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Article ; Online: The effect of childhood depression trajectories on sugar-sweetened beverage habit trajectories in adolescence: Exploring sleep problems as a mediator.

Lin, Chun-Ji / Chang, Ling-Yin / Wu, Chi-Chen / Chang, Hsing-Yi

2023 Volume 194, Page(s) 107199

Abstract: Although depression has been linked to the habit of consuming sugar-sweetened beverages (SSBs), little is known about their long-term relationships and the mediating role of sleep problems. This study examines the associations between childhood ... ...

Abstract	Although depression has been linked to the habit of consuming sugar-sweetened beverages (SSBs), little is known about their long-term relationships and the mediating role of sleep problems. This study examines the associations between childhood depressive symptoms trajectories and adolescent SSB-habit trajectories and whether these associations were mediated by sleep problems. Data came from 1560 adolescents participating in a longitudinal study across grades 1 through 12 in northern Taiwan. Group-based trajectory modeling was used to identify development of childhood depressive symptoms and an SSB habit in adolescence. Multinomial logistic regression was conducted to examine the influence of childhood depressive symptoms and adolescent SSB habit. Mediation analysis was conducted to test whether sleep problems mediated the associations examined. Four distinct trajectories of childhood depressive symptoms were identified: low-stable (30.79%), moderate-stable (42.32%), increasing (12.29%), and high-stable (11.60%). Three distinct trajectories of SSB habit in adolescence were identified: low-stable (44.32%), increasing (15.02%), and high-stable (40.65%). Children who had moderate-stable (aOR = 1.35; CI: 1.04-1.77), high-stable (aOR = 2.01; CI: 1.28-3.15), or increasing (aOR = 1.97; CI: 1.26-3.06) trajectories of depressive symptoms relative to those in the low-stable group were significantly more likely to belong to the high-stable trajectory of SSBs than to the low-stable SSBs group. The Z-mediation test showed that sleep problems significantly mediated the associations between trajectories of childhood depressive symptoms and trajectories of SSBs during adolescence (all p < 0.05). Childhood depressive symptoms conferred risks for adolescent SSB habits; and the effects were seen, in part, through increasing sleep problems.
MeSH term(s)	Child ; Humans ; Adolescent ; Depression ; Sugar-Sweetened Beverages/adverse effects ; Longitudinal Studies ; Habits ; Sleep Wake Disorders/epidemiology ; Sleep Wake Disorders/etiology ; Beverages
Language	English
Publishing date	2023-12-29
Publishing country	England
Document type	Journal Article
ZDB-ID	1461347-5
ISSN	1095-8304 ; 0195-6663
ISSN (online)	1095-8304
ISSN	0195-6663
DOI	10.1016/j.appet.2023.107199
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Article ; Online: Associations between social loneliness trajectories and chronotype among adolescents.

Chang, Chia-Shuan / Wu, Chi-Chen / Chang, Ling-Yin / Chang, Hsing-Yi

European child & adolescent psychiatry

2023 Volume 33, Issue 1, Page(s) 179–191

Abstract: Late chronotype during adolescence is a critical risk factor for poor physical and mental health among adolescents. While social loneliness is confirmed to negatively influence sleep behaviors, the long-term effect of social loneliness on chronotype ... ...

Abstract	Late chronotype during adolescence is a critical risk factor for poor physical and mental health among adolescents. While social loneliness is confirmed to negatively influence sleep behaviors, the long-term effect of social loneliness on chronotype remains unknown. This study aims to investigate whether social loneliness trajectories from middle childhood to adolescence are associated with chronotype in late adolescence and examine the potential sex differences in these associations. Data were obtained from 2398 adolescents who participated in the Child and Adolescent Behaviors in Long-Term Evolution project. Chronotype was calculated as the midpoint of sleep on free days adjusted for sleep debt. Group-based trajectory modeling and multiple linear regression were employed to establish social loneliness trajectories and determine their associations with chronotype. Social loneliness trajectories were significantly associated with chronotype and varied by sex. Specifically, boys following a high-decreasing trajectory had earlier chronotype during late adolescence than did those following a low-decreasing trajectory (B = - 0.07; p < 0.05). By contrast, girls following a low-to-moderate-increasing trajectory exhibited later chronotype than did those following a low-stable trajectory (B = 0.07; p < 0.01). Social loneliness trajectories, especially those displaying significant fluctuations over time, are critical indicators influencing chronotype among adolescents. Furthermore, these trajectories and their associations with chronotype display sex differences. These findings highlight the need for early interventions for psychological factors such as social loneliness to ensure that the late chronotype can be prevented. In addition, sex variations must be considered.
MeSH term(s)	Humans ; Male ; Child ; Adolescent ; Female ; Chronotype ; Loneliness/psychology ; Sleep ; Adolescent Behavior/psychology ; Risk Factors
Language	English
Publishing date	2023-02-08
Publishing country	Germany
Document type	Journal Article
ZDB-ID	1118299-4
ISSN	1435-165X ; 1018-8827 ; 1433-5719
ISSN (online)	1435-165X
ISSN	1018-8827 ; 1433-5719
DOI	10.1007/s00787-023-02160-5
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Article ; Online: Associations between social jetlag trajectories and body mass index among young adults.

