International Journal of Environmental Research and Public Health

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ISSN / EISSN : 16617827 / 16604601
Current Publisher: MDPI (10.3390)
Total articles ≅ 16,850
Google Scholar h5-index: 68
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Lihai Ren, Dangdang Wang, Xi Liu, Huili Yu, Chengyue Jiang, Yuanzhi Hu
International Journal of Environmental Research and Public Health, Volume 17; doi:10.3390/ijerph17072392

Abstract:
This study is aimed at investigating the influence of skull fractures on traumatic brain injury induced by blunt impact via numerous studies of head–ground impacts. First, finite element (FE) damage modeling was implemented in the skull of the Total HUman Model for Safety (THUMS), and the skull fracture prediction performance was validated against a head–ground impact experiment. Then, the original head model of the THUMS was assigned as the control model without skull element damage modeling. Eighteen (18) head–ground impact models were established using these two FE head models, with three head impact locations (frontal, parietal, and occipital regions) and three impact velocities (25, 35, and 45 km/h). The predicted maximum principal strain and cumulative strain damage measure of the brain tissue were employed to evaluate the effect of skull fracture on the cerebral contusion and diffuse brain injury risks, respectively. Simulation results showed that the skull fracture could reduce the risk of diffuse brain injury risk under medium and high velocities significantly, while it could increase the risk of brain contusion under high-impact velocity.
Li Ying, Xihe Zhu, Justin Haegele, Yang Wen
International Journal of Environmental Research and Public Health, Volume 17; doi:10.3390/ijerph17072395

Abstract:
The purposes of this study were (a) to examine the proportions of adolescents in China who partially or fully meet three 24-h movement guidelines on physical activity, screen-time, and sleep duration and (b) to examine whether there were gender differences in the proportion of boys and girls meeting these guidelines. The sample was made up of high school adolescents from an eastern province of China (N = 1338). The participants completed a self-reported survey on demographic variables and weekly health behaviors including physical activity, screen-time, and sleep duration. A frequency analysis was conducted to summarize the number of 24-h movement guidelines met of the total sample and by gender; chi-squared tests were used to examine the gender differences in the proportion of students meeting different guidelines, independently and jointly. A high proportion of adolescents did not meet physical activity (97.2%, 95% CI = 96.2–98.0%), or sleep (92.1%, 95% CI = 90.6–93.5%) guidelines, but met screen-time (93.6%, 95% CI = 92.4–94.7%) guidelines. Overall, only 0.3% (95%CI = 0.1–0.6%) of the sample met all three guidelines, 8.8% (95%CI = 7.5–10.2%) met two, 85.8%% (95%CI = 84.0–87.4%) met one, and 5.1% (95%CI = 4.0–6.4%) met none. There was no statistically significant percentage difference between female and male participants in meeting physical activity, screen-time viewing, or sleep duration guidelines, independently or jointly (p values > 0.05). These figures of participants meeting all three guidelines or physical activity and sleep independently are much lower than many estimates in prior research internationally. Considerations to improve adherence to physical activity and sleep guidelines are critical in this population.
Jolien Pieters, Diana Dolmans, Marieke Van Den Beuken-Van Everdingen, Franca Warmenhoven, Judith Westen, Daniëlle Verstegen
International Journal of Environmental Research and Public Health, Volume 17; doi:10.3390/ijerph17072396

Abstract:
As nearly all doctors deal with patients requiring palliative care, it is imperative that palliative care education starts early. This study aimed to validate a national, palliative care competency framework for undergraduate medical curricula. We conducted a Delphi study with five groups of stakeholders (palliative care experts, physicians, nurses, curriculum coordinators, and junior doctors), inviting them to rate a competency list. The list was organized around six key competencies. For each competency, participants indicated the level to which students should have mastered the skill at the end of undergraduate training. Stability was reached after two rating rounds (N = 82 round 1, N = 54 round 2). The results showed high levels of agreement within and between stakeholder groups. Participants agreed that theoretical knowledge is not enough: Students must practice palliative care competencies, albeit to varying degrees. Overall, communication and personal development and well-being scored the highest: Junior doctors should be able to perform these in the workplace under close supervision. Advance care planning scored the lowest, indicating performance in a simulated setting. A wide range of stakeholders validated a palliative care competency framework for undergraduate medical curricula. This framework can be used to guide teaching about palliative care.
Abdonas Tamosiunas, Laura Sapranaviciute-Zabazlajeva, Dalia Luksiene, Dalia Virviciute, Martin Bobak
International Journal of Environmental Research and Public Health, Volume 17; doi:10.3390/ijerph17072397

