{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T04:46:06Z","timestamp":1787028366290,"version":"build-2736575974"},"reference-count":40,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2023,3,7]],"date-time":"2023-03-07T00:00:00Z","timestamp":1678147200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Coordena\u00e7\u00e3o para o Aperfei\u00e7oamento de Pessoal de N\u00edvel Superior\u2014Brazil (CAPES)","award":["001"],"award-info":[{"award-number":["001"]}]},{"name":"Coordena\u00e7\u00e3o para o Aperfei\u00e7oamento de Pessoal de N\u00edvel Superior\u2014Brazil (CAPES)","award":["#E-26\/010.001313\/2019"],"award-info":[{"award-number":["#E-26\/010.001313\/2019"]}]},{"DOI":"10.13039\/501100004586","name":"Funda\u00e7\u00e3o de Amparo \u00e0 Pesquisa do Estado do Rio de Janeiro\u2014Brazil (FAPERJ)","doi-asserted-by":"publisher","award":["001"],"award-info":[{"award-number":["001"]}],"id":[{"id":"10.13039\/501100004586","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004586","name":"Funda\u00e7\u00e3o de Amparo \u00e0 Pesquisa do Estado do Rio de Janeiro\u2014Brazil (FAPERJ)","doi-asserted-by":"publisher","award":["#E-26\/010.001313\/2019"],"award-info":[{"award-number":["#E-26\/010.001313\/2019"]}],"id":[{"id":"10.13039\/501100004586","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>During the COVID-19 pandemic, longstanding issues involving nursing work, which has always involved significant risks of illness and infection, were intensified. It is necessary to acknowledge the risks and nurses\u2019 perceptions about the risks qualitatively during the period of the health crisis. The aim of this study was to examine the health repercussions perceived by nursing workers in emergency services during the outbreak of the COVID-19 pandemic in Brazil. This was a qualitative, descriptive, cross-sectional study. The settings of the study were emergency services with a national scope; the participants were nursing workers. Data were collected via face-to-face virtual calling interviews and analyzed via a content analysis technique, which was supported by IRAMUTEQ software. The formation of textual classes pointed in three thematic directions, from which three categories emerged: nursing workers\u2019 exposure, due to a lack of protective equipment, to the risk of being contaminated with, falling ill from, and transmitting the COVID-19 virus; changes in work environments, processes, and relations in response to the pandemic; and physical, mental, and psychosocial alterations perceived by emergency service nursing workers. The exposure to the virus, risk of contamination, and changes in the work environment and relations all resulted in health repercussions, which were perceived as physical, mental, and psychosocial alterations that were described as dietary disturbances, physical fatigue, burnout, increased smoking, anxiety, sleep alterations, fear, exhaustion, stress, social isolation, loneliness, distancing from relatives, and social stigma.<\/jats:p>","DOI":"10.3390\/ijerph20064675","type":"journal-article","created":{"date-parts":[[2023,3,7]],"date-time":"2023-03-07T02:07:38Z","timestamp":1678154858000},"page":"4675","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["COVID-19 Pandemic: Analysis of Health Effects on Emergency Service Nursing Workers via a Qualitative Approach"],"prefix":"10.3390","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5153-4083","authenticated-orcid":false,"given":"Elaine Cristine da Concei\u00e7\u00e3o","family":"Vianna","sequence":"first","affiliation":[{"name":"Nursing School, Universidade do Estado do Rio de Janeiro, Rio de Janeiro 20551-030, RJ, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5150-8299","authenticated-orcid":false,"given":"Raquel Veiga","family":"Baptista","sequence":"additional","affiliation":[{"name":"Nursing School, Universidade do Estado do Rio de Janeiro, Rio de Janeiro 20551-030, RJ, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2131-2009","authenticated-orcid":false,"given":"Raquel Silva","family":"Gomes","sequence":"additional","affiliation":[{"name":"Nursing