Physical Activity and Plasma Glucose Control among Diabetic Patients Attending Outpatients Clinics in Hanoi, Vietnam

Reaching the recommendation on physical activity (PA) for health is highly important to effectively manage blood glucose in patients with type 2 diabetes (T2D). The aims of this study were to assess the level and pattern of PA among T2D outpatients and to relate PA levels to glucose control. A cross...

Ausführliche Beschreibung

Gespeichert in:
Bibliographische Detailangaben
Veröffentlicht in:INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021-01, Vol.18 (3), p.1182
Hauptverfasser: Nguyen, Tam Ngoc, Nguyen, Tam Thi, Hagströmer, Maria, Pham, Thang, van der Ploeg, Ingeborg, Sundberg, Carl Johan, Vu, Huyen Thi Thanh
Format: Artikel
Sprache:eng
Schlagworte:
Online-Zugang:Volltext
Tags: Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
container_end_page
container_issue 3
container_start_page 1182
container_title INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH
container_volume 18
creator Nguyen, Tam Ngoc
Nguyen, Tam Thi
Hagströmer, Maria
Pham, Thang
van der Ploeg, Ingeborg
Sundberg, Carl Johan
Vu, Huyen Thi Thanh
description Reaching the recommendation on physical activity (PA) for health is highly important to effectively manage blood glucose in patients with type 2 diabetes (T2D). The aims of this study were to assess the level and pattern of PA among T2D outpatients and to relate PA levels to glucose control. A cross-sectional study was conducted in outpatient clinics in Hanoi, Vietnam. PA levels were reported using the Global Physical Activity Questionnaire (GPAQ) version 2.0. Participants meeting the WHO recommendations on PA for health or not were respectively categorized as "sufficiently active" and "insufficiently active". FPG < 7.2 mmol/L was defined as controlled plasma glucose. In total, 407 participants with T2D (55% women, mean (SD) age 61.6 (9.7) years) were included. The fraction of T2D outpatients reporting as insufficiently active was 21%. The lowest amount of energy expenditure was from transport activities (travel from and to places). On multivariate logistic regression, being sufficiently active was associated with a two-fold increased likelihood of having better glycemic control. The findings warrant action plans to increase physical activity in general and in specific active transport for T2D patients in Vietnam.
doi_str_mv 10.3390/ijerph18031182
format Article
fullrecord <record><control><sourceid>proquest_swepu</sourceid><recordid>TN_cdi_swepub_primary_oai_swepub_ki_se_464383</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2485582918</sourcerecordid><originalsourceid>FETCH-LOGICAL-c572t-952db9829998b31afc8156d98a83aa2be1f4052999daf0caccf27bf3969dbfd43</originalsourceid><addsrcrecordid>eNp1kkFv1DAQhSMEoqVw5YgsceFAWjt2EvuCtNpCi1SpewCu1sRxul4SO9hO0f77Otrd0kXqyaOZ770ZjybL3hN8TqnAF2aj_bgmHFNCePEiOyVVhXNWYfLySXySvQlhgzHlrBKvsxNKy7qoCT_N4mq9DUZBjxYqmnsTtwhsi1Y9hAHQVT8pFzRaOhu96xEMzt6hSwONjkahFUSjbQxoEaO2rUm12ymOh-yyN9aogIxF12Cd-Yx-GR0tDG-zVx30Qb_bv2fZz29ffyyv85vbq-_LxU2u0ngxF2XRNoIXQgjeUAKd4qSsWsGBU4Ci0aRjuJzLLXRYgVJdUTcdFZVom65l9CzLd77hrx6nRo7eDOC30oGR-9TvFGnJKkY5Tbx4lh-9a_-JDkLCSk5rxmbtl502AYNuVdqAh_7Y4qhizVreuXtZC8xJgZPBp72Bd38mHaIcTFC678FqNwVZMC6KGuNy7vXxP3TjJm_TKmeqLNPKCE_U-Y5S3oXgdfc4DMFyPh55fDxJ8OHpFx7xw7XQByTPxLw</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2485582918</pqid></control><display><type>article</type><title>Physical Activity and Plasma Glucose Control among Diabetic Patients Attending Outpatients Clinics in Hanoi, Vietnam</title><source>MEDLINE</source><source>SWEPUB Freely available online</source><source>PubMed