Most-cited articles · 2022

The 100 most-cited articles in International Journal of Environmental Research and Public Health, 2022

Ranked by OpenAlex citation count on 29 October 2026, out of 17,314 eligible articles International Journal of Environmental Research and Public Health published in 2022. Ranks are frozen; this page will not change. Number one, with 841 citations: Burnout: A Review of Theory and Measurement.

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17,314 articles
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Top 100 (0.6%)
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2026-10-29

The most-cited articles published in the International Journal of Environmental Research and Public Health in 2022 cluster around several themes, including occupational and mental health, environmental pollution and waste, and the health effects of the COVID-19 pandemic. The top paper is "Burnout: A Review of Theory and Measurement" by Edú-Valsania, Laguía and Moriano, with 841 citations. It is followed by a review of solid waste management in the Global South (837 citations) and an overview of PM2.5-mediated toxicity in humans (813 citations).

The ranking, based on OpenAlex citation counts among 17,314 eligible articles, offers a view of the research that drew the most attention in this journal for that year. Readers can use the list to identify frequently cited reviews and empirical studies across topics such as burnout, air pollution, waste, food security, telework and digital technology, while noting that citation counts reflect attention rather than quality.

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  1. 1
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    Burnout: A Review of Theory and Measurement

    Sergio Edú-Valsania, Ana Laguía, Juan Antonio Moriano

    841 citationsOpen access (CC-BY)doi:10.3390/ijerph19031780OpenAlex

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    A growing body of empirical evidence shows that occupational health is now more relevant than ever due to the COVID-19 pandemic. This review focuses on burnout, an occupational phenomenon that results from chronic stress in the workplace. After analyzing how burnout occurs and its different dimensions, the following aspects are discussed: (1) Description of the factors that can trigger burnout and the individual factors that have been proposed to modulate it, (2) identification of the effects that burnout generates at both individual and organizational levels, (3) presentation of the main actions that can be used to prevent and/or reduce burnout, and (4) recapitulation of the main tools that have been developed so far to measure burnout, both from a generic perspective or applied to specific occupations. Furthermore, this review summarizes the main contributions of the papers that comprise the Special Issue on "Occupational Stress and Health: Psychological Burden and Burnout", which represent an advance in the theoretical and practical understanding of burnout.

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    Environmental Sustainability Impacts of Solid Waste Management Practices in the Global South

    Ismaila Rimi Abubakar, Khandoker Md. Maniruzzaman, Umar Lawal Dano, Faez S. Alshihri, Maher S. Alshammari and 3 more

    837 citationsOpen access (CC-BY)doi:10.3390/ijerph191912717OpenAlex

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    Solid waste management (SWM) is one of the key responsibilities of city administrators and one of the effective proxies for good governance. Effective SWM mitigates adverse health and environmental impacts, conserves resources, and improves the livability of cities. However, unsustainable SWM practices, exacerbated by rapid urbanization and financial and institutional limitations, negatively impact public health and environmental sustainability. This review article assesses the human and environmental health impacts of SWM practices in the Global South cities that are the future of global urbanization. The study employs desktop research methodology based on in-depth analysis of secondary data and literature, including official documents and published articles. It finds that the commonplace SWM practices include mixing household and commercial garbage with hazardous waste during storage and handling. While waste storage is largely in old or poorly managed facilities such as storage containers, the transportation system is often deficient and informal. The disposal methods are…

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    Recent Insights into Particulate Matter (PM2.5)-Mediated Toxicity in Humans: An Overview

    Prakash Thangavel, Duckshin Park, Young‐Chul Lee

    813 citationsOpen access (CC-BY)doi:10.3390/ijerph19127511OpenAlex

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    Several epidemiologic and toxicological studies have commonly viewed ambient fine particulate matter (PM2.5), defined as particles having an aerodynamic diameter of less than 2.5 µm, as a significant potential danger to human health. PM2.5 is mostly absorbed through the respiratory system, where it can infiltrate the lung alveoli and reach the bloodstream. In the respiratory system, reactive oxygen or nitrogen species (ROS, RNS) and oxidative stress stimulate the generation of mediators of pulmonary inflammation and begin or promote numerous illnesses. According to the most recent data, fine particulate matter, or PM2.5, is responsible for nearly 4 million deaths globally from cardiopulmonary illnesses such as heart disease, respiratory infections, chronic lung disease, cancers, preterm births, and other illnesses. There has been increased worry in recent years about the negative impacts of this worldwide danger. The causal associations between PM2.5 and human health, the toxic effects and potential mechanisms of PM2.5, and molecular pathways have been described in this review.

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    Stress, Burnout, Anxiety and Depression among Teachers: A Scoping Review

    Belinda Agyapong, Gloria Obuobi-Donkor, Lisa Burback, Yifeng Wei

    705 citationsOpen access (CC-BY)doi:10.3390/ijerph191710706OpenAlex

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    BACKGROUND: Worldwide, stress and burnout continue to be a problem among teachers, leading to anxiety and depression. Burnout may adversely affect teachers' health and is a risk factor for poor physical and mental well-being. Determining the prevalence and correlates of stress, burnout, anxiety, and depression among teachers is essential for addressing this public health concern. OBJECTIVE: To determine the extent of the current literature on the prevalence and correlates of stress, burnout, anxiety, and depression among teachers. METHOD: This scoping review was performed using the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews). Relevant search terms were used to determine the prevalence and correlates of teachers' stress, burnout, anxiety, and depression. Articles were identified using MEDLINE (Medical Literature Analysis and Retrieval System Online), EMBASE (Excerpta Medica Data Base), APA PsycINFO, CINAHL Plus (Cumulative Index of Nursing and Allied Health Literature), Scopus Elsevier and ERIC (Education Resources…

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    The Use of Social Media in Children and Adolescents: Scoping Review on the Potential Risks

    Elena Bozzola, Giulia Spina, Rino Agostiniani, Sarah Barni, Rocco Russo and 6 more

    552 citationsOpen access (CC-BY)doi:10.3390/ijerph19169960OpenAlex

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    In recent years, social media has become part of our lives, even among children. From the beginning of COVID-19 pandemic period, media device and Internet access rapidly increased. Adolescents connected Internet alone, consulting social media, mostly Instagram, TikTok, and YouTube. During "lockdown", the Internet usage allowed communication with peers and the continuity activities such as school teaching. However, we have to keep in mind that media usage may be related to some adverse consequences especially in the most vulnerable people, such as the young. Aim of the review is to focus on risks correlated to social media use by children and adolescents, identifying spies of rising problems and engaging in preventive recommendations. The scoping review was performed according to PRISMA guidelines, searching on PubMed the terms "social media" or "social network", "health", and "pediatrics". Excluding articles not pertinent, we found 68 reports. Out of them, 19 were dealing with depression, 15 with diet, and 15 with psychological problems, which appeared to be the most reported risk…

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    Consumer Acceptance toward Functional Foods: A Scoping Review

    Matt Baker, Peng Lu, Jean A. Parrella, Holli R. Leggette

    436 citationsOpen access (CC-BY)doi:10.3390/ijerph19031217OpenAlex

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    Chronic diseases (e.g., heart disease, cancer, diabetes) are of major public concern. Such chronic diseases are often caused by a dietary pattern characterized as relatively high in fat, refined sugar, salt, and cholesterol. Societal interest in consuming healthy foods and the demand for healthy food products have increased significantly. As a result, functional foods have gained significant research attention in the food health and technology innovations field. To date, many studies have investigated the factors that may predict consumer acceptance of functional foods, and a wide range of influential factors have been reported. However, studies conducted in different contexts pose challenges to gaining a clear understanding of the factors influencing consumer acceptance. Therefore, the purpose of our scoping review was to synthesize the possible determinants of consumer acceptance toward functional foods and provide a resource that describes global trends regarding consumers' functional foods behavior. We identified 75 articles published with varying populations around the globe…

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    Digital Economy Development, Industrial Structure Upgrading and Green Total Factor Productivity: Empirical Evidence from China’s Cities

    Yang Liu, Yanlin Yang, Huihui Li, Kaiyang Zhong

    427 citationsOpen access (CC-BY)doi:10.3390/ijerph19042414OpenAlex

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    The digital economy is an important engine to promote sustainable economic growth. Exploring the mechanism by which the digital economy promotes economic development, industrial upgrading and environmental improvement is an issue worth studying. This paper takes China as an example for study and uses the data of 286 cities from 2011 to 2019. In the empirical analysis, the direction distance function (DDF) and the Global Malmquist-Luenberger (GML) productivity index methods are used to measure the green total factor productivity (GTFP), while Tobit, quantile regression, impulse response function and intermediary effect models are used to study the relationship among digital economy development, industrial structure upgrading and GTFP. The results show that: (1) The digital economy can significantly improve China's GTFP; however, there are clear regional differences. (2) The higher the GTFP, the greater the promotion effect of the digital economy on the city's GTFP. (3) From a dynamic long-term perspective, the digital economy has indeed positively promoted China's GTFP. (4) The…

  8. 8
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    How Virtual Reality Technology Has Changed Our Lives: An Overview of the Current and Potential Applications and Limitations

    Ayah Hamad, Bochen Jia

    390 citationsOpen access (CC-BY)doi:10.3390/ijerph191811278OpenAlex

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    Despite virtual reality (VR) being initially marketed toward gaming, there are many potential and existing VR applications in various sectors and fields, including education, training, simulations, and even in exercise and healthcare. Unfortunately, there is still a lack of general understanding of the strengths and limitations of VR as a technology in various application domains. Therefore, the aim of this literature review is to contribute to the library of literature concerning VR technology, its applications in everyday use, and some of its existing drawbacks. Key VR applications were discussed in terms of how they are currently utilized or can be utilized in the future, spanning fields such as medicine, engineering, education, and entertainment. The main benefits of VR are expressed through the text, followed by a discussion of some of the main limitations of current VR technologies and how they can be mitigated or improved. Overall, this literature review shows how virtual reality technology has the potential to be a greatly beneficial tool in a multitude of applications and a…

  9. 9
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    Burn Wound Healing: Clinical Complications, Medical Care, Treatment, and Dressing Types: The Current State of Knowledge for Clinical Practice

    Agnieszka Markiewicz-Gospodarek, Małgorzata Maria Kozioł, Maciej Tobiasz, Jacek Baj, Elżbieta Radzikowska-Büchner and 1 more

    379 citationsOpen access (CC-BY)doi:10.3390/ijerph19031338OpenAlex

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    According to the World Health Organization (WHO), it is estimated that each year approximately 11 million people suffer from burn wounds, 180,000 of whom die because of such injuries. Regardless of the factors causing burns, these are complicated wounds that are difficult to heal and are associated with high mortality rates. Medical care of a burn patient requires a lot of commitment, experience, and multidirectional management, including surgical activities and widely understood pharmacological approaches. This paper aims to comprehensively review the current literature concerning burn wounds, including classification of burns, complications, medical care, and pharmacological treatment. We also overviewed the dressings (with an emphasis on the newest innovations in this field) that are currently used in medical practice to heal wounds.

  10. 10
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    A Review on Plants and Microorganisms Mediated Synthesis of Silver Nanoparticles, Role of Plants Metabolites and Applications

    Tijjani Mustapha, Norashiqin Misni, Nur Raihana Ithnin, Abdullahi Muhammad Daskum, Ngah Zasmy Unyah

    352 citationsOpen access (CC-BY)doi:10.3390/ijerph19020674OpenAlex

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    Silver nanoparticles are one of the most extensively studied nanomaterials due to their high stability and low chemical reactivity in comparison to other metals. They are commonly synthesized using toxic chemical reducing agents which reduce metal ions into uncharged nanoparticles. However, in the last few decades, several efforts were made to develop green synthesis methods to avoid the use of hazardous materials. The natural biomolecules found in plants such as proteins/enzymes, amino acids, polysaccharides, alkaloids, alcoholic compounds, and vitamins are responsible for the formation of silver nanoparticles. The green synthesis of silver nanoparticles is an eco-friendly approach, which should be further explored for the potential of different plants to synthesize nanoparticles. In the present review we describe the green synthesis of nanoparticles using plants, bacteria, and fungi and the role of plant metabolites in the synthesis process. Moreover, the present review also describes some applications of silver nanoparticles in different aspects such as antimicrobial,…

  11. 11
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    Indoor Air Pollution and the Health of Vulnerable Groups: A Systematic Review Focused on Particulate Matter (PM), Volatile Organic Compounds (VOCs) and Their Effects on Children and People with Pre-Existing Lung Disease

    Tun Zan Maung, Jack E. Bishop, Eleanor Holt, Alice Margaret Turner, Christian Pfrang

    349 citationsOpen access (CC-BY)doi:10.3390/ijerph19148752OpenAlex

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    Air pollution affects health, but much of the focus to this point has been on outdoor air. Higher indoor pollution is anticipated due to increasingly energy-efficient and less leaky buildings together with more indoor activities. Studies of indoor air pollution focusing on children and people with respiratory disease from the database Web of Science (1991-2021) were systemically reviewed according to the PRISMA guidelines, with 69 studies included in the final selection. Emissions from building materials affected indoor air quality, and ventilation also had an influence. The main indoor air pollutants are Volatile Organic Compounds (VOCs) and Particulate Matter (PM). PM sources included smoking, cooking, heating, candles, and insecticides, whereas sources of coarse particles were pets, housework and human movements. VOC sources included household products, cleaning agents, glue, personal care products, building materials and vehicle emissions. Formaldehyde levels were particularly high in new houses. Personal exposure related to both indoor and outdoor pollutant levels, highlighting…

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    Plastic Waste Degradation in Landfill Conditions: The Problem with Microplastics, and Their Direct and Indirect Environmental Effects

    Irena Wojnowska‐Baryła, Katarzyna Bernat, Magdalena Zaborowska

    348 citationsOpen access (CC-BY)doi:10.3390/ijerph192013223OpenAlex

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    As landfilling is a common method for utilizing plastic waste at its end-of-life, it is important to present knowledge about the environmental and technical complications encountered during plastic disposal, and the formation and spread of microplastics (MPs) from landfills, to better understand the direct and indirect effects of MPs on pollution. Plastic waste around active and former landfills remains a source of MPs. The landfill output consists of leachate and gases created by combined biological, chemical, and physical processes. Thus, small particles and/or fibers, including MPs, are transported to the surroundings by air and by leachate. In this study, a special focus was given to the potential for the migration and release of toxic substances as the aging of plastic debris leads to the release of harmful volatile organic compounds via oxidative photodegradation. MPs are generally seen as the key vehicles and accumulators of non-biodegradable pollutants. Because of their small size, MPs are quickly transported over long distances throughout their surroundings. With large…

