Int. J. Environ. Res. Public Health, Volume 19, Issue 12 (June-2 2022) – 597 articles

Research on environmental pollution and public health has aroused increasing concern from international scholars; particularly, environmental hazards are among the important issues in China, focusing public attention on significant health risks. However, there are few studies concentrated on how perceived environmental hazards are characterized by spatial variation and on the impact of these risks on residents’ health. Based on a large-scale survey of Zhengzhou City in 2020, we investigated how the self-rated health of residents and the environmental hazards perceived by them were spatially inequal at a fine (subdistrict) scale in Zhengzhou City, China, and examined the relationship among self-rated health, environmental hazards, and geographical context. The Getis–Ord Gi* method was applied to explore the spatially dependent contextual (neighborhood) effect on environmental health inequality, and the ordered multivariate logistic regression method was used to examine the correlative factors with environmental hazards, geographical context, and health inequality. The results reveal that self-rated health and environmental hazards were disproportionately distributed across the whole city and that these distributions showed certain spatial cluster characteristics. The hot spot clusters of self-rated health had favorable environmental quality where the hot spot clusters of environmental hazards were located and vice versa. In addition, health inequality was evident and was related to gender, income level, educational attainment, and housing area of residents, and the inequalities of environmental hazards existed with respect to income and housing area. Meanwhile, environmental risk inequalities associated with the social vulnerability of residents (the poor and those with low educational attainment) were obvious, with those residents experiencing a disproportionately high exposure to environmental hazards and reporting bad health conditions. The role of the geographical context (subdistrict location feature) also helps to explain the spatial distribution of health and environmental inequalities. Residents with better exposure to green coverage generally reported higher levels of self-rated health condition. In addition, the geographical location of the subdistrict also had a significant impact on the difference in residents’ self-rated health status. The purpose of this study is to provide reference for policy makers to optimize the spatial pattern of urban public services and improve public health and environmental quality at a fine scale. Full article

Diabetes and prediabetes (called abnormal glucose regulation (AGR)) are adverse health effects associated with exposure to pesticides. However, there are few epidemiological studies on the relationship between pesticide use and the incidence of AGR. We examined the causal relationship between pesticide use and AGR incidence in a rural population using data from a Korean Farmers’ Cohort study of 1076 participants. Poisson regression with robust error variance was used to calculate the relative risks (RR) and 95% confidence intervals (CI) to estimate the relationship between pesticide exposure and AGR. The incidence of AGR in the pesticide-exposed group was 29.1%. Pesticide use increased the RR of AGR (RR 1.32, 95% CI 1.03–1.69). We observed a low-dose effect related to exposure of pesticides to AGR and a U-shaped dose–response relationship in men. Pesticide exposure is related to the incidence of AGR, and the causal relationship differs between men and women. Full article

Black ice is one of the main causes of traffic accidents in winter, and warning signs for black ice are generally ineffective because of the lack of credible information. To overcome this limitation, new warning signs for black ice were developed using materials that change color in response to different temperatures. The performance and effects of the new signs were investigated by conducting driver behavior analysis. To this end, driving simulator experiments were conducted with 37 participants for two different rural highway sections, i.e., a curve and a tangent. The analysis results of the driving behavior and visual behavior experiments showed that the conventional signs had insufficient performance in terms of inducing changes in driving behavior for safety. Meanwhile, the new signs actuated by weather conditions offered a statistically significant performance improvement. Typically, driver showed two times higher speed deceleration when they fixed eyes on the new weather-actuated warning sign (12.80 km/h) compared to the conventional old warning sign (6.84 km/h) in the curve segment. Accordingly, this study concluded that the new weather-actuated warning signs for black ice are more effective than the conventional ones for accident reduction during winters. Full article

Abuse of alcohol and other drugs is a major risk factor at work. To reduce this risk, workplace drug testing is performed in transportation and other industries. VERIFY, an observational method, is one of the key elements in a procedure adopted by the police of the canton of Zurich, Switzerland, for detecting impaired drivers. The observational method has been successfully applied by adequately trained police officers since 2014. The aim of this study is to examine the interrater reliability of the observational method, the effect of training in use of the method, and the role of having experience in the police force and traffic police force on the outcome when rating a driver’s impairment. For this purpose, driver impairment in staged road traffic controls presented in videos was rated by laypeople (n = 81), and police officers without (n = 146) and with training (n = 172) in the VERIFY procedure. In general, the results recorded for police officers with training revealed a moderate to very good interrater reliability of the observational method. Among the three groups, impaired drivers were best identified by officers with training (ranging between 82.6% and 89.5% correct identification). Trained officers reported a higher impairment severity of the impaired drivers than the other two groups, indicating that training increases sensitivity to signs of impairment. Our findings also suggest that online video technology could be helpful in identifying impaired drivers. Trained police officers could be connected to a road traffic control to make observations via live video. By this method efficiency and reliability in detecting abuse of alcohol and other drugs could be improved. Our findings also apply to workplace drug testing in general. Full article

