.3390/ijerph17072309OpenAlex
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Coronavirus (COVID-19) is a humanitarian emergency, which started in Wuhan in China in early December 2019, brought into the notice of the authorities in late December, early January 2020, and, after investigation, was declared as an emergency in the third week of January 2020. The WHO declared this as Public Health Emergency of International Concern (PHEIC) on 31th of January 2020, and finally a pandemic on 11th March 2020. As of March 24th, 2020, the virus has caused a casualty of over 16,600 people worldwide with more than 380,000 people confirmed as infected by it, of which more than 10,000 cases are serious. Mainly based on Chinese newspapers, social media and other digital platform data, this paper analyzes the timeline of the key actions taken by the government and people over three months in five different phases. It found that although there was an initial delay in responding, a unique combination of strong governance, strict regulation, strong community vigilance and citizen participation, and wise use of big data and digital technologies, were some of the key factors in…
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Mental Health Problems during the COVID-19 Pandemics and the Mitigation Effects of Exercise: A Longitudinal Study of College Students in China
Yao Zhang, Haoyu Zhang, Xindong Ma, Qian Di
563 citationsOpen access (CC-BY)doi:10.3390/ijerph17103722OpenAlex
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(1) Background: The novel coronavirus disease 2019 (COVID-19) is a global public health emergency that has caused worldwide concern. Vast resources have been allocated to control the pandemic and treat patients. However, little attention has been paid to the adverse impact on mental health or effective mitigation strategies to improve mental health. (2) Purpose: The aim of this study was to assess the adverse impact of the COVID-19 outbreak on Chinese college students’ mental health, understand the underlying mechanisms, and explore feasible mitigation strategies. (3) Methods: During the peak time of the COVID-19 outbreak in China, we conducted longitudinal surveys of sixty-six college students. Structured questionnaires collected information on demographics, physical activity, negative emotions, sleep quality, and aggressiveness level. A mixed-effect model was used to evaluate associations between variables, and the mediating effect of sleep quality was further explored. A generalized additive model was used to determine the dose-response relationships between the COVID-19 death…
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Chronic and Acute Toxicities of Aflatoxins: Mechanisms of Action
Noreddine Benkerroum
557 citationsOpen access (CC-BY)doi:10.3390/ijerph17020423OpenAlex
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Aflatoxins continue to raise health concerns as unavoidable and widespread natural contaminants of foods and feeds with serious impact on health, agricultural and livestock productivity, and food safety. They are secondary metabolites produced by Aspergillus species distributed on three main sections of the genus (section Flavi, section Ochraceorosei, and section Nidulantes). Aflatoxin-producing species, mainly A. flavus and A. parasiticus thrive under hot and humid conditions in the field or during storage, which are met in tropical and sub-tropical regions. Poor economic status of a country exacerbates the risk and the extent of crop contamination due to faulty storage conditions that are usually suitable for mold growth and mycotoxin production; temperature of 22 to 29°C and water activity of 0.90 to 0.99. This situation paralleled the prevalence of high liver cancer and the occasional acute aflatoxicosis episodes that have been associated with these regions. Few of the presently known aflatoxins (>18) have been sufficiently studied for their incidence, health-risk, and…
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Worldwide Research Trends on Medicinal Plants
Esther Salmerón-Manzano, José Antonio Garrido-Cárdenas, Francisco Rogelio Manzano-Agugliaro
548 citationsOpen access (CC-BY)doi:10.3390/ijerph17103376OpenAlex
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The use of medicinal plants has been done since ancient times and may even be considered the origin of modern medicine. Compounds of plant origin have been and still are an important source of compounds for drugs. In this study a bibliometric study of all the works indexed in the Scopus database until 2019 has been carried out, analyzing more than 100,000 publications. On the one hand, the main countries, institutions and authors researching this topic have been identified, as well as their evolution over time. On the other hand, the links between the authors, the countries and the topics under research have been analyzed through the detection of communities. The last two periods, from 2009 to 2014 and from 2015 to 2019, have been examined in terms of research topics. It has been observed that the areas of study or clusters have been reduced, those of the last period being those engaged in unclassified drug, traditional medicine, cancer, in vivo study-antidiabetic activity, and animals-anti-inflammatory activity. In summary, it has been observed that the trend in global research is…
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Indoor Exposure to Selected Air Pollutants in the Home Environment: A Systematic Review
Sotiris Vardoulakis, Evanthia Giagloglou, Susanne Steinle, Alice Davis, Anne Sleeuwenhoek and 3 more
540 citationsOpen access (CC-BY)doi:10.3390/ijerph17238972OpenAlex
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(1) Background: There is increasing awareness that the quality of the indoor environment affects our health and well-being. Indoor air quality (IAQ) in particular has an impact on multiple health outcomes, including respiratory and cardiovascular illness, allergic symptoms, cancers, and premature mortality. (2) Methods: We carried out a global systematic literature review on indoor exposure to selected air pollutants associated with adverse health effects, and related household characteristics, seasonal influences and occupancy patterns. We screened records from six bibliographic databases: ABI/INFORM, Environment Abstracts, Pollution Abstracts, PubMed, ProQuest Biological and Health Professional, and Scopus. (3) Results: Information on indoor exposure levels and determinants, emission sources, and associated health effects was extracted from 141 studies from 29 countries. The most-studied pollutants were particulate matter (PM2.5 and PM10); nitrogen dioxide (NO2); volatile organic compounds (VOCs) including benzene, toluene, xylenes and formaldehyde; and polycyclic aromatic…
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Physical Activity and Sedentary Lifestyle in University Students: Changes during Confinement Due to the COVID-19 Pandemic
Cristina Romero, Julián Rodríguez‐Almagro, María Dolores Onieva Zafra, María Laura Parra-Fernández, María del Carmen Prado-Laguna and 1 more
521 citationsOpen access (CC-BY)doi:10.3390/ijerph17186567OpenAlex
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Regular physical activity is related to many factors in a university student's environment. The coronavirus pandemic and the resulting lockdown have restricted many elements of our environment. The aim of this study was to evaluate students' physical activity and sedentary behaviour at two points in time: before and during the coronavirus lockdown. As a secondary aim, we also wanted to look at changes resulting from other factors (alcohol, tobacco, diet, stages of change, symptoms of anxiety/depression and sociodemographic characteristics). We conducted an observational, cross-sectional, pre-post study with two cut-off points. Two hundred and thirteen students took part in the study. The main dependent variables were physical activity and sitting time, measured using the International Physical Activity Questionnaire-Short Form (IPAQ-SF). Parametric and non-parametric tests were used for paired and unpaired data, as well as group-stratified analysis. During lockdown, both weekly physical activity (MD: -159.87; CI: -100.44, -219.31) and weekly sitting time increased (MD: -106.76; CI:…
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Impact of Air Pollution on Asthma Outcomes
Angelica I. Tiotiu, Plamena Ivanova Novakova, Denislava Nedeva, Herberto José Chong‐Neto, Silviya Mihaylova Novakova and 2 more
515 citationsOpen access (CC-BY)doi:10.3390/ijerph17176212OpenAlex
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Asthma is a chronic respiratory disease characterized by variable airflow obstruction, bronchial hyperresponsiveness, and airway inflammation. Evidence suggests that air pollution has a negative impact on asthma outcomes in both adult and pediatric populations. The aim of this review is to summarize the current knowledge on the effect of various outdoor and indoor pollutants on asthma outcomes, their burden on its management, as well as to highlight the measures that could result in improved asthma outcomes. Traffic-related air pollution, nitrogen dioxide and second-hand smoking (SHS) exposures represent significant risk factors for asthma development in children. Nevertheless, a causal relation between air pollution and development of adult asthma is not clearly established. Exposure to outdoor pollutants can induce asthma symptoms, exacerbations and decreases in lung function. Active tobacco smoking is associated with poorer asthma control, while exposure to SHS increases the risk of asthma exacerbations, respiratory symptoms and healthcare utilization. Other indoor pollutants…
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The Psychological Causes of Panic Buying Following a Health Crisis
Kum Fai Yuen, Xueqin Wang, Fei Ma, Kevin X. Li
513 citationsOpen access (CC-BY)doi:10.3390/ijerph17103513OpenAlex
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Attributed to the recent COVID-19 pandemic, panic buying is now a frequent occurrence in many countries, leading to stockouts and supply chain disruptions. Consequently, it has received much attention from academics and the retail industry. The aim of this study is to review, identify, and synthesise the psychological causes of panic buying, which is a relatively new and unexplored area in consumer behaviour research. A systematic review of the related literature is conducted. The review suggests that panic buying is influenced by (1) individuals' perception of the threat of the health crisis and scarcity of products; (2) fear of the unknown, which is caused by negative emotions and uncertainty; (3) coping behaviour, which views panic buying as a venue to relieve anxiety and regain control over the crisis; and (4) social psychological factors, which account for the influence of the social network of an individual. This study contributes to the literature by consolidating the scarce and scattered research on the causes of panic buying, drawing greater theoretical insights into each…
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COVID-19 Lockdown: Housing Built Environment’s Effects on Mental Health
Andrea Amerio, Andrea Brambilla, Alessandro Morganti, Andrea Aguglia, Davide Gianluca Bianchi and 8 more
498 citationsOpen access (CC-BY)doi:10.3390/ijerph17165973OpenAlex
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Since the World Health Organization (WHO) declared the coronavirus infectious disease 2019 (COVID-19) outbreak a pandemic on 11 March, severe lockdown measures have been adopted by the Italian Government. For over two months of stay-at-home orders, houses became the only place where people slept, ate, worked, practiced sports, and socialized. As consolidated evidence exists on housing as a determinant of health, it is of great interest to explore the impact that COVID-19 response-related lockdown measures have had on mental health and well-being. We conducted a large web-based survey on 8177 students from a university institute in Milan, Northern Italy, one of the regions most heavily hit by the pandemic in Europe. As emerged from our analysis, poor housing is associated with increased risk of depressive symptoms during lockdown. In particular, living in apartments <60 m2 with poor views and scarce indoor quality is associated with, respectively, 1.31 (95% CI: 1046–1637), 1.368 (95% CI: 1166–1605), and 2.253 (95% CI: 1918–2647) times the risk of moderate–severe and severe depressive…
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Relationships between Severity of Internet Gaming Disorder, Severity of Problematic Social Media Use, Sleep Quality and Psychological Distress
