International Journal of Environmental Research and Public Health

Review

8 pages, 321 KiB

Open AccessFeature PaperEditor’s ChoiceReview

Will Nothing Be the Same Again?: Changes in Lifestyle during COVID-19 Pandemic and Consequences on Mental Health

by Emanuele Caroppo, Marianna Mazza, Alessandra Sannella, Giuseppe Marano, Carla Avallone, Angelo Emilio Claro, Delfina Janiri, Lorenzo Moccia, Luigi Janiri and Gabriele Sani

Int. J. Environ. Res. Public Health 2021, 18(16), 8433; https://doi.org/10.3390/ijerph18168433 - 10 Aug 2021

Cited by 120 | Viewed by 14781

Abstract

Social isolation caused by the COVID-19 pandemic has drastically affected lifestyles: from sedentary behaviors to reduced physical activity, from disrupted sleep patterns to altered dietary habits. As a consequence, serious mental and emotional responses have been registered. There was a significant decline in [...] Read more.

Social isolation caused by the COVID-19 pandemic has drastically affected lifestyles: from sedentary behaviors to reduced physical activity, from disrupted sleep patterns to altered dietary habits. As a consequence, serious mental and emotional responses have been registered. There was a significant decline in physical and other meaningful activities of daily living, leisure, social activity, and education. In children, collateral effects of the pandemic include inadequate nutrition with a risk of both overweight and underweight, addiction to screens, lack of schooling, and psychosocial difficulties. Older adults are frequently unable to adapt to lockdown measures and suffer from depression and cognitive complaints. Recent studies focusing on changes in lifestyle during the Covid-19 pandemic and consequences on mental health have been identified in PubMed/Medline, Scopus, Embase, and ScienceDirect. All the available literature has been retrospectively reviewed. The results of the present narrative review suggest that mental distress caused by social isolation seems to be linked not only to personality characteristics but also to several lifestyle components (sleep disruption, altered eating habits, reduced physical activity). This review aims to explore major changes in the lifestyle and quality of life and the impact of these changes on mental health, and to inform clinicians and policymakers about elements that may reduce the negative psychological effects of the quarantine period imposed during this worldwide crisis. There is an urgent need for tailored preventive, diagnostic, and therapeutic mental health interventions for the general population and for higher risk groups. Full article

(This article belongs to the Special Issue Health Promotion in Relation to Behavioral Nutrition and Physical Activity in the Era of Sars-Cov2 Pandemic)

19 pages, 434 KiB

Open AccessEditor’s ChoiceReview

Associations between Nature Exposure and Health: A Review of the Evidence

by Marcia P. Jimenez, Nicole V. DeVille, Elise G. Elliott, Jessica E. Schiff, Grete E. Wilt, Jaime E. Hart and Peter James

Int. J. Environ. Res. Public Health 2021, 18(9), 4790; https://doi.org/10.3390/ijerph18094790 - 30 Apr 2021

Cited by 199 | Viewed by 32814

Abstract

There is extensive empirical literature on the association between exposure to nature and health. In this narrative review, we discuss the strength of evidence from recent (i.e., the last decade) experimental and observational studies on nature exposure and health, highlighting research on children [...] Read more.

There is extensive empirical literature on the association between exposure to nature and health. In this narrative review, we discuss the strength of evidence from recent (i.e., the last decade) experimental and observational studies on nature exposure and health, highlighting research on children and youth where possible. We found evidence for associations between nature exposure and improved cognitive function, brain activity, blood pressure, mental health, physical activity, and sleep. Results from experimental studies provide evidence of protective effects of exposure to natural environments on mental health outcomes and cognitive function. Cross-sectional observational studies provide evidence of positive associations between nature exposure and increased levels of physical activity and decreased risk of cardiovascular disease, and longitudinal observational studies are beginning to assess long-term effects of nature exposure on depression, anxiety, cognitive function, and chronic disease. Limitations of current knowledge include inconsistent measures of exposure to nature, the impacts of the type and quality of green space, and health effects of duration and frequency of exposure. Future directions include incorporation of more rigorous study designs, investigation of the underlying mechanisms of the association between green space and health, advancement of exposure assessment, and evaluation of sensitive periods in the early life-course. Full article

(This article belongs to the Special Issue Greenspaces and Health: Measures and Methods)

23 pages, 928 KiB

Open AccessEditor’s ChoiceReview

Green Gentrification and Health: A Scoping Review

by Na’Taki Osborne Jelks, Viniece Jennings and Alessandro Rigolon

Int. J. Environ. Res. Public Health 2021, 18(3), 907; https://doi.org/10.3390/ijerph18030907 - 21 Jan 2021

Cited by 66 | Viewed by 18857

Abstract

Urban greening initiatives are often linked to enhanced human health and wellbeing, but they can also be a driver of gentrification. To date, few studies have focused on how green gentrification shapes health. In this scoping review, we analyzed existing peer-reviewed research on [...] Read more.