Surfactant enhanced aquifer remediation is a common treatment to remediate polluted sites with the inconvenience that the effluent generated must be treated. In this work, a complex mixture of chlorobenzene and dichlorobenzenes in a non-ionic surfactant emulsion has been carried out by volatilization. Since this techhnique is strongly affected by the presence of the surfactant, modifying the vapour pressure, $P_v^0,$ and activity coefficient, $\gamma$, a correlation between $P_{v_j}^0{\gamma }_j$ and surfactant concentration and temperature was proposed for each compound, employing the Surface Response Methodology (RSM). Volatilization experiments were carried out at different temperatures and gas flow rates. A good agreement between experimental and predicted remaining SVCOCs during the air stripping process was obtained, validating the thermodynamic parameters obtained with RSM. Regarding the results of volatilization, at 60 °C 80% of SVCOCs were removed after 6 h, and the surfactant capacity was almost completely recovered so the solution can be recycled in soil flushing. Full article

Although obesity level is considered to influence weight-control behavior, few studies have examined how predictors of weight-control behavior differ according to obesity level. We compared the predictors of weight-control behavior in healthy weight and overweight middle-aged Korean women. This study used a comparative cross-sectional design. In total, 352 middle-aged women (131 overweight and 221 healthy) who visited community centers in eight Korean cities participated in the study. Participants completed self-report questionnaires concerning perceived health, body dissatisfaction, health-related concerns, self-esteem, and weight-control behavior. Scores for weight-control behavior in the overweight group were higher than those in the healthy weight group. Stepwise multiple regression showed that health-related concerns, body dissatisfaction, socioeconomic status, and self-esteem predicted weight-control behavior in the overweight group. Perceived health, socioeconomic status, meal regularity, health-related concerns, and age predicted weight-control behavior in the healthy weight group. The findings indicate that nursing strategies should differ according to obesity level to improve weight-control behavior in middle-aged women. In community or clinical settings, nurses are advised to develop customized weight control programs based on obesity levels in middle-aged women. Full article

Influenza vaccination is an imperative public health task for elderly people due to a higher risk of developing more severe complications. The main aim of our study was to determine the influencing factors of being vaccinated against influenza among subjects aged 65 and above. Data were from the Hungarian implementations of the European Health Interview Survey 2009, 2014 and 2019 studies with a final sample size of 3355. A multivariate logistic regression model with interactions was used to identify the possible factors associated with vaccination. Approximately 32% of the participants were vaccinated for the most recent influenza season. The most important factors were identified that contributed to influenza vaccination among individuals, which were the following: educational attainment, having a partner, the annual frequency of specialist and doctor visits, and having comorbidities. Respondents who thought that they could do a lot for their health had higher odds of being immunized. Being obese seemed to be a risk factor. According to our findings, the current influenza vaccination coverage was considered as low in Hungary; hence, the implementation of minor reformulations in the field of health policy is suggested. Full article

Introduction: Patients in neurosurgical units are particularly susceptible to healthcare-associated infections (HAI) due to invasive interventions in the central nervous system. Materials and methods: The study was conducted between 2014 and 2019 in neurosurgery units in Poland. The aim of the study was to investigate the epidemiology and microbiology of HAIs and to assess the effectiveness of surveillance conducted in two hospital units. Both hospitals ran (since 2012) the unified prospective system, based on continuous surveillance of HAIs designed and recommended by the European Centre for Disease Prevention and Control (protocol version 4.3) in the Healthcare-Associated Infections Surveillance Network (HAI-Net). In study hospitals, HAIs were detected by the Infection Prevention Control Nurse (IPCN). The surveillance of healthcare infections in hospital A was based mainly on analysis of microbiological reports and telephone communication between the epidemiological nurse and the neurosurgery unit. HAI monitoring in hospital B was an outcome of daily personal communication between the infection prevention and control nurse and patients in the neurosurgery unit (HAI detection at the bedside) and assessment of their health status based on clinical symptoms presented by the patient, epidemiological definitions, microbiological and other diagnostic tests (e.g., imaging studies). In hospital A, HAI monitoring did not involve personal communication with the unit but was rather based on remote analysis of medical documentation found in the hospital database. Results: A total of 12,117 patients were hospitalized. There were 373 HAIs diagnosed, the general incidence rate was 3.1%. In hospital A, the incidence rate was 2.3%, and in hospital B: 4.8%. HAI types detected: pneumonia (PN) (n = 112, 0.9%), (urinary tract infection (UTI) (n = 108, 0.9%), surgical site infection (SSI) (n = 96, 0.8%), bloodstream infection (BSI) (n = 57, 0.5%), gastrointestinal system infection (GI) (n = 13, 0.1%), skin and soft tissue (SST) (n = 9, 0.1%). HAI with invasive devices: 44 ventilator-associated pneumonia (VAP) cases (45.9/1000 pds with ventilator); catheter-associated urinary tract infection (CA-UTI): 105 cases (2.7/1000 pds with catheter); central venous catheter (CVC-BSI): 18 cases (1.9/1000 pds with CVC). The greatest differences between studied units were in the incidence rate of PN (p < 0.001), UTI (p < 0.001), and SSI (p < 0.05). Conclusions: The way HAIs are diagnosed and qualified and the style of work of the infection control team may have a direct impact on the unit epidemiology with the application of epidemiological coefficients. Prospective surveillance run by the infection prevention and control nurse in hospital B could have been associated with better detection of infections expressed in morbidity, especially PN and UTI, and a lower risk of VAP. In hospital A, the lower incidence might have resulted from an inability to detect a UTI or BSI and less supervision of VAP. The present results require further profound research in this respect. Full article