School, Universidade do Estado do Rio de Janeiro, Rio de Janeiro 20551-030, RJ, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4930-3390","authenticated-orcid":false,"given":"Gabrielle Silva","family":"Pereira","sequence":"additional","affiliation":[{"name":"Nursing School, Universidade do Estado do Rio de Janeiro, Rio de Janeiro 20551-030, RJ, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9550-1267","authenticated-orcid":false,"given":"Giovanna Costa","family":"Guimar\u00e3es","sequence":"additional","affiliation":[{"name":"Nursing School, Universidade do Estado do Rio de Janeiro, Rio de Janeiro 20551-030, RJ, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9928-6392","authenticated-orcid":false,"given":"Magda Guimar\u00e3es de Araujo","family":"Faria","sequence":"additional","affiliation":[{"name":"Department of Public Health Nursing, Nursing School, Universidade do Estado do Rio de Janeiro, Rio de Janeiro 20551-030, RJ, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7541-5946","authenticated-orcid":false,"given":"Jo\u00e3o Silvestre","family":"Silva-Junior","sequence":"additional","affiliation":[{"name":"Department of Medicine, Centro Universit\u00e1rio S\u00e3o Camilo, S\u00e3o Paulo 04262-200, SP, Brazil"},{"name":"Department of Forensic Medicine, Bioethics, Occupational Medicine, Physical Medicine and Rehabilitation, Medical School, Universidade de S\u00e3o Paulo, S\u00e3o Paulo 01246-903, SP, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcelia Cristina de","family":"Oliveira","sequence":"additional","affiliation":[{"name":"Nursing School, Universidade do Estado do Rio de Janeiro, Rio de Janeiro 20551-030, RJ, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2629-8584","authenticated-orcid":false,"given":"Luana Cardoso","family":"Pestana","sequence":"additional","affiliation":[{"name":"Hospital Federal Cardoso Fontes, Minist\u00e9rio da Sa\u00fade, Rio de Janeiro 22745-130, RJ, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3050-0378","authenticated-orcid":false,"given":"Daniela Campos de Andrade","family":"Louren\u00e7\u00e3o","sequence":"additional","affiliation":[{"name":"Nursing School, Universidade de S\u00e3o Paulo, S\u00e3o Paulo 05403-000, SP, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9178-1345","authenticated-orcid":false,"given":"Mirian Cristina dos Santos","family":"Almeida","sequence":"additional","affiliation":[{"name":"Nursing Undergraduation Course, Universidade Federal do Tocantins, Palmas 77001-092, TO, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9985-5575","authenticated-orcid":false,"given":"Vivian Aline","family":"Mininel","sequence":"additional","affiliation":[{"name":"Department of Nursing, Centro de Ci\u00eancias Biol\u00f3gicas e da Sa\u00fade, Universidade Federal de S\u00e3o Carlos, S\u00e3o Carlos 13565-905, SP, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8322-3917","authenticated-orcid":false,"given":"Silmar Maria da","family":"Silva","sequence":"additional","affiliation":[{"name":"Department of Basic Nursing, School of Nursing, Universidade Federal de Minas Gerais, Belo Horizonte 30130-100, MG, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9301-0379","authenticated-orcid":false,"given":"Aline Coutinho Sento","family":"S\u00e9","sequence":"additional","affiliation":[{"name":"Hospital Federal Cardoso Fontes, Minist\u00e9rio da Sa\u00fade, Rio de Janeiro 22745-130, RJ, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0823-0818","authenticated-orcid":false,"given":"Cristiane Helena","family":"Gallasch","sequence":"additional","affiliation":[{"name":"Department of Medical-Surgical Nursing, Nursing School, Universidade do Estado do Rio de Janeiro, Rio de Janeiro 20551-030, RJ, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,3,7]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"e49596","DOI":"10.12957\/reuerj.2020.49596","article-title":"Prevention related to occupational exposure: COVID-19","volume":"28","author":"Gallasch","year":"2020","journal-title":"Rev. Enferm. UERJ"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"e20210149","DOI":"10.1590\/0034-7167-2021-0149","article-title":"Management of resources in a federal emergency hospital during the COVID-19 pandemic","volume":"75","author":"Vianna","year":"2022","journal-title":"Rev. Bras. Enferm."