Urban greening initiatives are often linked to enhanced human health and wellbeing, but they can also be a driver of gentrification. To date, few studies have focused on how green gentrification shapes health. In this scoping review, we analyzed existing peer-reviewed research on how greening initiatives in gentrifying neighborhoods impact health, well-being, and health pathways (e.g., physical activity, affordable housing). Using a multi-step approach to scoping the literature (including searches in PubMed, JSTOR, and Google Scholar), we identified 15 empirical studies that met our inclusion criteria. We found studies focusing on green space use, physical activity, sense of community, safety, and self-reported health. Overall, longtime, marginalized residents are negatively impacted by green gentrification as they experience a lower sense of community, feel that they do not belong in green space, and, in many studies, use green space less often than newcomers. Overall, the research in this area is limited, and more studies on mental health and cardiovascular health markers could advance this literature. Based on the limited available evidence, we suggest that public health, urban planning, and parks professionals could collaborate to enhance the use of green space for marginalized residents and their feelings of inclusion in gentrifying areas. Full article

(This article belongs to the Special Issue Environmental Health: Feature Review Papers)

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16 pages, 569 KiB

Open AccessEditor’s ChoiceReview

Psychological Wellbeing in Physical Education and School Sports: A Systematic Review

by Javier Piñeiro-Cossio, Antonio Fernández-Martínez, Alberto Nuviala and Raquel Pérez-Ordás

Int. J. Environ. Res. Public Health 2021, 18(3), 864; https://doi.org/10.3390/ijerph18030864 - 20 Jan 2021

Cited by 38 | Viewed by 12686

Abstract

Mental health in children and adolescents has become an increasingly important topic in recent years. It is against this backdrop that physical education and school sports play an important role in promoting psychological wellbeing. The aim of this review was to analyse interventions [...] Read more.

Mental health in children and adolescents has become an increasingly important topic in recent years. It is against this backdrop that physical education and school sports play an important role in promoting psychological wellbeing. The aim of this review was to analyse interventions for improving psychological wellbeing in this area. To this end, a literature review was conducted using four databases (WOS, SPORTDiscus, SCOPUS and ERIC) and the following keywords: psychological wellbeing, physical education, and school sports. Twenty-one articles met the inclusion criteria. The results showed that interventions varied greatly in terms of duration and used a wide range of strategies (conventional and non-conventional sports, physical activity, games, etc.) for promoting psychological wellbeing, primarily among secondary school students. There was a lack of consensus as to the conceptualisation of the construct of psychological wellbeing, resulting in a variety of tools and methods for assessing it. Some studies also suggested a link between psychological wellbeing and other variables, such as basic psychological needs and self-determination. Finally, this study provides a definition of psychological wellbeing through physical activity based on our findings. Full article

(This article belongs to the Special Issue Physical Activity in Children's Health: Management for Leisure, Recreation and Sports)

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24 pages, 2271 KiB

Open AccessEditor’s ChoiceReview

Indoor Exposure to Selected Air Pollutants in the Home Environment: A Systematic Review

by Sotiris Vardoulakis, Evanthia Giagloglou, Susanne Steinle, Alice Davis, Anne Sleeuwenhoek, Karen S. Galea, Ken Dixon and Joanne O. Crawford

Int. J. Environ. Res. Public Health 2020, 17(23), 8972; https://doi.org/10.3390/ijerph17238972 - 2 Dec 2020

Cited by 225 | Viewed by 20369

Abstract

(1) Background: There is increasing awareness that the quality of the indoor environment affects our health and well-being. Indoor air quality (IAQ) in particular has an impact on multiple health outcomes, including respiratory and cardiovascular illness, allergic symptoms, cancers, and premature mortality. (2) [...] Read more.

(1) Background: There is increasing awareness that the quality of the indoor environment affects our health and well-being. Indoor air quality (IAQ) in particular has an impact on multiple health outcomes, including respiratory and cardiovascular illness, allergic symptoms, cancers, and premature mortality. (2) Methods: We carried out a global systematic literature review on indoor exposure to selected air pollutants associated with adverse health effects, and related household characteristics, seasonal influences and occupancy patterns. We screened records from six bibliographic databases: ABI/INFORM, Environment Abstracts, Pollution Abstracts, PubMed, ProQuest Biological and Health Professional, and Scopus. (3) Results: Information on indoor exposure levels and determinants, emission sources, and associated health effects was extracted from 141 studies from 29 countries. The most-studied pollutants were particulate matter (PM_2.5 and PM₁₀); nitrogen dioxide (NO₂); volatile organic compounds (VOCs) including benzene, toluene, xylenes and formaldehyde; and polycyclic aromatic hydrocarbons (PAHs) including naphthalene. Identified indoor PM_2.5 sources include smoking, cooking, heating, use of incense, candles, and insecticides, while cleaning, housework, presence of pets and movement of people were the main sources of coarse particles. Outdoor air is a major PM_2.5 source in rooms with natural ventilation in roadside households. Major sources of NO₂ indoors are unvented gas heaters and cookers. Predictors of indoor NO₂ are ventilation, season, and outdoor NO₂ levels. VOCs are emitted from a wide range of indoor and outdoor sources, including smoking, solvent use, renovations, and household products. Formaldehyde levels are higher in newer houses and in the presence of new furniture, while PAH levels are higher in smoking households. High indoor particulate matter, NO₂ and VOC levels were typically associated with respiratory symptoms, particularly asthma symptoms in children. (4) Conclusions: Household characteristics and occupant activities play a large role in indoor exposure, particularly cigarette smoking for PM_2.5, gas appliances for NO₂, and household products for VOCs and PAHs. Home location near high-traffic-density roads, redecoration, and small house size contribute to high indoor air pollution. In most studies, air exchange rates are negatively associated with indoor air pollution. These findings can inform interventions aiming to improve IAQ in residential properties in a variety of settings. Full article