Colorectal polyps are the precursor lesions of most colorectal cancers. This study aimed to evaluate associations between bone mineral density (BMD), metabolic syndrome (MetS), and gastrointestinal diseases with colorectal polyps in middle-aged and elderly populations. A retrospective cross-sectional study was performed using data from the health examination database of a tertiary medical center in southern Taiwan in 2015. Subjects aged 50 years and older who had been assessed for metabolic factors and had undergone colonoscopy, upper gastrointestinal endoscopy, and dual energy X-ray absorptiometry scan (DEXA) were included. Factors associated with colorectal polyps were evaluated using univariate and multivariate logistic regression. In total, 1515 subjects were included, with mean age 60.1 years. Among them, 710 (46.9%) had colorectal polyps. Multivariate logistic regression analysis showed that high fasting glucose (OR = 1.08, p = 0.001), high triglycerides (OR = 1.02, p = 0.008), high total cholesterol (OR = 1.004, p = 0.009), reflux esophagitis (OR = 1.44, p = 0.002), duodenal polyps (OR = 1.75, p = 0.026), gastric ulcer (OR = 1.38, p = 0.024), duodenal ulcers (OR = 1.45, p = 0.028), osteopenia (OR = 1.48, p = 0.001), and MetS (OR = 1.46, p < 0.001) were independently associated with colorectal polyps. In conclusion, hyperglycemia, hypercholesterolemia, hypertriglyceridemia, MetS, duodenal polyps, gastric and duodenal ulcers, reflux esophagitis, and low BMD are independent risk factors associated with colorectal polyps in the middle-aged and elderly Taiwanese population. Full article

The Malay version of the WHOQOL-BREF was published approximately 15 years ago. Since then, no known research has been conducted to identify the psychometric properties of the scale using confirmatory factor analysis. This study aimed to establish a model by applying a scientific approach to the translation and adaptation method. The back translation technique was used for the translation process. This cross-sectional study involved 282 employees at Universiti Kebangsaan Malaysia. The instrument received satisfactory Cronbach’s alpha reliability values. The data were analysed with SEM using AMOS. Results showed that the model produced is parsimonious, with CMIN/df = 0.23, CFI = 0.93, SRMR = 0.08, RMSEA = 0.08 and PCLOSE = 0.07. Adopting the Malay version of the WHOQOL-BREF for future research is highly recommended due to its properties. Full article

Respiratory diseases such as asthma, allergic rhinitis (AR) and chronic obstructive pulmonary disease (COPD) affect millions worldwide and pose a significant global public health burden. Over the years, changes in land use and climate have increased pollen quantity, allergenicity and duration of the pollen season, thus increasing its impact on respiratory disease. Many studies have investigated the associations between short-term ambient pollen (i.e., within days or weeks of exposure) and respiratory outcomes. Here, we reviewed the current evidence on the association between short-term outdoor pollen exposure and thunderstorm asthma (TA), asthma and COPD hospital presentations, general practice (GP) consultations, self-reported respiratory symptoms, lung function changes and their potential effect modifiers. The literature suggests strong evidence of an association between ambient pollen concentrations and almost all respiratory outcomes mentioned above, especially in people with pre-existing respiratory diseases. However, the evidence on sub-clinical lung function changes, COPD, and effect modifiers other than asthma, hay fever and pollen sensitisation are still scarce and requires further exploration. Better understanding of the implications of pollen on respiratory health can aid healthcare professionals to implement appropriate management strategies. Full article

