1. |
- Foley, Sarah, et al.
(author)
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Family Function and Child Adjustment Difficulties in the COVID-19 Pandemic : An International Study
- 2021
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In: International journal of environmental research and public health. - : MDPI AG. - 1660-4601. ; 18:21
-
Other publication (other academic/artistic)abstract
- To estimate specific proximal and distal effects of COVID-19-related restrictions on families on children’s adjustment problems, we conducted a six-site international study. In total, 2516 parents from Australia, China, Italy, Sweden, the United Kingdom, and the United States of America living with a young child (Mage = 5.77, SD = 1.10, range = 3 to 8 years, 47.9% female) completed an online survey between April and July 2020. The survey included the Strengths and Difficulties Questionnaire and family risk factors (parent distress, parent–child conflict, couple conflict, and household chaos) as well as a scale to index COVID-19-related family disruption. Our analyses also included public data on the stringency of national restrictions. Across the six sites, parental responses indicated elevated levels of hyperactivity, conduct, and emotion problems in children from families characterized by heightened levels of parent distress, parent–child conflict, and household chaos. In contrast, increased peer problems were more strongly related to COVID-19-related social disruption and stringency measures. Mediation models demonstrated that associations between COVID-19 social disruption and child difficulties could be explained by parental distress. Taken together, these results suggest that although the experience of the pandemic differed across countries, associations between COVID-19-related family experiences and child adjustment difficulties were similar in their nature and magnitude across six different contexts. Programs to support family resilience could help buffer the impact of the pandemic for two generations.
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2. |
- Almén, Niclas, 1971-
(author)
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A Cognitive Behavioral Model Proposing That Clinical Burnout May Maintain Itself
- 2021
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In: International Journal of Environmental Research and Public Health. - : MDPI. - 1661-7827 .- 1660-4601. ; 16:7
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Research review (peer-reviewed)abstract
- Burnout is common in many countries and is associated with several other problems such as depression, anxiety, insomnia, and memory deficits, and prospectively it predicts long-term sick-leave, cardiovascular disease, and death. Clinical burnout or its residual symptoms often last several years and a common assumption is that recovery takes a long time by nature, despite full time sick-leave and the absence of work stress. The literature suggests models that hypothetically explain the development, but not maintenance, of the syndrome. Based on cognitive and behavioral principles, stress research, and stress theories, this paper describes a theoretical model explaining how clinical burnout can develop and be maintained. While the development of clinical burnout is mainly explained by prolonged stress reactions and disturbed recovery processes due to work related stressors, maintenance of the syndrome is particularly explained by prolonged stress reactions and disturbed recovery processes due to the new context of experiencing burnout and being on sick-leave. Worry about acquired memory deficits, passivity and excessive sleep, shame, fear of stress reactions, and the perception of not being safe are examples of responses that can contribute to the maintenance. The model has important implications for research and how to intervene in clinical burnout. For example, it can offer support to professional care providers and patients in terms of focusing on, identifying, and changing current contextual factors and behaviors that maintain the individual’s clinical burnout symptoms and by that facilitate burnout recovery. Regarding research, the model provides a highly important reason for researchers to study contextual factors and behaviors that contribute to the maintenance of clinical burnout, which has been neglected in research.
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3. |
- Arvidsson, Inger, et al.
(author)
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Should I stay or should I go? Associations between occupational factors, signs of exhaustion and the intention to change workplace among swedish principals
- 2021
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In: International Journal of Environmental Research and Public Health. - : MDPI AG. - 1661-7827 .- 1660-4601. ; 18:10, s. 1-20
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Journal article (peer-reviewed)abstract
- A high turnover among principals may disrupt the continuity of leadership and negatively affect teachers and, by extension, the students. The aim was to investigate to what extent various work environment factors and signs of exhaustion were associated with reported intentions to change workplace among principals working in compulsory schools. A web-based questionnaire was administered twice, in 2018 and in 2019. Part I of the study involved cross-sectional analyses of the associations 2018 (n = 984) and 2019 (n = 884) between occupational factors, signs of exhaustion, and the intention to change workplace, using Generalized Estimating Equations models. Part II involved 631 principals who participated in both surveys. The patterns of intended and actual changes of workplace across two years were described, together with associated changes of occupational factors and signs of exhaustion. Supportive management was associated with an intention to stay, while demanding role conflicts and the feeling of being squeezed between management and co-workers (buffer-function) were associated with the intention to change workplace. The principals who intended to change their workplace reported more signs of exhaustion. To increase retention among principals, systematic efforts are probably needed at the national, municipal, and local level, in order to improve their working conditions.
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4. |
- Brogårdh, Christina, et al.
(author)
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Fall-Related activity avoidance among persons with late effects of polio and its influence on daily life : A mixed-methods study
- 2021
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In: International Journal of Environmental Research and Public Health. - : MDPI AG. - 1661-7827 .- 1660-4601. ; 18:13, s. 1-11
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Journal article (peer-reviewed)abstract
- Falls are common among persons with late effects of polio (LEoP), which may lead to fear of falling and activity avoidance in everyday life. Here, we assessed the occurrence of fall-related activity avoidance among persons with LEoP and explored how these experiences influenced daily life. Fourteen ambulatory persons (seven women; mean age 70 years) with LEoP participated. They responded to the modified Survey of Activities and Fear of Falling in the Elderly (mSAFFE) and participated in individual interviews, which were analysed by systematic text condensation. Each quotation was deductively analysed from its representation with regard to mSAFFE. We found that many persons often avoided activities related to standing and walking, for example, taking a bath, performing household chores, walking outdoors, attending social events if there were stairs in the building and travelling by public transport, due to fear of falling, increased pain and fatigability. To facilitate the performance of daily activities participants expressed that strategic thinking and aids were important to use. In conclusion, fall-related activity avoidance is common in persons with LEoP, which negatively influence daily life and social participation. To increase daily functioning in this population, fall-related activity avoidance should be included in a multifaceted fall management program.
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5. |
- Colombo, P. E., et al.
(author)
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Optimizing School Food Supply: Integrating Environmental, Health, Economic, and Cultural Dimensions of Diet Sustainability with Linear Programming
- 2019
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In: International Journal of Environmental Research and Public Health. - : MDPI AG. - 1660-4601 .- 1661-7827. ; 16:17
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Journal article (peer-reviewed)abstract
- There is great potential for reducing greenhouse gas emissions (GHGE) from public-sector meals. This paper aimed to develop a strategy for reducing GHGE in the Swedish school food supply while ensuring nutritional adequacy, affordability, and cultural acceptability. Amounts, prices and GHGE-values for all foods and drinks supplied to three schools over one year were gathered. The amounts were optimized by linear programming. Four nutritionally adequate models were developed: Model 1 minimized GHGE while constraining the relative deviation (RD) from the observed food supply, Model 2 minimized total RD while imposing stepwise GHGE reductions, Model 3 additionally constrained RD for individual foods to an upper and lower limit, and Model 4 further controlled how pair-wise ratios of 15 food groups could deviate. Models 1 and 2 reduced GHGE by up to 95% but omitted entire food categories or increased the supply of some individual foods by more than 800% and were deemed unfeasible. Model 3 reduced GHGE by up to 60%, excluded no foods, avoided high RDs of individual foods, but resulted in large changes in food-group ratios. Model 4 limited the changes in food-group ratios but resulted in a higher number of foods deviating from the observed supply and limited the potential of reducing GHGE in one school to 20%. Cost was reduced in almost all solutions. An omnivorous, nutritionally adequate, and affordable school food supply with considerably lower GHGE is achievable with moderate changes to the observed food supply; i.e., with Models 3 and 4. Trade-offs will always have to be made between achieving GHGE reductions and preserving similarity to the current supply.
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6. |
- Ekvall Hansson, Eva, et al.
(author)
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Gait flexibility among older persons significantly more impaired in fallers than non-fallers-a longitudinal study
- 2021
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In: International Journal of Environmental Research and Public Health. - : MDPI AG. - 1661-7827 .- 1660-4601. ; 18:13, s. 1-13
-
Journal article (peer-reviewed)abstract
- Gait disorders are a relevant factor for falls and possible to measure with wearable devices. If a wearable sensor can detect differences in gait parameters between fallers and non-fallers has not yet been studied. The aim of this study was to measure and compare gait parameters, vestibular function, and balance performance between fallers and non-fallers among a group of older persons. Participants were senior members (n = 101) of a Swedish non-profit gymnastic association. Gait parameters were obtained using an inertial measurement unit (IMU) that the participants wore on the leg while walking an obstacle course and on an even surface. Vestibular function was assessed by the Head-shake test, the Head impulse test, and the Dix-Hallpike maneuver. Balance was assessed by the Timed Up and Go, the Timed Up and Go manual, and the Timed Up and Go cognitive tests. Falls during the 12-month follow-up period were monitored using fall diaries. Forty-two persons (41%) had fallen during the 12-month follow-up. Fallers had more limited ability to vary their gait (gait flexibility) than non-fallers (p < 0.001). No other differences between fallers and non-fallers were found. The use of gait flexibility, captured by an IMU, seems better for identifying future fallers among healthy older persons than Timed Up and Go or Timed Up and Go combined with a cognitive or manual task.
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7. |
- Khalaf, Atika, 1973-, et al.