(This article belongs to the Special Issue Designing Healthy Indoor Air Quality)

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11 pages, 281 KiB

Open AccessEditor’s ChoiceReview

Consideration of the Psychological and Mental Health of the Elderly during COVID-19: A Theoretical Review

by Kunho Lee, Goo-Churl Jeong and JongEun Yim

Int. J. Environ. Res. Public Health 2020, 17(21), 8098; https://doi.org/10.3390/ijerph17218098 - 3 Nov 2020

Cited by 96 | Viewed by 22452

Abstract

COVID-19 has spread worldwide causing an unprecedented public health crisis. After the World Health Organization declared a pandemic in March 2020, the number of confirmed cases and deaths has continued to increase. This situation may be prolonged until an effective, tested, and safe [...] Read more.

COVID-19 has spread worldwide causing an unprecedented public health crisis. After the World Health Organization declared a pandemic in March 2020, the number of confirmed cases and deaths has continued to increase. This situation may be prolonged until an effective, tested, and safe treatment is available. COVID-19 can occur at any age. However, the maximum confirmed cases and deaths have occurred among the elderly. Particularly, the mental and physical health of the elderly aged above 60 and classified as high-risk groups is more vulnerable than other age groups, requiring more attention. Strong social restraint, social distancing, and quarantine measures to prevent the COVID-19 spread have raised concerns about their mental health. Therefore, it is crucial to analyze and identify the psychological concepts and protective factors that support and constitute these guidelines and strategies and prepare practical suggestions and guidelines to protect the mental health of the elderly during COVID-19. These discussions will facilitate a deeper understanding and expansion of these guidelines and strategies. Therefore, this study explores factors—including pandemic-induced stress, self-integration, self-efficacy, and resilience—in order to prepare practical and detailed suggestions and guidelines using studies that considered these factors, including coping with COVID-19-induced stress, social support, and physical activity. Full article

(This article belongs to the Section Mental Health)

45 pages, 5305 KiB

Open AccessEditor’s ChoiceReview

PFAS Environmental Pollution and Antioxidant Responses: An Overview of the Impact on Human Field

by Marco Bonato, Francesca Corrà, Marta Bellio, Laura Guidolin, Laura Tallandini, Paola Irato and Gianfranco Santovito

Int. J. Environ. Res. Public Health 2020, 17(21), 8020; https://doi.org/10.3390/ijerph17218020 - 30 Oct 2020

Cited by 69 | Viewed by 12496

Abstract

Due to their unique properties, perfluorinated substances (PFAS) are widely used in multiple industrial and commercial applications, but they are toxic for animals, humans included. This review presents some available data on the PFAS environmental distribution in the world, and in particular in [...] Read more.

Due to their unique properties, perfluorinated substances (PFAS) are widely used in multiple industrial and commercial applications, but they are toxic for animals, humans included. This review presents some available data on the PFAS environmental distribution in the world, and in particular in Europe and in the Veneto region of Italy, where it has become a serious problem for human health. The consumption of contaminated food and drinking water is considered one of the major source of exposure for humans. Worldwide epidemiological studies report the negative effects that PFAS have on human health, due to environmental pollution, including infertility, steroid hormone perturbation, thyroid, liver and kidney disorders, and metabolic disfunctions. In vitro and in vivo researches correlated PFAS exposure to oxidative stress effects (in mammals as well as in other vertebrates of human interest), produced by a PFAS-induced increase of reactive oxygen species formation. The cellular antioxidant defense system is activated by PFAS, but it is only partially able to avoid the oxidative damage to biomolecules. Full article

(This article belongs to the Special Issue Environmental Pollution and Oxidative Status)

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29 pages, 772 KiB

Open AccessEditor’s ChoiceReview

Stigma and Discrimination (SAD) at the Time of the SARS-CoV-2 Pandemic

by Antonio Baldassarre, Gabriele Giorgi, Federico Alessio, Lucrezia Ginevra Lulli, Giulio Arcangeli and Nicola Mucci

Int. J. Environ. Res. Public Health 2020, 17(17), 6341; https://doi.org/10.3390/ijerph17176341 - 31 Aug 2020

Cited by 104 | Viewed by 11614

Abstract

Infectious disease control is a crucial public health issue. Although it is important to urgently perform public health measures in order to reduce the risk of spread, it could end up stigmatizing entire groups of people rather than offering control measures based on [...] Read more.