Central Open Access</source><source>MDPI - Multidisciplinary Digital Publishing Institute</source><source>EZB-FREE-00999 freely available EZB journals</source><source>PubMed Central</source><source>Free Full-Text Journals in Chemistry</source><creator>Nguyen, Tam Ngoc ; Nguyen, Tam Thi ; Hagströmer, Maria ; Pham, Thang ; van der Ploeg, Ingeborg ; Sundberg, Carl Johan ; Vu, Huyen Thi Thanh</creator><creatorcontrib>Nguyen, Tam Ngoc ; Nguyen, Tam Thi ; Hagströmer, Maria ; Pham, Thang ; van der Ploeg, Ingeborg ; Sundberg, Carl Johan ; Vu, Huyen Thi Thanh</creatorcontrib><description>Reaching the recommendation on physical activity (PA) for health is highly important to effectively manage blood glucose in patients with type 2 diabetes (T2D). The aims of this study were to assess the level and pattern of PA among T2D outpatients and to relate PA levels to glucose control. A cross-sectional study was conducted in outpatient clinics in Hanoi, Vietnam. PA levels were reported using the Global Physical Activity Questionnaire (GPAQ) version 2.0. Participants meeting the WHO recommendations on PA for health or not were respectively categorized as "sufficiently active" and "insufficiently active". FPG &lt; 7.2 mmol/L was defined as controlled plasma glucose. In total, 407 participants with T2D (55% women, mean (SD) age 61.6 (9.7) years) were included. The fraction of T2D outpatients reporting as insufficiently active was 21%. The lowest amount of energy expenditure was from transport activities (travel from and to places). On multivariate logistic regression, being sufficiently active was associated with a two-fold increased likelihood of having better glycemic control. The findings warrant action plans to increase physical activity in general and in specific active transport for T2D patients in Vietnam.</description><identifier>ISSN: 1660-4601</identifier><identifier>ISSN: 1661-7827</identifier><identifier>EISSN: 1660-4601</identifier><identifier>DOI: 10.3390/ijerph18031182</identifier><identifier>PMID: 33572718</identifier><language>eng</language><publisher>Switzerland: MDPI AG</publisher><subject>Active transport ; Ambulatory Care Facilities ; Blood Glucose ; Blood pressure ; Cross-Sectional Studies ; Data collection ; Diabetes ; Diabetes mellitus ; Diabetes mellitus (non-insulin dependent) ; Diabetes Mellitus, Type 2 ; Energy expenditure ; Exercise ; Female ; Glucose ; Hospitals ; Humans ; Male ; Medicin och hälsovetenskap ; Metabolism ; Middle Aged ; Outpatient care facilities ; Outpatients ; Patients ; Physical activity ; Physical fitness ; Plasma ; Population ; Questionnaires ; Risk Factors ; Self report ; Sociodemographics ; Surveys and Questionnaires ; Vietnam</subject><ispartof>INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH, 2021-01, Vol.18 (3), p.1182</ispartof><rights>2021. This work is licensed under http://creativecommons.org/licenses/by/3.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2021 by the authors. 2021</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c572t-952db9829998b31afc8156d98a83aa2be1f4052999daf0caccf27bf3969dbfd43</citedby><cites>FETCH-LOGICAL-c572t-952db9829998b31afc8156d98a83aa2be1f4052999daf0caccf27bf3969dbfd43</cites><orcidid>0000-0002-4607-8677 ; 0000-0002-3132-3801</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC7908120/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC7908120/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,552,727,780,784,885,27924,27925,53791,53793</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/33572718$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink><backlink>$$Uhttp://kipublications.ki.se/Default.aspx?queryparsed=id:145837443$$DView