County-to-district reform (CTDR) is an important policy path for the government to promote the cultivation and construction of urban agglomerations, and exploring its “carbon emission” effect is of great significance for the high-quality development of urban agglomerations and the realization of the “dual carbon” goal. Based on the panel data of 120 counties in the Yangtze River Delta urban agglomeration from 2000–2017, this paper empirically tests the effect of county-to-district reforms on per capita carbon emissions in the counties of the central and peripheral cities of the Yangtze River Delta urban agglomeration under the Kutznets curve (EKC) hypothesis and the integrated difference-in-difference (DID) model and STIRPAT model. The results show that: (1) The carbon emission effect of county-to-district reforms have significant regional heterogeneity. The reforms of the central city of the urban agglomeration significantly reduced the per capita carbon emission of the county by 4.27%, whereas the reforms of the periphery cities of the urban agglomeration significantly increased per capita carbon emission by 6.56%. (2) The impact of county-to-district reforms on county per capita carbon emissions began to appear in the fourth year of reform. (3) Mechanism analysis showed that county-to-district reforms promoted central cities population agglomeration and reduction of carbon emission intensity can help reduce the per capita carbon emission level in counties, whereas peripheral cities have a dual carbon-increasing effect of decreasing population density and increasing carbon emission intensity. Therefore, the approval of county-to-district reforms should be strictly controlled, and the reform of non-central cities would be especially prudent, so as to reduce the negative effect of reform on the high-quality development of cities. Full article

University students frequently engage in unhealthy behaviors. However, there is a lack of studies examining a wide range of their lifestyle characteristics by sex and academic level of study. This cross-sectional survey of students enrolled in BSc, MSc, or PhD programs at one university in Germany (N = 3389) assessed physical activity (PA), sedentary behavior (SB), nutrition, sleep quality, and alcohol, tobacco, and other drug (ATOD) use by sex and academic level and was conducted with EvaSys version 8.0. Chi-squared tests compared categorical variables by sex, and binary logistic regression analyses adjusted for sex with Bonferroni adjustments evaluated differences across academic level. Although 91% of students achieved the aerobic PA guidelines, only 30% achieved the muscle strengthening exercises (MSE) guidelines, and 44% had high SB. Likewise, <10% met the fruit and vegetable consumption (FVC) recommendations, >40% of students experienced impaired sleep, and >30% had hazardous alcohol consumption. Less than 20% of the sample achieved the guideline/recommendation of all three PA, MSE and SB. Some behaviors exhibited significant sex and academic level differences. The identified at-risk groups included males (lower FVC), females (eating more during stress), and BSc students (poorer nutrition/sleep quality, more ATOD use). Given the above findings, multipronged strategies are needed with an overarching focus highlighting the health–academic achievement links. Behavioral interventions and environmental policies are required to raise awareness and promote student health. Full article

In the last decade, more and more attention has been paid to the efficiency of ecological products’ value in the literature. Studying the value-conversion efficiency of forest ecological products can measure and reflect the huge value contained in forests, which is of great significance to promote the transformation between “clear water and green mountains” and “gold and silver mountains” as well as solve the problem of economic development and environmental protection. Studying the value-conversion efficiency of forest ecological products can scientifically evaluate the results of the mutual transformation of “clear water and green mountains” and “gold and silver mountains”, which is of great significance for deepening the theory of the “two mountains”. This paper took Zhejiang Province as the research object, constructed an index system of forest ecological products’ value accounting, used the super-SBM model and Malmquist index to calculate the conversion efficiency of forest ecological products’ value, and proposed optimization paths according to the research results. The results showed that: (1) From 2000 to 2020, the value of forest ecological products in Zhejiang Province showed a fluctuating upward trend. In 2020, the total value of forest ecological products was RMB 973.717 billion. Among them, the value of material products was RMB 12.560 billion, the value of ecological regulatory products was RMB 726.323 billion, and the value of cultural service products was RMB 234.834 billion. (2) There were great differences in the value-conversion efficiency of forest ecological products among cities in Zhejiang Province, but the overall trend was steady and developing in a positive direction. (3) The total-factor productivity of forest ecological products in Zhejiang Province showed a fluctuating trend, and its growth was mainly limited by the technical efficiency and technological progress index. (4) The main reasons for the conversion-efficiency loss of forest ecological products’ value in Zhejiang Province were excessive input and insufficient output. The specific reasons for the loss of efficiency in different cities were different, so it is necessary to find improvement paths according to local conditions. Our research provides a new perspective for the academic community to evaluate the value-realization effect of ecological products as well as a decision-making reference for policy makers of ecological environmental protection and construction. Full article

The intentional homicide of female victims, which is most commonly perpetrated by intimate partners or family members, has been recognized in recent years as a matter of grave public concern that needs to be addressed from the cultural and judicial perspectives. To allow an in-depth criminological and psychopathological evaluation of female homicide in Italy in 2021 to be conducted, the authors performed a newspaper report analysis of the phenomenon. All female homicides that occurred in Italy in 2021 (n = 119) were included in the study. The analysis confirmed the low rate of female homicides in Italy when compared with other countries and also showed the phenomenon to be more complex than usually described. The highest rate of homicides was observed in elderly females when compared with other age groups, implying different criminological considerations and suggesting that gender-based violence may only explain some of the identified cases. The high incidence of suicide or attempted suicide among offenders, together with the high incidence of reported mental disorders in that population, suggests that a psychopathological perspective on the phenomenon of female homicide could help with the development and implementation of preventive strategies that focus on managing mental health at a territorial level and intervening in difficult domestic situations. Full article