},{"key":"ref_3","first-page":"ecov2","article-title":"Nurses\u2019 perception regarding their health and working conditions during the COVID-19 pandemic","volume":"47","author":"Galon","year":"2022","journal-title":"Rev. Bras. Saude Ocup."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"100","DOI":"10.1016\/j.jhin.2020.03.002","article-title":"Reasons for healthcare workers becoming infected with novel coronavirus disease 2019 (COVID-19) in China","volume":"105","author":"Wang","year":"2020","journal-title":"J. Hosp. Infect."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"eAO6281","DOI":"10.31744\/einstein_journal\/2021AO6281","article-title":"Occupational psychosocial stressors and mental distress among healthcare workers during COVID-19 pandemic","volume":"19","author":"Cunha","year":"2021","journal-title":"Einstein"},{"key":"ref_6","unstructured":"Conselho Federal de Enfermagem (2021, December 10). Observat\u00f3rio da Enfermagem. Profissionais Infectados por COVID-19 Informado Pelos Enfermeiros Respons\u00e1veis T\u00e9cnicos\/Coordenadores, Available online: http:\/\/observatoriodaenfermagem.cofen.gov.br\/."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"101003","DOI":"10.1016\/j.ienj.2021.101003","article-title":"Work experience of triage nurses in emergency departments during the prevalence of COVID-19","volume":"56","author":"Xu","year":"2021","journal-title":"Int. Emerg. Nurs."},{"key":"ref_8","unstructured":"(2020, May 05). Brasil. Minist\u00e9rio da Sa\u00fade. Portaria GM n.\u00ba 2048 de 5 de Novembro de 2002. Aprova o Regulamento T\u00e9cnico dos Sistemas Estaduais de Urg\u00eancia e Emerg\u00eancia. Bras\u00edlia. Available online: https:\/\/cutt.ly\/UPtaHdg."},{"key":"ref_9","unstructured":"(2020, May 05). Brasil. Minist\u00e9rio da Sa\u00fade. Pol\u00edtica Nacional de Aten\u00e7\u00e3o \u00e0s Urg\u00eancias. Bras\u00edlia, Available online: https:\/\/bvsms.saude.gov.br\/bvs\/publicacoes\/politica_nac_urgencias.pdf."},{"key":"ref_10","doi-asserted-by":"crossref","unstructured":"Tofani, L.F.N., Furtado, L.A.C., Andreazza, R., and Nasser, M.A. (2022). Integrality in the Urgent and Emergency Health Care Network: Care over services. Interface, 26.","DOI":"10.1590\/interface.210690"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"e20180263","DOI":"10.1590\/1983-1447.2019.20180263","article-title":"Humanization in urgent and emergency services: Contributions to nursing care","volume":"40","author":"Sousa","year":"2019","journal-title":"Rev. Ga\u00facha Enferm."},{"key":"ref_12","unstructured":"(2021, April 05). Brasil. Minist\u00e9rio do Trabalho. Di\u00e1rio Oficial da uni\u00e3o. Portaria n.\u00ba 877, de 24 de Outubro de 2018 Que Altera a Al\u00ednea \u201cl\u201d do Item 6.8.1 e Inclui o Item 6.9.3.2 na Norma Regulamentadora n.\u00ba 06-Equipamento de Prote\u00e7\u00e3o Individual\u2013EPI, Bras\u00edlia, Available online: https:\/\/www.gov.br\/trabalho-e-previdencia\/pt-br\/composicao\/orgaos-especificos\/secretaria-de-trabalho\/inspecao\/seguranca-e-saude-no-trabalho\/sst-portarias\/2018\/portaria_mtb_877_altera_nr_06_repub.pdf."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"e63904","DOI":"10.12957\/reuerj.2022.63904","article-title":"Impacts of the COVID-19 pandemic on nurses\u2019 health","volume":"30","author":"Acioli","year":"2022","journal-title":"Rev. Enferm. UERJ"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"241","DOI":"10.1007\/s10926-022-10035-w","article-title":"Development of a computational policy model for comparing the effect of compensation scheme policies on recovery after workplace injury","volume":"32","author":"Thompson","year":"2022","journal-title":"J. Occup. Reahb."