Hiu Yan Wong, Hoi Yi Mo, Marc Nicholas Potenza, Mung Ni Monica Chan, Wai Man Lau and 3 more
483 citationsOpen access (CC-BY)doi:10.3390/ijerph17061879OpenAlex
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Internet gaming and social media use are prevalent and integral to many people’s lives. However, excessive engagement in either could lead to negative health impacts. This study aimed to investigate relationships between severities of internet gaming disorder (IGD) and problematic social media use (operationalized as social media addiction; SMA) with sleep quality and psychological distress among young adults. A cross-sectional study with snowball sampling was conducted among Hong Kong university students in 2019. All participants (n = 300; mean (SD) age = 20.89 (1.48); 122 males (40.67%)) responded to an online survey that included Chinese versions of the Internet Gaming Disorder Scale-Short Form (IGDS9-SF), Bergen Social Media Addiction Scale (BSMAS), Pittsburgh Sleep Quality Index (PSQI), and Depression Anxiety Stress Scales (DASS-21). Multiple linear regressions demonstrated that IGDS-SF9 scores demonstrated associations with psychological distress measures (standardized coefficient (β) = 0.295 for depression, 0.325 for anxiety, 0.339 for stress, all p < 0.001). BSMAS scores…
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Air Pollution and COVID-19: The Role of Particulate Matter in the Spread and Increase of COVID-19’s Morbidity and Mortality
Silvia Comunian, Dario Dongo, Chiara Milani, Paola Palestini
464 citationsOpen access (CC-BY)doi:10.3390/ijerph17124487OpenAlex
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Sars-cov-2 virus (Covid-19) is a member of the coronavirus family and is responsible for the pandemic recently declared by the World Health Organization. A positive correlation has been observed between the spread of the virus and air pollution, one of the greatest challenges of our millennium. Covid-19 could have an air transmission and atmospheric particulate matter (PM) could create a suitable environment for transporting the virus at greater distances than those considered for close contact. Moreover, PM induces inflammation in lung cells and exposure to PM could increase the susceptibility and severity of the Covid-19 patient symptoms. The new coronavirus has been shown to trigger an inflammatory storm that would be sustained in the case of pre-exposure to polluting agents. In this review, we highlight the potential role of PM in the spread of Covid-19, focusing on Italian cities whose PM daily concentrations were found to be higher than the annual average allowed during the months preceding the epidemic. Furthermore, we analyze the positive correlation between the virus…
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Urban Trees and Human Health: A Scoping Review
Kathleen L. Wolf, Sharon T. Lam, Jennifer McKeen, Gregory R. A. Richardson, Matilda Annerstedt van den Bosch and 1 more
460 citationsOpen access (CC-BY)doi:10.3390/ijerph17124371OpenAlex
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The urban forest is a green infrastructure system that delivers multiple environmental, economic, social and health services, and functions in cities. Environmental benefits of urban trees are well understood, but no review to date has examined how urban trees affect human health. This review provides a comprehensive summary of existing literature on the health impacts of urban trees that can inform future research, policy, and nature-based public health interventions. A systematic search used keywords representing human health, environmental health, and urban forestry. Following screening and appraisal of several thousand articles, 201 studies were conceptually sorted into a three-part framework. Reducing Harm, representing 41% of studies, includes topics such as air pollution, ultraviolet radiation, heat exposure, and pollen. Restoring Capacities, at 31%, includes attention restoration, mental health, stress reduction, and clinical outcomes. Building Capacities, at 28%, includes topics such as birth outcomes, active living, and weight status. The studies that were reviewed show…
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Professional Quality of Life and Mental Health Outcomes among Health Care Workers Exposed to Sars-Cov-2 (Covid-19)
Rodolfo Buselli, Martina Corsi, Sigrid Baldanzi, Martina Chiumiento, Elena Del Lupo and 6 more
431 citationsOpen access (CC-BY)doi:10.3390/ijerph17176180OpenAlex
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The novel coronavirus disease 2019 (COVID-19) is a global pandemic spreading worldwide, and Italy represented the first European country involved. Healthcare workers (HCWs) facing COVID-19 pandemic represented an at-risk population for new psychosocial COVID-19 strain and consequent mental health symptoms. The aim of the present study was to identify the possible impact of working contextual and personal variables (age, gender, working position, years of experience, proximity to infected patients) on professional quality of life, represented by compassion satisfaction (CS), burnout, and secondary traumatization (ST), in HCWs facing COVID-19 emergency. Further, two multivariable linear regression analyses were fitted to explore the association of mental health selected outcomes, anxiety and depression, with some personal and working characteristics that are COVID-19-related. A sample of 265 HCWs of a major university hospital in central Italy was consecutively recruited at the outpatient service of the Occupational Health Department during the acute phase of COVID-19 pandemic. HCWs…
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Critical Review on the Presence of Phthalates in Food and Evidence of Their Biological Impact
Angela Alessia Giuliani, Mariachiara Zuccarini, Angelo Cichelli, Haroon Zaman Khan, Marcella Reale
420 citationsOpen access (CC-BY)doi:10.3390/ijerph17165655OpenAlex
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Phthalates are a huge class of chemicals with a wide spectrum of industrial uses, from the manufacture of plastics to food contact applications, children's toys, and medical devices. People and animals can be exposed through different routes (i.e., ingestion, inhalation, dermal, or iatrogenic exposure), as these compounds can be easily released from plastics to water, food, soil, air, making them ubiquitous environmental contaminants. In the last decades, phthalates and their metabolites have proven to be of concern, particularly in products for pregnant women or children. Moreover, many authors reported high concentrations of phthalates in soft drinks, mineral waters, wine, oil, ready-to-eat meals, and other products, as a possible consequence of their accumulation along the food production chain and their accidental release from packaging materials. However, due to their different physical and chemical properties, phthalates do not have the same human and environmental impacts and their association to several human diseases is still under debate. In this review we provide an…
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Oral Cancer and Precancer: A Narrative Review on the Relevance of Early Diagnosis
Silvio Abati, Chiara Bramati, Stefano Bondi, Alessandra Lissoni, Matteo Trimarchi
419 citationsOpen access (CC-BY)doi:10.3390/ijerph17249160OpenAlex
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Oral cancer (OC) is an uncommon malignancy in Western countries, being one of the most common cancers in some high-risk areas of the world. It is a largely preventable cancer, since most of the different risk factors identified, such as tobacco use, alcohol consumption, and betel nut chewing, are behaviors that increase the likelihood of the disease. Given its high mortality, early diagnosis is of utmost importance. Prevention and the anticipation of diagnosis begin with identification of potentially malignant lesions of the oral mucosa and with local conditions promoting chronic inflammation. Therefore, every lesion must be recognized promptly and treated adequately. The clinical recognition and evaluation of oral mucosal lesions can detect up to 99% of oral cancers/premalignancies. As stated by the World Health Organization, any suspicious lesion that does not subside within two weeks from detection and removal of local causes of irritation must be biopsied. Surgical biopsy remains the gold standard for diagnosis of oral cancer. Adjunctive tools have been developed and studied to…
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Coronavirus-Related Health Literacy: A Cross-Sectional Study in Adults during the COVID-19 Infodemic in Germany
Orkan Okan, Torsten Michael Bollweg, Eva-Maria Berens, Klaus Hurrelmann, Ullrich Bauer and 1 more
411 citationsOpen access (CC-BY)doi:10.3390/ijerph17155503OpenAlex
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There is an "infodemic" associated with the COVID-19 pandemic-an overabundance of valid and invalid information. Health literacy is the ability to access, understand, appraise, and apply health information, making it crucial for navigating coronavirus and COVID-19 information environments. A cross-sectional representative study of participants ≥ 16 years in Germany was conducted using an online survey. A coronavirus-related health literacy measure was developed (HLS-COVID-Q22). Internal consistency was very high (α = 0.940; ρ = 0.891) and construct validity suggests a sufficient model fit, making HLS-COVID-Q22 a feasible tool for assessing coronavirus-related health literacy in population surveys. While 49.9% of our sample had sufficient levels of coronavirus-related health literacy, 50.1% had "problematic" (15.2%) or "inadequate" (34.9%) levels. Although the overall level of health literacy is high, a vast number of participants report difficulties dealing with coronavirus and COVID-19 information. The participants felt well informed about coronavirus, but 47.8% reported having…
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Impact of Nurse-Patient Relationship on Quality of Care and Patient Autonomy in Decision-Making
Jesús Molina‐Mula, Julia Gallo Estrada
409 citationsOpen access (CC-BY)doi:10.3390/ijerph17030835OpenAlex
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BACKGROUND: The patient is observed to acquire a passive role and the nurse an expert role with a maternalistic attitude. This relationship among others determines the capacity for autonomy in the decision making of patients. OBJECTIVES: The aim of this study is to analyse the nurse-patient relationship and explore their implications for clinical practice, the impact on quality of care, and the decision-making capacity of patients. DESIGN: A phenomenological qualitative study was conducted. SETTINGS AND PARTICIPANTS: Thirteen in-depth interviews with nurses and 61,484 nursing records from internal medicine and specialties departments in a general hospital from 2015-2016. METHODS: A discourse analysis and triangulation for these sources were conducted. RESULTS: The category elaborated from nursing records was defined according to the following codes: Good Patient, Bad patient, and Social Problem. Analysis of the interviews resulted in a category defined as Patient as a passive object. DISCUSSION: A good nurse-patient relationship reduces the days of hospital stay and improves the…
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COVID-19 Home Confinement Negatively Impacts Social Participation and Life Satisfaction: A Worldwide Multicenter Study
Achraf Ammar, Hamdi Chtourou, Omar F. Boukhris, Khaled Trabelsi, Liwa Masmoudi and 25 more
408 citationsOpen access (CC-BY)doi:10.3390/ijerph17176237OpenAlex
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Public health recommendations and governmental measures during the new coronavirus disease (COVID-19) pandemic have enforced numerous restrictions on daily living including social distancing, isolation, and home confinement. While these measures are imperative to mitigate spreading of COVID-19, the impact of these restrictions on psychosocial health is undefined. Therefore, an international online survey was launched in April 2020 to elucidate the behavioral and lifestyle consequences of COVID-19 restrictions. This report presents the preliminary results from more than one thousand responders on social participation and life satisfaction. Methods: Thirty-five research organizations from Europe, North-Africa, Western Asia, and the Americas promoted the survey through their networks to the general society, in 7 languages (English, German, French, Arabic, Spanish, Portuguese, and Slovenian). Questions were presented in a differential format with questions related to responses “before” and “during” confinement conditions. Results: 1047 participations (54% women) from Asia (36%), Africa…