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    A Review on Aging, Sarcopenia, Falls, and Resistance Training in Community-Dwelling Older Adults

    Filipe Rodrigues, Christophe Domingos, Diogo Monteiro, Pedro Morouço

    324 citationsOpen access (CC-BY)doi:10.3390/ijerph19020874OpenAlex

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    As aging continues to grow in our society, sarcopenia and associated fall risk is considered a public health problem since falling is the third cause of chronic disability. Falls are negatively related to functionality and independence and positively associated with morbidity and mortality. The cost of treatment of secondary injuries related to falls is high. For example, one in ten fall incidents leads to bone fractures and several other comorbidities. As demonstrated by several experimental studies, adopting a more active lifestyle is critical for reducing the number of fall episodes and their consequences. Therefore, it is essential to debate the proven physical exercise methods to reduce falls and fall-related effects. Since muscle mass, muscle strength, bone density, and cartilage function may play significant roles in daily activities, resistance training may positively and significantly affect the elderly. This narrative review aimed to examine current evidence on existing resistance training using resistance machines and bodyweight or low-cost equipment for the elderly and…

  14. 14
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    Changes in Physical Activity Patterns Due to the Covid-19 Pandemic: A Systematic Review and Meta-Analysis

    Kathrin Wunsch, Korbinian Kienberger, Claudia Niessner

    322 citationsOpen access (CC-BY)doi:10.3390/ijerph19042250OpenAlex

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    With the outbreak of the Corona Virus Disease 19 (Covid-19) in late 2019, governments increasingly imposed containment strategies, including social distancing as well as restricted population movement, potentially having negative impacts on mental and physical health. A growing number of studies have examined the impact of the pandemic on different facets of physical activity (PA); an overview combining these (mixed) results, however, is missing. Thus, the objective of this systematic review and meta-analysis was to investigate whether and to which extent PA changed from before to during the Covid-19 pandemic, taking age, gender, and measurement method into account. The literature search was conducted using PubMed, Web of Science, and Scopus. Results of the main characteristics were descriptively synthesized and analyzed in a meta-analysis quantifying effects of the pandemic on PA divided by age groups, with additional subgroup analyses of the characteristics age, gender, and measurement method being narratively synthesized. Overall, 57 studies with a total sample size of 119,094…

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    Reversing Years for Global Food Security: A Review of the Food Security Situation in Sub-Saharan Africa (SSA)

    Abdulazeez Hudu Wudil, Muhammad Usman, Joanna Rosak-Szyrocka, Ladislav Pilař, Mortala Boye

    311 citationsOpen access (CC-BY)doi:10.3390/ijerph192214836OpenAlex

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    All around the world, inequalities persist in the complex web of social, economic, and ecological factors that mediate food security outcomes at different human and institutional scales. There have been rapid and continuous improvements in agricultural productivity and better food security in many regions of the world during the past 50 years due to an expansion in crop area, irrigation, and supportive policy and institutional initiatives. However, in Sub-Saharan Africa, the situation is inverted. Statistics show that food insecurity has risen since 2015 in Sub-Saharan African countries, and the situation has worsened owing to the Ukraine conflict and the ongoing implications of the COVID-19 threat. This review looks into multidimensional challenges to achieving the SDG2 goal of "End hunger, achieve food security and improved nutrition, and promote sustainable agriculture" in Sub-Saharan Africa and the prosper policy recommendations for action. Findings indicate that weak economic growth, gender inequality, high inflation, low crop productivity, low investment in irrigated…

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    Telework and Worker Health and Well-Being: A Review and Recommendations for Research and Practice

    Julia L. O. Beckel, Gwenith G. Fisher

    302 citationsOpen access (CC-BY)doi:10.3390/ijerph19073879OpenAlex

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    Telework (also referred to as telecommuting or remote work), is defined as working outside of the conventional office setting, such as within one's home or in a remote office location, often using a form of information communication technology to communicate with others (supervisors, coworkers, subordinates, customers, etc.) and to perform work tasks. Remote work increased over the last decade and tremendously in response to the COVID-19 pandemic. The purpose of this article is to review and critically evaluate the existing research about telework and worker health and well-being. In addition, we review and evaluate how engaging in this flexible form of work impacts worker health and well-being. Specifically, we performed a literature search on the empirical literature related to teleworking and worker health and well-being, and reviewed articles published after the year 2000 based on the extent to which they had been discussed in prior reviews. Next, we developed a conceptual framework based on our review of the empirical literature. Our model explains the process by which telework…

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    Changes in Access to Health Services during the COVID-19 Pandemic: A Scoping Review

    Georgina Pujolar-Díaz, Aida Oliver-Anglès, Íngrid Vargas, María Luisa Vázquez

    286 citationsOpen access (CC-BY)doi:10.3390/ijerph19031749OpenAlex

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    The COVID-19 pandemic and the measures adopted are having a profound impact on a major goal of public healthcare systems: universal access to health services. The objective is to synthesize the available knowledge on access to health care for non-COVID-19 conditions and to identify knowledge gaps. A scoping review was conducted searching different databases (Medline, Google Scholar, etc.) for original articles published between December 2019 and September 2021. A total of 53 articles were selected and analyzed using the Aday and Andersen framework as a guide. Of these, 37 analyzed changes in levels of use of health services, 15 focused on the influencing factors and barriers to access, and 1 studied both aspects. Most focused on specific diseases and the early stages of the pandemic, based on a review of records. Analyses of the impact on primary care services' use, unmet needs or inequalities in access were scarce. A generalized reduction in the use of health services was described. The most frequent access barrier described for non-COVID-19 conditions related to the services was a…

  18. 18
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    Pharmaceuticals in the Aquatic Environment: A Review on Eco-Toxicology and the Remediation Potential of Algae

    Monika Hejna, Dominika Kapuścińska, Anna Aksmann

    284 citationsOpen access (CC-BY)doi:10.3390/ijerph19137717OpenAlex

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    The pollution of the aquatic environment has become a worldwide problem. The widespread use of pesticides, heavy metals and pharmaceuticals through anthropogenic activities has increased the emission of such contaminants into wastewater. Pharmaceuticals constitute a significant class of aquatic contaminants and can seriously threaten the health of non-target organisms. No strict legal regulations on the consumption and release of pharmaceuticals into water bodies have been implemented on a global scale. Different conventional wastewater treatments are not well-designed to remove emerging contaminants from wastewater with high efficiency. Therefore, particular attention has been paid to the phycoremediation technique, which seems to be a promising choice as a low-cost and environment-friendly wastewater treatment. This technique uses macro- or micro-algae for the removal or biotransformation of pollutants and is constantly being developed to cope with the issue of wastewater contamination. The aims of this review are: (i) to examine the occurrence of pharmaceuticals in water, and…

  19. 19
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    A Review of the Role of Extracellular Polymeric Substances (EPS) in Wastewater Treatment Systems

    Lei Huang, Yinie Jin, Danheng Zhou, Linxin Liu, Shikun Huang and 2 more

    279 citationsOpen access (CC-BY)doi:10.3390/ijerph191912191OpenAlex

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    A review of the characterization and functions of extracellular polymeric substances (EPS) of microbial aggregates in biological wastewater treatment systems is presented in this paper. EPS represent the complex high-molecular-weight mixture of polymers excreted by microorganisms generated from cell lysis as well as adsorbed inorganic and organic matter from wastewater. EPS exhibit a three-dimensional, gel-like, highly hydrated matrix that facilitates microbial attachment, embedding, and immobilization. EPS play multiple roles in containments removal, and the main components of EPS crucially influence the properties of microbial aggregates, such as adsorption ability, stability, and formation capacity. Moreover, EPS are important to sludge bioflocculation, settleability, and dewatering properties and could be used as carbon and energy sources in wastewater treatment. However, due to the complex structure of EPS, related knowledge is incomplete, and further research is necessary to understand fully the precise roles in biological treatment processes.

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    Linking Soil Microbial Diversity to Modern Agriculture Practices: A Review

    Amrita Gupta, Udai Bhan Singh, Pramod Kumar Sahu, Surinder Paul, Adarsh M Kumar and 11 more

    269 citationsOpen access (CC-BY)doi:10.3390/ijerph19053141OpenAlex

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    Agriculture is a multifarious interface between plants and associated microorganisms. In contemporary agriculture, emphasis is being given to environmentally friendly approaches, particularly in developing countries, to enhance sustainability of the system with the least negative effects on produce quality and quantity. Modern agricultural practices such as extensive tillage, the use of harmful agrochemicals, mono-cropping, etc. have been found to influence soil microbial community structure and soil sustainability. On the other hand, the question of feeding the ever-growing global population while ensuring system sustainability largely remains unanswered. Agriculturally important microorganisms are envisaged to play important roles in various measures to raise a healthy and remunerative crop, including integrated nutrient management, as well as disease and pest management to cut down agrochemicals without compromising the agricultural production. These beneficial microorganisms seem to have every potential to provide an alternative opportunity to overcome the ill effects of various…

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    Artificial Intelligence Enabled Personalised Assistive Tools to Enhance Education of Children with Neurodevelopmental Disorders—A Review

    Prabal Datta Barua, Jahmunah Vicnesh, Raj Gururajan, Shu Lih Oh, Elizabeth E. Palmer and 3 more

    268 citationsOpen access (CC-BY)doi:10.3390/ijerph19031192OpenAlex

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    Mental disorders (MDs) with onset in childhood or adolescence include neurodevelopmental disorders (NDDs) (intellectual disability and specific learning disabilities, such as dyslexia, attention deficit disorder (ADHD), and autism spectrum disorders (ASD)), as well as a broad range of mental health disorders (MHDs), including anxiety, depressive, stress-related and psychotic disorders. There is a high co-morbidity of NDDs and MHDs. Globally, there have been dramatic increases in the diagnosis of childhood-onset mental disorders, with a 2- to 3-fold rise in prevalence for several MHDs in the US over the past 20 years. Depending on the type of MD, children often grapple with social and communication deficits and difficulties adapting to changes in their environment, which can impact their ability to learn effectively. To improve outcomes for children, it is important to provide timely and effective interventions. This review summarises the range and effectiveness of AI-assisted tools, developed using machine learning models, which have been applied to address learning challenges in…

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    A Scoping Review of Moral Stressors, Moral Distress and Moral Injury in Healthcare Workers during COVID-19

    Priya-Lena Riedel, Alexander Kreh, Vanessa Kulcar, Angela S. Lieber, Barbara Hildegard Juen

    258 citationsOpen access (CC-BY)doi:10.3390/ijerph19031666OpenAlex

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    Ethical dilemmas for healthcare workers (HCWs) during pandemics highlight the centrality of moral stressors and moral distress (MD) as well as potentially morally injurious events (PMIEs) and moral injury (MI). These constructs offer a novel approach to understanding workplace stressors in healthcare settings, especially in the demanding times of COVID-19, but they so far lack clear identification of causes and consequences. A scoping review of moral stressors, moral distress, PMIEs, and MI of healthcare workers during COVID-19 was conducted using the databases Web of Science Core Collection and PsycINFO based on articles published up to October 2021. Studies were selected based on the following inclusion criteria: (1) the measurement of either moral stress, MD, PMIEs, or MI among HCWs; (2) original research using qualitative or quantitative methods; and (3) the availability of the peer-reviewed original article in English or German. The initial search revealed n = 149,394 studies from Web of Science and n = 34 studies from EBSCOhost. Nineteen studies were included in the review.…

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    Microplastics in Fish and Fishery Products and Risks for Human Health: A Review

    Leonardo Alberghini, Alessandro Truant, Serena Santonicola, Giampaolo Colavita, Valério Giaccone

    253 citationsOpen access (CC-BY)doi:10.3390/ijerph20010789OpenAlex

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    In recent years, plastic waste has become a universally significant environmental problem. Ingestion of food and water contaminated with microplastics is the main route of human exposure. Fishery products are an important source of microplastics in the human diet. Once ingested, microplastics reach the gastrointestinal tract and can be absorbed causing oxidative stress, cytotoxicity, and translocation to other tissues. Furthermore, microplastics can release chemical substances (organic and inorganic) present in their matrix or previously absorbed from the environment and act as carriers of microorganisms. Additives present in microplastics such as polybrominated diphenyl ethers (PBDE), bisphenol A (BPA), nonylphenol (NP), octylphenol (OP), and potentially toxic elements can be harmful for humans. However, to date, the data we have are not sufficient to perform a reliable assessment of the risks to human health. Further studies on the toxicokinetics and toxicity of microplastics in humans are needed.