(author)
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Female university students’ physical activity levels and associated factors : a cross-sectional study in southwestern Saudi Arabia
- 2013
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In: International Journal of Environmental Research and Public Health. - 1661-7827 .- 1660-4601. ; 10:8, s. 3502-3517
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Journal article (peer-reviewed)abstract
- Background: The high prevalence of physical inactivity in Saudi Arabia is a growing challenge to public health. This study aimed to examine the prevalence of physical activity (PA) and associated factors among female university students. Methods: This cross-sectional study involved 663 randomly selected female university students who completed the Arab Teens Life Style questionnaire. Data included measurements of anthropometric, socioeconomic and environmental factors, as well as self-reported PA. Ordinal regression was used to identify associated factors with low, moderate and high PA levels. Results: The mean age of participants was 20.4 years (SD 1.5). Mean BMI of the students in relation to PA were 23.0, 22.9, 22.1 for high, moderate and low levels of activity, respectively. The analysis revealed significantly higher PA levels among married students, those with high educated mothers, and those who lived far from parks, and lower activity levels among underweight students. Conclusions: This study raises four important determinants for female university students’ PA levels. These factors could be of great importance in the endeavor to prevent the health-threatening increase in physical inactivity patterns and thus non-communicable diseases and obesity where the focus should be on the specific situation and needs of women in Saudi Arabia.
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8. |
- Neumann, Tim, et al.
(author)
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Gold standard program for heavy smokers in a real-life setting.
- 2013
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In: International Journal of Environmental Research and Public Health. - : MDPI AG. - 1660-4601. ; 10:9, s. 4186-4199
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Journal article (peer-reviewed)abstract
- Background: High-intensity smoking cessation programs generally lead to more continuous abstinence, however, lower rates of success have been reported among heavy smokers. The aim was to evaluate continuous abstinence among heavy smokers during the intensive 6-week Gold Standard Program (GSP) and to identify modifiable factors associated with continuous abstinence. Methods: In this nationwide clinical study based on 36,550 smokers attending an intensive cessation program in Denmark. Heavy smoking was defined as ≥7 points in the Fagerström Nicotine Dependency Test, smoking ≥20 cigarettes daily or ≥20 pack-years. Results: Overall, 28% had a Fagerström score ≥7 points, 58% smoked ≥20 cigarettes daily and 68% smoked ≥20 pack-years. Continuous abstinence was 33% in responders (6-months response rate: 78%); however, abstinence was approximately 1-6% lower in the heavy smokers than the overall population. Attending GSP with an individual format (vs. group/other, OR 1.23-1.44); in a hospital setting (vs. pharmacy/municipality services, OR 1.05-1.11); and being compliant (attending the planned meetings OR 4.36-4.89) were associated with abstinence. Abstinence decreased in a dose-dependent manner with increasing smoking severity. Conclusions: Abstinence after GSP was 1-6% lower in the heavy smokers than in the overall study population. Modifiable factors may be used for small improvements in continued abstinence. However attempts to improve compliance seemed especially promising.
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9. |
- Nielsen, Christel, et al.
(author)
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Susceptibility to COVID-19 after High Exposure to Perfluoroalkyl Substances from Contaminated Drinking Water: An Ecological Study from Ronneby, Sweden
- 2021
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In: International Journal of Environmental Research and Public Health. - : MDPI AG. - 1660-4601. ; 18:20
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Journal article (peer-reviewed)abstract
- There is concern that immunotoxic environmental contaminants, particularly perfluoroalkyl substances (PFAS), may play a role in the clinical course of COVID-19 and epidemiologic studies are needed to answer if high-exposed populations are especially vulnerable in light of the ongoing pandemic. The objective was, therefore, to determine if exposure to highly PFAS-contaminated drinking water was associated with an increased incidence of COVID-19 in Ronneby, Sweden, during the first year of the pandemic. We conducted an ecological study determining the sex- and age-standardized incidence ratio (SIR) in the adult population relative to a neighboring reference town with similar demographic characteristics but with only background levels of exposure. In Sweden, COVID-19 is subject to mandatory reporting, and we retrieved aggregated data on all verified cases until 3 March 2021 from the Public Health Agency of Sweden. The SIR in Ronneby was estimated at 1.19 (95% CI: 1.12; 1.27). The results suggest a potential link between high PFAS exposure and susceptibility to COVID-19 that warrants further research to clarify causality.
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10. |
- Nilsson, Kerstin, et al.
(author)
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Organisational Measures and Strategies for a Healthy and Sustainable Extended Working Life and Employability-A Deductive Content Analysis with Data Including Employees, First Line Managers, Trade Union Representatives and HR-Practitioners
- 2021
-
In: International Journal of Environmental Research and Public Health. - 1661-7827 .- 1660-4601. ; 18:11, s. 1-29
-
Journal article (peer-reviewed)abstract
- Due to the global demographic change many more people will need to work until an older age, and organisations and enterprises need to implement measures to facilitate an extended working life. The aim of this study was to investigate organisational measures and suggestions to promote and make improvements for a healthy and sustainable working life for all ages in an extended working life. This is a qualitative study, and the data were collected through both focus group interviews and individual interviews that included 145 participants. The study identified several suggestions for measures and actions to increase employability in the themes: to promote a good physical and mental work environment; to promote personal financial and social security; to promote relations, social inclusion and social support in the work situation; and to promote creativity, knowledge development and intrinsic work motivation, i.e., based on the spheres of determination in the theoretical swAge-model (sustainable working life for all ages). Based on the study results a tool for dialogue and discussion on employee work situation and career development was developed, and presented in this article. Regular conversations, communication and close dialogue are needed and are a prerequisite for good working conditions and a sustainable working environment, as well as to be able to manage employees and develop the organisation further. The identified measures need to be revisited regularly throughout the employees' entire working life to enable a healthy and sustainable working life for all ages.
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11. |
- Nilsson, Kerstin, et al.
(author, creator_code:000000023193205X_t)
-
Organisational Measures and Strategies for a Healthy and Sustainable Extended Working Life and Employability-A Deductive Content Analysis with Data Including Employees, First Line Managers, Trade Union Representatives and HR-Practitioners
- 2021
-
In: International Journal of Environmental Research and Public Health. - : MDPI Multidisciplinary Digital Publishing Institute. - 1661-7827 .- 1660-4601. ; 18:11, s. 1-29
-
Journal article (peer-reviewed)abstract
- Due to the global demographic change many more people will need to work until an older age, and organisations and enterprises need to implement measures to facilitate an extended working life. The aim of this study was to investigate organisational measures and suggestions to promote and make improvements for a healthy and sustainable working life for all ages in an extended working life. This is a qualitative study, and the data were collected through both focus group interviews and individual interviews that included 145 participants. The study identified several suggestions for measures and actions to increase employability in the themes: to promote a good physical and mental work environment; to promote personal financial and social security; to promote relations, social inclusion and social support in the work situation; and to promote creativity, knowledge development and intrinsic work motivation, i.e., based on the spheres of determination in the theoretical swAge-model (sustainable working life for all ages). Based on the study results a tool for dialogue and discussion on employee work situation and career development was developed, and presented in this article. Regular conversations, communication and close dialogue are needed and are a prerequisite for good working conditions and a sustainable working environment, as well as to be able to manage employees and develop the organisation further. The identified measures need to be revisited regularly throughout the employees' entire working life to enable a healthy and sustainable working life for all ages.
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12. |
- Westblad, Niklas, et al.
(author)
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The Effect of Autoregulated Flywheel and Traditional Strength Training on Training Load Progression and Motor Skill Performance in Youth Athletes.
- 2021
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In: International Journal of Environmental Research and Public Health. - : MDPI. - 1661-7827 .- 1660-4601. ; 18:7
-
Journal article (peer-reviewed)abstract
- BACKGROUND: The effects of flywheel resistance training (FRT) on youth are relatively unknown. The aim of this study was to compare the effects of autoregulated FRT with traditional strength training (TST) on jumping, running performance and resistance training load progression in youth athletes. Thirty youth athletes (11.8 ± 0.9 yr) were matched for peak height velocity (PHV) status and block-randomised into two groups: FRT (n = 15, PHV -0.8 ± 1.6) and TST (n = 15, PHV -0.8 ± 1.5). Twelve resistance training sessions over a six-week intervention with flywheel or barbell squats were performed using autoregulated load prescription. Squat jump (SJ); countermovement jump (CMJ); and 10 m, 20 m and 30 m sprints were assessed pre- and post-intervention. The external load increased similarly for FRT and TST (z = 3.8, p = 0.06). SJ increased for both groups (p < 0.05) but running performance was unaffected (p > 0.05).CONCLUSIONS: FRT resulted in similar load progression and motor skill development in youth athletes as TST, but the perceived exertion was less. Autoregulation is a practical method for adjusting training load during FRT and should be considered as an alternative to autoregulated TST.
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13. |
- Zubak, Zoran, et al.