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Exercising in Times of Lockdown: An Analysis of the Impact of COVID-19 on Levels and Patterns of Exercise among Adults in Belgium
Bram Constandt, Erik Thibaut, Veerle De Bosscher, Jeroen Scheerder, Margot Ricour and 1 more
404 citationsOpen access (CC-BY)doi:10.3390/ijerph17114144OpenAlex
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Countries all over the world implemented lockdowns to counteract COVID-19. These lockdowns heavily limited people's exercise possibilities. At the same time, experts advocated to remain physically active to prevent future health problems. Based on an online survey, this study examines adults' exercise levels and patterns during the COVID-19 lockdown in Belgium. Ordinal logistic regression analyses of 13,515 valid and population-weighted responses indicate a general increase in exercise frequencies, as well as in sedentary behavior. Except for people aged 55+, previously low active adults self-reported to exercise more during the lockdown. Among the people who were already high active before COVID-19, those above 55 years old, those with low education, those used to exercise with friends or in a sport club, and those who were not using online tools to exercise, self-reported to exercise less during the lockdown. Having less time, sitting more, and missing the familiar way and competitive element of exercising were the main reasons for a self-reported exercise reduction. Given the…
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Fear of COVID-19 Scale—Associations of Its Scores with Health Literacy and Health-Related Behaviors among Medical Students
Hiep Thanh Nguyen, Binh N. Do, Phạm Minh Khuê, Kim Bảo Giang, Hoa T. B. Dam and 6 more
398 citationsOpen access (CC-BY)doi:10.3390/ijerph17114164OpenAlex
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The coronavirus disease 2019 (COVID-19) pandemic causes fear, as its immediate consequences for the public have produced unprecedented challenges for the education and healthcare systems. We aimed to validate the fear of COVID-19 scale (FCoV-19S) and examine the association of its scores with health literacy and health-related behaviors among medical students. A cross-sectional study was conducted from 7 to 29 April 2020 on 5423 students at eight universities across Vietnam, including five universities in the North, one university in the Center, two universities in the South. An online survey questionnaire was used to collect data on participants’ characteristics, health literacy, fear of COVID-19 using the FCoV-19S, and health-related behaviors. The results showed that seven items of the FCoV-19S strongly loaded on one component, explained 62.15% of the variance, with good item–scale convergent validity and high internal consistency (Cronbach’s alpha = 0.90). Higher health literacy was associated with lower FCoV-19S scores (coefficient, B, −0.06; 95% confidence interval, 95%CI,…
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Evolving Role of Social Media in Health Promotion: Updated Responsibilities for Health Education Specialists
Michael Stellefson, Samantha R. Paige, Beth H. Chaney, J. Don Chaney
397 citationsOpen access (CC-BY)doi:10.3390/ijerph17041153OpenAlex
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The use of social media in public health education has been increasing due to its ability to remove physical barriers that traditionally impede access to healthcare support and resources. As health promotion becomes more deeply rooted in Internet-based programming, health education specialists are tasked with becoming more competent in computer-mediated contexts that optimize both online and offline consumer health experiences. Generating a better understanding of the benefits and drawbacks to using social media in the field is important, since health education specialists continue to weigh its advantages against potential concerns and barriers to use. Accordingly, this Special Issue aims to explore social media as a translational health promotion tool by bridging principles of health education and health communication that examine (1) the method with which social media users access, negotiate, and create health information that is both actionable and impactful for diverse audiences; (2) strategies for overcoming challenges to using social media in health promotion; and (3) best…
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Experiences of Nursing Students during the Abrupt Change from Face-to-Face to e-Learning Education during the First Month of Confinement Due to COVID-19 in Spain
Antonio Jesús Ramos‐Morcillo, César Leal‐Costa, José Enrique Moral García, María Ruzafa‐Martínez
391 citationsOpen access (CC-BY)doi:10.3390/ijerph17155519OpenAlex
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The current state of alarm due to the COVID-19 pandemic has led to the urgent change in the education of nursing students from traditional to distance learning. The objective of this study was to discover the learning experiences and the expectations about the changes in education, in light of the abrupt change from face-to-face to e-learning education, of nursing students enrolled in the Bachelor's and Master's degree of two public Spanish universities during the first month of confinement due to the COVID-19 pandemic. Qualitative study was conducted during the first month of the state of alarm in Spain (from 25 March-20 April 2020). Semi-structured interviews were given to students enrolled in every academic year of the Nursing Degree, and nurses who were enrolled in the Master's programs at two public universities. A maximum variation sampling was performed, and an inductive thematic analysis was conducted. The study was reported according with COREQ checklist. Thirty-two students aged from 18 to 50 years old participated in the study. The interviews lasted from 17 to 51 min. Six…
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The Relationships between Physical Activity and Life Satisfaction and Happiness among Young, Middle-Aged, and Older Adults
Hsin-Yu An, Wei Chen, Cheng-Wei Wang, Hui-Fei Yang, Wan‐Ting Huang and 1 more
389 citationsOpen access (CC-BY)doi:10.3390/ijerph17134817OpenAlex
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Physical activity has benefits on physical and psychological health. The aims of this study were to investigate (1) the relationships between physical activity and life satisfaction and happiness in young, middle-aged, and older adults while controlling for demographic characteristics, and (2) the relationships between age and life satisfaction and happiness for different physical activity levels. A total of 2345 healthy adults were recruited. Demographic characteristic, physical activity, life satisfaction, and happiness were collected. Participants were divided into young, middle-aged, and older adult groups based on age, and physical activity was categorized as high, moderate, and low. After controlling for demographic characteristics, participants with high and moderate activity levels had significantly higher life satisfaction and happiness than those with a low activity level across the total population and the three age groups. Age squared was a significant predictor of a positive curvilinear between age and life satisfaction and happiness. Physical activity was significantly…
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The Burden of Endometriosis on Women’s Lifespan: A Narrative Overview on Quality of Life and Psychosocial Wellbeing
Luigi Della Corte, Claudia Di Filippo, Olimpia Gabrielli, Sabrina Reppuccia, Valentina Lucia La Rosa and 5 more
387 citationsOpen access (CC-BY)doi:10.3390/ijerph17134683OpenAlex
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Endometriosis is a chronic, inflammatory disease affecting more than 170 million women worldwide and up to 10% of women of reproductive age. As a consequence of inflammatory reaction and infiltration of anatomic structures, endometriosis can cause "pain symptoms" including dysmenorrhea, dyspareunia, dyschezia, dysuria, and chronic pelvic pain. In this review, we summarized the impact of endometriosis on quality of life in all its aspects including sexual life, work, and social relationships. The data research was conducted using web-based search engines and/or various electronic research databases querying for all articles related to endometriosis and quality of life from the inception of the database up to February 2020. Endometriosis has not only physical but also psychological effects, causing depression, anxiety, and compromising social relationships. Furthermore, endometriosis negatively impacts sexual life and social relationships. At last, the economic burden of endometriosis should not be underestimated, both individually and for the community, as this pathology leads to a…
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Alcohol Consumption during the COVID-19 Pandemic: A Cross-Sectional Survey of US Adults
Elyse R. Grossman, Sara E. Benjamin‐Neelon, Susan Sonnenschein
386 citationsOpen access (CC-BY)doi:10.3390/ijerph17249189OpenAlex
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Emerging but limited evidence suggests that alcohol consumption has increased during the COVID-19 pandemic. This study assessed: (1) whether drinking behaviors changed during the pandemic; and, (2) how those changes were impacted by COVID-19-related stress. We conducted a cross-sectional online survey with a convenience sample of U.S. adults over 21 years in May 2020. We conducted adjusted linear regressions to assess COVID-19 stress and alcohol consumption, adjusting for gender, race, ethnicity, age, and household income. A total of 832 responded: 84% female, 85% White, and 72% ages 26–49. Participants reported consuming 26.8 alcohol drinks on 12.2 of the past 30 days. One-third of participants (34.1%) reported binge drinking and 7.0% reported extreme binge drinking. Participants who experienced COVID-19-related stress (versus not) reported consuming more drinks (β = 4.7; CI (0.2, 9.1); p = 0.040) and a greater number of days drinking (β = 2.4; CI (0.6, 4.1); p = 0.007). Additionally, 60% reported increased drinking but 13% reported decreased drinking, compared to pre-COVID-19.…
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Updating the Mediterranean Diet Pyramid towards Sustainability: Focus on Environmental Concerns
Lluís Serra‐Majem, Laura Tomaino, S. Dernini, Elliot M. Berry, Denis Lairon and 10 more
379 citationsOpen access (CC-BY)doi:10.3390/ijerph17238758OpenAlex
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BACKGROUND: Nowadays the food production, supply and consumption chain represent a major cause of ecological pressure on the natural environment, and diet links worldwide human health with environmental sustainability. Food policy, dietary guidelines and food security strategies need to evolve from the limited historical approach, mainly focused on nutrients and health, to a new one considering the environmental, socio-economic and cultural impact-and thus the sustainability-of diets. OBJECTIVE: To present an updated version of the Mediterranean Diet Pyramid (MDP) to reflect multiple environmental concerns. METHODS: We performed a revision and restructuring of the MDP to incorporate more recent findings on the sustainability and environmental impact of the Mediterranean Diet pattern, as well as its associations with nutrition and health. For each level of the MDP we provided a third dimension featuring the corresponding environmental aspects related to it. CONCLUSIONS: The new environmental dimension of the MDP enhances food intake recommendations addressing both health and…
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How Big Data and Artificial Intelligence Can Help Better Manage the COVID-19 Pandemic
Nicola Luigi Bragazzi, Haijiang Dai, Giovanni Battista Damiani, Masoud Behzadifar, Mariano Martini and 1 more
377 citationsOpen access (CC-BY)doi:10.3390/ijerph17093176OpenAlex
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SARS-CoV2 is a novel coronavirus, responsible for the COVID-19 pandemic declared by the World Health Organization. Thanks to the latest advancements in the field of molecular and computational techniques and information and communication technologies (ICTs), artificial intelligence (AI) and Big Data can help in handling the huge, unprecedented amount of data derived from public health surveillance, real-time epidemic outbreaks monitoring, trend now-casting/forecasting, regular situation briefing and updating from governmental institutions and organisms, and health facility utilization information. The present review is aimed at overviewing the potential applications of AI and Big Data in the global effort to manage the pandemic.