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    Central and Peripheral Fatigue in Physical Exercise Explained: A Narrative Review

    José Francisco Tornero-Aguilera, Jorge Jiménez-Morcillo, Alejandro Rubio-Zarapuz, Vicente Javier Clemente‐Suárez

    253 citationsOpen access (CC-BY)doi:10.3390/ijerph19073909OpenAlex

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    The study of the origin and implications of fatigue in exercise has been widely investigated, but not completely understood given the complex multifactorial mechanisms involved. Then, it is essential to understand the fatigue mechanism to help trainers and physicians to prescribe an adequate training load. The present narrative review aims to analyze the multifactorial factors of fatigue in physical exercise. To reach this aim, a consensus and critical review were performed using both primary sources, such as scientific articles, and secondary ones, such as bibliographic indexes, web pages, and databases. The main search engines were PubMed, SciELO, and Google Scholar. Central and peripheral fatigue are two unison constructs part of the Integrative Governor theory, in which both psychological and physiological drives and requirements are underpinned by homeostatic principles. The relative activity of each one is regulated by dynamic negative feedback activity, as the fundamental general operational controller. Fatigue is conditioned by factors such as gender, affecting men and women…

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    The Impact of Heatwaves on Mortality and Morbidity and the Associated Vulnerability Factors: A Systematic Review

    Fadly Syah Arsad, Rozita Hod, Norfazilah Ahmad, Rohaida Ismail, Norlen Mohamed and 4 more

    242 citationsOpen access (CC-BY)doi:10.3390/ijerph192316356OpenAlex

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    BACKGROUND: This study aims to investigate the current impacts of extreme temperature and heatwaves on human health in terms of both mortality and morbidity. This systematic review analyzed the impact of heatwaves on mortality, morbidity, and the associated vulnerability factors, focusing on the sensitivity component. METHODS: This systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 flow checklist. Four databases (Scopus, Web of Science, EBSCOhost, PubMed) were searched for articles published from 2012 to 2022. Those eligible were evaluated using the Navigation Guide Systematic Review framework. RESULTS: A total of 32 articles were included in the systematic review. Heatwave events increased mortality and morbidity incidence. Sociodemographic (elderly, children, male, female, low socioeconomic, low education), medical conditions (cardiopulmonary diseases, renal disease, diabetes, mental disease), and rural areas were crucial vulnerability factors. CONCLUSIONS: While mortality and morbidity are critical aspects for…

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    Identifying Types of Eco-Anxiety, Eco-Guilt, Eco-Grief, and Eco-Coping in a Climate-Sensitive Population: A Qualitative Study

    Csilla Ágoston, Benedek Csaba, Bence J. Nagy, Zoltán Kőváry, Andrea Dúll and 2 more

    241 citationsOpen access (CC-BY)doi:10.3390/ijerph19042461OpenAlex

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    BACKGROUND: Climate change is one of the greatest challenges of the 21st century and it can affect mental health either directly through the experience of environmental traumas or indirectly through the experience of emotional distress and anxiety about the future. However, it is not clear what possible subtypes of the emerging "psychoterratic" syndromes such as eco-anxiety, eco-guilt, and eco-grief exist, how much distress they may cause, and to what extent they facilitate ecofriendly behavior. METHODS: We analyzed semi-structured interviews (N = 17) focusing on the thoughts, emotions, and behaviors related to climate change by using a combination of inductive and deductive qualitative methods. RESULTS AND CONCLUSIONS: The interviews revealed six eco-anxiety components, eight types of eco-guilt, and two types of eco-grief that help to understand the multifactorial nature of these phenomena. The six categories of coping strategies are in line with traditional coping models, and they are linked in various ways to pro-environmental behavior and the management of negative emotions. The…

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    20 Years of ICF—International Classification of Functioning, Disability and Health: Uses and Applications around the World

    Matilde Leonardi, Haejung Lee, Nenad Friedrich Ivan Kostanjsek, Arianna Fornari, Alberto Raggi and 25 more

    236 citationsOpen access (CC-BY)doi:10.3390/ijerph191811321OpenAlex

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    The International Classification of Functioning Disability and Health (ICF) was approved in 2001 and, since then, several studies reported the increased interest about its use in different sectors. A recent overview that summarizes its applications is lacking. This study aims to provide an updated overview about 20 years of ICF application through an international online questionnaire, developed by the byline authors, and sent to each World Health Organization Collaborating Centers of the Family of International Classifications (WHO-FIC CCs). Data was collected during October 2020 and December 2021 and descriptive content analyses were used to report main results. Results show how, in most of the respondent countries represented by WHO-FIC CCs, ICF was mainly used in clinical practice, policy development and social policy, and in education areas. Despite its applications in different sectors, ICF use is not mandatory in most countries but, where used, it provides a biopsychosocial framework for policy development in health, functioning and disability. The study provides information…

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    Freshwater as a Sustainable Resource and Generator of Secondary Resources in the 21st Century: Stressors, Threats, Risks, Management and Protection Strategies, and Conservation Approaches

    Doru Bănăduc, Vladica Simić, Kevin Cianfaglione, Sophia S. Barinova, S. A. Afanasyev and 4 more

    235 citationsOpen access (CC-BY)doi:10.3390/ijerph192416570OpenAlex

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    This paper is a synthetic overview of some of the threats, risks, and integrated water management elements in freshwater ecosystems. The paper provides some discussion of human needs and water conservation issues related to freshwater systems: (1) introduction and background; (2) water basics and natural cycles; (3) freshwater roles in human cultures and civilizations; (4) water as a biosphere cornerstone; (5) climate as a hydrospheric 'game changer' from the perspective of freshwater; (6) human-induced stressors' effects on freshwater ecosystem changes (pollution, habitat fragmentation, etc.); (7) freshwater ecosystems' biological resources in the context of unsustainable exploitation/overexploitation; (8) invasive species, parasites, and diseases in freshwater systems; (9) freshwater ecosystems' vegetation; (10) the relationship between human warfare and water. All of these issues and more create an extremely complex matrix of stressors that plays a driving role in changing freshwater ecosystems both qualitatively and quantitatively, as well as their capacity to offer sustainable…

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    Plastic Waste Management Strategies and Their Environmental Aspects: A Scientometric Analysis and Comprehensive Review

    Saimin Huang, Hongchang Wang, Waqas Ahmad, Ayaz Ahmad, Nikolai Ivanovich Vatin and 3 more

    232 citationsOpen access (CC-BY)doi:10.3390/ijerph19084556OpenAlex

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    Plastic consumption increases with the growing population worldwide and results in increased quantities of plastic waste. There are various plastic waste management strategies; however, the present management progress is not sustainable, and plastic waste dumping in landfills is still the most commonly employed strategy. Being nonbiodegradable, plastic waste dumping in landfills creates several environmental and human health problems. Numerous research studies have been conducted recently to determine safe and ecologically beneficial methods of plastic waste handling. This article performed a bibliographic analysis of the available literature on plastic waste management using a computational approach. The highly used keywords, most frequently cited papers and authors, actively participating countries, and sources of publications were analyzed during the bibliographic analysis. In addition, the various plastic waste management strategies and their environmental benefits have been discussed. It has been concluded that among the six plastic waste management techniques (landfills,…

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    Chlorpyrifos Occurrence and Toxicological Risk Assessment: A Review

    Elżbieta Wołejko, Bożena Łozowicka, Agata Jabłońska‐Trypuć, Marta Pietruszyńska, Urszula Wydro

    230 citationsOpen access (CC-BY)doi:10.3390/ijerph191912209OpenAlex

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    Chlorpyrifos (CPF) was the most frequently used pesticide in food production in the European Union (EU) until 2020. Unfortunately, this compound is still being applied in other parts of the world. National monitoring of pesticides conducted in various countries indicates the presence of CPF in soil, food, and water, which may have toxic effects on consumers, farmers, and animal health. In addition, CPF may influence changes in the population of fungi, bacteria, and actinomycete in soil and can inhibit nitrogen mineralization. The mechanisms of CPF activity are based on the inhibition of acetylcholinesterase (AChE) activity. This compound also exhibits reproductive toxicity, neurotoxicity, and genotoxicity. The problem seems to be the discrepancy between the actual observations and the final conclusions drawn for the substance's approval in reports presenting the toxic impact of CPF on human health. Therefore, this influence is still a current and important issue that requires continuous monitoring despite its withdrawal from the market in the EU. This review traces the scientific…

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    Digital Transformation on Enterprise Green Innovation: Effect and Transmission Mechanism

    Hua Feng, Fengyan Wang, Guomin Song, Lanlan Liu

    227 citationsOpen access (CC-BY)doi:10.3390/ijerph191710614OpenAlex

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    With the development of blockchain, big data, cloud computing and other new technologies, how to achieve innovative development and green sustainable development in digital transformation has become one of the key issues for enterprises to obtain and maintain core competitiveness. However, little of the literature has paid attention to the impact of digital transformation on enterprise green innovation. Using the data of Chinese A-share listed companies from 2010 to 2020, this paper empirically analyzes the impact of enterprise digital transformation on green innovation and its transmission mechanism, by constructing double fixed-effect models. The results show that digital transformation has remarkably promoted the green innovation of enterprises. R&D investment, government subsidies, and income tax burden have played a conductive role between digital transformation and enterprise green innovation. Furthermore, digital transformation can significantly promote the high-quality green innovation of enterprises and also plays a more significant role in promoting the green innovation of…

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    A Review of PFAS Destruction Technologies

    Jay N. Meegoda, Bruno Bezerra de Souza, Melissa Monteiro Casarini, Jitendra A. Kewalramani

    224 citationsOpen access (CC-BY)doi:10.3390/ijerph192416397OpenAlex

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    Per- and polyfluoroalkyl substances (PFASs) are a family of highly toxic emerging contaminants that have caught the attention of both the public and private sectors due to their adverse health impacts on society. The scientific community has been laboriously working on two fronts: (1) adapting already existing and effective technologies in destroying organic contaminants for PFAS remediation and (2) developing new technologies to remediate PFAS. A common characteristic in both areas is the separation/removal of PFASs from other contaminants or media, followed by destruction. The widely adopted separation technologies can remove PFASs from being in contact with humans; however, they remain in the environment and continue to pose health risks. On the other hand, the destructive technologies discussed here can effectively destroy PFAS compounds and fully address society's urgent need to remediate this harmful family of chemical compounds. This review reports and compare widely accepted as well as emerging PFAS destruction technologies. Some of the technologies presented in this review…

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    Accidental Hypothermia: 2021 Update

    Peter Paal, Mathieu Pasquier, Tomasz Darocha, Raimund Lechner, Sylweriusz Kosiński and 3 more

    219 citationsOpen access (CC-BY)doi:10.3390/ijerph19010501OpenAlex

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    Accidental hypothermia is an unintentional drop of core temperature below 35 °C. Annually, thousands die of primary hypothermia and an unknown number die of secondary hypothermia worldwide. Hypothermia can be expected in emergency patients in the prehospital phase. Injured and intoxicated patients cool quickly even in subtropical regions. Preventive measures are important to avoid hypothermia or cooling in ill or injured patients. Diagnosis and assessment of the risk of cardiac arrest are based on clinical signs and core temperature measurement when available. Hypothermic patients with risk factors for imminent cardiac arrest (temperature < 30 °C in young and healthy patients and <32 °C in elderly persons, or patients with multiple comorbidities), ventricular dysrhythmias, or systolic blood pressure < 90 mmHg) and hypothermic patients who are already in cardiac arrest, should be transferred directly to an extracorporeal life support (ECLS) centre. If a hypothermic patient arrests, continuous cardiopulmonary resuscitation (CPR) should be performed. In hypothermic patients, the…

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    Serum Cholesterol Levels and Risk of Cardiovascular Death: A Systematic Review and a Dose-Response Meta-Analysis of Prospective Cohort Studies

    Eujene Jung, So Yeon Kong, Young Sun Ro, Hyun Ho Ryu, Sang Do Shin

    216 citationsOpen access (CC-BY)doi:10.3390/ijerph19148272OpenAlex

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    INTRODUCTION: Numerous studies have demonstrated that abnormal levels of cholesterol are associated with a high attributable risk for the occurrence of cardiovascular disease (CVD). However, there has been no comprehensive study to investigate the relationship between serum cholesterol levels and cardiovascular mortality. Therefore, we conducted a systematic review and dose-response meta-analysis. METHODS: A systematic literature search of key databases, including EMBASE and MEDLINE, was conducted and included all the published epidemiological studies that contained estimates of the hazard ratios (HR) of serum cholesterol of CVD mortality. Data extraction, eligibility, and assessment of the risk of bias were assessed by two reviewers independently. All published risk estimates were hazard ratios and analyzed by quantitative meta-analysis using a random-effects model and dose-response relationships of serum cholesterol with CVD mortality. RESULTS: A total of 14 independent reports, including 1,055,309 subjects and 9457 events, were analyzed. The pooled HR (95% CI) was 1.27 (95% CI,…

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    Rehabilitation Interventions for Post-Acute COVID-19 Syndrome: A Systematic Review

    Stefania Fugazzaro, Angela Contri, Otmen Esseroukh, Shaniko Kaleci, Stefania Croci and 6 more

    216 citationsOpen access (CC-BY)doi:10.3390/ijerph19095185OpenAlex

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    Increasing numbers of individuals suffer from post-acute COVID-19 syndrome (PACS), which manifests with persistent symptoms, the most prevalent being dyspnea, fatigue, and musculoskeletal, cognitive, and/or mental health impairments. This systematic review investigated the effectiveness of rehabilitation interventions for individuals with PACS. We searched the MEDLINE, Embase, Cochrane Register of Controlled Trials, CINHAL, Scopus, Prospero, and PEDro databases and the International Clinical Trials Registry Platform for randomized controlled trials (RCTs) up to November 2021. We screened 516 citations for eligibility, i.e., trials that included individuals with PACS exposed to exercise-based rehabilitation interventions. Five RCTs were included, accounting for 512 participants (aged 49.2-69.4 years, 65% males). Based on the revised Cochrane risk-of-bias tool (RoB 2.0), two RCTs had "low risk of bias", and three were in the "some concerns" category. Three RCTs compared experimental rehabilitation interventions with no or minimal rehabilitation, while two compared two active…

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    Occurrence of Microplastics in Tap and Bottled Water: Current Knowledge

    Isabella Gambino, Francesco Bagordo, Tiziana Grassi, Alessandra Panìco, Antonella De Donno

    213 citationsOpen access (CC-BY)doi:10.3390/ijerph19095283OpenAlex

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    = 21) showed the presence of microplastics (MPs) in tap (TW) and bottled (BW) water, increasing concerns for public health due to the possible toxicity associated with their polymeric composition, additives, and other compounds or microorganism adsorbed on their surface. The MP concentration increase by decreasing particles size and was higher in BW than in TW. Among BW, reusable PET and glass bottles showed a higher MP contamination than other packages. The lower MP abundance in TW than in natural sources indicates a high removal rate of MPs in drinking water treatment plants. This evidence should encourage the consumers to drink TW instead of BW, in order to limit their exposure to MPS and produce less plastic waste. The high variability in the results makes it difficult to compare the findings of different studies and build up a general hypothesis on human health risk. A globally shared protocol is needed to harmonize results also in view of the monitoring plans for the emerging contaminants, including MPs, introduced by the new European regulation.

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    Microbial Degradation of Azo Dyes: Approaches and Prospects for a Hazard-Free Conversion by Microorganisms

    Anna Christina R. Ngo, Dirk Tischler

    210 citationsOpen access (CC-BY)doi:10.3390/ijerph19084740OpenAlex

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    Azo dyes have become a staple in various industries, as colors play an important role in consumer choices. However, these dyes pose various health and environmental risks. Although different wastewater treatments are available, the search for more eco-friendly options persists. Bioremediation utilizing microorganisms has been of great interest to researchers and industries, as the transition toward greener solutions has become more in demand through the years. This review tackles the health and environmental repercussions of azo dyes and its metabolites, available biological approaches to eliminate such dyes from the environment with a focus on the use of different microorganisms, enzymes that are involved in the degradation of azo dyes, and recent trends that could be applied for the treatment of azo dyes.