(author)
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A Prospective study on the influence of scholastic factors on the prevalence and initiation of illicit drug misuse in adolescence
- 2018
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In: International Journal of Environmental Research and Public Health. - : MDPI. - 1661-7827 .- 1660-4601. ; 15:5, s. 1-12
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Journal article (peer-reviewed)abstract
- Background: This study aimed to prospectively investigate the scholastic factors related to illicit drug misuse (IDM) and the initiation of IDM among older adolescents from Bosnia andHerzegovina. Methods: This 2-year prospective study included 436 participants (202 females), who were an average of 16 years old at the beginning of the study (baseline). The participants were tested at baseline and follow-up (20 months later). The predictors included variables of scholastic-achievement (grade point average, school absences, unexcused absences and behavioral grade). The criteria were: (i) IDM at baseline; (ii) IDM at follow-up; and (iii) initiation of IDM over the study course. Results: Logistic regression indicated increased odds of IDM in adolescents who were more frequent absent from school (baseline: Odds Ratio (OR): 3.73, 95% Confidence Interval (CI): 2.12–6.57; follow-up: OR: 2.91, 95% CI: 1.90–4.65). The lower grade point average and more unexcused absences were evidenced for adolescents who consumed drugs on follow-up(OR: 1.67, 95% CI: 1.11–2.51; OR: 1.74, 95% CI: 1.30–2.32 for grade point average and unexcused absences, respectively). Initiation of IDM was predicted by frequent absences from school (OR: 2.2,95% CI: 1.3–3.8), and lower behavioral grades (OR: 1.9, 95% CI: 1.2–3.3). Conclusions: The findings confirmed strong correlations between scholastic failure and IDM. Absences from school and lower behavioral grades at baseline were predictive of the initiation of IDM in older adolescents.
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14. |
- Tuvesson, Hanna, et al.
(author)
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Psychosocial Work Environment, Stress Factors and Individual Characteristics among Nursing Staff in Psychiatric In-Patient Care
- 2014
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In: International Journal of Environmental Research and Public Health. - Basel, Switzerland : MDPI. - 1661-7827 .- 1660-4601. ; 11:1, s. 1161-1175
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Journal article (peer-reviewed)abstract
- The psychosocial work environment is an important factor in psychiatric in-patient care, and knowing more of its correlates might open up new paths for future workplace interventions. Thus, the aims of the present study were to investigate perceptions of the psychosocial work environment among nursing staff in psychiatric in-patient care and how individual characteristicsMastery, Moral Sensitivity, Perceived Stress, and Stress of Conscienceare related to different aspects of the psychosocial work environment. A total of 93 nursing staff members filled out five questionnaires: the QPSNordic 34+, Perceived Stress Scale, Stress of Conscience Questionnaire, Moral Sensitivity Questionnaire, and Mastery scale. Multivariate analysis showed that Perceived Stress was important for Organisational Climate perceptions. The Stress of Conscience subscale Internal Demands and Experience in current units were indicators of Role Clarity. The other Stress of Conscience subscale, External Demands and Restrictions, was related to Control at Work. Two types of stress, Perceived Stress and Stress of Conscience, were particularly important for the nursing staff's perception of the psychosocial work environment. Efforts to prevent stress may also contribute to improvements in the psychosocial work environment.
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15. |
- Buli, Benti Geleta, et al.
(author)
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Active Commuting and Healthy Behavior among Adolescents in Neighborhoods with Varying Socioeconomic Status : The NESLA Study
- 2022
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In: International Journal of Environmental Research and Public Health. - : MDPI AG. - 1661-7827 .- 1660-4601. ; 19:7
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Journal article (peer-reviewed)abstract
- (1) Background: The World Health Organization recommends active commuting as a source of physical activity. Active commuting is determined by various factors, including the socioeconomic status (SES) of families and neighborhoods, distance to schools, perceived neighborhood safety, lifestyles, and availability of walkways and biking paths. This study aimed to assess factors associated with modes of transportation to and from school among adolescents aged 16–19 living in a middle-sized city in Sweden. (2) Method: Three hundred and fourteen students, of whom 55% were females, from schools in the city of Västerås participated in the study. Printed as well as web-based self-administered questionnaires were used to collect the data. (3) Results: Adolescents living in high SES neighborhoods were 80% more likely to bike or walk to school (OR = 1.80; CI: 1.01, 3.20) than adolescents living in low SES neighborhoods. Furthermore, active commuting was associated with higher consumption of fruits and vegetables (OR = 1.77; CI: 1.05, 2.97) and less consumption of junk foods (OR = 0.43; CI: 0.26, 0.71), as compared to passive commuting. (4) Conclusions: Active commuting is a cost-effective and sustainable source of regular physical activity and should be encouraged at a societal level.
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16. |
- Lõhmus, Mare, et al.
(author)
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Combined Exposure to Birch Pollen and Thunderstorms Affects Respiratory Health in Stockholm, Sweden—A Time Series Analysis
- 2022
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In: International Journal of Environmental Research and Public Health. - : MDPI AG. - 1661-7827 .- 1660-4601. ; 19:10, s. 5852-5852
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Journal article (peer-reviewed)abstract
- Background: Thunderstorm asthma is a term used to describe surges in acute respiratory illnesses following a thunderstorm and is often attributed to an intense exposure to aeroallergens. Several episodes of thunderstorm asthma have been observed worldwide; however, no such cases have been described in Sweden. In Sweden, the most prominent exposure to air-borne pollen occurs during the blooming of the birch. We aimed to explore the associations between respiratory health and the combined exposure to thunderstorms and birch pollen. Methods: We investigated the association between the daily numbers of outpatient visits due to respiratory cases and the combined exposure to thunderstorms and birch pollen during the period of 1 May–31 September in 2001–2017, in Stockholm County, Sweden, by using time series analysis with log linear models. Results: We detected noticeable increases in the number of outpatient visits on both the same day (max 26%; 95% CI 1.16–1.37) and the day after (max 50%; 95% CI 1.32–1.70) the occurrence of a thunderstorm, when the concentrations of birch pollen and the number of lightning discharges were within the highest categories. Conclusions: It is possible that co-exposure to heavy thunderstorms and high concentrations of birch pollen affects the respiratory health of the Stockholm population. To the best of our knowledge, this is the first study addressing the thunderstorm-related respiratory illnesses in Sweden and the effects of birch pollen. Our study may be important for future public health advice related to thunderstorm asthma.
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17. |
- Nivestam, Anna, et al.
(author)
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Give older persons a voice in the society : By using information compiled during preventive home visits on a societal level
- 2021
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In: International Journal of Environmental Research and Public Health. - 1661-7827 .- 1660-4601. ; 18:14, s. 1-17
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Journal article (peer-reviewed)abstract
- Preventive home visits (PHVs) are offered to older persons with the purpose of promoting health and preventing risks on an individual level. However, aspects of health need to be considered on a societal level as well. This study aims to get a deeper understanding of perceptions of the usability of the information compiled during the PHVs to promote health, among older persons, on a societal level. Three online focus groups were conducted with heads of unit of PHVs, heads of department, and politicians responsible for health and welfare in seven municipalities in Sweden (n = 12). The findings were visualised in the core category Enable an inclusive society and the interrelated categories Monitoring determinants of health and Enabling exchange of information. The information from the PHVs could be used to monitor determinants of health by identifying assets, challenges, shifts, trends, and future needs in the society. Moreover, exchange of information from the PHVs could occur within and outside the health and welfare organisation. However, the potential use was affected by hindrances illustrated in the category Obstacles to interpreting and communicating the information. To conclude, using the information from the PHVs could possibly contribute to an inclusive society, where persons not usually represented in decision making are given a voice.
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18. |
- Schön Persson, Sophie, 1979-, et al.
(author)
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Meetings are an important prerequisite for flourishing workplace relationships
- 2021
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In: International Journal of Environmental Research and Public Health. - 1661-7827 .- 1660-4601. ; 18:15, s. 1-13
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Journal article (peer-reviewed)abstract
- Relationships among colleagues, managers, and care recipients are mutually important, and need to be highlighted in workplace health promotion. The aim was to explore prerequisites for flourishing workplace relationships in a municipal healthcare setting for old people. As part of this process, we explored the staff’s suggestions on how work relationships could be improved. The study had a salutogenic and participatory approach, examining staff perceptions of what was required for flourishing relationships to be created, and their suggestions for the relationships to be more promotive. Four multi-stage focus groups, which met three times each, were conducted with staff (n = 26) in old age healthcare settings. A deductive analysis was performed, based on components of the flourishing concept: challenge, connectivity, autonomy, and competence. Informal and formal meetings at work were shown to build positively perceived relationships. The study describes meetings and relationships connected to the four components of flourishing. Suggestions for improving work relationships are also presented. This study contributes to workplace health promotion, and has a salutogenic and participatory focus on how to explore workplace relationships as a resource. The flourishing concept shows how workplace relationships can be explored as prerequisites for workplace health promotion.
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19. |
- Aamodt, Ina Thon, et al.
(author)
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Tools to Support Self-Care Monitoring at Home: Perspectives of Patients with Heart Failure
- 2020
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In: International Journal of Environmental Research and Public Health. - : MDPI. - 1661-7827 .- 1660-4601. ; 17:23
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Journal article (peer-reviewed)abstract
- Self-care monitoring at home can be a challenge for patients with heart failure (HF). Tools that leverage information and communication technology (ICT), comprise medical devices, or have written material may support their efforts at home. The aim of this study was to describe HF patients experiences and their prioritization of tools that support, or could support, self-care monitoring at home. A descriptive qualitative design employing semi-structured interviews was used with HF patients living at home and attending an HF outpatient clinic in Norway. We used a deductive analysis approach, using the concept of self-care monitoring with ICT tools, paper-based tools, medical devices, and tools to consult with healthcare professionals (HCPs) as the categorization matrix. Nineteen HF patients with a mean age of 64 years participated. ICT tools are used by individual participants to identify changes in their HF symptoms, but are not available by healthcare services. Paper-based tools, medical devices, and face-to-face consultation with healthcare professionals are traditional tools that are available and used by individual participants. HF patients use traditional and ICT tools to support recognizing, identifying, and responding to HF symptoms at home, suggesting that they could be used if they are available and supplemented by in-person consultation with HCPs.