Chang, Chia-Shuan / Chang, Ling-Yin / Wu, Chi-Chen / Chang, Hsing-Yi

Sleep

2023 Volume 47, Issue 1

Abstract: Study objectives: This study employed longitudinal data collected repeatedly from individuals over the course of several years to examine the trajectories of social jetlag from ages 11 to 22 years and their associations with subsequent body mass index ( ... ...

Abstract	Study objectives: This study employed longitudinal data collected repeatedly from individuals over the course of several years to examine the trajectories of social jetlag from ages 11 to 22 years and their associations with subsequent body mass index (BMI). Potential sex differences were also investigated. Methods: Data were obtained from two longitudinal studies conducted in Taiwan (N = 4287). Social jetlag was defined as ≥ 2 hours of absolute difference in sleep midpoint between weekdays and weekends. BMI was calculated using weight (kg)/height(m)2 and categorized as underweight (<18 kg/m2), normal weight (18 kg/m2 ≤ BMI < 24 kg/m2), overweight (24 kg/m2 ≤ BMI < 27 kg/m2), and obese (≥27 kg/m2). Group-based trajectory modeling and multinomial logistic regression were applied to investigate study objectives. Results: Four distinct trajectories of social jetlag throughout the adolescent years were identified, with corresponding proportions as follows: low-stable (42%), moderate-decreasing (19%), low-increasing (22%), and chronic (17%) trajectories. Among males, the risk of being underweight (aOR, 1.96; 95% CI: 1.35 to 2.84) or obese (aOR, 1.40; 95% CI: 1.02 to 1.92) was higher in individuals with a low-increasing trajectory than in those with a low-stable trajectory. Among females, those with a low-increasing (aOR, 1.61; 95% CI: 1.02 to 2.54) or chronic (aOR, 2.04; 95% CI: 1.27 to 3.25) trajectory were at a higher risk of being obese relative to those with a low-stable trajectory. Conclusions: Addressing the development of increasing or chronic social jetlag during adolescence can help prevent abnormal BMI in young adulthood. Practitioners should consider sex differences in treatment or consultation.
MeSH term(s)	Adolescent ; Humans ; Female ; Male ; Young Adult ; Adult ; Body Mass Index ; Thinness ; Risk Factors ; Obesity ; Overweight ; Longitudinal Studies ; Jet Lag Syndrome
Language	English
Publishing date	2023-11-30
Publishing country	United States
Document type	Journal Article
ZDB-ID	424441-2
ISSN	1550-9109 ; 0161-8105
ISSN (online)	1550-9109
ISSN	0161-8105
DOI	10.1093/sleep/zsad270
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Article: The Association Between Frequent Sugar-Sweetened Beverage Intake and Sleep Duration in School Children: A Cross-Sectional Study.

Shih, Ya-Hui / Wu, Hsin-Chuan / Pan, Wen-Harn / Chang, Hsing-Yi

Frontiers in nutrition

2022 Volume 9, Page(s) 847704

Abstract: Background: Higher consumption of sugar-sweetened beverages (SSBs) maybe association with children's sleep pattern. However, few studies have considered this association in Asia, especially in school children. This study investigated the relationship ... ...