Promoting people’s happiness is a vital goal of public policy, and air pollution, as the focus of public opinion, is an important influencing factor of residents’ happiness. Although previous literature has explored the relationship between air pollution and happiness, the impact of pollution sensitivity on the relationship has so far received little attention. This paper uses the 2016 China Labor-force Dynamics Survey database (CLDS) to study the impact of air pollution on personal happiness and dissects the moderating effect of air pollution sensitivity from the stock and incremental perspectives. The results found that (1) there is an inverted U-shaped relationship between air pollution and residents’ happiness, such that happiness increases and then decreases with increasing air pollution. The PM10 concentration at the turning point is 119.69 μg/m³, which exceeds the national secondary standard limit (70 μg/m³) by 70.99% and is at the intermediate stage of mild pollution, exceeding the WHO recommended standard (20 μg/m³) by 498.45%, far higher than the international standard recommended level; (2) both air pollution stock sensitivity and incremental sensitivity have a significant positive moderating effect on the relationship between air pollution and happiness, and pollution sensitivity exacerbates the negative effect of air pollution on residents’ happiness by shifting the curve turning point to the left and steepening the curve shape; (3) in addition, the effect of air pollution on different groups is significantly heterogeneous, with lower-age and male groups more likely to have lower happiness due to air pollution; the positive moderating effect of pollution sensitivity is more significant in lower-age, female, and higher-income groups. Therefore, in order to enhance residents’ happiness, the government should not only improve air quality, but also focus on helping residents establish an appropriate subjective perception of air quality. Full article

The global climate change has resulted in huge flood damages, which seriously hinders the sustainable development of rural economy and society and causes famers’ livelihood problems. In flood-prone areas, it is imperative to actively study short and long-term strategies and solve farmers’ livelihood problems accordingly. Following the sustainable development analysis framework proposed by the Department for International Development (DFID), this study collects empirical data of 360 rural households in six sample villages in the Jialing River Basin of Sichuan Province, China through a village-to-household field questionnaire and applies the Multinominal Logit Model (MNL) to explore the influence of farmer households’ capital on livelihood strategy choice. Research results show that: (1) In human capital category, the education level of the household head has a significant positive impact on the livelihood strategies of farmers’ families; (2) In physical capital category, farmer households with larger space have more funds to choose among flood adaptation strategies; (3) In natural capital category, house location and the sale of family property for cash have the greatest negative impact on farmers’ livelihood strategies; (4) Rural households with more credit opportunities in financial capital are more willing to obtain emergency relief funds; (5) Farmers’ families helped by the village for a long time will probably not choose to move to avoid floods, but are more likely to choose buying flood insurance. This study provides an empirical reference for effective short and long term prevention and mitigation strategies design and application in rural in flood-prone areas. Full article

Introduction: Worsening air quality and pollution lead to numerous environmental health and sustainability issues in the South Asia region. This study analyzes India, Nepal, Bangladesh, Pakistan, Sri Lanka, and Nepal for air quality data trends and sustainability indicators. Methodology: By using a population-based study design, six South Asian countries were analyzed using a step-wise approach. Data were obtained from government websites and publicly available repositories for region dynamics and key variables. Results: Between 1990 and 2020, air quality data indicated the highest rise in CO₂ emissions in India (578.5 to 2441.8 million tons) (MT), Bangladesh, Nepal, and Pakistan. Greenhouse gas emissions, from 1990 to 2018, nearly tripled in India (1990.4 to 3346.6 MT of CO₂-equivalents), Nepal (20.6 to 54.6 MT of CO₂-equivalents), and Pakistan, and doubled in Bangladesh. Methane emissions rose the highest in Pakistan (70.4 to 151 MT of CO₂-equivalents), followed by Nepal (17 to 31 MT of CO₂-equivalents) and India (524.8 to 669.3 MT of CO₂-equivalents). Nitrous oxide nearly doubled in Bangladesh (16.5 to 29.3 MT of CO₂-equivalents), India (141.6 to 256.9 MT of CO₂-equivalents), Nepal (17 to 31 MT of CO₂-equivalents), and more than doubled in Pakistan (27 to 61 MT of CO₂-equivalents). On noting particulate matter 2,5 annual exposure, India saw the highest rise from 81.3 µg/m³ (in 1990) to 90.9 µg/m³ (2017), whereas trends were steady in Pakistan (60.34 to 58.3 µg/m³). The highest rise was noted in Nepal (87.6 to 99.7 µg/m³) until 2017. During the coronavirus disease 19 pandemic, the pre-and post-pandemic changes between 2018 and 2021 indicated the highest PM_2.5 concentration in Bangladesh (76.9 µg/m³), followed by Pakistan (66.8 µg/m³), India (58.1 µg/m³), Nepal (46 µg/m³) and Sri Lanka (17.4 µg/m³). Overall, South Asian countries contribute to the worst air quality and sustainability trends regions worldwide. Conclusions: Air pollution is prevalent across a majority of South Asia countries. Owing to unsustainable industrial practices, pollution trends have risen to hazardous levels. Economic, environmental, and human health impacts have manifested and require urgent, concerted efforts by governing bodies in the region. Full article