Infectious disease control is a crucial public health issue. Although it is important to urgently perform public health measures in order to reduce the risk of spread, it could end up stigmatizing entire groups of people rather than offering control measures based on sound scientific principles. This “us” versus “them” dynamic is common in stigmatization, in general, and indicates a way in which disease stigma can be viewed as a proxy for other types of fears, especially xenophobia and general fear of outsiders. The pandemic risk associated with SARS-CoV-2 infection led us to consider, among other related issues, how stigma and discrimination remain serious barriers to care for people suspected of being infected, even more if they are assisting professions, such as health workers, employed in emergency response. The purpose of this review is to evaluate and promote the importance of psychological aspects of the stigma and social discrimination (SAD) in pandemic realities and, more specifically, nowadays, in the context of SARS-CoV-2/COVID-19. Just as it happened with HIV, HCV, tuberculosis, and Zika, stigma and discrimination undermine the social fabric compromising the ethics and principles of civilization to which each individual in entitled. Recognizing disease stigma history can give us insight into how, exactly, stigmatizing attitudes are formed, and how they are disbanded. Instead of simply blaming the ignorance of people espousing stigmatizing attitudes about certain diseases, we should try to understand precisely how these attitudes are formed so that we can intervene in their dissemination. We should also look at history to see what sorts of interventions against stigma may have worked in the past. Ongoing research into stigma should evaluate what has worked in the past, as above-mentioned, providing us with some clues as to what might work in the current pandemic emergency, to reduce devastating discrimination that keeps people from getting the care they need. We propose a systematic and historical review, in order to create a scientific and solid base for the following SAD analysis. The aim is to propose a coping strategy to face stigma and discrimination (SAD) related to SARS-CoV-2/COVID-19 pandemic outbreak, borrowing coping strategy tools and solutions from other common contagious diseases. Furthermore, our study observes how knowledge, education level, and socioeconomic status (SES) can influence perception of SARS-CoV-2/ COVID-19 risk in a digital world, based on previous research, best practices, and evidence-based research. Full article

(This article belongs to the Special Issue The Dark Side and the Light Side of Technology Related Stress and Stress related to Workplace Innovations. From Artificial Intelligence to Business Transformations)

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14 pages, 355 KiB

Open AccessEditor’s ChoiceReview

Key Guidelines in Developing a Pre-Emptive COVID-19 Vaccination Uptake Promotion Strategy

by Jeff French, Sameer Deshpande, William Evans and Rafael Obregon

Int. J. Environ. Res. Public Health 2020, 17(16), 5893; https://doi.org/10.3390/ijerph17165893 - 13 Aug 2020

Cited by 139 | Viewed by 30217

Abstract

This paper makes the case for immediate planning for a COVID-19 vaccination uptake strategy in advance of vaccine availability for two reasons: first, the need to build a consensus about the order in which groups of the population will get access to the [...] Read more.

This paper makes the case for immediate planning for a COVID-19 vaccination uptake strategy in advance of vaccine availability for two reasons: first, the need to build a consensus about the order in which groups of the population will get access to the vaccine; second, to reduce any fear and concerns that exist in relation to vaccination and to create demand for vaccines. A key part of this strategy is to counter the anti-vaccination movement that is already promoting hesitancy and resistance. Since the beginning of the COVID-19 pandemic there has been a tsunami of misinformation and conspiracy theories that have the potential to reduce vaccine uptake. To make matters worse, sections of populations in many countries display low trust in governments and official information about the pandemic and how the officials are tackling it. This paper aims to set out in short form critical guidelines that governments and regional bodies should take to enhance the impact of a COVID-19 vaccination strategy. We base our recommendations on a review of existing best practice guidance. This paper aims to assist those responsible for promoting COVID-19 vaccine uptake to digest the mass of guidance that exists and formulate an effective locally relevant strategy. A summary of key guidelines is presented based on best practice guidance. Full article

(This article belongs to the Section Health Communication and Informatics)

17 pages, 623 KiB

Open AccessEditor’s ChoiceReview

Secular Trends in Physical Fitness of Children and Adolescents: A Review of Large-Scale Epidemiological Studies Published after 2006

by Tanja Eberhardt, Claudia Niessner, Doris Oriwol, Lydia Buchal, Annette Worth and Klaus Bös

Int. J. Environ. Res. Public Health 2020, 17(16), 5671; https://doi.org/10.3390/ijerph17165671 - 5 Aug 2020

Cited by 54 | Viewed by 4481

Abstract

Physical fitness (PF) of children and adolescents is an important resource for their future health. Population-based studies, however, rarely report secular changes of PF, although monitoring of these is crucial to deriving information for adequate interventions. This review aims to report trends in [...] Read more.

Physical fitness (PF) of children and adolescents is an important resource for their future health. Population-based studies, however, rarely report secular changes of PF, although monitoring of these is crucial to deriving information for adequate interventions. This review aims to report trends in PF of children and adolescents. A literature search was conducted in PubMed in July 2019. Cohort studies published in English allowing statements to be made on trends in PF by comparing youth between the ages of four and 18 years were included. The review identified 24 studies from 16 countries meeting the inclusion criteria, with an overall sample size of more than 860,000 children and adolescents. Through a standardized quality assessment tool, we classified two studies as strong, 21 as moderate, and only one as weak. We analyzed specific secular trends separately for the five different dimensions: endurance, strength, speed, flexibility, and coordination. The majority of studies report a decline of PF over time; however, a few studies report conflicting results. Performance in endurance, strength, and flexibility decreased over time, whereas there was no consistent trend reported for speed and coordination. Overall, there is no international standard on examining and reporting changes or secular trends in PF of children and adolescents, and comparability of studies is limited due to heterogeneous conditions of conducting and analyzing PF tests. Consequently, standardized and consistent international monitoring should be implemented. Full article

(This article belongs to the Special Issue Motor Competence and Physical Fitness in the Promotion of an Active and Healthy Lifestyle in Children and Adolescents)

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22 pages, 3568 KiB

Open AccessEditor’s ChoiceReview

Air Pollution and COVID-19: The Role of Particulate Matter in the Spread and Increase of COVID-19’s Morbidity and Mortality

by Silvia Comunian, Dario Dongo, Chiara Milani and Paola Palestini

Int. J. Environ. Res. Public Health 2020, 17(12), 4487; https://doi.org/10.3390/ijerph17124487 - 22 Jun 2020

Cited by 314 | Viewed by 22353

Abstract

Sars-Cov-2 virus (COVID-19) is a member of the coronavirus family and is responsible for the pandemic recently declared by the World Health Organization. A positive correlation has been observed between the spread of the virus and air pollution, one of the greatest challenges [...] Read more.