Abstract	Background: Higher consumption of sugar-sweetened beverages (SSBs) maybe association with children's sleep pattern. However, few studies have considered this association in Asia, especially in school children. This study investigated the relationship between children's consumption frequency of such beverages and their sleep duration. Methods: Participants aged 6-12 years were analyzed from two survey data in 2012 and 2013-2016 Nutrition and Health Surveys in Taiwan. A total of 2,628 participants were included in the analysis (2012, Results: The students slept for an average of 8.8 h on school days and 9.7 h on weekends. Relative to the low SSB intake group, the high intake group exhibited shorter sleep durations on school days ( Conclusions: Children who had consumed sugar-sweetened beverages frequently slept for shorter durations at night on school days and exhibited greater sleep debt. The causal relationship was not clear. Nonetheless, these two factors are important in promoting children health.
Language	English
Publishing date	2022-03-15
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2776676-7
ISSN	2296-861X
ISSN	2296-861X
DOI	10.3389/fnut.2022.847704
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Article ; Online: Gender difference on the mediation effects of filial piety on the association between chronic obstructive pulmonary disease and depressive symptoms in older adults: A community-based study.

Chang, Cheng-Chen / Hsu, Kaichi / Chen, Chun-Min / Huang, Si-Sheng / Wu, I-Chien / Hsu, Chih-Cheng / Hsiung, Agnes C / Chang, Hsing-Yi

PloS one

2024 Volume 19, Issue 2, Page(s) e0298360

Abstract: Filial piety is viewed as strong family support for older Chinese people, and strongly associated with depressive symptoms. It is unknown if there exists gender difference in the mediation effects of filial piety on the relationship between chronic ... ...

Abstract	Filial piety is viewed as strong family support for older Chinese people, and strongly associated with depressive symptoms. It is unknown if there exists gender difference in the mediation effects of filial piety on the relationship between chronic obstructive pulmonary disease (manifested as lung function) and depression. We investigated whether filial piety mediates the association between lung function and depression in community-dwelling older men and women using the Healthy Aging Longitudinal Study in Taiwan (HALST). Community dwelling adults aged 65 and above were analyzed. Pulmonary function, depressive symptoms, and filial piety expectation (FPE) and receipt of filial piety (RFP) were collected. The interaction and mediation of filial piety between lung function and depression was analyzed. We found that in older men, forced expiratory volume in the first second (FEV1) was inversely correlated with depression (β = -0.1281, p = 0.004) with no mediation effect of FPE. In older women, FEV1 was negatively associated with FPE, but FPE did not increase the risk of depression (β = 0.0605, p = 0.12). In both older men and women, FEV1 was negatively associated with RFP, while RFP reduced the risk of depression (p< 0.001). In older women, the correlation between FEV1 was complete mediation of RFP. Results indicate that feelings of insufficient filial piety may increase the likelihood of depression, especially in elderly women with worse lung function. Although modest, the main mediation effect of filial piety was improvement of lung function in older subjects, which might decrease depression.
MeSH term(s)	Aged ; Female ; Humans ; Male ; Depression ; East Asian People ; Longitudinal Studies ; Pulmonary Disease, Chronic Obstructive/complications ; Sex Factors ; Family Support
Language	English
Publishing date	2024-02-22
Publishing country	United States
Document type	Journal Article
ZDB-ID	2267670-3
ISSN	1932-6203 ; 1932-6203
ISSN (online)	1932-6203
ISSN	1932-6203
DOI	10.1371/journal.pone.0298360
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Article ; Online: Examining the role of living alone and loneliness in predicting health-related quality of life: results from the Healthy Aging Longitudinal Study in Taiwan (HALST).

Tseng, Han-Yun / Lee, Chun-Yi / Wu, Chi-Shin / Wu, I-Chien / Chang, Hsing-Yi / Hsu, Chih-Cheng / Hsiung, Chao Agnes

Quality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation

2024 Volume 33, Issue 4, Page(s) 1015–1028

Abstract: Purpose: This study aimed to investigate the distinct yet interconnected aspects of social isolation, namely living alone and loneliness, and their individual and combined effects on predicting health-related quality of life (HRQoL).: Methods: A ... ...

