International Journal of Environmental Research and Public Health
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(FIVE YEARS 28174)



Published By Mdpi Ag

Updated Wednesday, 28 July 2021

Misra Abdulahi ◽  
Atle Fretheim ◽  
Alemayehu Argaw ◽  
Jeanette H. Magnus

Understanding the underlying determinants of maternal knowledge and attitude towards breastfeeding guides the development of context-specific interventions to improve breastfeeding practices. This study aimed to assess the level and determinants of breastfeeding knowledge and attitude using validated instruments in pregnant women in rural Ethiopia. In total, 468 pregnant women were interviewed using the Afan Oromo versions of the Breastfeeding Knowledge Questionnaire (BFKQ-AO) and the Iowa Infant Feeding Attitude Scale (IIFAS-AO). We standardized the breastfeeding knowledge and attitude scores and fitted multiple linear regression models to identify the determinants of knowledge and attitude. 52.4% of the women had adequate knowledge, while 60.9% of the women had a neutral attitude towards breastfeeding. In a multiple linear regression model, maternal occupation was the only predictor of the BFKQ-AO score (0.56SD; 95%CI, 1.28, 4.59SD; p = 0.009). Age (0.57SD; 95%CI, 0.24, 0.90SD; p = 0.001), parity (−0.24SD; 95%CI, −0.47, −0.02SD; p = 0.034), antenatal care visits (0.41SD; 95%CI, 0.07, 0.74SD; p = 0.017) and the BFKQ-AO score (0.08SD; 95% CI, 0.06, 0.09SD; p < 0.000) were predictors of the IIFAS-AO score. Nearly half of the respondents had inadequate knowledge and most women had a neutral attitude towards breastfeeding. Policymakers and managers could address these factors when planning educational interventions to improve breastfeeding practices.

Nicholas J. Felicione ◽  
K. Michael Cummings ◽  
Shannon Gravely ◽  
David Hammond ◽  
Ann McNeill ◽  

Nicotine vaping products (NVPs) have evolved rapidly, and some vapers have difficulty reporting about their NVP. NVP knowledge may be important for providing accurate survey data, understanding the potential risks of NVP use, and assessing legal and regulated products. This paper examines current vapers who responded “don’t know” (DK) regarding their NVP features. Data are from adult daily/weekly vapers in Waves Two (2018, n = 4192) and Three (2020, n = 3894) of the ITC Four Country Smoking and Vaping Survey. Analyses assessed DK responses for NVP features (e.g., type/appearance, nicotine) and consumption. A DK index score was computed based on the percent of all features with DK responses, which was tested for associations with demographics, smoking/vaping status, NVP features, purchase location, and knowledge of NVP relative risks. NVP description and appearance were easily identified, but DK was more common for features such as nicotine content (7.3–9.2%) and tank/cartridge volume capacity (26.6–30.0%). DK responses often differed by vaping/smoking status, NVP type/appearance, purchase location, and country. Vapers who are younger, use box-shaped NVPs, purchase online, and exclusive daily vapers were associated with lower DK index scores. Higher DK index scores were associated with poorer knowledge of relative health risks of NVP use. The diversity of the NVP market and wide variation in how products are used makes it challenging to capture information from users about device features, such as nicotine content and capacity, in population surveys.

Daniel L.M. Duke ◽  
Megan Prictor ◽  
Elif Ekinci ◽  
Mariam Hachem ◽  
Luke J. Burchill