Sars-Cov-2 virus (COVID-19) is a member of the coronavirus family and is responsible for the pandemic recently declared by the World Health Organization. A positive correlation has been observed between the spread of the virus and air pollution, one of the greatest challenges of our millennium. COVID-19 could have an air transmission and atmospheric particulate matter (PM) could create a suitable environment for transporting the virus at greater distances than those considered for close contact. Moreover, PM induces inflammation in lung cells and exposure to PM could increase the susceptibility and severity of the COVID-19 patient symptoms. The new coronavirus has been shown to trigger an inflammatory storm that would be sustained in the case of pre-exposure to polluting agents. In this review, we highlight the potential role of PM in the spread of COVID-19, focusing on Italian cities whose PM daily concentrations were found to be higher than the annual average allowed during the months preceding the epidemic. Furthermore, we analyze the positive correlation between the virus spread, PM, and angiotensin-converting enzyme 2 (ACE2), a receptor involved in the entry of the virus into pulmonary cells and inflammation. Full article

(This article belongs to the Section Environmental Health)

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14 pages, 370 KiB

Open AccessEditor’s ChoiceReview

The Need for the Right Socio-Economic and Cultural Fit in the COVID-19 Response in Sub-Saharan Africa: Examining Demographic, Economic Political, Health, and Socio-Cultural Differentials in COVID-19 Morbidity and Mortality

by Andre M. N. Renzaho

Int. J. Environ. Res. Public Health 2020, 17(10), 3445; https://doi.org/10.3390/ijerph17103445 - 15 May 2020

Cited by 67 | Viewed by 12438

Abstract

The coronavirus disease (COVID-19) has spread quickly across the globe with devastating effects on the global economy as well as the regional and societies’ socio-economic fabrics and the way of life for vast populations. The nonhomogeneous continent faces local contextual complexities that require [...] Read more.

The coronavirus disease (COVID-19) has spread quickly across the globe with devastating effects on the global economy as well as the regional and societies’ socio-economic fabrics and the way of life for vast populations. The nonhomogeneous continent faces local contextual complexities that require locally relevant and culturally appropriate COVID-19 interventions. This paper examines demographic, economic, political, health, and socio-cultural differentials in COVID-19 morbidity and mortality. The health systems need to be strengthened through extending the health workforce by mobilizing and engaging the diaspora, and implementing the International Health Regulations (2005) core capacities. In the absence of adequate social protection and welfare programs targeting the poor during the pandemic, sub-Saharan African countries need to put in place flexible but effective policies and legislation approaches that harness and formalise the informal trade and remove supply chain barriers. This could include strengthening cross-border trade facilities such as adequate pro-poor, gender-sensitive, and streamlined cross-border customs, tax regimes, and information flow. The emphasis should be on cross-border infrastructure that not only facilitates trade through efficient border administration but can also effectively manage cross-border health threats. There is an urgent need to strengthen social protection systems to make them responsive to crises, and embed them within human rights-based approaches to better support vulnerable populations and enact health and social security benefits. The COVI-19 response needs to adhere to the well-established ‘do no harm’ principle to prevent further damage or suffering as a result of the pandemic and examined through local lenses to inform peace-building initiatives that may yield long-term gains in the post-COVID-19 recovery efforts. Full article

(This article belongs to the Collection Outbreak of a Novel Coronavirus: A Global Health Threat)

13 pages, 516 KiB

Open AccessEditor’s ChoiceReview

Five Challenges When Managing Mass Casualty or Disaster Situations: A Review Study

by Karin Hugelius, Julia Becker and Annsofie Adolfsson

Int. J. Environ. Res. Public Health 2020, 17(9), 3068; https://doi.org/10.3390/ijerph17093068 - 28 Apr 2020

Cited by 34 | Viewed by 7941

Abstract

Background: Managing mass casualty or disaster incidents is challenging to any person or organisation. Therefore, this paper identifies and describes common challenges to managing such situations, using case and lessons learned reports. It focuses on sudden onset, man-made or technologically caused mass [...] Read more.

Background: Managing mass casualty or disaster incidents is challenging to any person or organisation. Therefore, this paper identifies and describes common challenges to managing such situations, using case and lessons learned reports. It focuses on sudden onset, man-made or technologically caused mass casualty or disaster situations. Methods: A management review was conducted based on a structured search in the PubMed and Web of Science databases. Results: The review included 20 case—and lessons learned reports covering natural disasters, man-made events, and accidents across Europe, the United States of Amerika (USA), Asia and the Middle East. Five common challenges were identified: (1) to identify the situation and deal with uncertainty, (2) to balance the mismatch between the contingency plan and the reality, (3) to establish a functional crisis organization, (4) to adapt the medical response to the actual and overall situation and (5) to ensure a resilient response. Conclusions: The challenges when managing mass casualty or disaster events involved were mainly related to the ability to manage uncertainty and surprising situations, using structured processes to respond. The ability to change mind set, organization and procedures, both from an organizational- and individual perspective, was essential. Non-medical factors and internal factors influenced the medical management. In order to respond in an effective, timely and resilient way, all these factors should be taken into consideration. Full article