Abstract	Purpose: This study aimed to investigate the distinct yet interconnected aspects of social isolation, namely living alone and loneliness, and their individual and combined effects on predicting health-related quality of life (HRQoL). Methods: A comprehensive analysis, encompassing both cross-sectional and longitudinal approaches, was conducted using a nationally representative sample of 5644 community-dwelling adults aged 55 and older from the Healthy Aging Longitudinal Study in Taiwan (HALST). Results: Baseline data revealed that 9% of the sample reported living alone, while 10.3% reported experiencing loneliness, with 2.5% reporting both living alone and feeling lonely. Regression analyses consistently demonstrated that loneliness was significantly associated with concurrent and subsequent lower physical (PCS) and mental (MCS) component of HRQoL. Conversely, additional analyses indicated that living alone could indirectly exacerbate the adverse effects of loneliness or contribute to prolonged feelings of loneliness, subsequently predicting lower HRQoL after 3.2 year. Conclusion: In terms of practical implications, interventions and policies aiming to enhance HRQoL in older adults should give particular attention to those who report feelings of loneliness, especially individuals living alone.
MeSH term(s)	Humans ; Aged ; Loneliness ; Healthy Aging ; Quality of Life/psychology ; Longitudinal Studies ; Taiwan ; Cross-Sectional Studies ; Home Environment
Language	English
Publishing date	2024-01-17
Publishing country	Netherlands
Document type	Journal Article
ZDB-ID	1161148-0
ISSN	1573-2649 ; 0962-9343
ISSN (online)	1573-2649
ISSN	0962-9343
DOI	10.1007/s11136-023-03581-0
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Zs.A 3796: Show issues

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Article ; Online: Central obesity and elevated blood pressure in middle life are associated with physical and cognitive impairment in later life: A retrospective design with repeated measures.

Chuang, Shao-Yuan / Liu, Wen-Ling / Chang, Hsing-Yi / Hsu, Chih-Cheng / Pan, Wen-Harn

Experimental gerontology

2023 Volume 173, Page(s) 112093

Abstract: Background and aims: Physical and cognitive function decline indicates the prestage of disability and is associated with mortality among older adults. We investigated the association of metabolic disorders in midlife with physical and cognitive function ...

Abstract	Background and aims: Physical and cognitive function decline indicates the prestage of disability and is associated with mortality among older adults. We investigated the association of metabolic disorders in midlife with physical and cognitive function decline in later life in a retrospective cohort. Material and methods: A total of 618 older adults aged ≥60 years in wave-6 (2014-2017) were enrolled in the Cardiovascular Disease Risk Factor Two-Township Study to evaluate physical (hand grip strength and 4-m walking speed) and cognitive function (Mine-Mental State Examination [MMSE] score). Repeated metabolic disorder measures in wave-2, wave-3, and wave-5 were obtained to identify three trajectory pattern groups according to each metabolic disorder through group-based trajectory modeling. Linear and logistic regressions were conducted to investigate the association of metabolic disorders in middle life with physical and cognitive function decline in later life. Results: The prevalence rates of a weak hand grip (<28 kg for men and <18 kg for women), slow walking speed (<0.8 m/s), and poor cognitive function (MMSE <25) were 24.43 %, 16.83 % and 10.5 %, respectively, among the older adults. In the retrospective cohort with 15-year follow-up, those with a waist circumference of ≥95 cm for men and ≥85 cm for women in middle life exhibited a significantly weak hand grip (odds ratio: 2.78 [95 % confidence interval: 1.26, 6.11]) and slow walking speed (2.26 [1.15, 4.43]) in later life compared with those with a smaller waist circumference (<85 cm for men and <75 cm for women). Elevated blood pressure (systolic blood pressure [BP] ≥130 mmHg or diastolic BP ≥80 mmHg) was significantly associated with a higher risk of cognitive function decline in later life. Furthermore, the high-trajectory and middle-trajectory groups' body mass index (3.17 [1.25, 8.04] and 2.27 [1.28, 4.00], respectively) and waist circumference (4.39 [2.07, 9.31] and 2.54 [1.39, 4.67], respectively) were significantly associated with a weak hand grip and slow walking speed, respectively, compared with those of the low-trajectory group. The high-trajectory diastolic BP group was significantly associated with a higher risk of cognitive function decline compared with the low-trajectory diastolic BP group. Conclusion: Waist circumference and BP in middle life were associated with physical function decline and poor cognitive function in later life. The management of central obesity and BP in midlife may slow the decline of physical and cognitive function in later life.
MeSH term(s)	Male ; Humans ; Female ; Aged ; Blood Pressure ; Retrospective Studies ; Hand Strength/physiology ; Obesity, Abdominal ; Cognitive Dysfunction/epidemiology ; Hypertension
Language	English
Publishing date	2023-01-18
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	390992-x
ISSN	1873-6815 ; 0531-5565
ISSN (online)	1873-6815
ISSN	0531-5565
DOI	10.1016/j.exger.2023.112093
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Article: Joint predictability of physical frailty/pre-frailty and subjective memory complaints on mortality risk among cognitively unimpaired older adults.