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20. |
- Aartolahti, Eeva, et al.
(author)
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Perceived opportunities for physical activity and willingness to be more active in older adults with different physical activity levels
- 2021
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In: International Journal of Environmental Research and Public Health. - : MDPI AG. - 1661-7827 .- 1660-4601. ; 18:11
-
Journal article (peer-reviewed)abstract
- This study examined equity in physical activity (PA) by investigating whether perceived opportunity for PA was associated with willingness to be more active. Among community residents (75, 80, or 85 years old, n = 962) perceived opportunity for PA (poor and good), willingness to be more active (not at all, a bit, and a lot), and level of PA (low, moderate, and high) were assessed via questionnaires. Multinomial logistic regression showed that physical activity moderated the association between poor opportunity and willingness to increase PA. Among those with moderate PA, poor opportunity for PA increased the odds of willingness to be a lot more active (multinomial odds ratio, mOR 3.90, 95% confidence interval 2.21–6.87) than not wanting to be more active compared to those perceiving good opportunities. Associations were similar at high PA levels (p < 0.001), but were not found at low PA levels. Those with moderate or high PA wish to increase their activity particularly when the perceived opportunities for activity are not optimal. Among those with low PA, perceived opportunities are not associated with a perceived need to increase physical activity. Increasing equity in physical activity in old age requires provision of support and opportunities at every level of physical activity.
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21. |
- Abbasi-Perez, A, et al.
(author)
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Analysis of Tweets Containing Information Related to Rheumatological Diseases on Twitter
- 2021
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In: International journal of environmental research and public health. - : MDPI AG. - 1660-4601. ; 18:17
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Journal article (peer-reviewed)abstract
- Background: Tweets often indicate the interests of Twitter users. Data from Twitter could be used to better understand the interest in and perceptions of a variety of diseases and medical conditions, including rheumatological diseases which have increased in prevalence over the past several decades. The aim of this study was to perform a content analysis of tweets referring to rheumatological diseases. Methods: The content of each tweet was rated as medical (including a reference to diagnosis, treatment, or other aspects of the disease) or non-medical (such as requesting help). The type of user and the suitability of the medical content (appropriate content or, on the contrary, fake content if it was medically inappropriate according to the current medical knowledge) were also evaluated. The number of retweets and likes generated were also investigated. Results: We analyzed a total of 1514 tweets: 1093 classified as medical and 421 as non-medical. The diseases with more tweets were the most prevalent. Within the medical tweets, the content of these varied according to the disease (some more focused on diagnosis and others on treatment). The fake content came from unidentified users and mostly referred to the treatment of diseases. Conclusions: According to our results, the analysis of content posted on Twitter in regard to rheumatological diseases may be useful for investigating the public’s prevailing areas of interest, concerns and opinions. Thus, it could facilitate communication between health care professionals and patients, and ultimately improve the doctor–patient relationship. Due to the interest shown in medical issues it seems desirable to have healthcare institutions and healthcare workers involved in Twitter.
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22. |
- Abbaspour, A, et al.
(author)
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Comparison of Dual-Energy X-ray Absorptiometry and Bioelectrical Impedance Analysis in the Assessment of Body Composition in Women with Anorexia Nervosa upon Admission and Discharge from an Inpatient Specialist Unit
- 2021
-
In: International journal of environmental research and public health. - : MDPI AG. - 1660-4601. ; 18:21
-
Journal article (peer-reviewed)abstract
- Assessment of body composition is fundamental in diagnosis and treatment of anorexia nervosa (AN). The gold standard dual-energy X-ray absorptiometry (DXA) is expensive and not universally available. Bioelectrical impedance analysis (BIA) is a non-invasive, inexpensive method relative to DXA. We compared DXA and BIA in the assessment of fat-free mass (FFM), fat mass (FM), and body fat percentage (BF%) in women with AN upon admission (ANT1) and discharge (ANT2) from an inpatient specialist unit with a referent healthy control (HC) group. The study population consisted of 31 ANT1, 25 ANT2, and 52 HC women with median age of 21 years. Body composition was measured by DXA and Tanita foot-to-foot BIA. Comparison between the two methods was done using Bland–Altman analysis, Pearson’s correlation coefficient, Lin’s concordance correlation coefficient, and linear regression. The mean difference (bias) in FM and BF% values obtained by DXA and BIA in ANT1 (FM: +1.01 kg, BF%: +2.26%) and ANT2 (FM: +1.49 kg, BF%: +1.66%) were comparable to HC (FM: −1.32 kg, BF%: −2.29%) although in opposite directions. Less bias was observed in FFM values in ANT1 (−0.46 kg) and ANT2 (−0.86 kg) than in HC (+2.03 kg); however, the limits of agreement between the two methods were wider in ANT1 and ANT2 than in HC for all measurements. No association was observed between age, percentage of total body water, and the time spent on the inpatient specialist unit with the difference in estimates of body composition between DXA and BIA. Comparison of DXA and BIA suggests that DXA should remain the gold standard for measuring body composition; the development of more specific BIA equations is required to improve validity and precision of BIA in patients with AN. Despite ease and cost in both BIA access and operation, the suitability of BIA in a low bodyweight eating disorders population remains questionable.
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23. |
- Abdullah, Abu Sayeed Md., et al.
(author)
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Effects of climate change and maternal morality : Perspective from case studies in the rural area of Bangladesh
- 2019
-
In: International Journal of Environmental Research and Public Health. - : MDPI AG. - 1661-7827 .- 1660-4601. ; 16:23
-
Journal article (peer-reviewed)abstract
- This study explored the community perception of maternal deaths influenced by natural disaster (flood), and the practice of maternal complications during natural disaster among the rural population in Bangladesh. It also explored the challenges faced by the community for providing healthcare and referring the pregnant women experiencing complications during flood disaster. Three focus group discussions (FGDs) and eight in-depth interviews (IDIs) were conducted in the marginalized rural communities in the flood-prone Khaliajhuri sub-district, Netrakona district, Bangladesh. Flood is one of the major risk factors for influencing maternal death. Pregnant women seriously suffer from maternal complications, lack of antenatal checkup, and lack of doctors during flooding. During the time of delivery, it is difficult to find a skilled attendant, and referring the patient with delivery complications to the healthcare facility. Boats are the only mode of transport. The majority of maternal deaths occur on the boats during transfer from the community to the hospital. Rural people feel that the maternal deaths influenced by natural disaster are natural phenomena. Pre-preparation is needed to support pregnant women during disasters. There is unawareness of maternal health, related care, and complications during disasters among local health service providers and volunteers.
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24. |
- Abe, Takafumi, et al.
(author)
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Assessing the impact of a hilly environment on depressive symptoms among community-dwelling older adults in japan : A cross-sectional study
- 2021
-
In: International Journal of Environmental Research and Public Health. - : MDPI AG. - 1661-7827 .- 1660-4601. ; 18:9
-
Journal article (peer-reviewed)abstract
- Although some neighborhood environmental factors have been found to affect depressive symptoms, few studies have focused on the impact of living in a hilly environment, i.e., land slope, on depressive symptoms among rural older adults. This cross-sectional study aimed to investigate whether a land slope is associated with depressive symptoms among older adults living in rural areas. Data were collected from 935 participants, aged 65 years and older, who lived in Shimane prefecture, Japan. Depressive symptoms were assessed using the Zung Self-Rating Depression Scale (SDS) and defined on the basis of an SDS score ≥ 40. Land slopes within a 400 m network buffer were assessed using geographic information systems. Odds ratios (ORs) with 95% confidence intervals (CIs) of depressive symptoms were estimated using logistic regression. A total of 215 (23.0%) participants reported depressive symptoms. The land slope was positively associated with depressive symptoms (OR = 1.04; 95% CI = 1.01–1.08) after adjusting for all confounders. In a rural setting, living in a hillier environment was associated with depressive symptoms among community-dwelling older adults in Japan.
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25. |
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26. |
- Ahlström, Gerd, et al.
(author)
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Quality of Life among Next of Kin of Frail Older People in Nursing Homes : An Interview Study after an Educational Intervention concerning Palliative Care
- 2022
-
In: International Journal of Environmental Research and Public Health. - : MDPI AG. - 1661-7827 .- 1660-4601. ; 19:5
-
Journal article (peer-reviewed)abstract
- One cornerstone of palliative care is improving the family’s quality of life (QoL). The principles of palliative care have not been sufficiently applied in nursing homes. The aim of this study was to investigate the experiences of QoL of next of kin of frail older persons in nursing homes after an educational intervention concerning palliative care. This qualitative interview study with 37 next of kin used an abductive design with deductive and inductive content analysis. The deductive analysis confirmed the three themes of QoL from the study before the implementation: (1) orientation to the new life-situation, (2) challenges in the relationship, and (3) the significance of the quality of care in the nursing home. The inductive analysis resulted in the sub-theme “Unspoken palliative care”. Being the next of kin of an older person living in a nursing home can be distressing despite round-the-clock care, so staff need to apply a more explicitly palliative care perspective. Future research needs to evaluate the influence of meaning-focused coping on next of kin’s QoL and integrate this knowledge in psychosocial interventions. Clinical Trial Database for Clinical Research: KUPA project NCT02708498.