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COVID-19 Pandemic in the Italian Population: Validation of a Post-Traumatic Stress Disorder Questionnaire and Prevalence of PTSD Symptomatology
Giuseppe Forte, Francesca Favieri, Renata Tambelli, Maria Casagrande
376 citationsOpen access (CC-BY)doi:10.3390/ijerph17114151OpenAlex
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Since December 2019, the COVID-19 pandemic has attracted worldwide attention for its rapid and exponential diffusion. The long-term psychological impact, of both the spread of the virus and the restrictive policies adopted to counteract it, remains uncertain. However, recent studies reported a high level of psychological distress and Post-Traumatic Stress Disorder (PTSD) symptoms. The purpose of this study is to assess the psychometric properties of a new questionnaire, to evaluate PTSD risk related to the COVID-19 emergency. A total of Italian people completed a web-based cross-sectional survey broadcasted through different social-media. Demographic data and some psychological dimensions, such as general distress and sleep disturbance, were collected. A new self-report questionnaire (COVID-19-PTSD), consisting of 19 items, was developed starting from the PTSD Check List for DSM-5 (PCL-5) questionnaire, and it was administered in order to analyze its psychometric properties. The results highlighted the adequate psychometric properties of the COVID-19-PTSD questionnaire. The…
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The Psychological Impacts of a COVID-19 Outbreak on College Students in China: A Longitudinal Study
Hong Yan Li, Hui Cao, Doris Y. P. Leung, Yim Wah Mak
372 citationsOpen access (CC-BY)doi:10.3390/ijerph17113933OpenAlex
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An outbreak in Wuhan, China in late 2019 of a highly infectious new coronary pneumonia (COVID-19) led to the imposition of countrywide confinement measures from January to March 2020. This is a longitudinal study on changes in the mental health status of a college population before and after their COVID-19 confinement for the first two weeks, focusing on states of psychological distress, depression, anxiety and affectivity. The influence of possible stressors on their mental health were investigated, including inadequate supplies and fears of infection. Five hundred and fifty-five undergraduate students were recruited from Hebei Agricultural University in Baoding, China. The participants completed two online surveys—on anxiety and depression, and on positive and negative affect. One survey was conducted before the confinement and the other was conducted 15–17 days after the start of the confinement. Increases in negative affect and symptoms of anxiety and depression (p-values < 0.001) were observed after 2 weeks of confinement. Inadequate supplies of hand sanitizers, a higher year…
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Physical Activity Changes and Its Risk Factors among Community-Dwelling Japanese Older Adults during the COVID-19 Epidemic: Associations with Subjective Well-Being and Health-Related Quality of Life
Yūta Suzuki, Noriaki Maeda, Daigo Hirado, Taizan Shirakawa, Yukio Urabe
369 citationsOpen access (CC-BY)doi:10.3390/ijerph17186591OpenAlex
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Psychological distress caused by decreased physical activity (PA) is a growing concern among the elderly due to public health measures since the coronavirus disease (COVID-19). We aimed to (1) assess how public health restrictions impact PA, subjective well-being (SWB), and health-related quality of life (HRQoL) of community-dwelling elderly, and (2) investigate risk factors that lead to a decline in PA. Self-administered questionnaires assessed the changes in PA, SWB, HRQoL. Multivariate logistic regression analysis was performed to identify significant associated risk factors for decreased PA. Of 165 participants (valid response rate, 41.3%; mean age, 78.5 ± 8.0 years), 47.3% became less active, 23.0% became more active, and 29.7% maintained PA levels. There was a significant decrease in SWB at baseline and follow-up after COVID-19 restrictions in the less active group (p < 0.01). Higher levels of moderate or strenuous exercise/sports activity at baseline (odds ratio [OR], 1.12; 95% confidence interval [CI], 1.01–1.24), and lower mental component HRQoL scores at baseline (OR,…
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Psychological Adjustment of Healthcare Workers in Italy during the COVID-19 Pandemic: Differences in Stress, Anxiety, Depression, Burnout, Secondary Trauma, and Compassion Satisfaction between Frontline and Non-Frontline Professionals
Carmen Trumello, Sonia Monique Bramanti, Giulia Ballarotto, Carla Candelori, Luca Cerniglia and 6 more
367 citationsOpen access (CC-BY)doi:10.3390/ijerph17228358OpenAlex
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Emergency situations have been associated with negative psychological adjustment outcomes in healthcare professionals, although studies on the impact of the Coronavirus Disease 2019 (COVID-19) pandemic amongst Italian health workers are limited. The main aim of this study was to investigate the psychological adjustment of healthcare professionals during the peak of the COVID-19 pandemic, evaluating differences according to working or not with patients affected by COVID-19 and in areas with a more severe spread of this pandemic. Healthcare professionals' attitudes toward psychological support were analyzed. The levels of anxiety, depression, psychological stress, and professional quality of life (compassion satisfaction, burnout, and compassion fatigue) and attitudes toward psychological support were measured among 627 Italian healthcare workers (mean age = 40.55 years; SD = 11.49; range: 27-72). Significantly higher levels of stress, burnout, secondary trauma, anxiety, and depression were observed among professionals working with COVID-19 patients. Higher levels of stress and…
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A Content-Analysis Based Literature Review in Blockchain Adoption within Food Supply Chain
Jiang Duan, Chen Zhang, Yu Gong, Steve Brown, Zhi Li
367 citationsOpen access (CC-BY)doi:10.3390/ijerph17051784OpenAlex
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According to the World Health Organization (WHO), one out of 10 people get sick from eating contaminated food. Complex food production process and globalization make food supply chain more delicate. Many technologies have been investigated in recent years to address food insecurity and achieve efficiency in dealing with food recalls. One of the most promising technologies is Blockchain, which has already been used successfully in financial aspects, such as bitcoin, and it is attracting interests from food supply chain organizations. As blockchain has characteristics, such as decentralization, security, immutability, smart contract, it is therefore expected to improve sustainable food supply chain management and food traceability. This paper applies a content-analysis based literature review in blockchain adoption within food supply chain. We propose four benefits. Blockchain can help to improve food traceability, information transparency, and recall efficiency; it can also be combined with Internet of things (IoT) to achieve better efficiency. We also propose five potential…
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Reverse Logistics Network Design for Effective Management of Medical Waste in Epidemic Outbreaks: Insights from the Coronavirus Disease 2019 (COVID-19) Outbreak in Wuhan (China)
Hao Yu, Xu Sun, Wei Deng Solvang, Xu Zhao
364 citationsOpen access (CC-BY)doi:10.3390/ijerph17051770OpenAlex
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The outbreak of an epidemic disease may pose significant treats to human beings and may further lead to a global crisis. In order to control the spread of an epidemic, the effective management of rapidly increased medical waste through establishing a temporary reverse logistics system is of vital importance. However, no research has been conducted with the focus on the design of an epidemic reverse logistics network for dealing with medical waste during epidemic outbreaks, which, if improperly treated, may accelerate disease spread and pose a significant risk for both medical staffs and patients. Therefore, this paper proposes a novel multi-objective multi-period mixed integer program for reverse logistics network design in epidemic outbreaks, which aims at determining the best locations of temporary facilities and the transportation strategies for effective management of the exponentially increased medical waste within a very short period. The application of the model is illustrated with a case study based on the outbreak of the coronavirus disease 2019 (COVID-19) in Wuhan, China.…
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Using Social Media to Mine and Analyze Public Opinion Related to COVID-19 in China
Xuehua Han, Juanle Wang, Min Zhang, Xiaojie Wang
361 citationsOpen access (CC-BY)doi:10.3390/ijerph17082788OpenAlex
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The outbreak of Corona Virus Disease 2019 (COVID-19) is a grave global public health emergency. Nowadays, social media has become the main channel through which the public can obtain information and express their opinions and feelings. This study explored public opinion in the early stages of COVID-19 in China by analyzing Sina-Weibo (a Twitter-like microblogging system in China) texts in terms of space, time, and content. Temporal changes within one-hour intervals and the spatial distribution of COVID-19-related Weibo texts were analyzed. Based on the latent Dirichlet allocation model and the random forest algorithm, a topic extraction and classification model was developed to hierarchically identify seven COVID-19-relevant topics and 13 sub-topics from Weibo texts. The results indicate that the number of Weibo texts varied over time for different topics and sub-topics corresponding with the different developmental stages of the event. The spatial distribution of COVID-19-relevant Weibo was mainly concentrated in Wuhan, Beijing-Tianjin-Hebei, the Yangtze River Delta, the Pearl…
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Prevalence, Prevention, and Lifestyle Intervention of Gestational Diabetes Mellitus in China
Juan Juan, Huixia Yang
355 citationsOpen access (CC-BY)doi:10.3390/ijerph17249517OpenAlex