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    The Role of 3D Printing in Planning Complex Medical Procedures and Training of Medical Professionals—Cross-Sectional Multispecialty Review

    Jarosław Meyer-Szary, Marlon Souza Luis, Szymon Mikulski, Agastya Patel, Finn Schulz and 10 more

    210 citationsOpen access (CC-BY)doi:10.3390/ijerph19063331OpenAlex

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    Medicine is a rapidly-evolving discipline, with progress picking up pace with each passing decade. This constant evolution results in the introduction of new tools and methods, which in turn occasionally leads to paradigm shifts across the affected medical fields. The following review attempts to showcase how 3D printing has begun to reshape and improve processes across various medical specialties and where it has the potential to make a significant impact. The current state-of-the-art, as well as real-life clinical applications of 3D printing, are reflected in the perspectives of specialists practicing in the selected disciplines, with a focus on pre-procedural planning, simulation (rehearsal) of non-routine procedures, and on medical education and training. A review of the latest multidisciplinary literature on the subject offers a general summary of the advances enabled by 3D printing. Numerous advantages and applications were found, such as gaining better insight into patient-specific anatomy, better pre-operative planning, mock simulated surgeries, simulation-based training and…

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    Pro-Environmental Behavior Research: Theoretical Progress and Future Directions

    Hong Tian, Xinyu Liu

    209 citationsOpen access (CC-BY)doi:10.3390/ijerph19116721OpenAlex

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    Realistic environmental problems drive the growth of pro-environment behavior research, among which the most important progress is about the theoretical innovation and development of pro-environmental behavior. Thus, the main purpose of this paper was to review the literature and help researchers to understand the theoretical progress of pro-environmental behavior. This study systematically analyzed 1806 papers published in SCI-EXPANDED and SSCI databases. It presented the research overview of pro-environmental behavior in terms of status of literature publication, research hotspots and topics. On this basis, this paper further focused on key theoretical papers and summarized three paths of theoretical progress for pro-environmental behavior: theoretical development, theoretical exploration and theoretical integration. Along the theoretical development path, studies mainly apply theories of psychology, sociology and economics to analyze and explain the formation and consequences of pro-environmental behavior. In terms of theoretical exploration, existing studies propose and develop…

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    Effect of COVID-19 Vaccines on Reducing the Risk of Long COVID in the Real World: A Systematic Review and Meta-Analysis

    Peng Gao, Jue Liu, Min Liu

    204 citationsOpen access (CC-BY)doi:10.3390/ijerph191912422OpenAlex

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    The coronavirus disease 2019 (COVID-19) is still in a global pandemic state. Some studies have reported that COVID-19 vaccines had a protective effect against long COVID. However, the conclusions of the studies on the effect of COVID-19 vaccines on long COVID were not consistent. This study aimed to systematically review relevant studies in the real world, and performed a meta-analysis to explore the relationship between vaccination and long COVID. We systematically searched PubMed, Embase, Web of science, and ScienceDirect from inception to 19 September 2022. The PICO (P: patients; I: intervention; C: comparison; O: outcome) was as follows: patients diagnosed with COVID-19 (P); vaccination with COVID-19 vaccines (I); the patients were divided into vaccinated and unvaccinated groups (C); the outcomes were the occurrence of long COVID, as well as the various symptoms of long COVID (O). A fixed-effect model and random-effects model were chosen based on the heterogeneity between studies in order to pool the effect value. The results showed that the vaccinated group had a 29% lower risk…

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    Parental Attachment and Peer Relationships in Adolescence: A Systematic Review

    Elena Delgado, Cristina Serna Sarrato, Isabel Martínez, Edie Cruise

    202 citationsOpen access (CC-BY)doi:10.3390/ijerph19031064OpenAlex

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    According to attachment theory, children's early experiences with their primary caregivers, in terms of protection and security, are the basis for socioemotional development and for the establishment of close relationships throughout their lives. During adolescence, friends and peers become a primary developmental environment, and thereby establishing quality bonds with peers will foster good psychological adjustment. The aim of the present study was to review the evidence on the relation of parental attachment to the quality of peer relationships during adolescence. A systematic review was conducted according to the recommendations of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The search was performed in the PsycInfo, Scopus, and Web of Science (WOS) databases. Inclusion criteria were studies published since 2001, in English, that are academic publications in scientific journals, that explore adolescence, and that analyze the relationship between attachment styles and adolescent peer interactions. The search resulted in 1438 studies, of which…

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    Virtual Reality in Neurosurgery: Beyond Neurosurgical Planning

    Rakesh Mishra, M.D. Krishna Narayanan, Giuseppe Emmanuele Umana, Nicola Montemurro, Bipin Kumar Chaurasia and 1 more

    199 citationsOpen access (CC-BY)doi:10.3390/ijerph19031719OpenAlex

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    BACKGROUND: While several publications have focused on the intuitive role of augmented reality (AR) and virtual reality (VR) in neurosurgical planning, the aim of this review was to explore other avenues, where these technologies have significant utility and applicability. METHODS: This review was conducted by searching PubMed, PubMed Central, Google Scholar, the Scopus database, the Web of Science Core Collection database, and the SciELO citation index, from 1989-2021. An example of a search strategy used in PubMed Central is: "Virtual reality" [All Fields] AND ("neurosurgical procedures" [MeSH Terms] OR ("neurosurgical" [All Fields] AND "procedures" [All Fields]) OR "neurosurgical procedures" [All Fields] OR "neurosurgery" [All Fields] OR "neurosurgery" [MeSH Terms]). Using this search strategy, we identified 487 (PubMed), 1097 (PubMed Central), and 275 citations (Web of Science Core Collection database). RESULTS: Articles were found and reviewed showing numerous applications of VR/AR in neurosurgery. These applications included their utility as a supplement and augment for…

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    Artificial Intelligence in Dentistry—Narrative Review

    Agata Ossowska, Aida Kusiak, Dariusz Świetlik

    198 citationsOpen access (CC-BY)doi:10.3390/ijerph19063449OpenAlex

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    Nowadays, artificial intelligence (AI) is becoming more important in medicine and in dentistry. It can be helpful in many fields where the human may be assisted and helped by new technologies. Neural networks are a part of artificial intelligence, and are similar to the human brain in their work and can solve given problems and make fast decisions. This review shows that artificial intelligence and the use of neural networks has developed very rapidly in recent years, and it may be an ordinary tool in modern dentistry in the near future. The advantages of this process are better efficiency, accuracy, and time saving during the diagnosis and treatment planning. More research and improvements are needed in the use of neural networks in dentistry to put them into daily practice and to facilitate the work of the dentist.

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    Instagram Use and Body Dissatisfaction: The Mediating Role of Upward Social Comparison with Peers and Influencers among Young Females

    Federica Pedalino, Anne-Linda Camerini

    198 citationsOpen access (CC-BY)doi:10.3390/ijerph19031543OpenAlex

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    BACKGROUND: Instagram is one of the most popular social media platforms among young females. Idealized body images shared on the platform have been associated with lower levels of body satisfaction in this population, likely due to social comparison processes. In the present study, we tested a mediation model linking Instagram use (i.e., browsing through others' profiles, commenting on others' looks, posting one's own photos or stories) to body dissatisfaction (i.e., body image discrepancy and lack of body appreciation), mediated by upward social comparison with close peers, distant peers, and social media influencers. METHODS: = 19.8, SD = 4.6; 94.8% Italian). RESULTS: Our final model results show that browsing on Instagram was associated with lower levels of body appreciation, fully mediated by upward social comparison with social media influencers, not close or distant peers. Commenting on others' looks and posting own content were not associated with body dissatisfaction. Being an adolescent female (compared to a young woman) and having a higher BMI were associated with worse…

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    A Systematic Review to Compare Adverse Pregnancy Outcomes in Women with Pregestational Diabetes and Gestational Diabetes

    Nompumelelo Malaza, Matladi Masete, Sumaiya Adam, Stephanie C. Dias, Thembeka A. Nyawo and 1 more

    197 citationsOpen access (CC-BY)doi:10.3390/ijerph191710846OpenAlex

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    Pregestational type 1 (T1DM) and type 2 (T2DM) diabetes mellitus and gestational diabetes mellitus (GDM) are associated with increased rates of adverse maternal and neonatal outcomes. Adverse outcomes are more common in women with pregestational diabetes compared to GDM; although, conflicting results have been reported. This systematic review aims to summarise and synthesise studies that have compared adverse pregnancy outcomes in pregnancies complicated by pregestational diabetes and GDM. Three databases, Pubmed, EBSCOhost and Scopus were searched to identify studies that compared adverse outcomes in pregnancies complicated by pregestational T1DM and T2DM, and GDM. A total of 20 studies met the inclusion criteria and are included in this systematic review. Thirteen pregnancy outcomes including caesarean section, preterm birth, congenital anomalies, pre-eclampsia, neonatal hypoglycaemia, macrosomia, neonatal intensive care unit admission, stillbirth, Apgar score, large for gestational age, induction of labour, respiratory distress syndrome and miscarriages were compared. Findings…

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    The Effects of Ventilation, Humidity, and Temperature on Bacterial Growth and Bacterial Genera Distribution

    Yujia Qiu, Yan Zhou, Yanfen Chang, Xinyue Liang, Hui Zhang and 4 more

    192 citationsOpen access (CC-BY)doi:10.3390/ijerph192215345OpenAlex

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    BACKGROUND: Bacteria are readily nourished in airtight environments with high humidity, such as storage cabinets, clothing closets, and corners, where ventilation is normally low and humidity is high. OBJECTIVES: We characterized the role of humidity and ventilation in bacterial growth and genus distribution at different temperatures (26 °C and 34 °C). METHODS: Fresh pork, which was used as the substrate for bacterial culture, was placed in storage cabinets. Bacterial growth and genera distribution on the surface of pork placed in a storage cabinet under different temperatures (26 °C and 34 °C); relative humidity levels (RH: 50%, 70%, 90%); and ventilation conditions (no ventilation and low, medium, and high levels of ventilation) were assessed by rDNA sequencing. RESULTS: Increased ventilation and reduced humidity significantly decreased bacterial growth at 26 °C and 34 °C. The contribution of increased ventilation to the reduction in bacterial growth exceeded that of decreased humidity. Ventilation had the greatest effect on reducing bacterial growth compared to the unventilated…

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    Deeply in Plasticenta: Presence of Microplastics in the Intracellular Compartment of Human Placentas

    Antonio Ragusa, Maria Matta, Loredana Cristiano, Roberto Matassa, Ezio Battaglione and 13 more

    189 citationsOpen access (CC-BY)doi:10.3390/ijerph191811593OpenAlex

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    Microplastics (MPs) are defined as plastic particles smaller than 5 mm. They have been found almost everywhere they have been searched for and recent discoveries have also demonstrated their presence in human placenta, blood, meconium, and breastmilk, but their location and toxicity to humans have not been reported to date. The aim of this study was twofold: 1. To locate MPs within the intra/extracellular compartment in human placenta. 2. To understand whether their presence and location are associated with possible structural changes of cell organelles. Using variable pressure scanning electron microscopy and transmission electron microscopy, MPs have been localized in ten human placentas. In this study, we demonstrated for the first time the presence and localization in the cellular compartment of fragments compatible with MPs in the human placenta and we hypothesized a possible correlation between their presence and important ultrastructural alterations of some intracytoplasmic organelles (mitochondria and endoplasmic reticulum). These alterations have never been reported in…

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    The HIV Epidemic in South Africa: Key Findings from 2017 National Population-Based Survey

    Khangelani K Zuma, Leickness Chisamu Simbayi, Nompumelelo Precious Zungu, Sizulu Moyo, Edmore T. Marinda and 13 more

    187 citationsOpen access (CC-BY)doi:10.3390/ijerph19138125OpenAlex

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    South Africa has the largest number of people living with HIV worldwide. South Africa has implemented five population-based HIV prevalence surveys since 2002 aimed at understanding the dynamics and the trends of the epidemic. This paper presents key findings from the fifth HIV prevalence, incidence, and behaviour survey conducted in 2017 following policy, programme, and epidemic change since the prior survey was conducted in 2012. A cross-sectional population-based household survey collected behavioural and biomedical data on all members of the eligible households. A total of 39,132 respondents from 11,776 households were eligible to participate, of whom 93.6% agreed to be interviewed, and 61.1% provided blood specimens. The provided blood specimens were used to determine HIV status, HIV incidence, viral load, exposure to antiretroviral treatment, and HIV drug resistance. Overall HIV incidence among persons aged 2 years and above was 0.48% which translates to an estimated 231,000 new infections in 2017. HIV prevalence was 14.0% translating to 7.9 million people living with HIV.…

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    Sustainability of Heating, Ventilation and Air-Conditioning (HVAC) Systems in Buildings—An Overview

    Nilofar Asim, Marzieh Badiei, Masita Mohammad, Halim Razali, Armin Rajabi and 2 more

    183 citationsOpen access (CC-BY)doi:10.3390/ijerph19021016OpenAlex

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    Increasing demand on heating, ventilation, and air-conditioning (HVAC) systems and their importance, as the respiratory system of buildings, in developing and spreading various microbial contaminations and diseases with their huge global energy consumption share have forced researchers, industries, and policymakers to focus on improving the sustainability of HVAC systems. Understanding and considering various parameters related to the sustainability of new and existing HVAC systems as the respiratory system of buildings are vital to providing healthy, energy-efficient, and economical options for various building types. However, the greatest opportunities for improving the sustainability of HVAC systems exist at the design stage of new facilities and the retrofitting of existing equipment. Considering the high available percentage of existing HVAC systems globally reveals the importance of their retrofitting. The attempt has been made to gather all important parameters that affect decision-making to select the optimum HVAC system development considerations among the various…

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    Sleep Quality and Aging: A Systematic Review on Healthy Older People, Mild Cognitive Impairment and Alzheimer’s Disease

    Maria Casagrande, Giuseppe Forte, Francesca Favieri, Ilaria Corbo

    181 citationsOpen access (CC-BY)doi:10.3390/ijerph19148457OpenAlex

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    Aging is characterized by changes in the structure and quality of sleep. When the alterations in sleep become substantial, they can generate or accelerate cognitive decline, even in the absence of overt pathology. In fact, impaired sleep represents one of the earliest symptoms of Alzheimer's disease (AD). This systematic review aimed to analyze the studies on sleep quality in aging, also considering mild cognitive impairment (MCI) and AD. The review process was conducted according to the PRISMA statement. A total of 71 studies were included, and the whole sample had a mean age that ranged from 58.3 to 93.7 years (62.8-93.7 healthy participants and 61.8-86.7 pathological populations). Of these selected studies, 33 adopt subjective measurements, 31 adopt objective measures, and 10 studies used both. Pathological aging showed a worse impoverishment of sleep than older adults, in both subjective and objective measurements. The most common aspect compromised in AD and MCI were REM sleep, sleep efficiency, sleep latency, and sleep duration. These results underline that sleep alterations…

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    Avascular Necrosis of Femoral Head—Overview and Current State of the Art

    Wojciech Konarski, Tomasz Poboży, Andrzej M. Śliwczyński, Ireneusz Kotela, Jan Krakowiak and 2 more

    180 citationsOpen access (CC-BY)doi:10.3390/ijerph19127348OpenAlex

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    Avascular necrosis (AVN) of the femoral head is caused by disruption of the blood supply to the proximal femur. The alterations in the blood supply may occur following a traumatic event or result from a non-traumatic cause. Femoral neck fracture and hip dislocation and associated surgical procedures, corticosteroid therapy, and alcohol abuse frequently lead to AVN development. Type of fracture (displaced or undisplaced) and time between injury and surgery are the most critical factors in assessing the risk of developing AVN. Diagnosis of AVN can be established based on patients' complaints, medical history, and radiographic findings. There is no consensus on the treatment of patients with AVN to date. Non-surgical methods are dedicated to patients in the early pre-collapse stages of the disease and consist of pharmacotherapy and physiotherapy. Surgery is recommended for patients with advanced disease.