record from Swedish Publication Index$$Hfree_for_read</backlink></links><search><creatorcontrib>Nguyen, Tam Ngoc</creatorcontrib><creatorcontrib>Nguyen, Tam Thi</creatorcontrib><creatorcontrib>Hagströmer, Maria</creatorcontrib><creatorcontrib>Pham, Thang</creatorcontrib><creatorcontrib>van der Ploeg, Ingeborg</creatorcontrib><creatorcontrib>Sundberg, Carl Johan</creatorcontrib><creatorcontrib>Vu, Huyen Thi Thanh</creatorcontrib><title>Physical Activity and Plasma Glucose Control among Diabetic Patients Attending Outpatients Clinics in Hanoi, Vietnam</title><title>INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH</title><addtitle>Int J Environ Res Public Health</addtitle><description>Reaching the recommendation on physical activity (PA) for health is highly important to effectively manage blood glucose in patients with type 2 diabetes (T2D). The aims of this study were to assess the level and pattern of PA among T2D outpatients and to relate PA levels to glucose control. A cross-sectional study was conducted in outpatient clinics in Hanoi, Vietnam. PA levels were reported using the Global Physical Activity Questionnaire (GPAQ) version 2.0. Participants meeting the WHO recommendations on PA for health or not were respectively categorized as "sufficiently active" and "insufficiently active". FPG &lt; 7.2 mmol/L was defined as controlled plasma glucose. In total, 407 participants with T2D (55% women, mean (SD) age 61.6 (9.7) years) were included. The fraction of T2D outpatients reporting as insufficiently active was 21%. The lowest amount of energy expenditure was from transport activities (travel from and to places). On multivariate logistic regression, being sufficiently active was associated with a two-fold increased likelihood of having better glycemic control. The findings warrant action plans to increase physical activity in general and in specific active transport for T2D patients in Vietnam.</description><subject>Active transport</subject><subject>Ambulatory Care Facilities</subject><subject>Blood Glucose</subject><subject>Blood pressure</subject><subject>Cross-Sectional Studies</subject><subject>Data collection</subject><subject>Diabetes</subject><subject>Diabetes mellitus</subject><subject>Diabetes mellitus (non-insulin dependent)</subject><subject>Diabetes Mellitus, Type 2</subject><subject>Energy expenditure</subject><subject>Exercise</subject><subject>Female</subject><subject>Glucose</subject><subject>Hospitals</subject><subject>Humans</subject><subject>Male</subject><subject>Medicin och hälsovetenskap</subject><subject>Metabolism</subject><subject>Middle Aged</subject><subject>Outpatient care facilities</subject><subject>Outpatients</subject><subject>Patients</subject><subject>Physical activity</subject><subject>Physical fitness</subject><subject>Plasma</subject><subject>Population</subject><subject>Questionnaires</subject><subject>Risk Factors</subject><subject>Self report</subject><subject>Sociodemographics</subject><subject>Surveys and Questionnaires</subject><subject>Vietnam</subject><issn>1660-4601</issn><issn>1661-7827</issn><issn>1660-4601</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>D8T</sourceid><recordid>eNp1kkFv1DAQhSMEoqVw5YgsceFAWjt2EvuCtNpCi1SpewCu1sRxul4SO9hO0f77Otrd0kXqyaOZ770ZjybL3hN8TqnAF2aj_bgmHFNCePEiOyVVhXNWYfLySXySvQlhgzHlrBKvsxNKy7qoCT_N4mq9DUZBjxYqmnsTtwhsi1Y9hAHQVT8pFzRaOhu96xEMzt6hSwONjkahFUSjbQxoEaO2rUm12ymOh-yyN9aogIxF12Cd-Yx-GR0tDG-zVx30Qb_bv2fZz29ffyyv85vbq-_LxU2u0ngxF2XRNoIXQgjeUAKd4qSsWsGBU4Ci0aRjuJzLLXRYgVJdUTcdFZVom65l9CzLd77hrx6nRo7eDOC30oGR-9TvFGnJKkY5Tbx4lh-9a_-JDkLCSk5rxmbtl502AYNuVdqAh_7Y4qhizVreuXtZC8xJgZPBp72Bd38mHaIcTFC678FqNwVZMC6KGuNy7vXxP3TjJm_TKmeqLNPKCE_U-Y5S3oXgdfc4DMFyPh55fDxJ8OHpFx7xw7XQByTPxLw</recordid><startdate>20210129</startdate><enddate>20210129</enddate><creator>Nguyen, Tam