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Gestational diabetes mellitus (GDM) has become an epidemic and has caused a tremendous healthy and economic burden in China, especially after the "two-child policy" put into effect on October 2015. The prevalence of GDM has continued to increase during the past few decades and is likely to see a further rise in the future. The public health impact of GDM is becoming more apparent in China and it might lead to the development of chronic non-communicable diseases in the long-term for both mothers and their children. Early identification of high-risk individuals could help to take preventive and intervention measures to reduce the risk of GDM and adverse perinatal outcomes. Therefore, a focus on prevention and intervention of GDM in China is of great importance. Lifestyle interventions, including dietary and physical exercise intervention, are effective and first-line preventive strategies for GDM prevention and intervention. The GDM One-day Care Clinic established in 2011, which educates GDM patients on the basic knowledge of GDM, dietary intervention, physical exercise, weight…
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Ocean Acidification and Human Health
Laura J. Falkenberg, R. G. J. Bellerby, Sean D. Connell, Lora E. Fleming, Bruce Richard Maycock and 3 more
349 citationsOpen access (CC-BY)doi:10.3390/ijerph17124563OpenAlex
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The ocean provides resources key to human health and well-being, including food, oxygen, livelihoods, blue spaces, and medicines. The global threat to these resources posed by accelerating ocean acidification is becoming increasingly evident as the world's oceans absorb carbon dioxide emissions. While ocean acidification was initially perceived as a threat only to the marine realm, here we argue that it is also an emerging human health issue. Specifically, we explore how ocean acidification affects the quantity and quality of resources key to human health and well-being in the context of: (1) malnutrition and poisoning, (2) respiratory issues, (3) mental health impacts, and (4) development of medical resources. We explore mitigation and adaptation management strategies that can be implemented to strengthen the capacity of acidifying oceans to continue providing human health benefits. Importantly, we emphasize that the cost of such actions will be dependent upon the socioeconomic context; specifically, costs will likely be greater for socioeconomically disadvantaged populations,…
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Psychological Health and Physical Activity Levels during the COVID-19 Pandemic: A Systematic Review
Verónica Violant, Gloria Gallego Jiménez, Carina Soledad González González, Sarah Muñoz‐Violant, Manuel José Rodríguez and 2 more
348 citationsOpen access (CC-BY)doi:10.3390/ijerph17249419OpenAlex
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The coronavirus disease (COVID-19) pandemic has been devastating in all senses, particularly psychologically. Physical activity (PA) is known to aid psychological well-being, and it is worth investigating whether PA has been a coping strategy during this pandemic. The objective of this literature review is to analyze the extent to which engaging in PA during the COVID-19 pandemic impacts psychological health in the adult population. The literature was searched in all databases from the EBSCOhost Research Database-MEDLINE, APA PsycArticles, between others-published between 1 January 2019 and 15 July 2020. From 180 articles found, 15 were eligible. The reviewed articles showed an association between mental health distress-e.g., stress, anxiety, depressive symptoms, social isolation, psychological distress-and PA. This research concludes that the COVID-19 pandemic and the lockdown measures caused psychological distress. Those studies that analyzed PA showed that, during quarantine, adults increased their sedentary time and reduced their PA levels, showing controversial psychological…
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Effect of Emotional Intelligence and Psychosocial Risks on Burnout, Job Satisfaction, and Nurses’ Health during the COVID-19 Pandemic
Ana Lucila Soto-Rubio, María del Carmen Giménez‐Espert, Vicente Prado‐Gascó
344 citationsOpen access (CC-BY)doi:10.3390/ijerph17217998OpenAlex
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Nurses are exposed to psychosocial risks that can affect both psychological and physical health through stress. Prolonged stress at work can lead to burnout syndrome. An essential protective factor against psychosocial risks is emotional intelligence, which has been related to physical and psychological health, job satisfaction, increased job commitment, and burnout reduction. The present study aimed to analyze the effect of psychosocial risks and emotional intelligence on nurses' health, well-being, burnout level, and job satisfaction during the rise and main peak of the COVID-19 pandemic in Spain. It is a cross-sectional study conducted on a convenience sample of 125 Spanish nurses. Multiple hierarchical linear regression models were calculated considering emotional intelligence levels, psychosocial demand factors (interpersonal conflict, lack of organizational justice, role conflict, and workload), social support and emotional work on burnout, job satisfaction, and nurses' health. Finally, the moderating effect of emotional intelligence levels, psychosocial factors, social…
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Preserving Organizational Resilience, Patient Safety, and Staff Retention during COVID-19 Requires a Holistic Consideration of the Psychological Safety of Healthcare Workers
Pavani Rangachari, Jacquelynn L. Woods
344 citationsOpen access (CC-BY)doi:10.3390/ijerph17124267OpenAlex
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During the COVID-19 pandemic, healthcare workers are fighting a lethal virus with acute shortages of Personal Protective Equipment (PPE). These unprecedented circumstances have amplified the sources of emotional distress and worker burnout. However, many healthcare organizations (HCOs) in the United States, have opted for a "stoic approach" to healthcare worker support, i.e., no additional support beyond federal and state policy protections for the licensing and liability of healthcare workers. In this scenario, a key public health concern is sustaining an adequate healthcare workforce, both by way of quantity (adequate numbers) and quality (maximizing clinician resilience to provide safe care to large volumes of patients under challenging conditions). Therefore, it is imperative for HCO leaders to recognize that a limited view of worker psychological safety, without due consideration for the broader emotional distress created by the pandemic, could have the effect of restricting organizational resilience and adversely impacting patient safety and staff retention during and beyond…
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Investigating the Psychological Impact of COVID-19 among Healthcare Workers: A Meta-Analysis
Kavita Batra, Tejinder Pal Singh, Manoj Sharma, Ravi Batra, Nena Schvaneveldt
341 citationsOpen access (CC-BY)doi:10.3390/ijerph17239096OpenAlex
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Previous meta-analyses were conducted during the initial phases of the COVID-19 pandemic, which utilized a smaller pool of data. The current meta-analysis aims to provide additional (and updated) evidence related to the psychological impact among healthcare workers. The search strategy was developed by a medical librarian and bibliographical databases, including Medline, Embase, CINAHL, PsycINFO, and Scopus were searched for studies examining the impact of the COVID-19 pandemic on the psychological health of healthcare workers. Articles were screened by three reviewers. Heterogeneity among studies was assessed by I2 statistic. The random-effects model was utilized to obtain the pooled prevalence. A subgroup analysis by region, gender, quality of study, assessment methods, healthcare profession, and exposure was performed. Publication bias was assessed by Funnel plot and Egger linear regression test. Sixty-five studies met the inclusion criteria and the total sample constituted 79,437 participants. The pooled prevalence of anxiety, depression, stress, post-traumatic stress syndrome,…
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Challenges and Opportunities of Biocoagulant/Bioflocculant Application for Drinking Water and Wastewater Treatment and Its Potential for Sludge Recovery
Setyo Budi Kurniawan, Siti Rozaimah Sheikh Abdullah, Muhammad Fauzul Imron, Nor Sakinah Mohd Said, Nur ‘Izzati Ismail and 3 more
340 citationsOpen access (CC-BY)doi:10.3390/ijerph17249312OpenAlex
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The utilization of metal-based conventional coagulants/flocculants to remove suspended solids from drinking water and wastewater is currently leading to new concerns. Alarming issues related to the prolonged effects on human health and further pollution to aquatic environments from the generated nonbiodegradable sludge are becoming trending topics. The utilization of biocoagulants/bioflocculants does not produce chemical residue in the effluent and creates nonharmful, biodegradable sludge. The conventional coagulation-flocculation processes in drinking water and wastewater treatment, including the health and environmental issues related to the utilization of metal-based coagulants/flocculants during the processes, are discussed in this paper. As a counterpoint, the development of biocoagulants/bioflocculants for drinking water and wastewater treatment is intensively reviewed. The characterization, origin, potential sources, and application of this green technology are critically reviewed. This review paper also provides a thorough discussion on the challenges and opportunities…
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Alcohol Consumption Reported during the COVID-19 Pandemic: The Initial Stage
Jan Chodkiewicz, Monika Ewa Talarowska, Joanna Miniszewska, Natalia Nawrocka, Przemysław Biliński
338 citationsOpen access (CC-BY)doi:10.3390/ijerph17134677OpenAlex
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Physical health is not the only area affected by the outbreak of the SARS-CoV-2 virus pandemic. There are also other consequences that have globally affected many millions at other levels, namely: Societal, political, economic, and cultural. This study aims to survey alcohol drinking throughout the pandemic so as to investigate those factors considered most relevant; i.e., sociodemographic and clinical. A longitudinal study was designed. The first (or initial) stage was completed between April 10-20 2020 on 443 subjects during the enforcement of the "Lockdown" in Poland. The second stage will be due in June 2020. As well as an in-house questionnaire, the study used: The Alcohol Use Disorder Identification Test (AUDIT), General Health Questionnaire (GHQ-28), Perceived Stress Scale (PSS-10), and the Brief COPE Inventory (Mini COPE). Alcohol was the most commonly used psychoactive substance (73%) identified. More than 30% changed their drinking habits because of the pandemic, with 16% actually drinking less, whilst 14% did so more. The former group was significantly younger than the…
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Why Do Consumers Make Green Purchase Decisions? Insights from a Systematic Review