(This article belongs to the Special Issue Prehospital and Disaster Medicine and Crises Management)

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16 pages, 3841 KiB

Open AccessEditor’s ChoiceReview

Internet Addiction in the Web of Science Database: A Review of the Literature with Scientific Mapping

by Antonio-José Moreno-Guerrero, Gerardo Gómez-García, Jesús López-Belmonte and Carmen Rodríguez-Jiménez

Int. J. Environ. Res. Public Health 2020, 17(8), 2753; https://doi.org/10.3390/ijerph17082753 - 16 Apr 2020

Cited by 48 | Viewed by 7924

Abstract

Information and communication technologies (ICT) is a major element of today’s society with great potential that can offer both advantages and disadvantages. Addiction to the Internet and social networks is a growing problem in all age groups. Education is the context in which [...] Read more.

Information and communication technologies (ICT) is a major element of today’s society with great potential that can offer both advantages and disadvantages. Addiction to the Internet and social networks is a growing problem in all age groups. Education is the context in which to work and train in the correct use of these media. The objective of the study focuses on knowing the scientific production and the performance of the concepts “addiction” and “internet” (ADIN). A bibliometric methodology complemented with the scientific mapping technique was followed. Different processes related to the quantification, analysis, evaluation, and estimation of scientific documents were carried out. The literature was analyzed by specific programs such as SciMAT, Analyze Results, and Creation Citation Report. The unit of analysis was specified in 5644 scientific publications extracted from Web of Science (WoS), belonging to the period of years between 1996 and 2019. The results showed that the evolution in the study of the addiction to the Internet is constant and continuous, with articles in English being the most used means to present the information on the part of the investigators. In addition, the subject of study was based on time, given that the coincidence of key words between the periods analyzed was high. In conclusion, the importance of promoting healthy living habits that include responsible use of the Internet are discussed. Full article

(This article belongs to the Special Issue Internet and Smartphone Use-Related Addiction Health Problems: Treatment, Education and Research)

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17 pages, 363 KiB

Open AccessEditor’s ChoiceReview

Regulatory Policies for Alcohol, other Psychoactive Substances and Addictive Behaviours: The Role of Level of Use and Potency. A Systematic Review

by Jürgen Rehm, Jean-François Crépault, Omer S.M. Hasan, Dirk W. Lachenmeier, Robin Room and Bundit Sornpaisarn

Int. J. Environ. Res. Public Health 2019, 16(19), 3749; https://doi.org/10.3390/ijerph16193749 - 4 Oct 2019

Cited by 19 | Viewed by 6266

Abstract

The object of this contribution based on a systematic review of the literature is to examine to what degree the level of use and potency play a role in regulatory policies for alcohol, other psychoactive substances and gambling, and whether there is an [...] Read more.

The object of this contribution based on a systematic review of the literature is to examine to what degree the level of use and potency play a role in regulatory policies for alcohol, other psychoactive substances and gambling, and whether there is an evidence base for this role. Level of use is usually defined around a behavioural pattern of the user (for example, cigarettes smoked per day, or average ethanol use in grams per day), while potency is defined as a property or characteristic of the substance. For all substances examined (alcohol, tobacco, opioids, cannabis) and gambling, both dimensions were taken into consideration in the formulation of most regulatory policies. However, the associations between both dimensions and regulatory policies were not systematic, and not always based on evidence. Future improvements are suggested. Full article

(This article belongs to the Special Issue Alcohol Control Policy and Health in Europe)

49 pages, 889 KiB

Open AccessEditor’s ChoiceReview

A Scoping Review Mapping Research on Green Space and Associated Mental Health Benefits

by Charlotte Wendelboe-Nelson, Sarah Kelly, Marion Kennedy and John W. Cherrie

Int. J. Environ. Res. Public Health 2019, 16(12), 2081; https://doi.org/10.3390/ijerph16122081 - 12 Jun 2019

Cited by 106 | Viewed by 15065

Abstract

Background: There is a growing interest in research investigating the association between green space (GS) and mental health and wellbeing (HWB), in order to understand the underlying mechanisms. Accordingly, there is a need to map the literature and create an overview of the [...] Read more.

Background: There is a growing interest in research investigating the association between green space (GS) and mental health and wellbeing (HWB), in order to understand the underlying mechanisms. Accordingly, there is a need to map the literature and create an overview of the research. Methods: A scoping review approach was used to map literature on GS, including context and co-exposures (the GS exposome), and their associations with mental HWB. The review considers mental HWB definitions and measurements and how GS is characterized. Furthermore, the review aims to identify knowledge gaps and make recommendations for future research. Results: We identified a great diversity in study designs, definitions, outcome measures, consideration of the totality of the GS exposome, and reporting of results. Around 70% of the 263 reviewed studies reported a positive association between some aspect of GS and HWB. However, there is a limited amount of research using randomized controlled crossover trails (RCTs) and mixed methods and an abundance of qualitative subjective research. Conclusions: The discords between study designs, definitions, and the reporting of results makes it difficult to aggregate the evidence and identify any potential causal mechanisms. We propose key points to consider when defining and quantifying GS and make recommendations for reporting on research investigating GS and mental HWB. This review highlights a need for large well-designed RCTs that reliably measure the GS exposome in relation to mental HWB. Full article