Ngoc</creator><creator>Nguyen, Tam Thi</creator><creator>Hagströmer, Maria</creator><creator>Pham, Thang</creator><creator>van der Ploeg, Ingeborg</creator><creator>Sundberg, Carl Johan</creator><creator>Vu, Huyen Thi Thanh</creator><general>MDPI AG</general><general>MDPI</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8C1</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><scope>5PM</scope><scope>ADTPV</scope><scope>AOWAS</scope><scope>D8T</scope><scope>ZZAVC</scope><orcidid>https://orcid.org/0000-0002-4607-8677</orcidid><orcidid>https://orcid.org/0000-0002-3132-3801</orcidid></search><sort><creationdate>20210129</creationdate><title>Physical Activity and Plasma Glucose Control among Diabetic Patients Attending Outpatients Clinics in Hanoi, Vietnam</title><author>Nguyen, Tam Ngoc ; Nguyen, Tam Thi ; Hagströmer, Maria ; Pham, Thang ; van der Ploeg, Ingeborg ; Sundberg, Carl Johan ; Vu, Huyen Thi Thanh</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c572t-952db9829998b31afc8156d98a83aa2be1f4052999daf0caccf27bf3969dbfd43</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Active transport</topic><topic>Ambulatory Care Facilities</topic><topic>Blood Glucose</topic><topic>Blood pressure</topic><topic>Cross-Sectional Studies</topic><topic>Data collection</topic><topic>Diabetes</topic><topic>Diabetes mellitus</topic><topic>Diabetes mellitus (non-insulin dependent)</topic><topic>Diabetes Mellitus, Type 2</topic><topic>Energy expenditure</topic><topic>Exercise</topic><topic>Female</topic><topic>Glucose</topic><topic>Hospitals</topic><topic>Humans</topic><topic>Male</topic><topic>Medicin och hälsovetenskap</topic><topic>Metabolism</topic><topic>Middle Aged</topic><topic>Outpatient care facilities</topic><topic>Outpatients</topic><topic>Patients</topic><topic>Physical activity</topic><topic>Physical fitness</topic><topic>Plasma</topic><topic>Population</topic><topic>Questionnaires</topic><topic>Risk Factors</topic><topic>Self report</topic><topic>Sociodemographics</topic><topic>Surveys and Questionnaires</topic><topic>Vietnam</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Nguyen, Tam Ngoc</creatorcontrib><creatorcontrib>Nguyen, Tam Thi</creatorcontrib><creatorcontrib>Hagströmer, Maria</creatorcontrib><creatorcontrib>Pham, Thang</creatorcontrib><creatorcontrib>van der Ploeg, Ingeborg</creatorcontrib><creatorcontrib>Sundberg, Carl Johan</creatorcontrib><creatorcontrib>Vu, Huyen Thi Thanh</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Health &amp; Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Public Health Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health &amp; Medical Complete (Alumni)</collection><collection>Health &amp; Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Publicly Available Content Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>SwePub</collection><collection>SwePub Articles</collection><collection>SWEPUB Freely available online</collection><collection>SwePub Articles full text</collection><jtitle>INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Nguyen, Tam Ngoc</au><au>Nguyen, Tam Thi</au><au>Hagströmer, Maria</au><au>Pham, Thang</au><au>van der Ploeg, Ingeborg</au><au>Sundberg, Carl Johan</au><au>Vu, Huyen Thi Thanh</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Physical Activity and Plasma Glucose Control among Diabetic Patients Attending Outpatients Clinics in Hanoi, Vietnam</atitle><jtitle>INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH</jtitle><addtitle>Int