Xiaoyun Zhang, Feng Dong
337 citationsOpen access (CC-BY)doi:10.3390/ijerph17186607OpenAlex
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In order to achieve sustainable development to protect the environment and society, an increasing number of scholars have conducted in-depth research on green marketing and green purchases. Although great achievements have been made in this field, there still is room for further progress. This study reviews 97 papers providing empirical research on green purchase behavior from 2015 to 2020. First, we review the widely used consumer theory and its extended application in recent years. Second, we divide the influencing factors of green purchase behavior into the following three categories and discuss them in detail: individual factors, product attributes and marketing, and social factors. Finally, we put forward the following possible directions for future research. (1) The authors can consider adjustment to the survey objects to weaken the subjectivity of the data. (2) Longitudinal research can be used to assess the impact of education and policies with a lagging effect on consumers. (3) The authors can broaden the research direction towards a cross-cultural background. (4) The…
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Stress, Resilience, and Well-Being in Italian Children and Their Parents during the COVID-19 Pandemic
Maria Cusinato, Sara Iannattone, Andrea Spoto, Mikael Poli, Carlo Moretti and 2 more
336 citationsOpen access (CC-BY)doi:10.3390/ijerph17228297OpenAlex
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The novel coronavirus (COVID-19) outbreak has forced parents and children to adopt significant changes in their daily routine, which has been a big challenge for families, with important implications for family stress. In this study, we aimed to analyze the potential risk and protective factors for parents' and children's well-being during a potentially traumatic event such as the COVID-19 quarantine. Specifically, we investigated parents' and children's well-being, parental stress, and children's resilience. The study involved 463 Italian parents of children aged 5-17. All participants completed an online survey consisting of the Psychological General Well Being Index (PGWB) to assess parental well-being, the Strengths and Difficulties Questionnaire (SDQ) to measure children's well-being, the Parent Stress Scale (PSS) to investigate parental stress, and the Child and Youth Resilience Measure (CYRM-R) to measure children's resilience. The results show that confinement measures and changes in daily routine negatively affect parents' psychological dimensions, thus exposing children to…
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Effects and Mechanisms of Phthalates’ Action on Reproductive Processes and Reproductive Health: A Literature Review
Henrieta Hlisníková, Ida Petrovičová, Branislav Kolena, Miroslava Šidlovská, Alexander V. Sirotkin
335 citationsOpen access (CC-BY)doi:10.3390/ijerph17186811OpenAlex
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The production of plastic products, which requires phthalate plasticizers, has resulted in the problems for human health, especially that of reproductive health. Phthalate exposure can induce reproductive disorders at various regulatory levels. The aim of this review was to compile the evidence concerning the association between phthalates and reproductive diseases, phthalates-induced reproductive disorders, and their possible endocrine and intracellular mechanisms. Phthalates may induce alterations in puberty, the development of testicular dysgenesis syndrome, cancer, and fertility disorders in both males and females. At the hormonal level, phthalates can modify the release of hypothalamic, pituitary, and peripheral hormones. At the intracellular level, phthalates can interfere with nuclear receptors, membrane receptors, intracellular signaling pathways, and modulate gene expression associated with reproduction. To understand and to treat the adverse effects of phthalates on human health, it is essential to expand the current knowledge concerning their mechanism of action in the…
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Barriers to Accessing Maternal Care in Low Income Countries in Africa: A Systematic Review
Rana Dahab, Dikaios Sakellariou
335 citationsOpen access (CC-BY)doi:10.3390/ijerph17124292OpenAlex
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The new Sustainable Development Goals (SDGs) to 2030 aim to reduce maternal mortality and provide equitable access to maternal healthcare. Compromised access to maternal health facilities in low-income countries, and specifically in Africa, contribute to the increased prevalence of maternal mortality. We conducted a systematic review to investigate access barriers to maternal health in low-income countries in Africa since 2015, from the perspective of both community members and health providers. The findings show that the most important barriers to maternal health are transportation barriers to health facilities, economic factors, and cultural beliefs, in addition to lack of family support and poor quality of care. Further research is required to guide policymakers towards firm multi-sectoral action to ensure appropriate and equitable access to maternal health in line with the SDGs to 2030.
- 80top 0.9%
Triple-Negative Breast Cancer: A Review of Conventional and Advanced Therapeutic Strategies
Javier Mauricio Medina Salcedo, Goldie Oza, Ashutosh Kumar Sharma, L. Arriaga, José Manuel Hernández Hernández and 2 more
335 citationsOpen access (CC-BY)doi:10.3390/ijerph17062078OpenAlex
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Triple-negative breast cancer (TNBC) cells are deficient in estrogen, progesterone and ERBB2 receptor expression, presenting a particularly challenging therapeutic target due to their highly invasive nature and relatively low response to therapeutics. There is an absence of specific treatment strategies for this tumor subgroup, and hence TNBC is managed with conventional therapeutics, often leading to systemic relapse. In terms of histology and transcription profile these cancers have similarities to BRCA-1-linked breast cancers, and it is hypothesized that BRCA1 pathway is non-functional in this type of breast cancer. In this review article, we discuss the different receptors expressed by TNBC as well as the diversity of different signaling pathways targeted by TNBC therapeutics, for example, Notch, Hedgehog, Wnt/b-Catenin as well as TGF-beta signaling pathways. Additionally, many epidermal growth factor receptor (EGFR), poly (ADP-ribose) polymerase (PARP) and mammalian target of rapamycin (mTOR) inhibitors effectively inhibit the TNBCs, but they face challenges of either…
- 81top 0.9%
Nurses’ Adherence to Patient Safety Principles: A Systematic Review
Mojtaba Vaismoradi, Susanna Tella, Patricia Logan, Jayden Khakurel, María Flores Vizcaya-Moreno
335 citationsOpen access (CC-BY)doi:10.3390/ijerph17062028OpenAlex
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Background: Quality-of-care improvement and prevention of practice errors is dependent on nurses’ adherence to the principles of patient safety. Aims: This paper aims to provide a systematic review of the international literature, to synthesise knowledge and explore factors that influence nurses’ adherence to patient-safety principles. Methods: Electronic databases in English, Norwegian, and Finnish languages were searched, using appropriate keywords to retrieve empirical articles published from 2010–2019. Using the theoretical domains of the Vincent’s framework for analysing risk and safety in clinical practice, we synthesized our findings according to ‘patient’, ‘healthcare provider’, ‘task’, ‘work environment’, and ‘organisation and management’. Findings: Six articles were found that focused on adherence to patient-safety principles during clinical nursing interventions. They focused on the management of peripheral venous catheters, surgical hand rubbing instructions, double-checking policies of medicines management, nursing handover between wards, cardiac monitoring and…
- 82top 0.9%
Impacts of COVID-19 on Trade and Economic Aspects of Food Security: Evidence from 45 Developing Countries
Vasilii L. Erokhin, Gao Tianming
330 citationsOpen access (CC-BY)doi:10.3390/ijerph17165775OpenAlex
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The stability of food supply chains is crucial to the food security of people around the world. Since the beginning of 2020, this stability has been undergoing one of the most vigorous pressure tests ever due to the COVID-19 outbreak. From a mere health issue, the pandemic has turned into an economic threat to food security globally in the forms of lockdowns, economic decline, food trade restrictions, and rising food inflation. It is safe to assume that the novel health crisis has badly struck the least developed and developing economies, where people are particularly vulnerable to hunger and malnutrition. However, due to the recency of the COVID-19 problem, the impacts of macroeconomic fluctuations on food insecurity have remained scantily explored. In this study, the authors attempted to bridge this gap by revealing interactions between the food security status of people and the dynamics of COVID-19 cases, food trade, food inflation, and currency volatilities. The study was performed in the cases of 45 developing economies distributed to three groups by the level of income. The…
- 83top 0.9%
Work–Life Balance: Weighing the Importance of Work–Family and Work–Health Balance
Andrea Gragnano, Silvia Simbula, Massimo Miglioretti
328 citationsOpen access (CC-BY)doi:10.3390/ijerph17030907OpenAlex
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To date, research directed at the work–life balance (WLB) has focused mainly on the work and family domains. However, the current labor force is heterogeneous, and workers may also value other nonworking domains besides the family. The aim of this study was to investigate the importance of other nonworking domains in the WLB with a particular focus on health. Moreover, the importance of the effects of the work–family balance (WFB) and the work–health balance (WHB) on job satisfaction was investigated. Finally, we explored how the effects of the WFB and the WHB on job satisfaction change according to worker characteristics (age, gender, parental status, and work ability). This study involved 318 workers who completed an online questionnaire. The importance of the nonworking domains was compared with a t-test. The effect of the WFB and the WHB on job satisfaction was investigated with multiple and moderated regression analyses. The results show that workers considered health as important as family in the WLB. The WHB explained more of the variance in job satisfaction than the WFB.…