Indigenous health inequities persist in Australia due to a system of privilege and racism that has political, economic and social determinants, rather than simply genetic or behavioural causes. Research involving Aboriginal and Torres Strait Islander (‘Indigenous’) communities is routinely funded to understand and address these health inequities, yet current ethical and institutional conventions for Indigenous health research often fall short of community expectations. Typically, mainstream research projects are undertaken using traditional “top-down” approaches to governance that hold inherent tensions with other dominant governance styles and forms. This approach perpetuates long-held power imbalances between those leading the research and those being researched. As an alternative, Indigenous governance focuses on the importance of place, people, relationships and process for addressing power imbalances and achieving equitable outcomes. However, empowering principles of Indigenous governance in mainstream environments is a major challenge for research projects and teams working within organisations that are regulated by Western standards and conventions. This paper outlines the theoretical basis for a new Culturally Adaptive Governance Framework (CAGF) for empowering principles of Indigenous governance as a prerequisite for ethical conduct and practice in Indigenous health research. We suggest new orientations for mainstream research project governance, predicated on translating theoretical and practical attributes of real-world ethics, adaptive governance and critical allyship frameworks to Indigenous health research. The CAGF is being implemented in a national Indigenous multicenter trial evaluating the use of continuous blood glucose monitors as a new technology with the potential to improve diabetes care and treatment for Indigenous Australians—the FlashGM Study. The CAGF is a governance framework that identifies the realities of power, acknowledges the complexities of culture and emerging health technologies, and foregrounds the principle of equity for mainstream Indigenous health research.

Alberto Modenese ◽  
Tommaso Mazzoli ◽  
Nausicaa Berselli ◽  
Davide Ferrari ◽  
Annalisa Bargellini ◽  

The results of a voluntary screening campaign for the presence of anti-SARS-CoV-2 serum antibodies are presented, performed on workers in the highly industrialized province of Modena in northern Italy in the period 18 May–5 October 2020. The employment activities of the subjects that tested positive for anti-SARS-CoV-2 IgM and/or IgG antibodies were determined and classified using the International Standard Industrial Classification of All Economic Activities (ISIC). The distribution across different sectors was compared to the proportion of workers employed in the same sectors in the province of Modena as a whole. Workers with anti-SARS-CoV-2 serum antibodies were mainly employed in manufacturing (60%), trade (12%), transportation (9%), scientific and technical activities (5%), and arts, entertainment and recreation activities (4.5%). Within the manufacturing sector, a cluster of workers with positive serological tests was observed in the meat processing sector, confirming recent data showing a possible increased risk of SARS-CoV-2 infection in these workers.

Trish Dearlove ◽  
Andrea Begley ◽  
Jane Anne Scott ◽  
Gemma Devenish-Coleman

The digital marketing of commercial complementary foods (CCF) is an emerging area of concern in Australia. Although research into traditional methods has identified a range of problems, the marketing and messaging strategies employed within digital spaces have gone largely unscrutinized. This study sought to examine the methods used by CCF manufacturers to promote Australian baby foods and brands in a digital space. A multiple step approach was used to assess the CCF brands available in major Australian retailers, the social media platforms they used, and to thematically analyze the text and visual messages contained in posts published over a three-month period. Of the 15 brands identified, 12 had a digital presence, and all of these used Facebook. Four themes emerged from an analysis of 216 Facebook posts; (1) general product attributes, (2) socially desirable attributes (which included messaging related to taste (41%), self-feeding (29%) and fun (19%)), (3) concern-based attributes (including organic status (40%), age targets (39%) and additive-/allergen-free status (18%)) and (4) health-focused attributes (which included messaging related to healthy/nutritious ingredients (45%), and child development/growth (15%). Messages contained in Facebook posts were mostly positive brand/product aspects (Themes 1 and 2) or parental concern-based aspects (Theme 3 and 4). These themes match previous analyses of marketing content in traditional media and should be closely monitored due to the personalized nature of consumer social media interactions.

Mauricio Matus-Lopez ◽  
Alexander Chaverri-Carvajal

The population in Latin America is ageing, and there is an inevitable demand for long-term care services. However, there are no comparative analyses between Latin American countries of the dependency situation of older adults. This study aims to calculate and compare percentages of older adults who need help performing the activities of daily living in six Latin American nations. The study is observational, transversal, and cross-national and uses microdata drawn from national surveys conducted in Argentina (n = 3291), Brazil (n = 3903), Chile (n = 31,667), Colombia (n = 17,134), Mexico (n = 7909), and Uruguay (n = 4042). Comparable indicators of the need for help in performing the basic and instrumental activities of daily living were calculated. The percentages of older adults in need of help for basic activities of daily living ranged from 5.8% in Argentina to 11% in Brazil; for instrumental activities of daily living, from 13.8% in Mexico to 35.7% in Brazil; and combined, from 18.1% in Argentina to 37.1% in Brazil. Brazil thus has the highest indicators, followed by Colombia. The results warn of the frail physical condition of older people and the high potential demand for long-term care services. The information provided could be useful for further research on and planning for long-term care needs in Latin American and middle-income countries.