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27. |
- Ahmad Kiadaliri, Aliasghar, et al.
(author)
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Health utilities of type 2 diabetes-related complications: a cross-sectional study in Sweden.
- 2014
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In: International journal of environmental research and public health. - : MDPI AG. - 1660-4601. ; 11:5, s. 4939-52
-
Journal article (peer-reviewed)abstract
- This study estimates health utilities (HU) in Sweden for a range of type 2 diabetes-related complications using EQ-5D and two alternative tariffs (UK and Swedish) from 1757 patients with type 2 diabetes from the Swedish National Diabetes Register (NDR). Ordinary least squares were used for statistical analysis. Lower HU was found for female gender, younger age at diagnosis, higher BMI, and history of complications. Microvascular and macrovascular complications had the most negative effect on HU among women and men, respectively. The greatest decline in HU was associated with kidney disorders (-0.114) using the UK tariff and stroke (-0.059) using the Swedish tariff. Multiple stroke and non-acute ischaemic heart disease had higher negative effect than a single event. With the UK tariff, each year elapsed since the last microvascular/macrovascular complication was associated with 0.013 and 0.007 units higher HU, respectively. We found important heterogeneities in effects of complications on HU in terms of gender, multiple event, and time. The Swedish tariff gave smaller estimates and so may result in less cost-effective interventions than the UK tariff. These results suggest that incorporating subgroup-specific HU in cost-utility analyses might provide more insight for informed decision-making.
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28. |
- Ahmad Kiadaliri, Aliasghar, et al.
(author)
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Pure and social disparities in distribution of dentists: a cross-sectional province-based study in iran.
- 2013
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In: International Journal of Environmental Research and Public Health. - : MDPI AG. - 1660-4601. ; 10:5, s. 1882-1894
-
Journal article (peer-reviewed)abstract
- During past decades, the number of dentists has continuously increased in Iran. Beside the quantity, the distribution of dentists affects the oral health status of population. The current study aimed to assess the pure and social disparities in distribution of dentists across the provinces in Iran in 2009. Data on provinces' characteristics, including population and social situation, were obtained from multiple sources. The disparity measures (including Gini coefficient, index of dissimilarity, Gaswirth index of disparity and relative index of inequality (RII)) and pairwise correlations were used to evaluate the pure and social disparities in the number of dentists in Iran. On average, there were 28 dentists per 100,000 population in the country. There were substantial pure disparities in the distribution of dentists across the provinces in Iran. The unadjusted and adjusted RII values were 3.82 and 2.13, respectively; indicating area social disparity in favor of people in better-off provinces. There were strong positive correlations between density of dentists and better social rank. It is suggested that the results of this study should be considered in conducting plans for redistribution of dentists in the country. In addition, further analyses are needed to explain these disparities.
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29. |
- Ahmad, Naveed, et al.
(author)
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Corporate social responsibility at the micro-level as a “new organizational value” for sustainability : Are females more aligned towards it?
- 2021
-
In: International Journal of Environmental Research and Public Health. - : MDPI AG. - 1661-7827 .- 1660-4601. ; 18:4
-
Journal article (peer-reviewed)abstract
- While prior studies have largely addressed corporate social responsibility (CSR) at a macro or institutional level, its importance at the micro or individual level is to date underexplored, especially in the context of developing economies. Further, it is not clear from the studies in the extant literature how the role of females is more important in the context of environmental management as compared to males. Similarly, micro-level CSR (MCSR) is emerging as a “new organizational value”, and the organizations that acknowledge this “new organizational value” and incorporate it into their business operations are likely to achieve sustainability objectives far better as compared to their counterparts. The present study investigates the impact of MCSR on employees’ pro-environmental behavior with the moderating effect of gender in the healthcare sector of Pakistan. The data were collected from five large hospitals in the city of Lahore through a self-administered questionnaire and analyzed using structural equation modeling (SEM) in AMOS software. A total of 533 out of 800 responses were received, which were used for data analysis of the present study. The results revealed that MCSR positively influences employee’s pro-environmental behavior, and gender moderates this relationship but the moderating effect of females is stronger as compared to males. The findings of the present study would help policymakers understand the importance of MCSR as a “new organizational value” to influence employees’ pro-environmental behavior with a special focus to promote the proactive role of females at workplaces.
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30. |
- Ahmad, Naveed, et al.
(author)
-
The inter-relation of corporate social responsibility at employee level, servant leadership, and innovative work behavior in the time of crisis from the healthcare sector of pakistan
- 2021
-
In: International Journal of Environmental Research and Public Health. - : MDPI AG. - 1661-7827 .- 1660-4601. ; 18:9
-
Journal article (peer-reviewed)abstract
- Organizational crisis can serve as a base to provide an opportunity to an organization for enhancing individuals, organizations, and communities. The healthcare sector is one of those sectors that remains under continuous pressure to provide high-quality service delivery to the patients. Hence, the requirement of innovation for this sector is huge when compared to other sectors. The majority of the previous studies have investigated the phenomenon of CSR at the employee’s level (CSR-E) to influence employee behavior positively. However, the importance of CSR-E to enhance the innovative capability of the employees at the workplace is not well-explored in extant literature. Moreover, it is not clear from previous studies how the concept of servant leadership can explain the employee’s engagement towards innovative work behavior (EIB). Thus, the current survey aims to test the relationship of CSR-E and EIB in the healthcare sector of Pakistan with the mediating effect of servant leadership. The data of the current study were obtained through a self-administered (paper-pencil) survey and they were analyzed through the structural equation modeling (SEM) technique. The empirical results of SEM analysis revealed that CSR-E and EIB are positively related and servant leadership partially mediates this relationship. The findings of the current study will be helpful for policymakers to improve their understanding towards CSR-E to induce EIB in the time of crisis. At the same time, the current study also highlights the importance of servant leadership to the policymakers in encouraging the employees to display their innovative capability at the workplace to serve their organization during the time of crisis.
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31. |
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32. |
- Ahmed, Toqeer, et al.
(author)
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Climate change, water quality and water-related challenges : A review with focus on Pakistan
- 2020
-
In: International Journal of Environmental Research and Public Health. - : MDPI AG. - 1661-7827 .- 1660-4601. ; 17:22, s. 1-22
-
Research review (peer-reviewed)abstract
- Climate variability is heavily impacting human health all around the globe, in particular, on residents of developing countries. Impacts on surface water and groundwater resources and water-related illnesses are increasing, especially under changing climate scenarios such as diversity in rainfall patterns, increasing temperature, flash floods, severe droughts, heatwaves and heavy precipitation. Emerging water-related diseases such as dengue fever and chikungunya are reappearing and impacting on the life of the deprived; as such, the provision of safe water and health care is in great demand in developing countries to combat the spread of infectious diseases. Government, academia and private water bodies are conducting water quality surveys and providing health care facilities, but there is still a need to improve the present strategies concerning water treatment and management, as well as governance. In this review paper, climate change pattern and risks associated with water-related diseases in developing countries, with particular focus on Pakistan, and novel methods for controlling both waterborne and water-related diseases are discussed. This study is important for public health care, particularly in developing countries, for policy makers, and researchers working in the area of climate change, water quality and risk assessment.
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33. |
- Ahmed, Toqeer, et al.
(author)
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Climatic Conditions : Conventional and Nanotechnology-Based Methods for the Control of Mosquito Vectors Causing Human Health Issues
- 2019
-
In: International Journal of Environmental Research and Public Health. - : MDPI AG. - 1660-4601. ; 16:17
-
Research review (peer-reviewed)abstract
- Climate variability is highly impacting on mosquito-borne diseases causing malaria and dengue fever across the globe. Seasonal variability change in temperature and rainfall patterns are impacting on human health. Mosquitoes cause diseases like dengue fever, yellow fever, malaria, Chikungunya, West Nile and Japanese encephalitis. According to estimations by health organizations, annually one million human deaths are caused by vector-borne diseases, and dengue fever has increased about 30-fold over the past 50 years. Similarly, over 200 million cases of malaria are being reported annually. Mosquito-borne diseases are sensitive to temperature, humidity and seasonal variability. Both conventional (environmental, chemical, mechanical, biological etc.) and nanotechnology-based (Liposomes, nano-suspensions and polymer-based nanoparticles) approaches are used for the eradication of Malaria and dengue fever. Now green approaches are used to eradicate mosquitoes to save human health without harming the environment. In this review, the impact of climatic conditions on mosquito-borne diseases along with conventional and nanotechnology-based approaches used for controlling malaria and dengue fever have been discussed. Important recommendations have been made for people to stay healthy.
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34. |
- Ahmed, Toqeer, et al.