A better understanding of the dynamic variation in the ecosystem service value (ESV) under land use/cover change (LUCC) is conductive to improving ecosystem services and environmental protection. The present study took Landsat TM/ETM remote sensing images and socio-economic statistic data as data sources and extracted land-use data using RS and GIS technology at 5-year intervals from 1990 to 2020. Then, we interpreted the spatio-temporal characteristics of LUCC and analyzed ESV changes using the value equivalence method in the black soil region of northeastern China (BSRNC). The main results showed that land use changed significantly during the study period. Cultivated land continued to expand, especially paddy areas, which increased by 1.72 × 10⁶ ha, with a relative change of 60.9% over 30 years. However, grassland decreased by 2.47 × 10⁶ ha, with a relative change of −60.6% over 30 years. The ESV showed a declining trend, which decreased by CNY 607.96 million during 1990–2020. The decline in forest and grassland caused a significant decline in the ESV. Furthermore, the ESV sensitivity coefficients were less than one for all of the different categories of ecosystem services. LUCC has a considerable impact on ESV in the BSRNC, resulting in ecosystem function degradation. As a result, future policies must emphasize the relationship between food security and environmental protection in situations of significant land-use change. Full article

Undergraduate healthcare students were mobilized to support healthcare systems during the COVID-19 pandemic, but we have scarce information regarding their experience and its impact on their wellbeing. An anonymous online survey was conducted among undergraduate students and recently graduated physicians of a medical university in Spain, regarding their symptoms and volunteering experience during the initial months of the Spanish COVID-19 pandemic. Respondents showed a high prevalence of perceived stress, anxiety, and depressive symptoms, measured by the PHQ-9 and GAD-7. 14.5% reported healthcare-related volunteering tasks. Volunteering was a satisfactory experience for most of the respondents and the majority felt ready to do volunteering tasks (66.6%). Yet, 16.6% acknowledged not getting appropriate specific-task education before starting, 20.8% reported not having appropriate supervision, and 33.3% feel they did not have proper protective equipment. More than half of volunteers feared getting infected, more than 70% feared infecting their relatives or friends, and 54.2% reported stigmatization. Volunteers showed significantly higher stress, anxiety, and depression scores than the rest of the respondents, and 32% reported a highly traumatic event during volunteering, with high scores on the IES-R in the 16% of volunteers. Our results should help guide future potential volunteering processes in emergencies, enhance academic programs at medical schools and provide valuable data for psychological support services. Full article

Purpose: To evaluate the long-term effect of vibration therapy with holistic and local intervention in treating muscle fatigue in elite athletes during their intensive training season. Methods: Study participants included five male athletes from a provincial Greco-Roman wrestling team who were qualified for the finals of China’s national games. During the study, conventional therapeutic intervention was applied during the initial three weeks of the study, and an instrument intervention was adopted in the following three weeks. A surface electromyography (sEMG) was used to measure muscle fatigue of latissimus dorsi, both before and after each intervention session. Specifically, the pre-intervention measurement was conducted right after the daily training completion; and the post-intervention measurement occurred in the following morning. The data analyses were to compare the differences in the muscle fatigue data between the two modes of interventions, conventional and instrument therapy. Results: The conventional intervention showed no significant difference in the sEMG indexes before and after the intervention; while for the instrument intervention, the pre- and post- intervention sEMG indexes differed significantly (p < 0.05). Conclusion: The long-term effects of instrument vibration therapy on muscle fatigue recovery were studied based on observational data from elite athletes. The results indicate that the vibration therapy with holistic and local consideration demonstrated an effective reduction of muscle fatigue and/or fatigue accumulation in elite athletes during their intensive training season. Full article

This study investigated the association between emotional demands and depression or anxiety in a wide range of jobs. We used data from the third Korean Working Conditions Survey (n = 50,032) for all occupational classifications, with no limitations placed on job title or employment type. Among the full set of regular paid workers in addition to self-employed, unpaid family workers, and informal employees such as independent contractors, 23,989 respondents worked with “customers, passengers, students, or patients” (i.e., clients). Emotional demands were evaluated using two questions: handling angry clients and needing to hide feelings for work performance. Any depression or anxiety over the last 12 months was taken to indicate poor mental health. Multivariable logistic regression modeling was performed to calculate adjusted ORs with 95% confidence intervals for the influence of emotional demands on mental health, adjusting for demographic factors (age, gender, education, income), occupational psychological demands, decision latitude, social support, weekly work hours and job insecurity. The prevalence of emotional demands was higher in self-employed and informal employees than in regular paid employees. The more frequent the exposure to the two emotional demands combined was, the higher the risk of depression or anxiety. High psychological demands, low social support, and low job security each further increased the risk of poor mental health. Emotional demands turned out to be widespread in the entire economy, were not limited to service or sales occupations, and were more evident in precarious work. The contribution of emotional demands and other preventable job stressors to the burden of depression or anxiety in society may be substantial. Full article