J Environ Res Public Health</addtitle><date>2021-01-29</date><risdate>2021</risdate><volume>18</volume><issue>3</issue><spage>1182</spage><pages>1182-</pages><issn>1660-4601</issn><issn>1661-7827</issn><eissn>1660-4601</eissn><abstract>Reaching the recommendation on physical activity (PA) for health is highly important to effectively manage blood glucose in patients with type 2 diabetes (T2D). The aims of this study were to assess the level and pattern of PA among T2D outpatients and to relate PA levels to glucose control. A cross-sectional study was conducted in outpatient clinics in Hanoi, Vietnam. PA levels were reported using the Global Physical Activity Questionnaire (GPAQ) version 2.0. Participants meeting the WHO recommendations on PA for health or not were respectively categorized as "sufficiently active" and "insufficiently active". FPG &lt; 7.2 mmol/L was defined as controlled plasma glucose. In total, 407 participants with T2D (55% women, mean (SD) age 61.6 (9.7) years) were included. The fraction of T2D outpatients reporting as insufficiently active was 21%. The lowest amount of energy expenditure was from transport activities (travel from and to places). On multivariate logistic regression, being sufficiently active was associated with a two-fold increased likelihood of having better glycemic control. The findings warrant action plans to increase physical activity in general and in specific active transport for T2D patients in Vietnam.</abstract><cop>Switzerland</cop><pub>MDPI AG</pub><pmid>33572718</pmid><doi>10.3390/ijerph18031182</doi><orcidid>https://orcid.org/0000-0002-4607-8677</orcidid><orcidid>https://orcid.org/0000-0002-3132-3801</orcidid><oa>free_for_read</oa></addata></record>
fulltext fulltext
identifier ISSN: 1660-4601
ispartof INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH, 2021-01, Vol.18 (3), p.1182
issn 1660-4601
1661-7827
1660-4601
language eng
recordid cdi_swepub_primary_oai_swepub_ki_se_464383
source MEDLINE; SWEPUB Freely available online; PubMed Central Open Access; MDPI - Multidisciplinary Digital Publishing Institute; EZB-FREE-00999 freely available EZB journals; PubMed Central; Free Full-Text Journals in Chemistry
subjects Active transport
Ambulatory Care Facilities
Blood Glucose
Blood pressure
Cross-Sectional Studies
Data collection
Diabetes
Diabetes mellitus
Diabetes mellitus (non-insulin dependent)
Diabetes Mellitus, Type 2
Energy expenditure
Exercise
Female
Glucose
Hospitals
Humans
Male
Medicin och hälsovetenskap
Metabolism
Middle Aged
Outpatient care facilities
Outpatients
Patients
Physical activity
Physical fitness
Plasma
Population
Questionnaires
Risk Factors
Self report
Sociodemographics
Surveys and Questionnaires
Vietnam
title Physical Activity and Plasma Glucose Control among Diabetic Patients Attending Outpatients Clinics in Hanoi, Vietnam
url https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-05T04%3A56%3A03IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_swepu&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Physical%20Activity%20and%20Plasma%20Glucose%20Control%20among%20Diabetic%20Patients%20Attending%20Outpatients%20Clinics%20in%20Hanoi,%20Vietnam&rft.jtitle=INTERNATIONAL%20JOURNAL%20OF%20ENVIRONMENTAL%20RESEARCH%20AND%20PUBLIC%20HEALTH&rft.au=Nguyen,%20Tam%20Ngoc&rft.date=2021-01-29&rft.volume=18&rft.issue=3&rft.spage=1182&rft.pages=1182-&rft.issn=1660-4601&rft.eissn=1660-4601&rft_id=info:doi/10.3390/ijerph18031182&rft_dat=%3Cproquest_swepu%3E2485582918%3C/proquest_swepu%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2485582918&rft_id=info:pmid/33572718&rfr_iscdi=true