(This article belongs to the Section Environmental Health)

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15 pages, 783 KiB

Open AccessEditor’s ChoiceSystematic Review

The Effect of Community-Based Exercise on Health Outcomes for Indigenous Peoples with Type 2 Diabetes: A Systematic Review

by Lauren Hurst, Morwenna Kirwan, Vita Christie, Cara Cross, Sam Baylis, Liam White and Kylie Gwynne

Int. J. Environ. Res. Public Health 2024, 21(3), 290; https://doi.org/10.3390/ijerph21030290 - 1 Mar 2024

Viewed by 2272

Abstract

Indigenous peoples globally experience a high burden of type 2 diabetes in comparison to non-Indigenous peoples. While community-based exercise interventions designed for type 2 diabetes (T2D) management have garnered success in non-Indigenous populations, they likely require adjustments to meet the needs of Indigenous [...] Read more.

Indigenous peoples globally experience a high burden of type 2 diabetes in comparison to non-Indigenous peoples. While community-based exercise interventions designed for type 2 diabetes (T2D) management have garnered success in non-Indigenous populations, they likely require adjustments to meet the needs of Indigenous people. This systematic review aims to determine if health outcomes in Indigenous peoples with T2D could be improved by community-based exercise programmes and the features of those programmes that best meet their needs. The CINAHL, Embase, Informit Indigenous Collection, Medline, PubMed, Scopus, SportDiscus, and Web of Science databases have been searched to identify peer-reviewed literature with original outcome data that report on the health effects of community-based exercise interventions for the management of T2D among Indigenous peoples. The Mixed Methods Appraisal Tool and Indigenous Community Engagement Tool were implemented to assess methodological quality. Three moderate-to-high-quality studies were selected for review, including participants of Polynesian or Native American Zuni Indian descent. Results indicated positive effects of group exercise on glycated haemoglobin (HbA1c), body mass index, body weight, total cholesterol, blood pressure, quality of life, and patient activation levels in high-adhering participants. This review concludes that community-based exercise interventions may improve health outcomes for Indigenous adults with T2D when conducted with strong community engagement. Full article

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19 pages, 1560 KiB

Open AccessEditor’s ChoiceSystematic Review

Benzene Exposure and Lung Cancer Risk: A Systematic Review and Meta-Analysis of Human Studies

by Manuela Chiavarini, Patrizia Rosignoli, Beatrice Sorbara, Irene Giacchetta and Roberto Fabiani

Int. J. Environ. Res. Public Health 2024, 21(2), 205; https://doi.org/10.3390/ijerph21020205 - 9 Feb 2024

Cited by 2 | Viewed by 2817

Abstract

Lung cancer is a leading cause of death with nearly 1.8 million deaths estimated worldwide in 2020. Although benzene is classified as a human carcinogen (Group 1) on the basis of its association with acute myeloid/non-lymphocytic leukaemia, there is still limited evidence that [...] Read more.

Lung cancer is a leading cause of death with nearly 1.8 million deaths estimated worldwide in 2020. Although benzene is classified as a human carcinogen (Group 1) on the basis of its association with acute myeloid/non-lymphocytic leukaemia, there is still limited evidence that it may influence lung cancer risk. This study examined the potential link between benzene exposure and risk of lung cancer using a systematic review of epidemiological studies and meta-analysis. We searched through PubMed, Web of Science and Scopus databases up to 10 February 2023 to identify all articles on the association between benzene exposure and lung cancer (incidence or prevalence) and/or mortality. We extracted the risk estimates of the highest and the lowest reported categories of benzene exposure and conducted a meta-analysis using a random-effects model. Heterogeneity and publication bias were analysed using an I² test and funnel plots asymmetry, respectively. Twenty-one studies were included in the final analysis, with a total of 10,750 lung cancer cases and 2899 lung cancer deaths. Overall, risk estimates of lung cancer prevalence and mortality in association with benzene exposure were 1.20 (n = 14; 95% CI 1.05–1.37) and 1.15 (n = 13; 95% CI 1.02–1.30), respectively. In all cases, heterogeneity was quite large, while no significant publication bias was observed. When only studies that adjusted for smoking habit were selected, the risk for lung cancer increased by up to 34% (n = 9; 95% CI 1.10–1.64). Our data, which show a strong association between benzene exposure and lung cancer risk, may have important public health implications. However, further studies are needed to identify the lung cancer risk associated with benzene exposure considering different smoking conditions. Full article

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30 pages, 6489 KiB

Open AccessEditor’s ChoiceSystematic Review

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

by Avril Johnstone, Anne Martin, Rita Cordovil, Ingunn Fjørtoft, Susanna Iivonen, Boris Jidovtseff, Frederico Lopes, John J. Reilly, Hilary Thomson, Valerie Wells and Paul McCrorie

Int. J. Environ. Res. Public Health 2022, 19(10), 5967; https://doi.org/10.3390/ijerph19105967 - 13 May 2022

Cited by 31 | Viewed by 16131

Abstract

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 [...] Read more.