Since the early stage of the current pandemic, digital contact tracing (DCT) through mobile phone apps, called “Immuni”, has been introduced to complement manual contact tracing in Italy. Until 31 December 2021, Immuni identified 44,880 COVID-19 cases, which corresponds to less than 1% of total COVID-19 cases reported in Italy in the same period (5,886,411). Overall, Immuni generated 143,956 notifications. Although the initial download of the Immuni app represented an early interest in the new tool, Immuni has had little adoption across the Italian population, and the recent increase in its download is likely to be related to the mandatory Green Pass certification for conducting most daily activities that can be obtained via the application. Therefore, Immuni failed as a support tool for the contact tracing system. Other European experiences seem to show similar limitations in the use of DTC, leaving open questions about its effectiveness, although in theory, contact tracing could allow useful means of “proximity tracking”. Full article

An age-friendly environment is one of the measures of healthy aging. However, there is scarce evidence of the relationship between the age-friendliness of communities (AFC) and frailty status among Chinese older adults. This study aims to examine this relationship using a multilevel analysis with the data of a cross-sectional study conducted among 10,958 older adults living in 43 communities in four cities in China. The validated Age-friendly Community Evaluation Scale and Chinese frailty screening-10 Scale (CFS-10) were used to measure AFC and Frailty. Multilevel regression analyses were performed to examine the relationship between the AFC in two assessments of individual- and community-level and frailty status. After controlling for individual-level socio-demographic, health status, and lifestyle variables, compared with older adults in the lowest quartile of the individual-level perception of AFC, the frailty odds ratios for those in the top three quartiles were 0.69 (95% confidence interval [CI]: 0.56–0.83), 0.75 (95% CI: 0.61–0.91), and 0.56 (95% CI: 0.48–0.74). However, there was no association between the community-level AFC and frailty. A higher level of age-friendliness in the community is associated with lower frailty odds. Therefore, building age-friendly communities may be an important measure to prevent frailty among Chinese older adults. Full article

Some patients with moderate haemophilia (PWMH) report joint damage potentially responsible for gait disorders. Three-dimensional gait analysis (3DGA) is a relevant tool for the identification of complex musculoskeletal impairment. We performed an evaluation with 3DGA of 24 PWMH aged 44.3 ± 16.1 according to their joint status [Haemophilia Joint Health Score (HJHS) < 10 or HJHS ≥ 10] and assessed the correlation with the radiological and clinical parameters. Sixteen had HJHS < 10 (group 1) and eight had HJHS ≥ 10 (group 2). They were compared to 30 healthy subjects of a normative dataset. Both knee and ankle gait variable scores were increased in group 2 compared to the controls (p = 0.02 and p = 0.04, respectively). The PWMH of group 2 had a significant increase in their stance phase, double support duration, and stride width compared to the controls and group 1 (p < 0.01). Very low correlations were found for the ankle gait variable score with the ankle Pettersson sub-score (r² = 0.250; p = 0.004) and ankle HJHS sub-score (r² = 0.150; p = 0.04). For the knee, very low correlation was also found between the knee gait variable score and its HJHS sub-score (r² = 0.290; p < 0.0001). Patients with moderate haemophilia presented a gait alteration in the case of poor lower limb joint status. Full article

Mobile work is becoming increasingly common, and it has been, consequently, associated with new health-related hazards and resources. Our study examined health-related stresses, strains and resources of mobile work in a medium-sized company. The study aimed to generate implications for a work agreement and for workplace health management (WHM). For this, a multi-method longitudinal study (2019–20) was conducted, with 29 focus group and 6 individual interviews (absolute number of all participants N = 187). It was designed as a qualitative content analysis and theoretically based on the job demands-resources model (JD-R). Positive effects (e.g., increased work–life balance, higher concentration), as well as negative consequences (e.g., alienation in the team, communication effort), can be found. Numerous fields of action for both the work agreement and WHM could be identified. For example, the work agreement regulates the equipment for working from home with support from WHM in order to ensure occupational health-oriented selection and handling, or by fixing core working hours through the work agreement and supporting competence building for leaders in order to enable flexible work commitments for employees. Self-organised work at home can be supported both by rules in the service agreement and by building up self-management skills through the WHM’s offers. The findings illustrate that a work agreement can make a relevant contribution to a healthy design of mobile work by systematically linking it with WHM. The synergies between work agreement, employee health and WHM become clear. Full article