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    Digital Addiction and Sleep

    Birgitta Dresp, Axel Hutt

    180 citationsOpen access (CC-BY)doi:10.3390/ijerph19116910OpenAlex

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    In 2020, the World Health Organization formally recognized addiction to digital technology (connected devices) as a worldwide problem, where excessive online activity and internet use lead to inability to manage time, energy, and attention during daytime and produce disturbed sleep patterns or insomnia during nighttime. Recent studies have shown that the problem has increased in magnitude worldwide during the COVID-19 pandemic. The extent to which dysfunctional sleep is a consequence of altered motivation, memory function, mood, diet, and other lifestyle variables or results from excess of blue-light exposure when looking at digital device screens for long hours at day and night is one of many still unresolved questions. This article offers a narrative overview of some of the most recent literature on this topic. The analysis provided offers a conceptual basis for understanding digital addiction as one of the major reasons why people, and adolescents in particular, sleep less and less well in the digital age. It discusses definitions as well as mechanistic model accounts in context.…

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    Understanding Consumer Online Impulse Buying in Live Streaming E-Commerce: A Stimulus-Organism-Response Framework

    Mingwei Li, Qingjin Wang, Ying Cao

    179 citationsOpen access (CC-BY)doi:10.3390/ijerph19074378OpenAlex

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    With the proliferation of live streaming, there is evidence that online impulse buying is becoming an emerging phenomenon. Although many studies have investigated impulse buying in the context of offline shopping and business-to-consumer e-commerce, online impulse buying in live streaming has attracted little attention. In this study, we aim to explore the effect of social presence in live streaming on customer impulse buying based on the stimulus-organism-response framework. The research model presented here identifies pleasure and arousal as the mediation of impulse buying in live streaming. We use the AMOST and IBM SPSS PROCESS software to estimate our model based on data at the minute level from 189 customers, who watched live streaming in the past three months. The results suggest that the social presence of the broadcaster and the social presence of the live streamer positively affect impulse buying directly and indirectly via pleasure and arousal, promoting consumer online impulse buying in live streaming, but the social presence of the viewers has no significant effect on…

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    Current Stereotypes Associated with Nursing and Nursing Professionals: An Integrative Review

    Cristina Teresa-Morales, Margarita Rodríguez Pérez, Miriam Araujo Hernández, Carmen Feria-Ramírez

    173 citationsOpen access (CC-BY)doi:10.3390/ijerph19137640OpenAlex

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    Nursing and nursing professionals are associated with social stereotypes, which may hinder the profession's development and future prospects as a scientific discipline. The aim of this study was to identify and describe the stereotypes associated with the nursing profession-students and professionals. Therefore, we carried out an integrative review. The search was conducted using PubMed, WOS, and CINAHL databases, and its search strategy was based on a combination of standardised keywords and natural vocabulary, with a temporal limit between 2016 and 2021. The data extraction and analysis was based on the conceptual framework developed by Whittemore and Knafl. Twenty-seven studies were included in the review, and their results were classified and coded. Two categories emerged, namely, stereotypes relating to the professionals' gender and stereotypes relating to the profession itself. We concluded that the nursing profession is viewed as female with low skills, social status, salary, academic level and entry requirements, and with little autonomy. Male nurses' professional…

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    Summary Measures of Health Inequality: A Review of Existing Measures and Their Application

    Anne Schlotheuber, Ahmad Reza Hosseinpoor

    173 citationsOpen access (CC-BY)doi:10.3390/ijerph19063697OpenAlex

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    Measuring and monitoring health inequalities is key to achieving health equity. While disaggregated data are commonly used to assess differences in health between different population subgroups, summary measures of health inequality also play a vital role in monitoring health inequalities. Building on disaggregated data, they quantify the level of inequality in a single number and are useful to compare inequality over time and across different health indicators, programmes and settings. We provide a comprehensive overview of existing summary measures of health inequality, including their definition, calculation, interpretation and application. The use of these measures is illustrated based on an example from the WHO's Health Equity Monitor database using the WHO's Health Equity Assessment Toolkit (HEAT) software. We discuss the strengths and limitations of different measures and provide guidance for selecting suitable summary measures for analysing health inequalities and communicating results. Summary measures of health inequality should form an integral part of health inequality…

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    Household Pharmaceutical Waste Disposal as a Global Problem—A Review

    Justyna Rogowska, Agnieszka Ewa Zimmermann

    170 citationsOpen access (CC-BY)doi:10.3390/ijerph192315798OpenAlex

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    The negative effect of the pharmaceuticals presence (persistence?) in various components of the environment is a global problem today. These compounds are released into the environment as a result of, inter alia, their use and improper disposal. Therefore, it is important to reduce excessive drug consumption and to develop a system for the collection of unused/expired pharmaceuticals. The effectiveness of actions in this area is inextricably linked with the need to educate society on how to deal properly with unwanted medications. The aim of the study was to show that the inappropriate handling of unused/expired drugs by society is an important problem in waste management systems, and it impacts the state of the environment. Forty-eight scientific articles published between 2012 and 2021 were taken into account that discussed the systems in various countries for the collection of unused/expired pharmaceuticals. This literature review shows that the main method of disposing of unused/expired medications, according to respondents from different countries, is either by disposing of…

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    Mobile Health (m-Health) in Retrospect: The Known Unknowns

    R.S.H. Istepanian

    170 citationsOpen access (CC-BY)doi:10.3390/ijerph19073747OpenAlex

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    For nearly two decades, mobile health or (m-Health) was hailed as the most innovative and enabling area for the digital transformation of healthcare globally. However, this profound vision became a fleeting view since the inception and domination of smart phones, and the reorientation of the concept towards the exclusivity of global smart phone application markets and services. The global consumerization of m-Health in numerous disciplines of healthcare, fitness and wellness areas is unprecedented. However, this divergence between 'mobile health capitalism' and the 'science of mobile health' led to the creation of the 'm-Health schism'. This schism was sustained by the continued domination of the former on the expense of the latter. This also led to increased global m-Health inequality and divide between the much-perceived health and patient benefits and the markets of m-Health. This divergence was more evident in low and middle income (LMIC) countries compared to the developed world. This powerful yet misguided evolution of the m-Health was driven essentially by complex factors.…

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    An Evidence and Consensus-Based Definition of Second Victim: A Strategic Topic in Healthcare Quality, Patient Safety, Person-Centeredness and Human Resource Management

    Kris Vanhaecht, Deborah Seys, Sophia Russotto, Reinhard Strametz, José Joaquín Mira and 7 more

    167 citationsOpen access (CC-BY)doi:10.3390/ijerph192416869OpenAlex

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    The concept of second victims (SV) was introduced 20 years ago to draw attention to healthcare professionals involved in patient safety incidents. The objective of this paper is to advance the theoretical conceptualization and to develop a common definition. A literature search was performed in Medline, EMBASE and CINAHL (October 2010 to November 2020). The description of SV was extracted regarding three concepts: (1) involved persons, (2) content of action and (3) impact. Based on these concepts, a definition was proposed and discussed within the ERNST-COST consortium in 2021 and 2022. An international group of experts finalized the definition. In total, 83 publications were reviewed. Based on expert consensus, a second victim was defined as: "Any health care worker, directly or indirectly involved in an unanticipated adverse patient event, unintentional healthcare error, or patient injury and who becomes victimized in the sense that they are also negatively impacted". The proposed definition can be used to help to reduce the impact of incidents on both healthcare professionals and…

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    Time Spent on Social Media and Risk of Depression in Adolescents: A Dose–Response Meta-Analysis

    Mingli Liu, Kimberly E. Kamper‐DeMarco, Jie Zhang, Jia Xiao, Daifeng Dong and 1 more

    167 citationsOpen access (CC-BY)doi:10.3390/ijerph19095164OpenAlex

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    Adolescent depression is a worldwide public health concern and has contributed to significant socioeconomic burden. Investigating the association between time spent on social media (TSSM) and depression may provide guidance toward the prevention and intervention of adolescent depression. However, related literature reported mixed findings in terms of the relationship between TSSM and depression in adolescents. Hence, we conducted a comprehensive dose−response meta-analysis to clarify this issue. We conducted a systematic title/abstract and topic search of the relative terms in Web of Science, PubMed, PsycINFO databases through 9 January 2022. Odd ratios (ORs) were used to examine the pooled effect size of the association between TSSM and risk of depression. Dose−response analysis was evaluated by a generalized least squares trend estimation. Twenty-one cross-sectional studies and five longitudinal studies including a total of 55,340 participants were included. Overall, more TSSM was significantly associated with a higher risk of depression symptoms (OR = 1.60, 95%CI: 1.45 to 1.75)…

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    The Impact of the COVID-19 Pandemic on Mental Health Care of Children and Adolescents in Switzerland: Results of a Survey among Mental Health Care Professionals after One Year of COVID-19

    Anna Maria Werling, Susanne Walitza, Stephan Eliez M. D, Renate Drechsler

    167 citationsOpen access (CC-BY)doi:10.3390/ijerph19063252OpenAlex

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    BACKGROUND: To assess the impact of the COVID-19 pandemic on treatment demand and supply in children and adolescents with mental disorders during the first year of the pandemic from the perspective of child and adolescent psychiatrists and psychologists in Switzerland. METHODS: The survey was conducted anonymously, in German or French and online in April/May 2021. Mental health professionals working in child and adolescent psychiatry, psychotherapy services or independent practices were contacted by email. RESULTS: N = 454 professionals completed the survey (176 child and adolescent psychiatrists and 276 psychologists). After an initial period of decreased demand during the lockdown in spring 2020, requests for treatment increased, considerably exceeding the demand pre-pandemic and reaching a peak in January/February/March 2021. The vast majority of professionals (78.2%) estimated that there was currently too little supply during the pandemic, which differed from the evaluation of the pre-pandemic situation (37%). A total of 65% of participants indicated that waiting time until the…

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    The Burden of Microplastics Pollution and Contending Policies and Regulations

    Sunusi Usman, Ahmad Faizal Abdull Razis, Khozirah Shaari, Mohammad Noor Amal Azmai, Mohd Zamri Saad and 2 more

    165 citationsOpen access (CC-BY)doi:10.3390/ijerph19116773OpenAlex

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    The relationship between humans and plastics has become intricate due to their versatile nature and low production cost. Plastics generation has surpassed that of other manufactured products, which, coupled with the prevailing poor waste management systems, makes it a serious problem for the terrestrial and aquatic environments as its final destination. Their extensive presence has continued to pose a significant threat, not only to the aquatic ecosystem but also to the approximately 3 billion people relying on it for their livelihood. Even more disturbing were the recent findings of these plastics in food and drinking water and the evidence of human exposure, the long-term health effects of which are largely unknown. This ubiquitous phenomenon has over time put plastics under critical observation, leading to the development of many local and international policies, resolutions, and directives aimed at addressing and reversing the menace. This review provided the first snapshot of the global and local governance strategies currently aimed at mitigating plastic pollution, their…

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    Physical Activity and Body Image Perception in Adolescents: A Systematic Review

    Emanuela Gualdi‐Russo, Natascia Rinaldo, Luciana Zaccagni

    164 citationsOpen access (CC-BY)doi:10.3390/ijerph192013190OpenAlex

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    Adolescence represents a vulnerable phase of life for psychological health. The practice of physical activity (PA) appears to have a positive influence on adolescents, increasing self-esteem and producing a more positive body image. A systematic review of published articles over the past 10 years until June 2022 was conducted according to the PRISMA statement employing the electronic databases MEDLINE and Web of Science (639 records) to summarize the literature on the relationship between body image dissatisfaction (BID) and assessed by figural scales and practice of structured and unstructured PA in adolescents (10-18 years), taking into account BMI and/or weight status. All articles were independently reviewed using inclusion/exclusion criteria, retrieved data, and assessed quality with the adapted Newcastle-Ottawa Scale for observational studies. The main finding of interest that emerged from most of the 28 included studies is the negative association between BID and PA during adolescence: as PA increases, BID decreases. However, this updated systematic review also identified…

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    Early Prediction of Diabetes Using an Ensemble of Machine Learning Models

    Aishwariya Dutta, Md. Abdul Awal, Mohiuddin Ahmad, Md. Abdul Awal, Md. Abdul Awal and 2 more