Joanna Witkoś ◽  
Magdalena Hartman-Petrycka

Background: The aim of the study was to assess the influence of both physical activity, such as running and dancing, and the personal characteristics of the studied women on the occurrence and progression of premenstrual disorder (PMD). Methods: We surveyed 414 women aged 22–48 who were experiencing the menstrual cycle but not using hormonal contraception. There were two physically active groups, runners (N = 215) and Argentine tango dancers (N = 94), and there was one group not undertaking any physical activity—the control group (N = 104). The research was conducted using the researchers’ own questionnaire. Results: The number of days of PMD symptoms in the tango vs. runner vs. control groups are as follows: pre-bleeding (mean: 4.14 vs. 4.86 vs. 4.85; p = 0.024), after the onset of bleeding (mean: 1.76 vs. 2.39 vs. 2.16; p = 0.001), and in total (mean: 5.94 vs. 7.25 vs. 7.01; p < 0.001). The regression analysis results without grouping results are as follows: the number of days of symptoms before bleeding and menarche (B: −0.16; 95% CIs: from −0.29 to −0.04; p = 0.011), the total duration of symptoms and menarche (B: −0.17; 95% CIs: from −0.32 to −0.01; p = 0.036), lower abdominal pain and age (B: −0.05; 95% CIs: 0.92–0.98; p = 0.002), diarrhoea (B: −0.08; 95% CIs: 0.88–0.97; p < 0.001), tearfulness, depressive states and age (B: −0.06; 95% CIs: 0.91–0.97; p < 0.001), skin problems and age (B: −0.05; 95% CIs: 0.92–0.98; p = 0.004), joint pain and age (B: −0.09; 95% CIs: 0.86–0.96; p = 0.001), pain in the lumbar spine (B: −0.06, 95% CIs: 0.91–0.98; p = 0.001), water retention and BMI (B: 0.09; 95% CIs: 0.92–0.98; p = 0.007), and water retention and menarche (B: −0.19; 95% CIs: 0.73–0.94; p = 0.003). Information: generally there is one regression model, we have several here, we have a bit the description. Conclusions: Physical activity such as dancing (tango) shortens the duration of PMD symptoms but does not completely eliminate them. Running does not have as beneficial an effect on symptom relief as dancing. Current age, age when menstruation began (menarche), and BMI were revealed to be important factors influencing the symptoms of premenstrual disorders.

Sok Man Leong ◽  
Kuai In Tam ◽  
Sok Leng Che ◽  
Ming Xia Zhu

While advance directives (ADs) are considered to be part of government’s healthcare agenda, there has not been any public consultation for legislation, nor investigation regarding the public’s views about ADs in the Chinese culture of Macao. The current study explored the Macao Chinese people’s willingness to make ADs. Data were collected from 724 residents aged 18 years and above. Results showed that 533 respondents (73.6%) claimed that they were willing to complete an AD if the document was recognized legally. The experience of caring for relatives or friends with terminal illnesses, palliative care as the preferred end-of-life treatment option, and scoring higher in the Hospice Care Attitude Scale were the predictors of willingness to make ADs. Results of the study suggested that there was a relatively high number of people who would consider setting up ADs. Our study recommends that healthcare professionals should equip themselves to raise ADs-related discussions with patients. Moreover, the Macao Government is responsible for facilitating the introduction and implementation of ADs in order to improve overall end-of-life care quality in Macao.