Abstract:
Background: The purpose of the study is to evaluate the association between cognitive function and risk of all-cause and cardiovascular disease mortality during 10 years of the follow-up. Methods: 7087 participants were assessed in the baseline survey of the Health Alcohol Psychosocial Factors in Eastern Europe (HAPIEE) study in 2006–2008. During 10 years of follow-up, all-cause and CVD mortality risk were evaluated. Results: During 10 years of follow-up, 768 (23%) men and 403 (11%) women died (239 and 107 from CVD). After adjustment for sociodemographic, biological, lifestyle factors, and illnesses, a decrease per 1 standard deviation in different cognitive function scores increased risk for all-cause mortality (by 13%–24% in men, and 17%–33% in women) and CVD mortality (by 19%–32% in men, and 69%–91% in women). Kaplan-Meier survival curves for all-cause and CVD mortality, according to tertiles of cognitive function, revealed that the lowest cognitive function (1st tertile) predicts shorter survival compared to second and third tertiles (p < 0.001). Conclusions: The findings of this follow-up study suggest that older participants with lower cognitive functions have an increased risk for all-cause and CVD mortality compared to older participants with a higher level of cognitive function.
Ines Testoni, Elisa Tronca, Gianmarco Biancalani, Lucia Ronconi, Giovanna Calapai
International Journal of Environmental Research and Public Health, Volume 17; doi:10.3390/ijerph17072398

Abstract:
This study investigates the psychological effects of participation in Death Education (DeEd) by middle school children in two towns in northeast Italy in which suicides occur to a greater extent than in the rest of the region. The aims of the project “Beyond the Wall” were inherent to the prevention of suicide, address existential issues and enhance the meaning of life through positive intentions for the future and reflection on mortality. It involved eight classes (150 students in four classes in the experimental group; 81 in four classes in the control group) engaging with films, workgroup activities, photovoice and psychodrama. The constructs of resilience, emotional competency and psychological well-being were monitored with the Resilience Scale for Adolescents, the Hopelessness Scale for Children, the Alexithymia Questionnaire for Children and the Stirling Children’s Well-being Scale. The DeEd intervention was found to be significantly related to some of the variables investigated, improving the students’ ability to recognise emotions and communicate them verbally while maintaining stable initial characteristics, such as psychological well-being and positive expectations for the future.
Zixiong Wang, Tianxiang Wang, Xiaoli Liu, Suduan Hu, Lingxiao Ma, Xinguo Sun
International Journal of Environmental Research and Public Health, Volume 17; doi:10.3390/ijerph17072400

Abstract:
Continuous water-level decline makes the changes of water quality in reservoirs more complicated. This paper uses trend analyses, wavelet analysis and principal component analysis-multiple linear regression to explore the changes and pollution sources affecting water quality during a period of continuous reservoir water level decline (from 65.37 m to 54.15 m), taking the Biliuhe reservoir as an example. The results showed that the change of water level of Biliuhe reservoir has a significant 13-year periodicity. The unusual water quality changes during the low water level period were as follows: total nitrogen continued to decrease. And iron was lower than its historical level. pH, total phosphorus, and ammonia nitrogen were higher than historical levels and fluctuated seasonally. Permanganate index increased as water level decreased after initial fluctuations. Dissolved oxygen was characterized by high content in winter and relatively low content in summer. The pollutant sources of non-point source pollution (PC1), sediment and groundwater pollution (PC2), atmospheric and production & domestic sewage (PC3), other sources of pollution (PC4) were identified. The main source of DO, pH, TP, TN, NH4-N, Fe and CODMn were respectively PC3 (42.13%), PC1 (47.67%), PC3 (47.62%), PC1 (29.75%), PC2 (47.01%), PC1 (56.97%) and PC2 (50%). It is concluded that the continuous decline of water level has a significant impact on the changes and pollution sources affecting water quality. Detailed experiments focusing on sediment pollution release flux, and biological action will be explored next.
Shannon Gravely, Geoffrey Fong, Edward Sutanto, Ruth Loewen, Janine Ouimet, Steve Xu, Anne Quah, Mary Thompson, Christian Boudreau, Grace Li, et al.
International Journal of Environmental Research and Public Health, Volume 17; doi:10.3390/ijerph17072394

Abstract:
In Japan, the tobacco industry promotes heated tobacco products (HTPs) as a reduced-risk tobacco product. This study examines: (1) smokers’ harm perceptions of HTPs relative to combustible cigarettes; (2) differences in relative harm perceptions between exclusive smokers and smokers who use HTPs (concurrent users) and between concurrent users based on frequency of product use; and (3) if smokers who were exposed to HTP advertising hold beliefs that are consistent with marketing messages of lower harmfulness. This cross-sectional study included 2614 adult exclusive cigarette smokers and 986 concurrent users who reported their perceptions of harmfulness of HTPs compared to cigarettes, as well as their exposure to HTP advertising in the last six months. Among all smokers, 47.5% perceive that HTPs are less harmful than cigarettes, 24.6% perceive HTPs to be equally as harmful, 1.8% perceive HTPs as more harmful, and 26.1% did not know. Concurrent users are more likely than exclusive smokers to believe that HTPs are less harmful (62.1% versus 43.8%, p < 0.0001) and less likely to report that they did not know (14.3% versus 29.4%, p < 0.0001). Frequent HTP users are more likely than infrequent users to believe that HTPs are less harmful (71.7% versus 57.1%, p ≤ 0.001). Believing that HTPs are less harmful than cigarettes was associated with noticing HTP advertising on TV (p = 0.0005), in newspapers/magazines (p = 0.0001), on posters/billboards (p < 0.0001), in stores where tobacco (p < 0.0001) or where HTPs (p < 0.0001) are sold, on social media (p < 0.0001), or in bars/pubs (p = 0.04). HTP users were significantly more likely than non-HTP users to believe that HTPs are less harmful than cigarettes, with this belief being more prominent among frequent users. Smokers who have been exposed to HTP advertising were more likely to perceive HTPs as less harmful than cigarettes.
Lolwa Al-Abdelmuhsin, Maha Al-Ammari, Salmeen D Babelghaith, Syed Wajid, Yousef A Asiri, Mansour S Almetawaz, Sultan M. Alghadeer, Mohamed N. Al-Arifi
International Journal of Environmental Research and Public Health, Volume 17; doi:10.3390/ijerph17072399