    164 citationsOpen access (CC-BY)doi:10.3390/ijerph191912378OpenAlex

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    Diabetes is one of the most rapidly spreading diseases in the world, resulting in an array of significant complications, including cardiovascular disease, kidney failure, diabetic retinopathy, and neuropathy, among others, which contribute to an increase in morbidity and mortality rate. If diabetes is diagnosed at an early stage, its severity and underlying risk factors can be significantly reduced. However, there is a shortage of labeled data and the occurrence of outliers or data missingness in clinical datasets that are reliable and effective for diabetes prediction, making it a challenging endeavor. Therefore, we introduce a newly labeled diabetes dataset from a South Asian nation (Bangladesh). In addition, we suggest an automated classification pipeline that includes a weighted ensemble of machine learning (ML) classifiers: Naive Bayes (NB), Random Forest (RF), Decision Tree (DT), XGBoost (XGB), and LightGBM (LGB). Grid search hyperparameter optimization is employed to tune the critical hyperparameters of these ML models. Furthermore, missing value imputation, feature…

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    Striking a Balance between Work and Play: The Effects of Work–Life Interference and Burnout on Faculty Turnover Intentions and Career Satisfaction

    Sheila A. Boamah, Hanadi Y Hamadi, Farinaz Havaei, Hailey J. Smith, Fern Jureidini Webb

    164 citationsOpen access (CC-BY)doi:10.3390/ijerph19020809OpenAlex

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    BACKGROUND: The interactions between work and personal life are important for ensuring well-being, especially during COVID-19 where the lines between work and home are blurred. Work-life interference/imbalance can result in work-related burnout, which has been shown to have negative effects on faculty members' physical and psychological health. Although our understanding of burnout has advanced considerably in recent years, little is known about the effects of burnout on nursing faculty turnover intentions and career satisfaction. OBJECTIVE: To test a hypothesized model examining the effects of work-life interference on nursing faculty burnout (emotional exhaustion and cynicism), turnover intentions and, ultimately, career satisfaction. DESIGN: A predictive cross-sectional design was used. SETTINGS: An online national survey of nursing faculty members was administered throughout Canada in summer 2021. PARTICIPANTS: Nursing faculty who held full-time or part-time positions in Canadian academic settings were invited via email to participate in the study. METHODS: Data were collected…

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    Risk Perception towards COVID-19: A Systematic Review and Qualitative Synthesis

    Sabrina Cipolletta, Gabriela Rios Andreghetti, Giovanna Mioni

    163 citationsOpen access (CC-BY)doi:10.3390/ijerph19084649OpenAlex

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    Several studies have attempted to identify how people’s risk perceptions differ in regard to containing COVID-19 infections. The aim of the present review was to illustrate how risk awareness towards COVID-19 predicts people’s preventive behaviors and to understand which features are associated with it. For the review, 77 articles found in six different databases (ProQuest, PsycInfo, PubMed, Science Direct, SCOPUS, and Web of Science) were considered, the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines was followed, and data synthesis was conducted using a mixed-methods approach. The results indicate that a high-risk perception towards COVID-19 predicts, in general, compliance with preventive behaviors and social distancing measures. Additionally, risk awareness was found to be associated with four other key themes: demographic factors, individual factors, geographical factors, and timing. Therefore, gaining a greater understanding of individual and cultural differences as well as how people behave could be the basis of an effective strategy…

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    Impact of Work Stress and Job Burnout on Turnover Intentions among Hotel Employees

    Wagih Salama, Ahmed Hassan Abdou, Shaimaa Abo Khanger Mohamed, Hossam Said Shehata

    162 citationsOpen access (CC-BY)doi:10.3390/ijerph19159724OpenAlex

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    This research aims primarily to shed light on the impact of work stress and job burnout on employees’ turnover intention in the hotel industry. Furthermore, it aims to identify the effect of work stress on job burnout besides examining the potential mediating role of job burnout in the relationship between work stress and employees’ turnover intentions in Egyptian hotels. For achieving this aim, the questionnaire was designed for Egyptian hotel employees and structured to cover four key parts: (1) demographic characteristics of employees of hotels, (2) work stress items, (3) job burnout items, and (4) turnover intentions. Structural equation modeling (SEM) results were obtained using AMOS software, IBM, version 24. The results indicate that job burnout partially mediates the relationship between work stress and turnover intentions. To be more specific, work stress has a significant positive effect on the turnover intention (β = +0.40, p < 0.01), and a significant positive effect on job burnout (β = +0.43 p < 0.01). Thus, there exists a strong positive association between work stress…

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    Positive Effects of Digital Technology Use by Adolescents: A Scoping Review of the Literature

    Aaron D. Haddock, Nadia L. Ward, Rondy Yu, Nicole O’Dea

    161 citationsOpen access (CC-BY)doi:10.3390/ijerph192114009OpenAlex

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    This study examines the research literature published from 2012 to 2022 on the relationship between increases in adolescent consumption of digital technologies and its impact on multiple areas of development, with a focus on how adolescent immersion in an increasingly ubiquitous digital world engenders positive outcomes in terms of brain, cognitive, and social-emotional development. The literature search yielded 131 articles, 53 of which were empirical studies of the relationship between increases in consumption of digital technology and brain development, cognitive development, or social-emotional development among adolescents. Overall, these studies identify positive outcomes for adolescents who use different types of digital tech, including the internet, social media, and video games.

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    Interaction between Digital Economy and Environmental Pollution: New Evidence from a Spatial Perspective

    Sa Xu, Cunyi Yang, Zhehao Huang, Pierre Failler

    161 citationsOpen access (CC-BY)doi:10.3390/ijerph19095074OpenAlex

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    The digital economy and the green economy are two major issues for economic recovery in the post epidemic era. From spatial interaction spillover, we analyze and measure the relationships between the digital economy and environmental pollution in 287 prefecture-level cities in China from 2008 to 2018 using simultaneous spatial equations and the generalized 3-stage least square (GS3SLS) method. The results show that: (1) there is a reverse and complex spatio-temporal evolution of the digital economy and environmental pollution in Chinese cities. (2) There is a spatial interaction spillover effect between the digital economy and environmental pollution. Local digital economy and environmental pollution inhibit each other. The digital economy and environmental pollution have a significant spatial spillover. The digital economy of surrounding regions has a suppressive effect on local environmental pollution. The environmental pollution of surrounding cities has a crowding-out effect on the local digital economy. (3) Digital economy suppresses environmental pollution through the green…

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    Advancements in Monitoring Water Quality Based on Various Sensing Methods: A Systematic Review

    Siti Nadhirah Zainurin, Wan Zakiah Wan Ismail, Siti Nurul Iman Mahamud, Irneza Ismail, Juliza Jamaludin and 2 more

    160 citationsOpen access (CC-BY)doi:10.3390/ijerph192114080OpenAlex

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    Nowadays, water pollution has become a global issue affecting most countries in the world. Water quality should be monitored to alert authorities on water pollution, so that action can be taken quickly. The objective of the review is to study various conventional and modern methods of monitoring water quality to identify the strengths and weaknesses of the methods. The methods include the Internet of Things (IoT), virtual sensing, cyber-physical system (CPS), and optical techniques. In this review, water quality monitoring systems and process control in several countries, such as New Zealand, China, Serbia, Bangladesh, Malaysia, and India, are discussed. Conventional and modern methods are compared in terms of parameters, complexity, and reliability. Recent methods of water quality monitoring techniques are also reviewed to study any loopholes in modern methods. We found that CPS is suitable for monitoring water quality due to a good combination of physical and computational algorithms. Its embedded sensors, processors, and actuators can be designed to detect and interact with…

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    Titanium Dioxide: Structure, Impact, and Toxicity

    Anca Diana Racovita

    159 citationsOpen access (CC-BY)doi:10.3390/ijerph19095681OpenAlex

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    Titanium dioxide, first manufactured a century ago, is significant in industry due to its chemical inertness, low cost, and availability. The white mineral has a wide range of applications in photocatalysis, in the pharmaceutical industry, and in food processing sectors. Its practical uses stem from its dual feature to act as both a semiconductor and light scatterer. Optical performance is therefore of relevance in understanding how titanium dioxide impacts these industries. Recent breakthroughs are summarised herein, focusing on whether restructuring the surface properties of titanium dioxide either enhances or inhibits its reactivity, depending on the required application. Its recent exposure as a potential carcinogen to humans has been linked to controversies around titanium dioxide's toxicity; this is discussed by illustrating discrepancies between experimental protocols of toxicity assays and their results. In all, it is important to review the latest achievements in fast-growing industries where titanium dioxide prevails, while keeping in mind insights into its disputed…

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    The Adverse Effects of Air Pollution on the Eye: A Review

    Chia‐Ching Lin, Chien‐Chih Chiu, Po‐Yen Lee, Kuo‐Jen Chen, Chenxi He and 2 more

    156 citationsOpen access (CC-BY)doi:10.3390/ijerph19031186OpenAlex

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    Air pollution is inevitably the result of human civilization, industrialization, and globalization. It is composed of a mixture of gases and particles at harmful levels. Particulate matter (PM), nitrogen oxides (NOx), and carbon dioxides (CO2) are mainly generated from vehicle emissions and fuel consumption and are the main materials causing outdoor air pollution. Exposure to polluted outdoor air has been proven to be harmful to human eyes. On the other hand, indoor air pollution from environmental tobacco smoking, heating, cooking, or poor indoor ventilation is also related to several eye diseases, including conjunctivitis, glaucoma, cataracts, and age-related macular degeneration (AMD). In the past 30 years, no updated review has provided an overview of the impact of air pollution on the eye. We reviewed reports on air pollution and eye diseases in the last three decades in the PubMed database, Medline databases, and Google Scholar and discussed the effect of various outdoor and indoor pollutants on human eyes.

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    Healthy and Happy Working from Home? Effects of Working from Home on Employee Health and Job Satisfaction

    Fiona Niebuhr, Prem Borle, Franziska Boerner-Zobel, Susanne Voelter‐Mahlknecht

    154 citationsOpen access (CC-BY)doi:10.3390/ijerph19031122OpenAlex

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    In addition to its catastrophic health effects, the COVID-19 pandemic also acts as a catalyst for new forms of work. Working from home (WFH) has become commonplace for many people worldwide. But under what circumstances is WFH beneficial and when does it increase harms to health? The aim of this study was to investigate the influence of specific characteristics of WFH for health (work ability, stress-related physical and psychological symptoms) and job satisfaction among German employees. The study is based on data from a Germany-wide panel survey with employees from different industries (n = 519). Using multiple regressions, it was found that the functionality of the technical equipment at home has positive effects on the health of employees (i.e., ability to work, stress-related symptoms) and job satisfaction. The percentual weekly amount of WFH influences stress-related symptoms, i.e., a higher amount of weekly working time WFH, was associated with more stress-related symptoms. Furthermore, it negatively influences job satisfaction. The feeling of increased autonomy leads to…

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    Patient Satisfaction with Telemedicine during the COVID-19 Pandemic—A Systematic Review

    Karolina Pogorzelska, Sławomir Chlabicz

    153 citationsOpen access (CC-BY)doi:10.3390/ijerph19106113OpenAlex

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    Telemedicine is a convenient tool for providing medical care remotely. It is routinely offered as an alternative to face-to-face consultations in healthcare settings all over the world. Due to the COVID-19 pandemic and increased use of telemedicine in everyday clinical practice, the effectiveness of this modality and patient satisfaction with telemedicine is a subject of growing concern. PubMed and Google Scholar databases were searched. Papers published between January 2020 and August 2021 which met inclusion and exclusion criteria were analyzed. During the COVID-19 pandemic patients have found telemedicine a beneficial tool for consulting healthcare providers. A high level of satisfaction with telehealth was observed in each study across every medical specialty. Telemedicine is undoubtedly a convenient tool that has helped ensure continuity of medical care during the COVID-19 pandemic thanks to its considerable potential. In particular situations, telehealth may adequately replace face-to-face consultation. Regular patients' feedback is necessary to improve the use of telemedicine…

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    Ketogenic Diet Benefits to Weight Loss, Glycemic Control, and Lipid Profiles in Overweight Patients with Type 2 Diabetes Mellitus: A Meta-Analysis of Randomized Controlled Trails

    Chong Zhou, Meng Wang, Jiling Liang, HE Guo-min, Ning Chen

    151 citationsOpen access (CC-BY)doi:10.3390/ijerph191610429OpenAlex

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    A ketogenic diet, characterized by low calories with high levels of fat, adequate levels of protein, and low levels of carbohydrates, has beneficial effects on body weight control in overweight patients. In the present study, a meta-analysis was conducted to investigate the role of a ketogenic diet in body weight control and glycemic management in overweight patients with type 2 diabetes mellitus (T2DM). In summary, we systematically reviewed articles from the Embase, PubMed, Web of Science and Cochrane Library databases and obtained eight randomized controlled trials for meta-analysis. The results show that a ketogenic diet had significantly beneficial effects on the loss of body weight (SMD, −5.63, p = 0.008), the reduction of waist circumference (SMD, −2.32, p = 0.04), lowering glycated hemoglobin (SMD, −0.38, p = 0.0008) and triglycerides (SMD, −0.36, p = 0.0001), and increasing high-density lipoproteins (SMD, 0.28, p = 0.003). Overall, these results suggest that a ketogenic diet may be an effective dietary intervention for body weight and glycemic control, as well as improved…

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    Nature-Based Early Childhood Education and Children’s Social, Emotional and Cognitive Development: A Mixed-Methods Systematic Review

    Avril Johnstone, Anne Martin, Rita Cordovil, Ingunn Fjørtoft, Susanna Iivonen and 6 more

    151 citationsOpen access (CC-BY)doi:10.3390/ijerph19105967OpenAlex

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    This systematic review synthesised evidence on associations between nature-based early childhood education (ECE) and children’s social, emotional, and cognitive development. A search of nine databases was concluded in August 2020. Studies were eligible if: (a) children (2–7 years) attended ECE, (b) ECE integrated nature, and (c) assessed child-level outcomes. Two reviewers independently screened full-text articles and assessed study quality. Synthesis included effect direction, thematic analysis, and results-based convergent synthesis. One thousand three hundred and seventy full-text articles were screened, and 36 (26 quantitative; 9 qualitative; 1 mixed-methods) studies were eligible. Quantitative outcomes were cognitive (n = 11), social and emotional (n = 13), nature connectedness (n = 9), and play (n = 10). Studies included controlled (n = 6)/uncontrolled (n = 6) before-after, and cross-sectional (n = 15) designs. Based on very low certainty of the evidence, there were positive associations between nature-based ECE and self-regulation, social skills, social and emotional…

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    Detecting and Analyzing Suicidal Ideation on Social Media Using Deep Learning and Machine Learning Models