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Nomophobia: An Individual’s Growing Fear of Being without a Smartphone—A Systematic Literature Review
Antonio-Manuel Rodríguez-García, Antonio-José Moreno-Guerrero, Jesús López-Belmonte
328 citationsOpen access (CC-BY)doi:10.3390/ijerph17020580OpenAlex
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This review examines the current literature focused on nomophobia (objectives, methodological design, main variables, sample details, and measurement methods) in the Scopus and Web of Science databases. To this end, we conducted a systematic literature review in accordance with the Preferred Reporting Items for Systematic Reviews (PRISMA) guidelines. The initial sample consisted of 142 articles, of which 42 met the inclusion criteria and were analyzed in detail. The findings show that the current research is in an exploratory phase, with a greater predominance of descriptive, nonexperimental, and cross-sectional studies that explore the prevalence of nomophobia mainly in adolescents and university students. The most widely used measurement instrument is the Nomophobia Questionnaire (NMP-Q) proposed by Yildrim and Correia. In addition, the research suggests that nomophobia negatively affects personality, self-esteem, anxiety, stress, academic performance, and other physical and mental health problems. We are therefore faced with a health problem, which negatively affects a person,…
- 85top 0.9%
Nurse Reports of Stressful Situations during the COVID-19 Pandemic: Qualitative Analysis of Survey Responses
Judith E. Arnetz, Courtney M. Goetz, Bengt B. Arnetz, Eamonn Patrick Arble
326 citationsOpen access (CC-BY)doi:10.3390/ijerph17218126OpenAlex
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The coronavirus disease (COVID-19) pandemic has exposed nurses to conditions that threaten their health, well-being, and ability to work. It is therefore critical to study nurses' experiences and well-being during the current crisis in order to identify risk groups for ill health and potential sources of organizational intervention. The aim of this study was to explore perceptions of the most salient sources of stress in the early stages of the coronavirus pandemic in a sample of U.S. nurses. A cross-sectional online survey was conducted among a sample of 695 U.S. nurses in May 2020. Content analysis was conducted on nurses' responses (n = 455) to an open-ended question on the most stressful situations they had experienced during the pandemic. Six distinct themes emerged from the analysis: exposure/infection-self; illness/death-others; workplace; personal protective equipment/supplies; unknowns; opinions/politics. Two sub-themes concerned restrictions associated with the pandemic and feelings of inadequacy/helplessness regarding patients and their treatment. More than half of all…
- 86top 1%
Hand Sanitizers: A Review on Formulation Aspects, Adverse Effects, and Regulations
Jane Lee Jia Jing, Thong Pei Yi, Rajendran JC Bose, Jason R. McCarthy, Nagendran Tharmalingam and 1 more
325 citationsOpen access (CC-BY)doi:10.3390/ijerph17093326OpenAlex
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Hand hygiene is of utmost importance as it may be contaminated easily from direct contact with airborne microorganism droplets from coughs and sneezes. Particularly in situations like pandemic outbreak, it is crucial to interrupt the transmission chain of the virus by the practice of proper hand sanitization. It can be achieved with contact isolation and strict infection control tool like maintaining good hand hygiene in hospital settings and in public. The success of the hand sanitization solely depends on the use of effective hand disinfecting agents formulated in various types and forms such as antimicrobial soaps, water-based or alcohol-based hand sanitizer, with the latter being widely used in hospital settings. To date, most of the effective hand sanitizer products are alcohol-based formulations containing 62%-95% of alcohol as it can denature the proteins of microbes and the ability to inactivate viruses. This systematic review correlated with the data available in Pubmed, and it will investigate the range of available hand sanitizers and their effectiveness as well as the…
- 87top 1%
Lead Toxicity and Pollution in Poland
Angelika Edyta Charkiewicz, Jeffrey R. Backstrand
324 citationsOpen access (CC-BY)doi:10.3390/ijerph17124385OpenAlex
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BACKGROUND: Human exposure to lead can occur in a variety of ways, all of which involve exposure to potentially toxic elements as environmental pollutants. Lead enters the body via ingestion and inhalation from sources such as soil, food, lead dust and lead in products of everyday use and in the workplace. The aim of this review is to describe the toxic effects of lead on the human body from conception to adulthood, and to review the situation regarding lead toxicity in Poland. RESULTS: Pb is very dangerous when it is absorbed and accumulates in the main organs of the body, where it can cause a range of symptoms that vary from person to person, the time of exposure and dose. Lead in adults can cause an increase in blood pressure, slow nerve conduction, fatigue, mood swings, drowsiness, impaired concentration, fertility disorders, decreased sex drive, headaches, constipation and, in severe cases, encephalopathy or death. CONCLUSIONS: Exposure to lead in Poland remains an important public health problem. This review will cover the range of lead exposures, from mild to heavy. Public…
- 88top 1%
COVID-19 Pandemic: Age-Related Differences in Measures of Stress, Anxiety and Depression in Canada
Izu Nwachukwu, Nnamdi Nkire, Reham Shalaby, Marianne Hrabok, Wesley Vuong and 5 more
323 citationsOpen access (CC-BY)doi:10.3390/ijerph17176366OpenAlex
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BACKGROUND: The spread of COVID-19 along with strict public health measures have resulted in unintended adverse effects, including greater levels of distress, anxiety, and depression. This study examined relative presentations of these psychopathologies in different age groups in a Canadian cohort during the COVID-19 pandemic. METHODOLOGY: Participants were subscribers to the Text4Hope program, developed to support Albertans during the COVID-19 pandemic. A survey link was used to gather demographic information and responses on several self-report scales, such as Perceived Stress Scale (PSS), Generalized Anxiety Disorder 7-item (GAD-7) scale, and Patient Health Questionnaire-9 (PHQ-9). RESULTS: There were 8267 individuals who completed the survey, giving a response rate of 19.4%. Overall, 909 (11.0%) respondents identified as ≤25 years, 2939 (35.6%) identified as (26-40) years, 3431 (41.5%) identified as (41-60) years, 762 (9.2%) identified as over 60 years, and 226 (2.7%) did not identify their age. Mean scores on the PSS, GAD-7, and PHQ-9 scales were highest among those aged ≤25…
- 89top 1%
Observed and Potential Impacts of the COVID-19 Pandemic on the Environment
Sorin Cheval, Mihai Cristian Adamescu, Teodoro Georgiadis, Mathew Herrnegger, Adrian Piticar and 1 more
322 citationsOpen access (CC-BY)doi:10.3390/ijerph17114140OpenAlex
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Various environmental factors influence the outbreak and spread of epidemic or even pandemic events which, in turn, may cause feedbacks on the environment. The novel coronavirus disease (COVID-19) was declared a pandemic on 13 March 2020 and its rapid onset, spatial extent and complex consequences make it a once-in-a-century global disaster. Most countries responded by social distancing measures and severely diminished economic and other activities. Consequently, by the end of April 2020, the COVID-19 pandemic has led to numerous environmental impacts, both positive such as enhanced air and water quality in urban areas, and negative, such as shoreline pollution due to the disposal of sanitary consumables. This study presents an early overview of the observed and potential impacts of the COVID-19 on the environment. We argue that the effects of COVID-19 are determined mainly by anthropogenic factors which are becoming obvious as human activity diminishes across the planet, and the impacts on cities and public health will be continued in the coming years.
- 90top 1%
Students’ Acceptance of the COVID-19 Impact on Shifting Higher Education to Distance Learning in Poland
Mariia Rizun, Artur Strzelecki
318 citationsOpen access (CC-BY)doi:10.3390/ijerph17186468OpenAlex
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This paper is dedicated to the higher education institutions shifting towards distance learning processes due to the global pandemic situation caused by COVID-19 in 2020. The paper covers the pandemic situation in Poland generally, analyzing governmental ordinances and tracking the gradual extension of restrictions for educational institutions. The purpose of this study is to investigate the influence of Experience, Enjoyment, Computer Anxiety, and Self-Efficacy on students' acceptance of shifting education to distance learning. The study tested and used the adapted General Extended Technology Acceptance Model for E-Learning (GETAMEL) in the context of coronavirus pandemic. The partial least squares method of structural equation modeling was employed to test the proposed research model. The study utilizes an online survey to obtain data from 1692 Polish undergraduate and graduate students in both full- and part-time study. The dataset was analyzed using SmartPLS 3 software. Results showed that the best predictor of student's acceptance of shifting education to distance learning is…
- 91top 1%
COVID-19 Factors and Psychological Factors Associated with Elevated Psychological Distress among Dentists and Dental Hygienists in Israel
Maayan Shacham, Yaira Hamama‐Raz, Roni Kolerman, Ori Mijiritsky, Menachem Ben‐Ezra and 1 more
315 citationsOpen access (CC-BY)doi:10.3390/ijerph17082900OpenAlex
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The aim of this study was to evaluate the association of COVID-19 factors and psychological factors with psychological distress among dental staff during the COVID-19 pandemic outbreak. A cross-sectional survey was conducted among 338 Israeli dentists and dental hygienists, who provided their demographic data; answered questions about COVID-19-related factors; and were assessed by subjective overload, self-efficacy, and psychological distress scales. Data were analyzed using a multivariate logistic regression. Results revealed that elevated psychological distress was found among those who have background illness, fear of contracting COVID-19 from patient, and a higher subjective overload. Lower psychological distress was associated with being in a committed relationship and having higher scores for self-efficacy. Given these results, gathered during times of an infectious disease outbreak, exploring psychological distress among dental staff is warranted as the effects may be long-term.