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 development, nature relatedness, awareness of nature, and play interaction. Inconsistent associations were found for attention, attachment, initiative, environmentally responsible behaviour, and play disruption/disconnection. Qualitative studies (n = 10) noted that nature-based ECE afforded opportunities for play, socialising, and creativity. Nature-based ECE may improve some childhood development outcomes, however, high-quality experimental designs describing the dose and quality of nature are needed to explore the hypothesised pathways connecting nature-based ECE to childhood development (Systematic Review Registration: CRD42019152582). Full article

(This article belongs to the Special Issue Outdoor Play and Learning for Health, Wellbeing, and Development in Early Childhood)

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13 pages, 344 KiB

Open AccessEditor’s ChoiceConcept Paper

Sex, Gender and Health: Mapping the Landscape of Research and Policy

by Lorraine Greaves and Stacey A. Ritz

Int. J. Environ. Res. Public Health 2022, 19(5), 2563; https://doi.org/10.3390/ijerph19052563 - 23 Feb 2022

Cited by 29 | Viewed by 7030

Abstract

Including sex and gender considerations in health research is considered essential by many funders and is very useful for policy makers, program developers, clinicians, consumers and other end users. While longstanding confusions and conflations of terminology in the sex and gender field are [...] Read more.

Including sex and gender considerations in health research is considered essential by many funders and is very useful for policy makers, program developers, clinicians, consumers and other end users. While longstanding confusions and conflations of terminology in the sex and gender field are well documented, newer conceptual confusions and conflations continue to emerge. Contemporary social demands for improved health and equity, as well as increased interest in precision healthcare and medicine, have made obvious the need for sex and gender science, sex and gender-based analyses (SGBA+), considerations of intersectionality, and equity, diversity and inclusion initiatives (EDI) to broaden representation among participants and diversify research agendas. But without a shared and precise understanding of these conceptual areas, fields of study, and approaches and their inter-relationships, more conflation and confusion can occur. This article sets out these areas and argues for more precise operationalization of sex- and gender-related factors in health research and policy initiatives in order to advance these varied agendas in mutually supportive ways. Full article

(This article belongs to the Special Issue Sex, Gender, and Health)

23 pages, 916 KiB

Open AccessEditor’s ChoiceSystematic Review

Experiential Learning Interventions and Healthy Eating Outcomes in Children: A Systematic Literature Review

by Sumantla D. Varman, Dylan P. Cliff, Rachel A. Jones, Megan L. Hammersley, Zhiguang Zhang, Karen Charlton and Bridget Kelly

Int. J. Environ. Res. Public Health 2021, 18(20), 10824; https://doi.org/10.3390/ijerph182010824 - 15 Oct 2021

Cited by 21 | Viewed by 6571

Abstract

Experiential learning is the process where learners create meaning from direct experience. This systematic review aimed to examine the effects of experiential learning activities on dietary outcomes (knowledge, attitudes, behaviors) in children. Four databases: Education Research Complete, Scopus, Web of Science and PsychINFO [...] Read more.

Experiential learning is the process where learners create meaning from direct experience. This systematic review aimed to examine the effects of experiential learning activities on dietary outcomes (knowledge, attitudes, behaviors) in children. Four databases: Education Research Complete, Scopus, Web of Science and PsychINFO were searched from database inception to 2020. Eligible studies included children 0–12 years, assessed effect of experiential learning on outcomes of interest compared to non-experiential learning and were open to any setting. The quality of studies was assessed using the revised Cochrane risk of bias tool by two independent reviewers and effect size was calculated on each outcome. Nineteen studies were conducted in primary school, six in pre-school and one in an outside-of-school setting and used nine types of experiential learning strategies. Cooking, taste-testing, games, role-playing, and gardening were effective in improving nutrition outcomes in primary school children. Sensory evaluation, games, creative arts, and storybooks were effective for preschool children. Multiple strategies involving parents, and short/intense strategies are useful for intervention success. Experiential learning is a useful strategy to improve children’s knowledge, attitudes, and behaviors towards healthy eating. Fewer studies in pre-school and outside of school settings and high risk of bias may limit the generalizability and strength of the findings. Full article

(This article belongs to the Collection Review Papers in Children's Health)

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8 pages, 309 KiB

Open AccessEditor’s ChoiceOpinion

Core Temperature Measurement—Principles of Correct Measurement, Problems, and Complications

by Hubert Hymczak, Aleksandra Gołąb, Konrad Mendrala, Dariusz Plicner, Tomasz Darocha, Paweł Podsiadło, Damian Hudziak, Radosław Gocoł and Sylweriusz Kosiński

Int. J. Environ. Res. Public Health 2021, 18(20), 10606; https://doi.org/10.3390/ijerph182010606 - 10 Oct 2021

Cited by 49 | Viewed by 7024

Abstract

Core temperature reflects the temperature of the internal organs. Proper temperature measurement is essential to diagnose and treat temperature impairment in patients. However, an accurate approach has yet to be established. Depending on the method used, the obtained values may vary and differ [...] Read more.

Core temperature reflects the temperature of the internal organs. Proper temperature measurement is essential to diagnose and treat temperature impairment in patients. However, an accurate approach has yet to be established. Depending on the method used, the obtained values may vary and differ from the actual core temperature. There is an ongoing debate regarding the most appropriate anatomical site for core temperature measurement. Although the measurement of body core temperature through a pulmonary artery catheter is commonly cited as the gold standard, the esophageal temperature measurement appears to be a reasonable and functional alternative in the clinical setting. This article provides an integrative review of invasive and noninvasive body temperature measurements and their relations to core temperature. Full article

(This article belongs to the Special Issue Accidental and Environmental Hypothermia)

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