},{"key":"ref_15","first-page":"319","article-title":"Factors that influence the retention and turnover of dental professionals: Suggestion for Pacific nations","volume":"19","author":"Nair","year":"2021","journal-title":"J. Int. Oral. Health"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"e1","DOI":"10.1590\/2317-6369000028520","article-title":"Health workers and COVID-19: Flailing working conditions?","volume":"46","author":"Vedovato","year":"2021","journal-title":"Rev. Bras. Sa\u00fade Ocup."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"65","DOI":"10.47626\/1679-4435-2022-787","article-title":"The impact of the SARS-CoV-2 pandemic on sickness absenteeism among hospital workers","volume":"20","author":"Paiva","year":"2022","journal-title":"Rev. Bras. Med. Trab."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"1893","DOI":"10.1007\/s11135-017-0574-8","article-title":"Saturation in qualitative research: Exploring its conceptualization and operationalization","volume":"52","author":"Saunders","year":"2018","journal-title":"Qual. Quant."},{"key":"ref_19","first-page":"e03353","article-title":"The use of IRAMUTEQ software for data analysis in qualitative research","volume":"52","author":"Souza","year":"2018","journal-title":"Rev. Esc. Enferm. USP"},{"key":"ref_20","unstructured":"Camargo, B.V., and Justo, A.M. (2021, October 28). Tutorial para uso do software (Interface de R pour les Analyses Multidimensionnelles de Textes et de Questionnaires. Laborat\u00f3rio de Psicologia Social da Comunica\u00e7\u00e3o e Cogni\u00e7\u00e3o-UFSC\u2013Brazil. Available online: http:\/\/www.IRaMuTeQ.org\/documentation."},{"key":"ref_21","unstructured":"Conselho Federal de enfermagem (2021, October 28). Pesquisa Perfil da Enfermagem no Brasil. Banco de Dados, Available online: Cofen.gov.br\/perfilenfermagem\/index.html."},{"key":"ref_22","first-page":"11","article-title":"Caracteristicas Gerais Da Enfermagem: O Perfil S\u00f3cio Demogr\u00e1fico","volume":"6","author":"Machado","year":"2015","journal-title":"Enferm Foco."},{"key":"ref_23","unstructured":"(2020, July 06). Brasil. Minist\u00e9rio da Sa\u00fade. Secretaria de Vigil\u00e2ncia em Sa\u00fade. Centro de Opera\u00e7\u00f5es de Emerg\u00eancia em Sa\u00fade P\u00fablica. Boletim Epidemiol\u00f3gico n.\u00ba 08 de 09 de abril de 2020. Bras\u00edlia, Available online: https:\/\/antigo.saude.gov.br\/images\/pdf\/2020\/April\/09\/be-covid-08-final-2.pdf."},{"key":"ref_24","first-page":"e74115","article-title":"Mental health of brazilian nursing professionals in the context of the COVID-19 pandemic: Action of the nursing federal council","volume":"25","author":"Humerez","year":"2020","journal-title":"Cogitare Enferm."},{"key":"ref_25","first-page":"31","article-title":"Fatores de Estresse nos Profissionais de Enfermagem no Combate \u00e0 Pandemia da COVID-19: S\u00edntese de Evid\u00eancias","volume":"31","author":"Barbosa","year":"2020","journal-title":"Com. Ci\u00eancias Sa\u00fade."},{"key":"ref_26","unstructured":"Noal, D.S., Passos, M.F.D., and Freitas, C.M. (2021, November 18). Recomenda\u00e7\u00f5es e Orienta\u00e7\u00f5es em Sa\u00fade Mental e Aten\u00e7\u00e3o Psicossocial na COVID-Rio de Janeiro: Fiocruz. Available online: http:\/\/www.mpgo.mp.br\/portal\/arquivos\/2020\/10\/27\/16_54_35_452_saude_mental_COVID_Fiocruz_2020.pdf."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"e20104030","DOI":"10.15210\/jonah.v10i4.19367","article-title":"Estrat\u00e9gias protetivas, administrativas e ambientais para a sa\u00fade dos trabalhadores durante a pandemia","volume":"10","author":"Gomes","year":"2020","journal-title":"J. Nurs. Health"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"e20200363","DOI":"10.1590\/2177-9465-ean-2020-0363","article-title":"Psychological distress among nursing professionals during the COVID-19 pandemic: Scoping Review","volume":"25","author":"Miranda","year":"2021","journal-title":"Esc. Anna Nery"},{"key":"ref_29","doi-asserted-by":"crossref","unstructured":"Fontes, A.R.S., Oliveira, C.E.R., Domingos, O.R.S., Silva, R.A.C., Maia, L.F.S., Sanches, A.M., and Vasconcellos, C. (2021). Pandemia da COVID-19 e a viol\u00eancia ocupacional: Uma reflex\u00e3o a luz da literatura. Rev. Remecs., 64\u201368.","DOI":"10.24281\/rremecs2021.1.esp.64-68"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"115","DOI":"10.32811\/25954482-2021v4n2p115","article-title":"Viol\u00eancia causada aos profissionais de sa\u00fade durante a pandemia da COVID-19.","volume":"4","author":"Ribeiro","year":"2021","journal-title":"R. Sa\u00fade P\u00fabl. Paran\u00e1"},{"key":"ref_31","unstructured":"Leonel, F.O. (2022, December 10). Impacto da Pandemia Entre Profissionais de Sa\u00fade. Available online: https:\/\/portal.fiocruz.br\/noticia\/pesquisa-analisa-o-impacto-da-pandemia-entre-profissionais-de-saude."