    Theyazn H. H. Aldhyani, Saleh Nagi Alsubari, Ali Saleh Alshebami, Hasan Shojaa Alkahtani, Zeyad A. T. Ahmed

    150 citationsOpen access (CC-BY)doi:10.3390/ijerph191912635OpenAlex

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    Individuals who suffer from suicidal ideation frequently express their views and ideas on social media. Thus, several studies found that people who are contemplating suicide can be identified by analyzing social media posts. However, finding and comprehending patterns of suicidal ideation represent a challenging task. Therefore, it is essential to develop a machine learning system for automated early detection of suicidal ideation or any abrupt changes in a user's behavior by analyzing his or her posts on social media. In this paper, we propose a methodology based on experimental research for building a suicidal ideation detection system using publicly available Reddit datasets, word-embedding approaches, such as TF-IDF and Word2Vec, for text representation, and hybrid deep learning and machine learning algorithms for classification. A convolutional neural network and Bidirectional long short-term memory (CNN-BiLSTM) model and the machine learning XGBoost model were used to classify social posts as suicidal or non-suicidal using textual and LIWC-22-based features by conducting two…

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    Protein Intake and Sarcopenia in Older Adults: A Systematic Review and Meta-Analysis

    Hélio José Coelho‐Júnior, Riccardo Calvani, Domenico Azzolino, Anna Picca, Matteo Tosato and 3 more

    150 citationsOpen access (CC-BY)doi:10.3390/ijerph19148718OpenAlex

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    BACKGROUND: The present systematic review and meta-analysis investigated the cross-sectional and longitudinal associations between protein intake and sarcopenia in older adults. METHODS: Observational studies that investigated the association between protein intake and sarcopenia as the primary or secondary outcome in people aged 60 years and older were included. Studies published in languages other than English, Italian, Portuguese, and Spanish were excluded. Studies were retrieved from MEDLINE, SCOPUS, EMBASE, CINAHL, AgeLine, and Food Science Source databases through January 31, 2022. A pooled effect size was calculated based on standard mean differences. RESULTS: Five cross-sectional studies, one longitudinal study, and one case-control study that investigated 3353 community-dwelling older adults with a mean age of approximately 73 years were included. The meta-analysis of four studies indicated that older adults with sarcopenia consumed significantly less protein than their peers with no sarcopenia. CONCLUSIONS: Results of the present study suggest that an inadequate protein…

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    Bibliometric Analysis of Publications on the Omicron Variant from 2020 to 2022 in the Scopus Database Using R and VOSviewer

    Hasan Ejaz, Hafiz Muhammad Zeeshan, Fahad Ahmad, Syed Nasir Abbas Bukhari, Naeem Anwar and 8 more

    149 citationsOpen access (CC-BY)doi:10.3390/ijerph191912407OpenAlex

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    Human respiratory infections caused by coronaviruses can range from mild to deadly. Although there are numerous studies on coronavirus disease 2019 (COVID-19), few have been published on its Omicron variant. In order to remedy this deficiency, this study undertook a bibliometric analysis of the publishing patterns of studies on the Omicron variant and identified hotspots. Automated transportation, environmental protection, improved healthcare, innovation in banking, and smart homes are just a few areas where machine learning has found use in tackling complicated problems. The sophisticated Scopus database was queried for papers with the term "Omicron" in the title published between January 2020 and June 2022. Microsoft Excel 365, VOSviewer, Bibliometrix, and Biblioshiny from R were used for a statistical analysis of the publications. Over the study period, 1917 relevant publications were found in the Scopus database. Viruses was the most popular in publications for Omicron variant research, with 150 papers published, while Cell was the most cited source. The bibliometric analysis…

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    Influence of COVID-19-Related Restrictions on the Prevalence of Overweight and Obese Czech Children

    Anna Vážná, Jana Vignerová, Marek Brabec, Jan M. Novák, Bohuslav Procházka and 2 more

    149 citationsOpen access (CC-BY)doi:10.3390/ijerph191911902OpenAlex

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    Apart from influencing the health of the worldwide population, the COVID-19 pandemic changed the day-to-day life of all, including children. A sedentary lifestyle along with the transformation of eating and sleep habits took place in the child population. These changes created a highly obesogenic environment. Our aim was to evaluate the current weight in the child population and identify the real effects of the pandemic. Height and weight data were collected by pediatricians from the pre-COVID-19 and post-COVID-19 periods from 3517 children (1759 boys and 1758 girls) aged 4.71 to 17.33 years. We found a significant rise in the z-score BMI between pediatric visits in the years 2019 and 2021 in both sexes aged 7, 9, 11, and 13 years. Especially alarming were the percentages of (severely) obese boys at the ages of 9 and 11 years, which exceed even the percentages of overweight boys. With the use of statistical modeling, we registered the most dramatic increment at around 12 years of age in both sexes. Based on our research in the Czech Republic, we can confirm the predictions that were…

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    The Relationship among College Students’ Physical Exercise, Self-Efficacy, Emotional Intelligence, and Subjective Well-Being

    Kun Wang, Yan Li, Tingran Zhang, Jiong Luo

    148 citationsOpen access (CC-BY)doi:10.3390/ijerph191811596OpenAlex

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    PURPOSE: To deeply analyze the influencing factors on college students' subjective well-being and the path mechanism between each factor. METHOD: The physical activity rating scale (PARS-3), the emotional intelligence scale (EIS), the self-efficacy scale (GSES), and the subjective well-being scale (SWS) were used for 826 students from two comprehensive universities in southwest China. College students conducted a questionnaire survey, and used SPSS22.0 and AMOS21.0 statistical software to process and analyze the obtained data. RESULTS: (1) Physical exercise was significantly positively correlated with self-efficacy, emotional intelligence, and subjective well-being; self-efficacy was significantly positively correlated with emotional intelligence and subjective well-being; emotional intelligence was significantly positively correlated with subjective well-being; (2) Physical exercise has a direct positive predictive effect on subjective well-being (ES = 0.16); (3) Self-efficacy (ES = 0.057) and emotional intelligence (ES = 0.077) play a part in mediating the role between physical…

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    Prevalence of Orthodontic Malocclusions in Healthy Children and Adolescents: A Systematic Review

    Lutgart De Ridder, Antonia Aleksieva, Guy Willems, Dominique Declerck, María Cadenas de Llano‐Pérula

    147 citationsOpen access (CC-BY)doi:10.3390/ijerph19127446OpenAlex

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    The purpose of this study was to systematically review the literature regarding the prevalence of malocclusion and different orthodontic features in children and adolescents. METHODS: The digital databases PubMed, Cochrane, Embase, Open Grey, and Web of Science were searched from inception to November 2021. Epidemiological studies, randomized controlled trials, clinical trials, and comparative studies involving subjects ≤ 18 years old and focusing on the prevalence of malocclusion and different orthodontic features were selected. Articles written in English, Dutch, French, German, Spanish, and Portuguese were included. Three authors independently assessed the eligibility, extracted the data from, and ascertained the quality of the studies. Since all of the included articles were non-randomized, the MINORS tool was used to score the risk of bias. RESULTS: The initial electronic database search identified a total of 6775 articles. After the removal of duplicates, 4646 articles were screened using the title and abstract. A total of 415 full-text articles were assessed, and 123 articles…

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    Climate Changes, Natural Resources Depletion, COVID-19 Pandemic, and Russian-Ukrainian War: What Is the Impact on Habits Change and Mental Health?

    Benedetta Barchielli, Clarissa Cricenti, Francesca Gallé, Elita Anna Sabella, Fabrizio Liguori and 6 more

    146 citationsOpen access (CC-BY)doi:10.3390/ijerph191911929OpenAlex

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    Climate Change, Natural Resources Depletion, COVID-19, and Wars are some of the great challenges of our time. The consequences will affect psychological well-being and could have a harmful impact on mental health. This study aimed to assess the level of preoccupation and fears surrounding issues of the 21st-century and the implication for psychological well-being of the general population from Central/Southern Italy among different age groups. A questionnaire that included sociodemographic characteristics, topics formulated ad-hoc about preoccupation, fears, habits, and willingness to change habits in the future related to the 21st-century challenges, and the Depression Anxiety Stress Scales 21 (DASS-21) was administered online. A sample of 1831 participants (61% F; mean age 47.71 ± 17.30) was obtained. Results showed that young adults and older adults, respectively, reported greater and less psychological well-being. Young adults reported higher scores for preoccupation, changing habits, and willingness to change habits in the future, while older adults reported the lowest scores…

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    Barriers and Facilitators to Sustaining School-Based Mental Health and Wellbeing Interventions: A Systematic Review

    Anna March, Emily Stapley, Daniel Hayes, Rosa Town, Jessica Deighton

    146 citationsOpen access (CC-BY)doi:10.3390/ijerph19063587OpenAlex

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    Despite an increasing focus on schools to deliver support and education around mental health and wellbeing, interventions are often not sustained beyond initial funding and research. In this review, the barriers and facilitators to sustaining mental health and wellbeing interventions in schools are explored. A systematic review was conducted using keywords based on the terms: 'sustainability', 'school', 'intervention', 'mental health', and 'emotional wellbeing'. Six online databases (PsycINFO, Embase, MEDLINE, British Education Index, ERIC, and Web of Science) and relevant websites were searched resulting in 6160 unique references. After screening, 10 articles were included in the review and extracted data were qualitatively synthesized using thematic analysis. Data synthesis led to the identification of four sustainability factors at the school level (school leadership, staff engagement, intervention characteristics, and resources) and one at the wider system level (external support). These factors were separated into 15 themes and discussed as barriers and facilitators to…

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    Prevalence and Risk Factors Associated with Postpartum Depression during the COVID-19 Pandemic: A Literature Review and Meta-Analysis

    Qianqian Chen, Wenjie Li, Juan Xiong, Xujuan Zheng

    146 citationsOpen access (CC-BY)doi:10.3390/ijerph19042219OpenAlex

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    BACKGROUND: Owing to the high prevalence and detrimental consequences, postpartum depression (PPD) has been identified as one of the severe global public health issues in the last decade. Prior research found that during disasters or events, the prevalence rates of mental disorders among postpartum women are significantly high. However, the effect of the coronavirus disease 2019 (COVID-19) pandemic on PPD and its risk factors remained unclear for postpartum women. Therefore, the present systematic review and meta-analysis aimed to estimate the influence of the COVID-19 pandemic on the prevalence of PPD and to summarize risk factors for PPD during the COVID-19 pandemic. METHODS: Three electronic databases of MEDLINE, EMBASE, and Cochrane library databases were systematically searched for articles from their commencements until 1 November 2021. Quality assessment of included studies, random-effects meta-analysis, and sensitivity analysis were performed. RESULTS: A total of eight studies with 6480 postpartum women during the COVID-19 pandemic were included, and most studies were…

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    A Roadmap toward Achieving Sustainable Environment: Evaluating the Impact of Technological Innovation and Globalization on Load Capacity Factor

    Abraham Ayobamiji Awosusi, Kaan KUTLAY, Mehmet Altuntaş, Bakhtiyor Khodjiev, Ephraim Bonah Agyekum and 3 more

    144 citationsOpen access (CC-BY)doi:10.3390/ijerph19063288OpenAlex

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    Technological innovations have been a matter of contention, and their environmental consequences remain unresolved. Moreover, studies have extensively evaluated environmental challenges using metrics such as nitrogen oxide emissions, sulfur dioxide, carbon emissions, and ecological footprint. The environment has the supply and demand aspect, which is not a component of any of these indicators. By measuring biocapacity and ecological footprint, the load capacity factor follows a certain ecological threshold, allowing for a thorough study on environmental deterioration. With the reduction in load capacity factor, the environmental deterioration increases. In the context of the environment, the interaction between technological innovation and load capacity covers the demand and supply side of the environment. In light of this, employing the dataset ranging from 1980 to 2017 for the case of South Africa, the bound cointegration test in conjunction with the critical value of Kripfganz and Schneider showed cointegration in the model. The study also employed the ARDL, whose outcome…

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    Systematic Comparison of OWAS, RULA, and REBA Based on a Literature Review

    Dohyung Kee

    144 citationsOpen access (CC-BY)doi:10.3390/ijerph19010595OpenAlex

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    This study aimed to systematically compare three representative observational methods for assessing musculoskeletal loadings and their association with musculoskeletal disorders (MSDs): Ovako Working Posture Analysis System (OWAS), Rapid Upper Limb Assessment (RULA), and Rapid Entire Body Assessment (REBA). The comparison was based on a literature review without time limitations and was conducted on various factors related to observational methods. The comparisons showed that although it has a significant limitation of comprising only two classifications for the leg postures, (1) the RULA is the most frequently used method among the three techniques; (2) many studies adopted the RULA even in evaluation of unstable lower limb postures; (3) the RULA assessed postural loads as higher risk levels in most studies reviewed in this research; (4) the intra- and inter-reliabilities for the RULA were not low; and (5) the risk levels assessed by the RULA were more significantly associated with postural load criteria such as discomfort, MHTs and % capable at the trunk, and MSDs.