(author)
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Water-related impacts of climate change on agriculture and subsequently on public health : A review for generalists with particular reference to Pakistan
- 2016
-
In: International Journal of Environmental Research and Public Health. - : MDPI AG. - 1661-7827 .- 1660-4601. ; 13:11
-
Research review (peer-reviewed)abstract
- Water-related impacts due to change in climatic conditions ranging from water scarcity to intense floods and storms are increasing in developing countries like Pakistan. Water quality and waterborne diseases like hepatitis, cholera, typhoid, malaria and dengue fever are increasing due to chaotic urbanization, industrialization, poor hygienic conditions, and inappropriate water management. The morbidity rate is high due to lack of health care facilities, especially in developing countries. Organizations linked to the Government of Pakistan (e.g., Ministry of Environment, Ministry of Climate Change, Planning and Development, Ministry of Forest, Irrigation and Public Health, Pakistan Meteorological Department, National Disaster Management, Pakistan Agricultural Research Centre, Pakistan Council for Research in Water Resources, and Global Change Impact Study Centre), United Nation organizations, provincial government departments, non-governmental organizations (e.g., Global Facility and Disaster Reduction), research centers linked to universities, and international organizations (International Institute for Sustainable Development, Food and Agriculture, Global Climate Fund and World Bank) are trying to reduce the water-related impacts of climate change, but due to lack of public awareness and health care infrastructure, the death rate is steadily increasing. This paper critically reviews the scientific studies and reports both at national and at international level benefiting generalists concerned with environmental and public health challenges. The article underlines the urgent need for water conservation, risk management, and the development of mitigation measures to cope with the water-related impacts of climate change on agriculture and subsequently on public health. Novel solutions and bioremediation methods have been presented to control environmental pollution and to promote awareness among the scientific community. The focus is on diverse strategies to handle the forthcoming challenges associated with water resources management.
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35. |
- Al Awaji, N, et al.
(author)
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Quality of Life, Needs and Fears of Mothers of Children with Disabilities in Saudi Arabia during the COVID-19 Lockdown
- 2021
-
In: International journal of environmental research and public health. - : MDPI AG. - 1660-4601. ; 18:21
-
Journal article (peer-reviewed)abstract
- Substantial changes in life dynamics resulting from the outbreak of the coronavirus disease 2019 (COVID-19) could have an impact on the quality of life (QoL) of mothers of children with and without disabilities. This study compared the quality of life (QoL) of mothers of children with disabilities (MCD) to the QoL of mothers of children without disabilities (CON) in Saudi Arabia during COVID-19 lockdown. It explored mothers’ concerns and the type of support they need during the quarantine. A comparative cross-sectional study was conducted during the lockdown. An online questionnaire was distributed to mothers raising children with and without disabilities in Saudi Arabia. A total of 340 mothers participated in the study by completing the survey: 93 MCD and 247 CON. The QoL of MCD and CON was assessed using the WHOQOL-BREF questionnaire. Furthermore, detailed information was provided by the mothers regarding their needs and concerns during the lockdown. The results of the study revealed that the overall QoL was significantly higher in the CON group, compared to the MCD group, during the COVID-19 lockdown. The social well-being and environmental well-being reported by MCD were significantly lower on the total scale of the WHOQOL-BREF than those reported by the CON group. The comparison between the two groups revealed significant differences in the support required by mothers during the COVID-19 pandemic: a higher percentage of MCD needed emotional and psychological support, especially from family members. The major concerns reported by MCD were the deterioration of their children’s medical conditions and the lack of medical supplies during the lockdown.
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36. |
- Al-Rimawi, A, et al.
(author)
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3D Printed Temporary Veneer Restoring Autotransplanted Teeth in Children: Design and Concept Validation Ex Vivo
- 2019
-
In: International journal of environmental research and public health. - : MDPI AG. - 1660-4601. ; 16:3
-
Journal article (peer-reviewed)abstract
- (1) Background: Three-dimensional printing is progressing rapidly and is applied in many fields of dentistry. Tooth autotransplantation offers a viable biological approach to tooth replacement in children and adolescents. Restoring or reshaping the transplanted tooth to the anterior maxilla should be done as soon as possible for psychological and aesthetic reasons. However, to avoid interfering with the natural healing process, reshaping of transplanted teeth is usually delayed three to four months after transplantation. This delay creates a need for simple indirect temporary aesthetic restoration for autotransplanted teeth. The aim of this study was to develop and validate a digital solution for temporary restoration of autotransplanted teeth using 3D printing. (2) Methods: Four dry human skulls and four dry human mandibles were scanned using cone beam computed tomography to create 3D models for 15 premolars. Digital impression of the maxillary arch of one of the skulls was captured by intra oral scanner. The digital work flow for the design and fabrication of temporary veneers is presented. The seating and adaptation of the 3D printed veneers were evaluated using stereomicroscopy and micro-computed tomography. (3) Results: Evaluation of the veneer seating using stereomicroscopy showed that the mean marginal gap at all of the sides was below the cut-off value of 200 µm. The overall mean marginal gap was 99.9 ± 50.7 µm (median: 87.8 (IQR 64.2–133 µm)). The internal adaptation evaluation using micro-computed tomography showed an average median gap thickness of 152.5 ± 47.7 (IQR 129–149.3 µm). (4) Conclusions: The present concept of using temporary veneers that are designed and fabricated with CAD/CAM (computer-aided design/computer-aided manufacturing) technology using a DLP (digital light processing) printer may present a viable treatment option for restoration of autotransplanted teeth.
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37. |
- Al-Taai, Nameer, et al.
(author)
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A Superimposition-Based Cephalometric Method to Quantitate Craniofacial Changes
- 2021
-
In: International Journal of Environmental Research and Public Health. - : MDPI AG. - 1660-4601 .- 1661-7827. ; 18
-
Journal article (peer-reviewed)abstract
- To assess the craniofacial changes related to growth and/or to orthodontic and orthognathic treatments, it is necessary to superimpose serial radiographs on stable structures. However, conventional superimposition provides only a graphical illustration of these changes. To increase the precision of growth and treatment evaluations, it is desirable to quantitate these craniofacial changes. The aims of this study were to (1) evaluate a superimposition-based cephalometric method to process numerical data for craniofacial growth changes and (2) identify a valid, reliable, and feasible method for superimposition. Forty pairs of cephalograms were analyzed at T1 and T2 (mean age 9.9 and 15.0 years, respectively). The superimposition-based cephalometric method involved relating the sagittal and vertical measurements on the T2 radiographs to the nasion and sella landmarks on the T1 radiographs. Validity and reliability were evaluated for three superimposition methods: the sella-nasion (SN); the tuberculum sella-wing (TW); and Bjork's structural. Superimposition-based cephalometrics can be used to quantify craniofacial changes digitally. The numerical data from the superimposition-based cephalometrics reflected a graphical illustration of superimposition and differed significantly from the data acquired through conventional cephalometrics. Superimposition using the TW method is recommended as it is valid, reliable, and feasible.
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38. |
- Al-Wathinani, Ahmed M, et al.
(author)
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A Cross-Sectional Study on the Flood Emergency Preparedness among Healthcare Providers in Saudi Arabia.
- 2021
-
In: International journal of environmental research and public health. - : MDPI AG. - 1660-4601. ; 18:3
-
Journal article (peer-reviewed)abstract
- This study used a descriptive cross-sectional methodology to measure healthcare workers' knowledge, attitudes, perceptions, and willingness to respond to a flood scenario in Saudi Arabia. A validated survey was distributed to collect data using a convenience sampling technique through multiple social media platforms. A total of 227 participants were included in this study: 52% of them were aged between 26 to 34 years, 74% were residents from Riyadh, and 52.4% worked in nursing divisions. A significant number of respondents (73.2%) had positive perceptions towards their hospitals' ability to provide an effective response to a flood, 89% were willing to report to work following a flood, and 90% of participants reported the need to develop both guidelines and training for flood disaster preparedness. Preparation and successful flood mitigation in the hospital setting requires staff that have both knowledge and training in emergency management. One way to obtain such readiness is through competency-based training, including both table-top and full-scale live exercises. Although the willingness to respond to such a flooding emergency was high among staff, the development of guidelines and educational programs is needed in order to develop the competencies and skills sets to improve disaster preparedness response and preparedness efforts.
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39. |
- Aldhahi, MI, et al.
(author)
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Effect of Resilience on Health-Related Quality of Life during the COVID-19 Pandemic: A Cross-Sectional Study
- 2021
-
In: International journal of environmental research and public health. - : MDPI AG. - 1660-4601. ; 18:21
-
Journal article (peer-reviewed)abstract
- The unprecedented outbreak of coronavirus disease 2019 (COVID-19) has caused a huge global health and economic crisis. The aim of the study was to examine the extent to which the resilience of a person is associated with the quality of life (QoL) of adults amongst Saudi Arabia. A cross-sectional study was conducted among a sample of adults in Saudi Arabia. A total of 385 adults voluntarily participated in and completed the survey. The quality of life was measured using the “World Health Organization QoL”. The “Connor-Davidson Resilience Scale” instrument was also used to assess resilience during the COVID-19 pandemic. Amongst the 385 participants, 179 (46%) showed a good QoL, and 205 (54%) reported a relatively poor QoL. The resilience was found to be significantly associated with QoL. The study further revealed that gender-based differences were dominant in the QoL; the men respondents reported a significantly higher QoL in all the domains in comparison to the women respondents. The gender, income, and psychological health and interaction effect of resilience and age explained 40% of the variance in the total score of QoL. In reference to the predictors of the physical health domain of QoL, resilience, gender, and psychological health were significantly associated with the physical health domain of the QoL (R2 = 0.26, p = 0.001). It was also noted that gender was not associated with the social relationships and environmental domains of QoL (p > 0.05). Findings showed a statistically significant association between the score of QoL and resilience, age, gender, income, and psychological health. These findings highlight the significant contribution of gender-based differences, psychological health, and resilience on the domains of QoL.