Oriana D’Ecclesiis ◽  
Saverio Caini ◽  
Chiara Martinoli ◽  
Sara Raimondi ◽  
Camilla Gaiaschi ◽  

Background and aim: Over the last decades, the incidence of melanoma has been steadily growing, with 4.2% of the population worldwide affected by cutaneous melanoma (CM) in 2020 and with a higher incidence and mortality in men than in women. We investigated both the risk factors for CM development and the prognostic and predictive factors for survival, stratifying for both sex and gender. Methods: We conducted a systematic review of studies indexed in PUB-MED, EMBASE, and Scopus until 4 February 2021. We included reviews, meta-analyses, and pooled analyses investigating differences between women and men in CM risk factors and in prognostic and predictive factors for CM survival. Data synthesis: Twenty-four studies were included, and relevant data extracted. Of these, 13 studies concerned potential risk factors, six concerned predictive factors, and five addressed prognostic factors of melanoma. Discussion: The systematic review revealed no significant differences in genetic predisposition to CM between males and females, while there appear to be several gender disparities regarding CM risk factors, partly attributable to different lifestyles and behavioral habits between men and women. There is currently no clear evidence of whether the mutational landscapes of CM differ by sex/gender. Prognosis is justified by a complex combination of phenotypes and immune functions, while reported differences between genders in predicting the effectiveness of new treatments are inconsistent. Overall, the results emerging from the literature reveal the importance of considering the sex/gender variable in all studies and pave the way for including it towards precision medicine. Conclusion: Men and women differ genetically, biologically, and by social construct. Our systematic review shows that, although fundamental, the variable sex/gender is not among the ones collected and analyzed.

Pengzhi Wei ◽  
Shaofeng Xie ◽  
Liangke Huang ◽  
Lilong Liu

With the increasing application of global navigation satellite system (GNSS) technology in the field of meteorology, satellite-derived zenith tropospheric delay (ZTD) and precipitable water vapor (PWV) data have been used to explore the spatial coverage pattern of PM2.5 concentrations. In this study, the PM2.5 concentration data obtained from 340 PM2.5 ground stations in south-central China were used to analyze the variation patterns of PM2.5 in south-central China at different time periods, and six PM2.5 interpolation models were developed in the region. The spatial and temporal PM2.5 variation patterns in central and southern China were analyzed from the perspectives of time series variations and spatial distribution characteristics, and six types of interpolation models were established in central and southern China. (1) Through correlation analysis, and exploratory regression and geographical detector methods, the correlation analysis of PM2.5-related variables showed that the GNSS-derived PWV and ZTD were negatively correlated with PM2.5, and that their significances and contributions to the spatial analysis were good. (2) Three types of suitable variable combinations were selected for modeling through a collinearity diagnosis, and six types of models (geographically weighted regression (GWR), geographically weighted regression kriging (GWRK), geographically weighted regression—empirical bayesian kriging (GWR-EBK), multiscale geographically weighted regression (MGWR), multiscale geographically weighted regression kriging (MGWRK), and multiscale geographically weighted regression—empirical bayesian kriging (MGWR-EBK)) were constructed. The overall R2 of the GWR-EBK model construction was the best (annual: 0.962, winter: 0.966, spring: 0.926, summer: 0.873, and autumn: 0.908), and the interpolation accuracy of the GWR-EBK model constructed by inputting ZTD was the best overall, with an average RMSE of 3.22 μg/m3 recorded, while the GWR-EBK model constructed by inputting PWV had the highest interpolation accuracy in winter, with an RMSE of 4.5 μg/m3 recorded; these values were 2.17% and 4.26% higher than the RMSE values of the other two types of models (ZTD and temperature) in winter, respectively. (3) The introduction of the empirical Bayesian kriging method to interpolate the residuals of the models (GWR and MGWR) and to then correct the original interpolation results of the models was the most effective, and the accuracy improvement percentage was better than that of the ordinary kriging method. The average improvement ratios of the GWRK and GWR-EBK models compared with that of the GWR model were 5.04% and 14.74%, respectively, and the average improvement ratios of the MGWRK and MGWR-EBK models compared with that of the MGWR model were 2.79% and 12.66%, respectively. (4) Elevation intervals and provinces were classified, and the influence of the elevation and the spatial distribution of the plane on the accuracy of the PM2.5 regional model was discussed. The experiments showed that the accuracy of the constructed regional model decreased as the elevation increased. The accuracies of the models in representing Henan, Hubei and Hunan provinces were lower than those of the models in representing Guangdong and Guangxi provinces.

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