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    Artificial Intelligence Implementation in Healthcare: A Theory-Based Scoping Review of Barriers and Facilitators

    Taridzo Chomutare, Miguel Tejedor, Therese Olsen Svenning, Luis Marco-Ruiz, Maryam Tayefi and 6 more

    143 citationsOpen access (CC-BY)doi:10.3390/ijerph192316359OpenAlex

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    There is a large proliferation of complex data-driven artificial intelligence (AI) applications in many aspects of our daily lives, but their implementation in healthcare is still limited. This scoping review takes a theoretical approach to examine the barriers and facilitators based on empirical data from existing implementations. We searched the major databases of relevant scientific publications for articles related to AI in clinical settings, published between 2015 and 2021. Based on the theoretical constructs of the Consolidated Framework for Implementation Research (CFIR), we used a deductive, followed by an inductive, approach to extract facilitators and barriers. After screening 2784 studies, 19 studies were included in this review. Most of the cited facilitators were related to engagement with and management of the implementation process, while the most cited barriers dealt with the intervention's generalizability and interoperability with existing systems, as well as the inner settings' data quality and availability. We noted per-study imbalances related to the reporting…

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    Coping and Resilience Strategies among Ukraine War Refugees

    Lluís Oviedo, Berenika Seryczyńska, Josefa Torralba, Piotr Roszak, Javier Del Angel and 3 more

    143 citationsOpen access (CC-BY)doi:10.3390/ijerph192013094OpenAlex

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    (1) Background: The war in Ukraine has triggered a huge humanitarian crisis: millions of refugees have escaped from their homes looking for shelter beyond Ukraine's borders. This emergency offers a unique opportunity to investigate and to document those characteristics of the human condition that emerge in exceptional circumstances provoked by war. Based on considerations derived from recent studies on resilience, the research at the base of this paper was conducted to better understand the circumstances, states of mind, and coping mechanisms of the refugees leaving their homes looking for security. (2) Methods: A qualitative approach was applied, resorting to semi-structured interviews (n = 94) to closely explore the traumatic experiences lived by refugees and to identify their coping strategies. (3) Results: The data obtained pointed to a plurality of coping and resilience strategies. Maintaining communication with separated loved ones as well as experiencing accompaniment by helpers and hosts emerged as principal elements for coping and resilience. It was found that a prior…

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    Smartphone Addiction Prevalence and Its Association on Academic Performance, Physical Health, and Mental Well-Being among University Students in Umm Al-Qura University (UQU), Saudi Arabia

    Mohammad Saud Alotaibi, Mim Fox, Robyn L. Coman, Zubair Ahmed Ratan, Hassan Hosseinzadeh

    143 citationsOpen access (CC-BY)doi:10.3390/ijerph19063710OpenAlex

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    Smartphone use can lead to smartphone addiction, which is a growing concern worldwide. However, there are limited studies about smartphone addiction and its impacts on university students in Saudi Arabia. This study aims to fill this gap. This is a quantitative study conducted among undergraduate students in Umm Al-Qura University (UQU), Saudi Arabia from May 2019 and February 2021. Study data were collected using both online and hard copy administered surveys. A self-administered questionnaire, Grade point average, Smartphone Addiction Short Version, and Kessler Psychological Distress scales were used to assess the outcomes. A total of 545 undergraduate students, mostly females, aged ≤ 21 years old and lived with large family sizes. More than half owned a smartphone for 5-8 years and the majority used their smartphone on average 6-11 h per day for social networking (82.6%), entertainment (66.2%) and web surfing (59.6%). Most of the participants were smartphone-addicted (67.0%). Logistic regression analysis showed that age ≤ 21, not gainfully employed, small family size and high…

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    A Systematic Review of the Effect of Centella asiatica on Wound Healing

    Elena Arribas López, Nazanin Zand, Omorogieva Ojo, Martin John Snowden, Tony Kochhar

    143 citationsOpen access (CC-BY)doi:10.3390/ijerph19063266OpenAlex

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    Background: Under metabolic stress conditions, there is a higher demand for nutrients which needs to be met. This is to reduce the risk of delay in wound healing which could lead to chronic wound. Aim: This is a systematic review of the effect of Centella asiatica on wound healing. C. asiatica is a traditional medicinal plant used due to its antimicrobial, antioxidant, anti-inflammatory, neuroprotective, and wound healing properties. Methods: PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines were followed for the systematic review and four electronic databases were used. Results: Four clinical trials met the inclusion criteria. The following distinct areas were identified under C. asiatica: wound contraction and granulation; healing/bleeding time and re-epithelialization; VAS (visual analogue scale) scores; skin erythema and wound appearance. Conclusions: C. asiatica might enhance wound healing resulting from improved angiogenesis. This might occur due to its stimulating effect on collagen I, Fibroblast Growth Factor (FGF) and Vascular…

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    Overcoming the “Dark Side” of Technology—A Scoping Review on Preventing and Coping with Work-Related Technostress

    Elisabeth Rohwer, Joelle‐Cathrin Flöther, Volker Harth, Stefanie Mache

    142 citationsOpen access (CC-BY)doi:10.3390/ijerph19063625OpenAlex

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    In the course of the digitalisation of work, the phenomenon of technostress is increasingly being examined. While there is a plethora of research on its causes and consequences, a growing body of research on mitigating work-related technostress is emerging. In order to identify opportunities to overcome this "dark side" of technology, this scoping review aims to provide a comprehensive overview of the current state of research on how to prevent and cope with work-related technostress. The databases PubMed, MEDLINE, PsycInfo, PSYNDEX, and Web of Science were searched in the time period between 2008 and 2021. The studies were screened independently by two authors and selected based on predefined inclusion and exclusion criteria. Sixty-two studies were included and their methodological quality was assessed using standardised checklists. Resources were identified at the technical, organisational, social and personal level, including, e.g., leadership, organisational and technical support as well as self-efficacy and IT mindfulness. Problem- and emotion-focused coping strategies were,…

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    Antiviral Drugs in Influenza

    Magdalena Świerczyńska, Dagmara Maria Mirowska-Guzel, Edyta Pindelska

    142 citationsOpen access (CC-BY)doi:10.3390/ijerph19053018OpenAlex

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    Flu is a serious health, medical, and economic problem, but no therapy is yet available that has satisfactory results and reduces the occurrence of these problems. Nearly 20 years after the registration of the previous therapy, baloxavir marboxil, a drug with a new mechanism of action, recently appeared on the market. This is a promising step in the fight against the influenza virus. This article presents the possibilities of using all available antiviral drugs specific for influenza A and B. We compare all currently recommended anti-influenza medications, considering their mechanisms of action, administration, indications, target groups, effectiveness, and safety profiles. We demonstrate that baloxavir marboxil presents a similar safety and efficacy profile to those of drugs already used in the treatment of influenza. Further research on combination therapy is highly recommended and may have promising results.

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    Virtual Reality Aided Therapy towards Health 4.0: A Two-Decade Bibliometric Analysis

    Zhen Liu, Lingfeng Ren, Chang Xiao, Ke Zhang, Peter Demian

    142 citationsOpen access (CC-BY)doi:10.3390/ijerph19031525OpenAlex

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    Health 4.0 aligns with Industry 4.0 and encourages the application of the latest technologies to healthcare. Virtual reality (VR) is a potentially significant component of the Health 4.0 vision. Though VR in health care is a popular topic, there is little knowledge of VR-aided therapy from a macro perspective. Therefore, this paper was aimed to explore the research of VR in aiding therapy, thus providing a potential guideline for futures application of therapeutic VR in healthcare towards Health 4.0. A mixed research method was adopted for this research, which comprised the use of a bibliometric analysis (a quantitative method) to conduct a macro overview of VR-aided therapy, the identification of significant research structures and topics, and a qualitative review of the literature to reveal deeper insights. Four major research areas of VR-aided therapy were identified and investigated, i.e., post-traumatic stress disorder (PTSD), anxiety and fear related disorder (A&F), diseases of the nervous system (DNS), and pain management, including related medical conditions, therapies,…

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    Measuring Comprehensive, General Health Literacy in the General Adult Population: The Development and Validation of the HLS19-Q12 Instrument in Seventeen Countries

    Jürgen M. Pelikan, Thomas Link, Christa Straßmayr, Karin Waldherr, Tobias Alfers and 7 more

    141 citationsOpen access (CC-BY)doi:10.3390/ijerph192114129OpenAlex

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    Background: For improving health literacy (HL) by national and international public health policy, measuring population HL by a comprehensive instrument is needed. A short instrument, the HLS19-Q12 based on the HLS-EU-Q47, was developed, translated, applied, and validated in 17 countries in the WHO European Region. Methods: For factorial validity/dimensionality, Cronbach alphas, confirmatory factor analysis (CFA), Rasch model (RM), and Partial Credit Model (PCM) were used. For discriminant validity, correlation analysis, and for concurrent predictive validity, linear regression analysis were carried out. Results: The Cronbach alpha coefficients are above 0.7. The fit indices for the single-factor CFAs indicate a good model fit. Some items show differential item functioning in certain country data sets. The regression analyses demonstrate an association of the HLS19-Q12 score with social determinants and selected consequences of HL. The HLS19-Q12 score correlates sufficiently highly (r ≥ 0.897) with the equivalent score for the HLS19-Q47 long form. Conclusions: The HLS19-Q12, based…

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    Understanding the Spectrum of Anxiety Responses to Climate Change: A Systematic Review of the Qualitative Literature

    Catriona Soutar, Anne P. F. Wand

    141 citationsOpen access (CC-BY)doi:10.3390/ijerph19020990OpenAlex

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    BACKGROUND: Knowledge about climate change may produce anxiety, but the concept of climate change anxiety is poorly understood. The primary aim of this study was to systematically review the qualitative literature regarding the scope of anxiety responses to climate change. The secondary aim was to investigate the sociodemographic and geographical factors which influence experiences of climate change anxiety. METHODS: A systematic review of empirical qualitative studies was undertaken, examining the scope of climate change anxiety by searching five databases. Studies were critically appraised for quality. Content analysis was used to identify themes. RESULTS: Fifteen studies met the inclusion criteria. The content analysis was organised into two overarching themes. The scope of anxiety included worry about threats to livelihood, worry for future generations, worry about apocalyptic futures, anxiety at the lack of response to climate change, and competing worries. Themes pertaining to responses to climate change anxiety included symptoms of anxiety, feeling helpless and disempowered,…

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    The Benefits of Physical Activity for People with Obesity, Independent of Weight Loss: A Systematic Review

    Rachele M. Pojednic, Emma D’Arpino, Ian Halliday, Amy Bantham

    139 citationsOpen access (CC-BY)doi:10.3390/ijerph19094981OpenAlex

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    Purposeful weight loss continues to be the primary focus for treating obesity. However, this strategy appears to be inadequate as obesity rates continue to rise and a myriad of benefits of physical activity that affect multiple health outcomes related to obesity and associated comorbidities are not integrated into treatment strategies. There are emerging correlational data in individuals with obesity that demonstrate physical activity can be beneficial to many critical health markers, independent of weight loss or changes in BMI. This systematic review investigates interventional studies that examine health markers, independent of weight loss, in individuals with obesity. Fourteen studies were identified that utilized a variety of physical activity interventions with primary endpoints that included cellular, metabolic, systemic and brain health outcomes. The review of the literature demonstrates that for individuals with obesity, there are both small-scale and large-scale physiologic benefits that occur with increased physical activity of various modalities. Focusing on these…

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    Hemocytes: A Useful Tool for Assessing the Toxicity of Microplastics, Heavy Metals, and Pesticides on Aquatic Invertebrates

    Federica Impellitteri, Alexandrina-Ștefania Curpăn, Gabriel Ionut Plavan, Alin Stelian Ciobica, Caterina Faggio

    138 citationsOpen access (CC-BY)doi:10.3390/ijerph192416830OpenAlex

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    Invertebrates have long been an important tool for assessing water pollution due to their characteristics as intermediate consumers in aquatic ecosystem food chains. Most of the time, the effects of contaminants are measured by their effect on oxidative status or by mortality, although there already exists an easier tool-hemocytes. Hemocytes are circulating cells with a very important role in the immune system of invertebrates, which can be found within the hemolymph, analogous to the blood in vertebrates. The collection of hemolymph samples is easy, fast, minimally invasive, and poses no danger to the life of invertebrates. The purpose of this review was to highlight the advantages of using hemolymph for toxicity assays of various substances, including heavy metals, micro- and nano-plastics, pesticides, hydrocarbons, and oil spills. A literature search was conducted for this purpose using the most common and most often used databases, with a focus on the most recent and relevant studies. Bivalve mollusks, crustaceans, and gastropods were chosen for this investigation. This review…

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    Sex Differences in VO2max and the Impact on Endurance-Exercise Performance

    Kelsey J. Santisteban, Andrew Thomas Lovering, John R. Halliwill, Christopher Todd Minson

    138 citationsOpen access (CC-BY)doi:10.3390/ijerph19094946OpenAlex

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    It was not until 1984 that women were permitted to compete in the Olympic marathon. Today, more women than men participate in road racing in all distances except the marathon where participation is near equal. From the period of 1985 to 2004, the women’s marathon record improved at a rate three times greater than men’s. This has led many to question whether women are capable of surpassing men despite the fact that there remains a 10–12% performance gap in all distance events. The progressive developments in sports performance research and training, beginning with A.V. Hill’s establishment of the concept of VO2max, have allowed endurance athletes to continue performance feats previously thought to be impossible. However, even today women are significantly underrepresented in sports performance research. By focusing more research on the female physiology and sex differences between men and women, we can better define how women differ from men in adapting to training and potentially use this information to improve endurance-exercise performance in women. The male advantage in…

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    Whether Green Finance Can Effectively Moderate the Green Technology Innovation Effect of Heterogeneous Environmental Regulation

    Yong Fang, Zhenquan Shao

    138 citationsOpen access (CC-BY)doi:10.3390/ijerph19063646OpenAlex

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    As an essential way to promote ecological civilization, green finance is attracting wide attention. However, whether green finance can successfully regulate the green technology innovation effect of heterogeneous environmental regulations and boost green technology innovation in coordination with heterogeneous environmental regulations remains unclear. Based on the re-measurement of the green finance development index of various provinces and cities in China, this study uses the spatial Durbin model to test the above problems empirically. The results show that green finance and "market incentive" environmental regulations can promote regional green technology innovation, while "command and control" environmental regulations inhibit regional green technology innovation. Green finance plays a negative regulatory role in the mechanism of heterogeneous environmental regulations affecting green technology innovation. Green finance alleviates the negative impact of "command and control" environmental regulations on green technology innovation and weakens the positive impact of…

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    Examining the Associations between COVID-19-Related Psychological Distress, Social Media Addiction, COVID-19-Related Burnout, and Depression among School Principals and Teachers through Structural Equation Modeling

    Turgut Karaköse, Ramazan Yirci, Stamatios Papadakis

    138 citationsOpen access (CC-BY)doi:10.3390/ijerph19041951OpenAlex

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    This study aims to investigate the relationships between COVID-19-related psychological distress, social media addiction, COVID-19-related burnout, and depression. The research, which was designed according to the relational survey model, was conducted with the participation of 332 school principals and teachers who received graduate education in the field of educational administration. Research data were collected through online surveys and then structural equation modeling (SEM) was used to test and analyze the proposed hypotheses. The study's findings revealed that COVID-19-related psychological distress strongly predicted COVID-19-related burnout. In this context, as the psychological distress associated with COVID-19 increased, the sense of burnout associated with COVID-19 also increased. However, it was found that burnout associated with COVID-19 significantly and positively predicted depression. SEM results revealed that COVID-19-related psychological distress directly affected COVID-19-related burnout, depression, and social media addiction. In addition, it was determined…

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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 2022, 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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