The COVID-19 pandemic has led to massive changes in almost all aspects of human life, including emotional states such as anxiety and fear, perspectives about healthy lifestyles, and psychological outcomes. This study aimed to disentangle the mechanisms that underlie the relationships of anxiety towards COVID-19 and fear of negative appearance with well-being, we also investigated the effects of cultural variations on levels of anxiety, fear of negative appearance, healthy lifestyles, and well-being. A total of 881 Indonesians (n = 172) and Poles (n = 709) participated in this study. Participants completed self-report measures of psychological well-being, anxiety, fear of negative appearance, compulsive exercise, and eating disorders. Multigroup structural equation modelling (SEM) was used. The results showed no statistically meaningful relationship between anxiety towards COVID-19 and well-being. However, it was found that, in the Polish sample, compulsive exercise and eating disorders mediated the relationship between fear of negative appearance and well-being. Cultural differences were also found in the mean scores of all examined constructs, with eating disorders being an exception. Therefore, this study highlights cultural aspects that determine emotional states, healthy lifestyles, and well-being. Full article

Medical care for geriatric patients is a great challenge, mainly due to various overlapping deficits relevant to numerous coexisting diseases, of which the most common are diabetes mellitus and atherosclerosis. In the case of diabetes, the glycation process is intensified, which accelerates atherosclerosis development and diabetic complications. Our goal was to investigate the relationship between the classical biochemical parameters of diabetes and atherosclerosis, as well as parameters which may indicate a nephropathy, and the parameters strictly related to glycation, taking into account the pharmacological treatment of patients. Methods: We analyzed the patients’ serum concentrations of fluorescent glycation product—pentosidine, concentrations of soluble receptors for advanced glycation products (sRAGE), lipoprotein receptor-1 (LOX-1), galectin 3 (GAL3), scavenger receptor class A (SR-A), and scavenger receptor class B (SR-BI), as well as the level of lipid peroxidation and free amine content. Among the identified correlations, the most interesting are the following: sRAGE with triglycerides (r = 0.47, p = 0.009), sRAGE with SR-BI (r = 0.47, p = 0.013), SR-BI with LOX-1 (r = 0.31, p = 0.013), and SR-BI with HDL (r = −0.30, p = 0.02). It has been shown that pentosidine and reactive free amine contents are significantly higher in elderly patients with ischemic heart disease. Pentosidine is also significantly higher in patients with arterial hypertension. Malondialdehyde turned out to be higher in patients with diabetes mellitus type 2 that was not treated with insulin or metformin than in those treated with both medications (p = 0.052). GAL3 was found to be lower both in persons without diabetes and in diabetics treated with metformin (p = 0.005). LOX-1 was higher in diabetic patients not treated with metformin or insulin, and lowest in diabetics treated with both insulin and metformin, with the effect of metformin reducing LOX-1 levels (p = 0.039). Our results were the basis for a discussion about the diagnostic value in the clinical practice of LOX-1 and GAL3 in geriatric patients with diabetes and also provide grounds for inferring the therapeutic benefits of insulin and metformin treatment. Full article

The aim of this study was to reach a consensus among experts (using the Delphi technique) to validate the informative content that should be included in an App to be used by informal caregivers of stroke patients in order to improve their quality of life, facilitating access to the health care system and involving them in their own health. This technique was developed between June and December 2021. The group of experts was selected on the basis of previously established criteria, and the coefficient of variation (v) was used as a measure of consensus. In addition, the concordance index was calculated to determine the stability of the different rounds. In the first round, the preliminary content, previously elaborated by the research group, was evaluated as very appropriate for the objectives set (N-P < 1.07). In addition, averages of 4.5 out of five and a coefficient of variation of less than 0.5 were obtained, confirming the consensus. In the second round, suggestions were made by the experts on how to improve the content of the information, obtaining 100% agreement with the results obtained in the first round. The results obtained allow a positive evaluation of the use of the Delphi method for the elaboration of the information to be housed in an App. Full article

Physical fitness measures overall physical health. It is the ability of the body to work effectively and stay healthy during leisure and emergencies. Given the progressive integration of 2–3-year-olds into preschool, physical fitness testing of these children has become increasingly important. We aimed to develop and test the reliability of an appropriate field test method for physical fitness in 2–3-year-olds children. One hundred and three children (44 boys and 59 girls) volunteered for this study. Their height and weight were tested, and the same tester conducted the test twice for handgrip strength, 3 m balance walking, stair climbing, 5 m run, and kicking a ball at one-minute intervals. Pearson correlation coefficient and intraclass correlation coefficient (ICC) were used for reliability testing. The reliability of this field test method for physical fitness was high in the repetitive tests of Chinese 2–3-year-olds for the four items of handgrip strength, 3 m balance walking, stair climbing and 5 m run, and the reliability was moderate for the kicking the ball item. This study indicates that these field-based physical fitness test methods have good reliability and are simple, feasible, safe, and easy to be accepted and understood by 2–3-year-old children; thus, it may be used as a reference for professionals in China and abroad. Full article