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40. |
- Alene, KA, et al.
(author)
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Spatiotemporal Patterns of Tuberculosis in Hunan Province, China
- 2021
-
In: International journal of environmental research and public health. - : MDPI AG. - 1660-4601. ; 18:13
-
Journal article (peer-reviewed)abstract
- Tuberculosis (TB) is the leading cause of death from a bacterial pathogen worldwide. China has the third highest TB burden in the world, with a high reported burden in Hunan Province (amongst others). This study aimed to investigate the spatial distribution of TB and identify socioeconomic, demographic, and environmental drivers in Hunan Province, China. Numbers of reported cases of TB were obtained from the Tuberculosis Control Institute of Hunan Province, China. A wide range of covariates were collected from different sources, including from the Worldclim database, and the Hunan Bureau of Statistics. These variables were summarized at the county level and linked with TB notification data. Spatial clustering of TB was explored using Moran’s I statistic and the Getis–Ord statistic. Poisson regression models were developed with a conditional autoregressive (CAR) prior structure, and with posterior parameters estimated using a Bayesian approach with Markov chain Monte Carlo (MCMC) simulation. A total of 323,340 TB cases were reported to the Hunan TB Control Institute from 2013 to 2018. The mean age of patients was 51.7 years (SD + 17.6 years). The majority of the patients were male (72.6%, n = 234,682) and had pulmonary TB (97.5%, n = 315,350). Of 319,825 TB patients with registered treatment outcomes, 306,107 (95.7%) patients had a successful treatment outcome. The annual incidence of TB decreased over time from 85.5 per 100,000 population in 2013 to 76.9 per 100,000 population in 2018. TB case numbers have shown seasonal variation, with the highest number of cases reported during the end of spring and the beginning of summer. Spatial clustering of TB incidence was observed at the county level, with hotspot areas detected in the west part of Hunan Province. The spatial clustering of TB incidence was significantly associated with low sunshine exposure (RR: 0.86; 95% CrI: 0.74, 0.96) and a low prevalence of contraceptive use (RR: 0.88; 95% CrI: 0.79, 0.98). Substantial spatial clustering and seasonality of TB incidence were observed in Hunan Province, with spatial patterns associated with environmental and health care factors. This research suggests that interventions could be more efficiently targeted at locations and times of the year with the highest transmission risk.
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41. |
- Alfredsson, L, et al.
(author)
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Insufficient Sun Exposure Has Become a Real Public Health Problem
- 2020
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In: International journal of environmental research and public health. - : MDPI AG. - 1660-4601. ; 17:14
-
Journal article (peer-reviewed)abstract
- This article aims to alert the medical community and public health authorities to accumulating evidence on health benefits from sun exposure, which suggests that insufficient sun exposure is a significant public health problem. Studies in the past decade indicate that insufficient sun exposure may be responsible for 340,000 deaths in the United States and 480,000 deaths in Europe per year, and an increased incidence of breast cancer, colorectal cancer, hypertension, cardiovascular disease, metabolic syndrome, multiple sclerosis, Alzheimer’s disease, autism, asthma, type 1 diabetes and myopia. Vitamin D has long been considered the principal mediator of beneficial effects of sun exposure. However, oral vitamin D supplementation has not been convincingly shown to prevent the above conditions; thus, serum 25(OH)D as an indicator of vitamin D status may be a proxy for and not a mediator of beneficial effects of sun exposure. New candidate mechanisms include the release of nitric oxide from the skin and direct effects of ultraviolet radiation (UVR) on peripheral blood cells. Collectively, this evidence indicates it would be wise for people living outside the tropics to ensure they expose their skin sufficiently to the sun. To minimize the harms of excessive sun exposure, great care must be taken to avoid sunburn, and sun exposure during high ambient UVR seasons should be obtained incrementally at not more than 5–30 min a day (depending on skin type and UV index), in season-appropriate clothing and with eyes closed or protected by sunglasses that filter UVR.
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42. |
- Alga, A, et al.
(author)
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Hope for the Best, Prepare for the Worst-An Assessment of Flood Preparedness at Primary Health Care Facilities in Central Vietnam
- 2018
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In: International journal of environmental research and public health. - : MDPI AG. - 1660-4601. ; 15:12
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Journal article (peer-reviewed)abstract
- Background: Floods affect over 85 million people every year and are one of the deadliest types of natural disasters. The health effects of floods are partly due to a loss of access to health care. This loss can be limited with proper flood preparedness. Flood preparedness is especially needed at the primary health care (PHC) level. Flood preparedness assessments can be used to identify vulnerable facilities and help target efforts. The existing research on PHC flood preparedness is limited. We aimed to assess the flood preparedness of PHC facilities in a flood-prone province in central Vietnam. Methods: Based on flood experience, the PHC facilities in the province were grouped as “severe” (n = 23) or “non-severe” (n = 129). Assessments were conducted during monsoon season at five facilities from each group, using a pre-tested, semi-structured questionnaire. Data were checked against official records when possible. Results: Nine of the ten facilities had a flood plan and four received regular flood preparedness training. Six facilities reported insufficient preparedness support. Half of the facilities had additional funding available for flood preparedness, or in case of a flood. Flood preparedness training had been received by 21/28 (75%) of the staff at the facilities with severe flood experience, versus 15/25 (52%) of the staff at the non-severe experience facilities. Conclusions: Our results suggest that the assessed PHC facilities were not sufficiently prepared for the expected floods during monsoon season. PHC flood preparedness assessments could be used to identify vulnerable facilities and populations in flood-prone areas. More research is needed to further develop and test the validity and reliability of the questionnaire.
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43. |
- Alga, A, et al.
(author)
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Perceptions of Healthcare-Associated Infection and Antibiotic Resistance among Physicians Treating Syrian Patients with War-Related Injuries
- 2018
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In: International journal of environmental research and public health. - : MDPI AG. - 1660-4601. ; 15:12
-
Journal article (peer-reviewed)abstract
- Healthcare-associated infections (HAIs) constitute a major contributor to morbidity and mortality worldwide, with a greater burden on low- and middle-income countries. War-related injuries generally lead to large tissue defects, with a high risk of infection. The aim of this study was to explore how physicians in a middle-income country in an emergency setting perceive HAI and antibiotic resistance (ABR). Ten physicians at a Jordanian hospital supported by Médecins Sans Frontières were interviewed face-to-face. The recorded interviews were transcribed verbatim and analyzed by qualitative content analysis with an inductive and deductive approach. The participants acknowledged risk factors of HAI and ABR development, such as patient behavior, high numbers of injured patients, limited space, and non-compliance with hygiene protocols, but did not express a sense of urgency or any course of action. Overuse and misuse of antibiotics were reported as main contributors to ABR development, but participants expressed no direct interrelationship between ABR and HAI. We conclude that due to high patient load and limited resources, physicians do not see HAI as a problem they can prioritize. The knowledge gained by this study could provide insights for the allocation of resources and development of hygiene and wound treatment protocols in resource-limited settings.
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44. |
- Alghadir, Ahmad H., et al.
(author)
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Experiences of Overseas Trained Physical Therapists Working in Saudi Arabia : An Observational Study
- 2020
-
In: International Journal of Environmental Research and Public Health. - : MDPI. - 1661-7827 .- 1660-4601. ; 17:10
-
Journal article (peer-reviewed)abstract
- Background: Health professionals, including physical therapists (PTs), are known to migrate for better jobs, as well as for personal and professional development. However, this involves risks of maladjustment, discrimination, and exploitation. We conducted this study to investigate the experiences of overseas trained PTs in Saudi Arabia (SA) and their perceptions about physical therapy practice and problems regarding the profession in the country.Methods: A questionnaire and accompanying explanation of the study was sent to 175 members of the Saudi Physical Therapy Association (SPTA) working in SA who had been trained outside SA and had a minimum of one year of work experience before moving to SA.Results: One hundred and fifty (86%) respondents completed the questionnaire. Among the respondents, the majority had more than five years of work experience after moving to SA. While 54% of the respondents reported that they were satisfied with their work experiences in SA, the remaining respondents reported their dissatisfaction for various reasons.Conclusions: With the increase in aged population and rise in disability, the need for PTs has simultaneously increased in the health care sector around the world, including in SA. Until PTs of local origin are ready to fill the requirements, the services of PTs from other countries will be required in SA. Although the majority of respondents reported having positive work experiences in SA, the negative aspects and challenges faced by PTs in SA have also been highlighted in this study. These problems need to be addressed in order to promote the development of a better and more holistic approach to patient care.
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45. |
- Ali, Nadeem, et al.