Abstract:
Objective: The primary objective was to assess the satisfaction of patients undergoing hemodialysis regarding counseling services provided by pharmacists. The secondary objectives were to compare the effect of years on dialysis and the presence of comorbidities on patient satisfaction. Methods: A total of 138 patients were included in the study, and all demographic and clinical variables were retrieved from the dialysis unit records of King Abdulaziz Medical City over a period of 4 months from July to October 2015. Chi-square test and Fisher’s exact test were used for group comparisons at a significance level of 0.05. Results: Most patients aged between 51 and 75 years and had been on dialysis for 1 to 5 years; 94.9% of them had comorbidities. The overall satisfaction of patients toward pharmacy services was excellent (77.5%), and approximately 38.4% of patients thought that pharmacists were providing clear information about their prescribed medications. In addition, 55.8 % of the patients did not know that hemodialysis could affect the efficacy of their medications. Conclusions: Patients undergoing hemodialysis were somewhat satisfied with the counseling provided by the pharmacist. Moreover, there is a need for educational programs for patients undergoing hemodialysis that would increase awareness among hospital pharmacists to improve patients’ medication knowledge.
Gianluca Serafini, Valentina Parisi, Andrea Aguglia, Andrea Amerio, Gaia Sampogna, Andrea Fiorillo, Maurizio Pompili, Mario Amore
International Journal of Environmental Research and Public Health, Volume 17; doi:10.3390/ijerph17072393

Abstract:
Consistent evidence indicates the association between inflammatory markers and suicidal behavior. The burden related to immunological differences have been widely documented in both major affective disorders and suicidal behavior. Importantly, abnormally elevated pro-inflammatory cytokines levels have been reported to correlate with suicidal behavior but whether and to what extent specific inflammatory cytokines abnormalities may contribute to our understanding of the complex pathophysiology of suicide is unknown. The present manuscript aimed to systematically review the current literature about the role of pro-inflammatory cytokines in suicidal behavior. Most studies showed a link between abnormally higher interleukin (IL)-1β, IL-6, tumor necrosis factor (TNF)-α, transforming growth factor (TGF)-β1, vascular endothelial growth factor (VEGF), kynurenic acid (KYN), and lower IL-2, IL-4, and interferon (IFN)-γ levels in specific brain regions and suicidal behavior. Unfortunately, most studies are not able to exclude the exact contribution of major depressive disorder (MDD) as a mediator/moderator of the link between inflammatory cytokines abnormalities and suicidal behavior. The association between suicidal patients (both suicide attempters or those with suicidal ideation) and the altered immune system was documented by most studies, but this does not reflect the existence of a specific causal link. Additional studies are needed to clarify the immune pathways underlying suicidal behavior.
Caio Sousa, Rinaldo Pereira, Thomas Rosemann, Pantelis Nikolaidis, Beat Knechtle
International Journal of Environmental Research and Public Health, Volume 17; doi:10.3390/ijerph17072390

Abstract:
The present case study analyzed performance, pacing, and potential predictors in a self-paced world record attempt of a professional triathlete to finish 40 Ironman-distance triathlons within 40 days. Split times (i.e., swimming, cycling, running) and overall times, body weight, daily highest temperature, wind speed, energy expenditure, mean heart rate, and sleeping time were recorded. Non-linear regressions were applied to investigate changes in split and overall times across days. Multivariate regression analyses were performed to test which variables showed the greatest influence on the dependent variables cycling, running and overall time. The athlete completed the 40×Ironman distances in a total time of 444:22 h:min. He spent 50:26 h:min in swimming, 245:37 h:min in cycling, 137:17 h:min in running and 11:02 h:min in transition times. Swimming and cycling times became slower across days, whereas running times got faster until the 20th day and, thereafter, became slower until the 40th day. Overall times got slower until the 15th day, became faster to 31st, and started then to get slower until the end. Wind speed, previous day’s race time and average heart race during cycling were significant independent variables influencing cycling time. Body weight and average heart rate during running were significant independent variables influencing running performance. Cycling performance, running performance, and body weight were significant independent variables influencing overall time. In summary, running time was influenced by body weight, cycling by wind speed, and overall time by both running and cycling performances.