- 92top 1%
Bioplastic Production from Microalgae: A Review
Senem Önen Cinar, Zhi Kai Chong, Mehmet Ali Küçüker, Nils Wieczorek, Uğur Cengiz and 1 more
314 citationsOpen access (CC-BY)doi:10.3390/ijerph17113842OpenAlex
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Plastic waste production around the world is increasing, which leads to global plastic waste pollution. The need for an innovative solution to reduce this pollution is inevitable. Increased recycling of plastic waste alone is not a comprehensive solution. Furthermore, decreasing fossil-based plastic usage is an important aspect of sustainability. As an alternative to fossil-based plastics in the market, bio-based plastics are gaining in popularity. According to the studies conducted, products with similar performance characteristics can be obtained using biological feedstocks instead of fossil-based sources. In particular, bioplastic production from microalgae is a new opportunity to be explored and further improved. The aim of this study is to determine the current state of bioplastic production technologies from microalgae species and reveal possible optimization opportunities in the process and application areas. Therefore, the species used as resources for bioplastic production, the microalgae cultivation methods and bioplastic material production methods from microalgae were…
- 93top 1%
Determinants of Ageism against Older Adults: A Systematic Review
Sibila Marques, João Mariano, Joana Mendonça, Wouter De Tavernier, Moritz Heß and 3 more
314 citationsOpen access (CC-BY)doi:10.3390/ijerph17072560OpenAlex
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Ageism is a widespread phenomenon and constitutes a significant threat to older people's well-being. Identifying the factors contributing to ageism is critical to inform policies that minimise its societal impact. In this systematic review, we gathered and summarised empirical studies exploring the key determinants of ageism against older people for a period of over forty years (1970-2017). A comprehensive search using fourteen databases identified all published records related to the umbrella concept of "ageism". Reviewers independently screened the final pool to identify all papers focusing on determinants, according to a predefined list of inclusion and exclusion criteria. All relevant information was extracted and summarised following a narrative synthesis approach. A total of 199 papers were included in this review. We identified a total of 14 determinants as robustly associated with ageism. Of these, 13 have an effect on other-directed ageism, and one on self-directed ageism. The quality of contact with older people and the positive or negative presentation of older people to…
- 94top 1%
Characterization of Home Working Population during COVID-19 Emergency: A Cross-Sectional Analysis
Antimo Moretti, Fabrizio Menna, Milena Aulicino, Marco Paoletta, Sara Liguori and 1 more
313 citationsOpen access (CC-BY)doi:10.3390/ijerph17176284OpenAlex
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Evidence about the characterization of home workers in terms of both work-related outcomes and health issues is lacking. The purpose of this cross-sectional study was to examine the impact of home working on perceived job productivity and satisfaction, work-related stress, and musculoskeletal (MSK) issues. We included 51 mobile workers, collecting data about demographic characteristics, working experience, job productivity, and stress. Job satisfaction was assessed through the Utrecht Work Engagement Scale (UWES), while MSK pain was investigated by the Brief Pain Inventory (BPI) and Fear Avoidance Beliefs Questionnaire (FABQ). Moreover, a home workplace analysis had to be carried out according to current Italian regulations. Participants declared that they were less productive (39.2%) but less stressed (39.2%) and equally satisfied (51%) compared to the time of office working. Regarding MSK disorders, low back pain (LBP) was referred by 41.2% of home workers and neck pain by 23.5% of them. Neck pain worsened in 50% of home workers, while LBP did not exacerbate in 47.6% of cases.…
- 95top 1.1%
Using Principal Components Analysis and IDW Interpolation to Determine Spatial and Temporal Changes of Surface Water Quality of Xin’anjiang River in Huangshan, China
Wenjie Yang, Yue Zhao, Dong Wang, Huihui Wu, Aijun Lin and 1 more
313 citationsOpen access (CC-BY)doi:10.3390/ijerph17082942OpenAlex
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This study was aimed at assessing the spatial and temporal distribution of surface water quality variables of the Xin'anjiang River (Huangshan). For this purpose, 960 water samples were collected monthly along the Xin'anjiang River from 2008 to 2017. Twenty-four water quality indicators, according to the environmental quality standards for surface water (GB 3838-2002), were detected to evaluate the water quality of the Xin'anjiang River over the past 10 years. Principal component analysis (PCA) was used to comprehensively evaluate the water quality across eight monitoring stations and analyze the sources of water pollution. The results showed that all samples could be analyzed by three main components, which accounted for 87.24% of the total variance. PCA technology identified important water quality parameters and revealed that nutrient pollution and organic pollution are major latent factors which influence the water quality of Xin'anjiang River. It also showed that agricultural activities, erosion, domestic, and industrial discharges are fundamental causes of water pollution in…
- 96top 1.1%
Psychological and Behavioral Responses in South Korea During the Early Stages of Coronavirus Disease 2019 (COVID-19)
Minjung Lee, Myoungsoon You
310 citationsOpen access (CC-BY)doi:10.3390/ijerph17092977OpenAlex
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Background: The psychological and behavioral responses during the early stage of Coronavirus disease 2019 (COVID-19) in South Korea were investigated to guide the public as full and active participants of public health emergency preparedness (PHEP), which is essential to improving resilience and reducing the population’s fundamental vulnerability. Methods: Data were collected through an online survey four weeks after the Korea Centers for Disease Control and Prevention (KCDC) confirmed the first case in South Korea; 973 subjects were included in the analysis. Results: Respondents’ perceived risk of COVID-19 infection; the majority of respondents reported that their perceived chance of infection was “neither high nor low” (51.3%). The average perceived severity score was higher than perceived susceptibility; 48.6 % reported that the severity would be “high,” while 19.9% reported “very high.” Many respondents reported taking precautions, 67.8% reported always practicing hand hygiene, and 63.2% reported always wearing a facial mask when outside. Approximately 50% reported postponing or…
- 97top 1.1%
Microplastics in Food: A Review on Analytical Methods and Challenges
Jung‐Hwan Kwon, Jin Woo Kim, Dat Thanh Pham, Abhrajyoti Tarafdar, Soonki Hong and 6 more
307 citationsOpen access (CC-BY)doi:10.3390/ijerph17186710OpenAlex
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Human exposure to microplastics contained in food has become a significant concern owing to the increasing accumulation of microplastics in the environment. In this paper, we summarize the presence of microplastics in food and the analytical methods used for isolation and identification of microplastics. Although a large number of studies on seafood such as fish and shellfish exist, estimating the overall human exposure to microplastics via food consumption is difficult owing to the lack of studies on other food items. Analytical methods still need to be optimized for appropriate recovery of microplastics in various food matrices, rendering a quantitative comparison of different studies challenging. In addition, microplastics could be added or removed from ingredients during processing or cooking. Thus, research on processed food is crucial to estimate the contribution of food to overall human microplastic consumption and to mitigate this exposure in the future.
- 98top 1.1%
The Conceptual and Methodological Mayhem of “Screen Time”
Linda Katherine Kaye, Amy C. Orben, David A. Ellis, Simon C. Hunter, Stephen John Houghton
303 citationsOpen access (CC-BY)doi:10.3390/ijerph17103661OpenAlex
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Debates concerning the impacts of screen time are widespread. Existing research presents mixed findings, and lacks longitudinal evidence for any causal or long-term effects. We present a critical account of the current shortcomings of the screen time literature. These include poor conceptualisation, the use of non-standardised measures that are predominantly self-report, and issues with measuring screen time over time and context. Based on these issues, we make a series of recommendations as a basis for furthering academic and public debate. These include drawing on a user-focused approach in order to seek the various affordances gained from "screen use". Within this, we can better understand the way in which these vary across time and context, and make distinction between objective measures of "screen time" compared to those more subjective experiences of uses or affordances, and the differential impacts these may bring.
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COVID-19 Pandemic Brings a Sedentary Lifestyle in Young Adults: A Cross-Sectional and Longitudinal Study
Chen Zheng, Yajun Huang, Sinead E. Sheridan, Cindy H. P. Sit, Xiang‐Ke Chen and 1 more
301 citationsOpen access (CC-BY)doi:10.3390/ijerph17176035OpenAlex
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ABSTRACT Objectives The coronavirus disease 2019 (COVID-19) pandemic continues to pose profound challenges on society. Governments around the world have managed to mitigate its spread through strategies including social distancing; however, this may result in the adoption of sedentary lifestyle. This study aimed to investigate: 1) physical activity (PA) levels, sedentary behavior (SB) and sleep among young adults during COVID-19 epidemic, and 2) the change in these behaviors before and during the pandemic. Methods A total of 631 young adults (38.8% males) participated in the cross-sectional study and completed an online survey that included five components: general information, COVID-19 related issues, PA, SB, and sleep. For longitudinal study, PA, SB, and sleep data collected from 70 participants before and during COVID-19 pandemic were analyzed. Results Participants reported engaging in low PA, high SB and long sleep duration during COVID-19 pandemic. Females had greater concern for COVID-19 related issues and engaged in more prevention strategies than males. Moreover, a…
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A One Health Perspective on the Human–Companion Animal Relationship with Emphasis on Zoonotic Aspects
Paul A. M. Overgaauw, Claudia Maureen Vinke, Marjan A. E. van Hagen, Len J.A. Lipman
301 citationsOpen access (CC-BY)doi:10.3390/ijerph17113789OpenAlex
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Over time the human-animal bond has been changed. For instance, the role of pets has changed from work animals (protecting houses, catching mice) to animals with a social function, giving companionship. Pets can be important for the physical and mental health of their owners but may also transmit zoonotic infections. The One Health initiative is a worldwide strategy for expanding collaborations in all aspects of health care for humans, animals, and the environment. However, in One Health communications the role of particularly dogs and cats is often underestimated. OBJECTIVE: Evaluation of positive and negative One Health issues of the human-companion animal relationship with a focus on zoonotic aspects of cats and dogs in industrialized countries. METHOD: Literature review. RESULTS: Pets undoubtedly have a positive effect on human health, while owners are increasing aware of pet's health and welfare. The changing attitude of humans with regard to pets and their environment can also lead to negative effects such as changes in feeding practices, extreme breeding, and behavioral…
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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 2020, 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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