(author)
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Semi-Volatile Organic Compounds in Car Dust : A Pilot Study in Jeddah, Saudi Arabia
- 2021
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In: International Journal of Environmental Research and Public Health. - : MDPI AG. - 1661-7827 .- 1660-4601. ; 18:9
-
Journal article (peer-reviewed)abstract
- People may spend a significant amount of their daily time in cars and thus be exposed to chemicals present in car dust. Various chemicals are emitted from during car use, contaminating the car dust. In this study, we compiled published and unpublished data on the occurrence of phthalates, flame retardants (FRs), polycyclic aromatic hydrocarbons (PAHs), and polychlorinated biphenyls (PCBs) in Saudi car dust. Phthalates, a class of chemical commonly used as plasticizers in different car parts, were the major pollutants found in car dust, with a median value of n-ary sumation phthalates 1,279,000 ng/g. Among other chemicals, organophosphate flame retardants (OPFRs) were found to be between 1500-90,500 ng/g, which indicates their use as alternative FRs in the car industry. The daily exposure to Saudi drivers (regular and taxi drivers) was below the respective reference dose (RfD) values of the individual chemicals. However, the estimated incremental lifetime cancer risk (ILCR) values due to chronic exposure to these chemicals was >1 x 10(-5) for taxi drivers for phthalates and PAHs, indicating that the long-term exposure to these chemicals is a cause of concern for drivers who spend considerable time in cars. The study has some limitations, due to the small number of samples, lack of updated RfD values, and missing cancer slope factors for many studied chemicals. Despite these limitations, this study indicates the possible range of exposure to drivers from chemicals in car dust and warrants further extensive studies to confirm these patterns.
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46. |
- Alijanzadeh, M., et al.
(author)
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Fear of covid-19 and trust in the healthcare system mediates the association between individual’s risk perception and preventive covid-19 behaviours among iranians
- 2021
-
In: International Journal of Environmental Research and Public Health. - : MDPI. - 1661-7827 .- 1660-4601. ; 18:22
-
Journal article (peer-reviewed)abstract
- Problems caused by the novel coronavirus disease-2019 (COVID-19) and its mutations have brought challenges in pandemic control for all countries worldwide. The present study examines the mediating roles of fear of COVID-19 and trust in the healthcare system in the association between individual’s risk perception and performing preventive COVID-19 behaviours among Iranians. A cross-sectional study design was used to collect data from 3652 residents of Qazvin province in Iran from 3 February to 15 April 2021 using a multistage stratified cluster sampling method. Participants responded to an online questionnaire concerning their fear of COVID-19, risk perception, trust in the healthcare system, and preventive COVID-19 behaviours. Small to medium positive interrelationships were observed between the variables of the study. Fear of COVID-19, trust in the healthcare system or both (fear of COVID-19 and trust in the healthcare system) mediated the association between an individual’s risk perception and performing preventive COVID-19 behaviours. The study demonstrated there are at least four ways through which an individual’s risk perception can influence preventive COVID-19 behaviours. Therefore, clinicians, health communicators, and researchers may capitalize on these findings to enhance preventive COVID-19 behaviours to help mitigate the spread of COVID-19 infection.
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47. |
- Aljaberi, Musheer A., et al.
(author)
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Efficacy of interventional programs in reducing acculturative stress and enhancing adjustment of international students to the new host educational environment : a systematic review and meta-analysis
- 2021
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In: International Journal of Environmental Research and Public Health. - : MDPI. - 1661-7827 .- 1660-4601. ; 18:15
-
Research review (peer-reviewed)abstract
- This review aimed to systematically outline and meta-analyze the efficacy of psychoeduca-tional, cultural orientation, socio-cultural, and peer-pairing programs in reducing acculturative stress and enhancing adjustment among international students worldwide. The consulted databases were PubMed, Scopus, Web of Science, ScienceDirect, EBSCO, and ProQuest. Eligibility criteria allowed the inclusion of randomized controlled trials (RCTs) and quasi-experimental trials without applying lan-guage, country, publication type or time restrictions. The quality of the eligible studies was appraised by the RoB2 tool of Cochrane for RCTs and JBI critical appraisal tools for quasi-experimental trials. Data items were collected based on PICO acronym by two investigators and reviewed for accuracy by a third one. The evidence was narratively synthesized and validated by proceeding with a random model meta-analysis using Cochrane RevMan software(Version 5.4). The quality of the pooled evidence from meta-analysis was assessed using the tool of GRADE. Out of 29,975 retrieved records, 14 studies (six RCTs and eight quasi-experimental trials) were included. The psychoeducational program significantly reduced acculturative stress and enhanced adjustment. In contrast, cultural orientation and peer-pairing programs significantly enhanced adjustment, but could not reduce acculturative stress. In meta-analysis, acculturative stress was significantly reduced in the psychoe-ducational intervention versus controls [overall pooled size effect = −3.89 (95% CI: −5.42, −2.53) at p < 0.001]. Similarly, adjustment was significantly enhanced in the psychoeducation and sociocultural interventions versus control [overall pooled size effect = 3.10 (95% CI: 2.35, 3.85) at p <0.001]. In conclusion, the psychoeducational program demonstrated superior efficacy in reducing accultur-ative stress and enhancing adjustment compared to the other interventional programs. However, socio-cultural programs have still been effective in enhancing adjustment. This systematic review is registered in PROSPERO (CRD42018104211).
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48. |
- Aljeaidi, Muhamad, et al.
(author)
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Dry Eyes, Ocular Lubricants, and Use of Systemic Medications Known or Suspected to Cause Dry Eyes in Residents of Aged Care Services
- 2020
-
In: International Journal of Environmental Research and Public Health. - : MDPI AG. - 1661-7827 .- 1660-4601. ; 17:15
-
Journal article (peer-reviewed)abstract
- Ocular issues are common, burdensome, and under-researched among residents of aged care services. This study aims to investigate the prevalence of dry eyes or use of ocular lubricants among residents, and the possible association with systemic medications known or suspected to cause dry eyes. A cross-sectional study of 383 residents of six aged care services in South Australia was conducted. Data were extracted from participants' medical histories, medication charts, and validated assessments. The main exposure was systemic medications known to cause, contribute to, or aggravate dry eyes. The primary outcome was documented dry eyes or regular administration of ocular lubricants. Logistic regression was used to estimate odds ratios (ORs) and 95% confidence intervals (CIs) for the association between systemic medications and dry eyes/use of ocular lubricants. Dry eyes were documented for 53 (13.8%) residents and 98 (25.6%) residents were administered ocular lubricants. Overall, 116 (30.3%) residents had documented dry eyes/used ocular lubricants. Of these, half (n= 58) were taking a medication known to cause, contribute to, or aggravate dry eyes. Taking one or more medications listed as known to cause dry eyes was associated with having dry eyes/use of ocular lubricants (OR 1.83, 95% CI 1.15-2.94). In sub-analyses, no individual medication was associated with dry eyes/use of ocular lubricants. Dry eyes and use of ocular lubricants are common in residential aged care. Our hypothesis generating findings suggest the need for further research into the clinical significance of systemic medications as a possible cause of dry eyes.
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49. |
- Alm, Susanne, et al.
(author)
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Poor Family Relationships in Adolescence and the Risk of Premature Death : Findings from the Stockholm Birth Cohort Study
- 2019
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In: International Journal of Environmental Research and Public Health. - : MDPI. - 1661-7827 .- 1660-4601. ; 16:10
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Journal article (peer-reviewed)abstract
- Poor family relationships during childhood have been shown to have long-term negative effects on an offspring's health. However, few studies have followed the offspring to retirement age, and relatedly, knowledge about the link between poor family relationships and premature death is scarce. The aim of this study was to examine the association between poor family relationships in adolescence and the risk of premature death, even when considering other adverse childhood conditions. Prospective data from the Stockholm Birth Cohort study were used, with 2636 individuals born in 1953 who were followed up until age 65. Information on family relations was based on interviews with the participants' mothers in 1968. Information on mortality was retrieved from administrative register data from 1969-2018. Cox proportional hazards regressions showed that poor family relationships in adolescence were associated with an increased risk of premature death, even when adjusting for childhood conditions in terms of household social class, household economic poverty, contact with the child services, parental alcohol abuse, and parental mental illness (Hazard Ratio (HR), 2.08, 95% Confidence Interval (CI), 1.40-3.09). The findings show that poor family relationships in adolescence can have severe and long-lasting health consequences, highlighting the importance of early interventions.
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50. |
- Almuktar, Suhad A.A.A.N., et al.
(author)
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Contaminations of soil and two capsicum annuum generations irrigated by reused urban wastewater treated by different reed beds
- 2018
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In: International Journal of Environmental Research and Public Health. - : MDPI AG. - 1661-7827 .- 1660-4601. ; 15:8
-
Journal article (peer-reviewed)abstract
- Background: In order to save potable water, this study aims to evaluate the contamination of soil and Capsicum annuum L. (chilli) watered with urban wastewater (sewage) pre-treated by various wetland systems. Methods: The appropriateness of wetland outflow for irrigation when applying reused wastewater with high contamination of minerals and pathogens was assessed. The impact of wastewaters pre-treated by various wetlands on soil and harvest was tested in terms of mineral and biological contamination risk. Results: The wetlands met the standards for irrigation water for most water quality variables. However, the thresholds for key water quality parameters were significantly (p < 0.05) exceeded. The highest values for total coliforms, ammonium-nitrogen, phosphorus and potassium were 157,072 CFU/100 mL, 8.5 mg/L, 5.0 mg/L, and 7.0 mg/L, respectively. The harvest was moderately polluted only by zinc according to vegetable quality standards (threshold of 50 mg/kg). Zinc concentrations for Filters 2, 4, 6, 7 and 8 were 35.8, 60.6, 65.1, 65.5 and 53.2 mg/kg, respectively. No bacterial contamination was detected. Conclusions: Treatment of domestic wastewater applying constructed wetlands and subsequent recycling of the treated wastewater for irrigation of crops is a good substitute to the traditional application of drinking water for irrigation purposes.
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