Li, Chia-Lin / Stanaway, Fiona F / Chang, Hsing-Yi / Chen, Min-Chi / Tsai, Yu-Hsuan

European journal of ageing

2023 Volume 20, Issue 1, Page(s) 17

Abstract: The aim of the present study was to investigate how frailty/pre-frailty in combination with subjective memory complaints predicts all-cause mortality in community dwelling cognitively unimpaired older adults. There were 1904 community-dwelling ... ...

Abstract	The aim of the present study was to investigate how frailty/pre-frailty in combination with subjective memory complaints predicts all-cause mortality in community dwelling cognitively unimpaired older adults. There were 1904 community-dwelling cognitively unimpaired persons aged 65 years or older who participated in the 2013 Taiwan National Health Interview Survey with a 5-year follow-up. Frailty was determined based on the fatigue, resistance, ambulation, illness, and loss of weight (FRAIL) scale. Two questions ("Do you have difficulties with your memory or attention?" and "Do you have difficulties with your memory only or attention only or both?") were used to screen for subjective memory complaints (SMC). In this study, 11.9% of participants had both frailty/pre-frailty and SMC. A total of 239 deaths were recorded after 9009.5 person-years of follow-up. After adjustment for other factors, compared with participants who were physically robust with no SMC, participants who reported either SMC alone (HR = 0.88, 95% CI = 0.60-1.27) or were frail/pre-frail alone (HR = 1.32, 95% CI = 0.90-1.92) had no significantly increased mortality risk. However, coexisting frailty/pre-frailty and SMC was associated with a significantly increased hazard ratio for mortality of 1.48 (95% CI = [1.02-2.16]). Our results highlight the high prevalence of co-occurring frailty/pre-frailty and SMC and that this co-occurrence is associated with an increased risk of mortality among cognitively unimpaired older adults.
Language	English
Publishing date	2023-05-18
Publishing country	Germany
Document type	Journal Article
ZDB-ID	2190233-1
ISSN	1613-9372
ISSN	1613-9372
DOI	10.1007/s10433-023-00765-y
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Article ; Online: Burden of cardiovascular disease attributable to long-term exposure to ambient PM2.5 concentration and the cost–benefit analysis for the optimal control level

Chen, Chu-Chih / Wang, Yin-Ru / Liu, Jhi-Shin / Chang, Hsing-Yi / Guo, Yue Leon / Chen, Pau-Chung

Science of the Total Environment. 2023 Sept., v. 892 p.164767-

2023

Abstract: Environmental exposure to fine particulate matter PM₂.₅ is known to be associated with many hazardous health effects, including cardiovascular diseases (CVDs). To reduce the related health burden, it is crucial that policy-makers throughout the world set ...