},{"key":"ref_32","doi-asserted-by":"crossref","unstructured":"Portela, M.C., and Grabois, V.T.C. (2022, January 20). Matriz Linha de Cuidado COVID-19 na Rede de Aten\u00e7\u00e3o \u00e0 Sa\u00fade. Observat\u00f3rio COVID-19. Fiocruz. Available online: https:\/\/www.arca.fiocruz.br\/handle\/icict\/42324.","DOI":"10.7476\/9786557081587.0010"},{"key":"ref_33","unstructured":"Organiza\u00e7\u00e3o Pan Americana de Sa\u00fade (2022, January 10). Pol\u00edtica e Gest\u00e3o da For\u00e7a de Trabalho em Sa\u00fade no Contexto da Resposta \u00e0 Pandemia da COVID-19. Orienta\u00e7\u00e3o Provis\u00f3ria 3 de Dezembro de 2020b. Available online: https:\/\/cutt.ly\/5PtW2dG."},{"key":"ref_34","unstructured":"World Health Organization (2021, November 20). Actualizaci\u00f3n de la Estrategia Frente a la COVID-19, Available online: https:\/\/www.who.int\/docs\/default-source\/coronaviruse\/COVID-strategy-update-14april2020.pdf?sfvrsn=29da3ba0_19."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"e70","DOI":"10.5902\/2179769264313","article-title":"Repercussions for mental health of nursing professionals who are in the face of Covid-19: Integrative review","volume":"11","author":"Faria","year":"2021","journal-title":"Rev. Enferm. UFSM"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"457","DOI":"10.46919\/archv2n3-021","article-title":"Post covid-19: The sequels left by Sars-Cov-2 and the impact on the life of the those affected","volume":"20","author":"Nogueira","year":"2021","journal-title":"Arch. Health"},{"key":"ref_37","unstructured":"Organiza\u00e7\u00e3o Pan-Americana da Sa\u00fade\/Organiza\u00e7\u00e3o Mundial da Sa\u00fade (2022, January 20). Alerta Epidemiol\u00f3gico Complica\u00e7\u00f5es e Sequelas da COVID-19. 12 August 2020, Available online: https:\/\/www.paho.org\/bra\/dmdoments\/covid-19-materiais-de-comunicacao-1\/alerta%20epidemiologico%20-%20Complicacoes%20e%20sequelas%20da%COVID-19.pdf."},{"key":"ref_38","doi-asserted-by":"crossref","unstructured":"Chen, S., Zhang, C., and Li, W. (2022). The effects of competency-based training model in the training of new nurses: A meta-analysis and systematic review. PLoS ONE, 17.","DOI":"10.1371\/journal.pone.0277484"},{"key":"ref_39","doi-asserted-by":"crossref","unstructured":"Hung, M.S.Y., Lam, S.K.K., Chow, M.C.M., Ng, W.W.M., and Pau, O.K. (2021). The Effectiveness of Disaster Education for Undergraduate Nursing Students\u2019 Knowledge, Willingness, and Perceived Ability: An Evaluation Study. Int. J. Environ. Res. Public Health, 18.","DOI":"10.3390\/ijerph181910545"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"103327","DOI":"10.1016\/j.nepr.2022.103327","article-title":"Exploring the relationships among training needs, willingness to participate and job satisfaction in disaster nursing: The mediating effect of achievement motivation","volume":"61","author":"Chien","year":"2022","journal-title":"Nurs. Ed. Pact."}],"container-title":["International Journal of Environmental Research and Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1660-4601\/20\/6\/4675\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T18:49:25Z","timestamp":1760122165000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1660-4601\/20\/6\/4675"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,3,7]]},"references-count":40,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2023,3]]}},"alternative-id":["ijerph20064675"],"URL":"https:\/\/doi.org\/10.3390\/ijerph20064675","relation":{},"ISSN":["1660-4601"],"issn-type":[{"value":"1660-4601","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,3,7]]}}}