Abstract	Environmental exposure to fine particulate matter PM₂.₅ is known to be associated with many hazardous health effects, including cardiovascular diseases (CVDs). To reduce the related health burden, it is crucial that policy-makers throughout the world set regulation levels according to their own evidence-based study outcomes. However, there appears to be a lack of decision-making methods for the control level of PM₂.₅ based on the burden of disease. In this study, 117,882 CVD-free participants (≥30-years-old) of the MJ Health Database were followed-up (for a median of 9 years) between 2007 and 2017. Each participant's residential address was matched to the 3× 3 km grid PM₂.₅ concentration estimates with a 5-year average for long-term exposure. We used a time-dependent nonlinear weight-transformation Cox regression model for the concentration–response function (CRF) between exposure to PM₂.₅ and CVD incidence. Town/district-specific PM₂.₅-attributable years of life in disability (YLDs) in CVD incidence were calculated by using the relative risk (RR) of the PM₂.₅ concentration level relative to the reference level. A cost–benefit analysis was proposed by assessing the trade-off between the gain in avoidable YLDs (given a reference level at u and considering mitigation cost) versus the loss in unavoidable YLDs by not setting at the lowest observed health effect level u0. The CRF varied across different areas with dissimilar PM₂.₅ exposure ranges. Areas with low PM2.5 concentrations and population sizes provided crucial information for the CVD health effect at the lower end. Additionally, women and older participants were more susceptible. The avoided town/district-specific YLDs in CVD incidence due to lower RRs ranged from 0 to 3000 person-years comparing the PM₂.₅ concentration levels in 2019 with the levels in 2011. Based on the cost–benefit analysis, an annual PM₂.₅ concentration of 13 μg/m3 would be optimal, which provides a guideline for the updated regulation level (currently at 15 μg/m3). The proposed cost–benefit analysis method may be applied to other countries/regions for regulation levels that are most suitable for their air pollution status and population health.
Keywords	air pollution ; burden of disease ; cardiovascular diseases ; chronic exposure ; cost benefit analysis ; databases ; decision making ; environment ; guidelines ; particulates ; regression analysis ; relative risk ; Concentration–response function ; Interim target ; Population attributable fraction (PAF) ; Regulation level ; Years of life with disability (YLDs)
Language	English
Dates of publication	2023-09
Publishing place	Elsevier B.V.
Document type	Article ; Online
ZDB-ID	121506-1
ISSN	1879-1026 ; 0048-9697
ISSN (online)	1879-1026
ISSN	0048-9697
DOI	10.1016/j.scitotenv.2023.164767
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Article ; Online: Effects of Social Attachment on Experimental Drug Use From Childhood to Adolescence: An 11-Year Prospective Cohort Study.

Chiang, Yi-Chen / Li, Xian / Lee, Chun-Yang / Wu, Chi-Chen / Chang, Hsing-Yi / Zhang, Shuoxun

Frontiers in public health

2022 Volume 10, Page(s) 818894

Abstract: Background: Drug use among adolescents are still crucial issues that endanger their lifetime health. Evidence concerning the interpersonal-related factors influencing youngsters' experimental drug use behavior, especially from longitudinal and school- ... ...

Abstract	Background: Drug use among adolescents are still crucial issues that endanger their lifetime health. Evidence concerning the interpersonal-related factors influencing youngsters' experimental drug use behavior, especially from longitudinal and school-based prospective cohort studies, is insufficient. We aimed to describe the annual incidence rate and mean annual incidence rate of experimental drug use from childhood to adolescence by education stage, clarify the risk in childhood and examine the longitudinal relationship between social attachment factors and experimental drug use. Materials and methods: The data were derived from the 1st to 11th wave of the longitudinal study. In total, 1,106 respondents aged 19-20-year-old were followed up for 11 years (from 9 to 10-year-old) in Taiwan. A survival analysis was used to analyze the time-invarying/time-dependent effects of social attachment factors on experimental drug use. Results: The mean annual incidence rate of experimental drug use from childhood to adolescence was 6.8‰. The incidence increased over time and was the highest in the first year of university (19.3‰). Boys were more likely to use drugs than girls. A low degree of self-perceived likeability in childhood was a risk factor influencing experimental drug use. On average, a low degree of parental supervision and a high degree of family conflict were both influential risk factors. According to the time-dependent models, a high degree of parental supervision, a high degree of family support and a low degree of family conflict in the current year can protect children and adolescents from drug use, whereas a sustained low degree of parental supervision and a high degree of family conflict may promote students' experimental drug use. Conclusion: Parents should be informed and educated to avoid family conflict during childhood, maintain consistent supervision of their children's behavior, provide adequate family support, and pay attention to their children's interpersonal relationships in school. Teachers should focus on the social attachment status of their students while considering their attachments to their families and peers.
MeSH term(s)	Adolescent ; Adolescent Behavior ; Adult ; Child ; Female ; Humans ; Longitudinal Studies ; Male ; Parents ; Peer Group ; Prospective Studies ; Substance-Related Disorders/epidemiology ; Young Adult
Language	English
Publishing date	2022-03-29
Publishing country	Switzerland
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2711781-9
ISSN	2296-2565 ; 2296-2565
ISSN (online)	2296-2565
ISSN	2296-2565
DOI	10.3389/fpubh.2022.818894
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