ALBERT

Beschreibung: Stunting is highly prevalent in Indonesian children. The objective of this study was to identify the associations of stunting with morbidity, parental education and socioeconomic status (SES) in Indonesian children. The study population was part of the South East Asian Nutrition Surveys (SEANUTS). A total of 2236 Indonesian children aged 0.5 to 12 years, who had participated in the SEANUTS, were included in this study. Stunting was defined as height for age Z-score (HAZ) ≤ −2 using WHO criteria and severe stunting as HAZ ≤ −3. Information on morbidity, parental education and family SES were collected by structured questionnaires. ANOVA was used for evaluating differences across groups, with or without correction for confounders. The results showed that the overall prevalence of stunting was 31.4%. HAZ in stunted children was associated with disease incidence, including frequency, parental education and family income. There were no significant differences in HAZ values in stunted children with one or more bouts of infectious, digestive tract or respiratory tract illnesses compared to stunted children with no reported illness. The prevalence of stunting in Indonesian children was high and was strongly associated with child morbidity, parental education and SES.

Beschreibung: Background: In Spain, colorectal cancer screening using the fecal occult blood test, targeted towards the 50–69 age bracket, was implemented on different dates. We aim to assess the temporal trend of colorectal cancer (CRC) screening uptake according to the year of screening implementation in each region and to identify predictors for the uptake of CRC screening. Methods: A cross-sectional study with 12,657 participants from the Spanish National Health Surveys 2011 and 2017 was used. Uptake rates were analyzed according to the date that the screening program was implemented. Results: For regions with programs implemented before 2011, the uptake rate increased 3.34-fold from 2011 to 2017 (9.8% vs. 32.7%; p 〈 0.001). For regions that implemented screening within the 2011–2016 period, the uptake rose from 4.3% to 13.2% (3.07-fold; p 〈 0.001), and for regions that implemented screening after 2016, the uptake increased from 3.4% to 8.8% (2.59-fold; p 〈 0.001). For the entire Spanish population, the uptake increased 3.21-fold (6.8% vs. 21.8%; p 〈 0.001). Positive predictors for uptake were older age, Spanish nationality, middle-to-high educational level, suffering chronic diseases, non-smoking and living in regions where screening programs were implemented earlier. Conclusions: The different periods for the implementation of CRC screening as well as sociodemographic and health inequalities may have limited the improvement in the screening uptake from 2011 to 2017 in Spain.

Beschreibung: While food insecurity (FI) has been extensively studied in many countries, there have been few empirical contributions in Poland to date. The main objective of our research was to identify the socio-demographic factors affecting the risk of FI in Poland within 2014–2019. Moreover, we aimed to examine the effects of the family-oriented social program “Family 500+” by comparing the situation in various types of households with children a few years before and after the program was launched. The analysis was based on the set of eight-item FI indicators adopted by the Food and Agriculture Organization using the Gallup World Poll nationally representative survey data. Based on our results the most vulnerable groups in the context of FI were identified. We confirmed the importance of education, gender, age, marital status, household composition, status of employment and income in preventing FI. The effectiveness of the support program in reducing FI was demonstrated as households with at least three children experienced significant improvement in the FI status during the studied years. These findings should be especially important in the context of the impact of the COVID-19 pandemic on FI. As FI can affect the quality and quantity of food choices it is associated with a poorer health status, which increases the risk of infection, including COVID-19, and worsens recovery prognosis. Planning an efficient response to the pandemic requires a comprehension of the increased risk of exposure experienced by people, especially those who are food insecure.

Beschreibung: In 2017, the Government of Mozambique declared localized acute malnutrition crises in a range of districts across Mozambique including Cabo Delgado. This is in spite of intensive efforts by different non-governmental organizations (NGO) and the Government of Mozambique to expand access to information on good nutritional practices as well as promote nutrition-specific interventions, such as cooking demonstrations, home gardens and the distribution of micronutrient powder to children. This paper examines and discusses key nutritional influences on the health of pregnant and breastfeeding mothers in Cabo Delgado province, Mozambique. We conducted 21 key informant interviews (KIIs) with a wide range of stakeholders and 16 in-depth interviews (IDIs) with women. In addition, we conducted four focus group discussions with each of the following groups: (1) pregnant adolescent girls, (2) pregnant women 〉20 yrs, (3) women 〉20 yrs with babies 20 yrs of children

Beschreibung: Environmental protection and sustainable development have become an inevitable trend in many areas, including the energy industry. The development of energy supply networks is strongly correlated with the economics of energy sources as well as ecological and socio-political issues. However, the energy supply network is often distant from the social perspective. This paper therefore combines examination of perceptions and awareness of general public (web-based questionnaire) and top energy experts (a Delphi survey) on the energy supply network and identifies their potential integration in energy supply decision making processes. The results showed that public should be better informed as well as integrated into designing energy supply network as the prosumers gain power and the energy suppliers will no longer dominate the market. Public actors are ready to shape sustainable energy supply and also willing to pay 5.8% more for a sustainable energy supply. The majority are prepared to invest in renewable energy supply network close to their place of residence. Another result is that the public is calling for a shift in priority towards more sustainable and socially friendlier energy supply rather than focusing mainly on the economic and technical perspectives.

Beschreibung: Knowledge gaps remain regarding the cardiorespiratory impacts of ambient volatile organic compounds (VOCs) for the general population. This study identified contributing sources to ambient VOCs and estimated the short-term effects of VOC apportioned sources on daily emergency hospital admissions for cardiorespiratory diseases in Hong Kong from 2011 to 2014. We estimated VOC source contributions using fourteen organic chemicals by positive matrix factorization. Then, we examined the associations between the short-term exposure to VOC apportioned sources and emergency hospital admissions for cause-specific cardiorespiratory diseases using generalized additive models with polynomial distributed lag models while controlling for meteorological and co-pollutant confounders. We identified six VOC sources: gasoline emissions, liquefied petroleum gas (LPG) usage, aged VOCs, architectural paints, household products, and biogenic emissions. We found that increased emergency hospital admissions for chronic obstructive pulmonary disease were positively linked to ambient VOCs from gasoline emissions (excess risk (ER%): 2.1%; 95% CI: 0.9% to 3.4%), architectural paints (ER%: 1.5%; 95% CI: 0.2% to 2.9%), and household products (ER%: 1.5%; 95% CI: 0.2% to 2.8%), but negatively associated with biogenic VOCs (ER%: −6.6%; 95% CI: −10.4% to −2.5%). Increased congestive heart failure admissions were positively related to VOCs from architectural paints and household products in cold seasons. This study suggested that source-specific VOCs might trigger the exacerbation of cardiorespiratory diseases.

Beschreibung: Although fatigue usually goes unnoticed, it is a symptom that poses great challenges to patients with fibromyalgia and is a strong limitation. The aim of this study is to identify and describe the variables involved in fatigue in nine different situations of the Goal Pursuit Questionnaire (GPQ) that may occur in the daily lives of women with fibromyalgia, according to an ABC (Antecedents–Behaviors–Consequences) model. This study followed a qualitative descriptive research method and a deductive–inductive hybrid approach based on a phenomenological paradigm. Twenty-six women with fibromyalgia participated in focus group discussions between February and March of 2018. Thematic content analysis was carried out from transcribed verbatim interviews. We identified nine major themes that emerged from the participants’ conversations: self-imposed duties, muscle fatigue, overwhelming feeling of tiredness, difficulty thinking, difficulty concentrating, negative emotions, lifestyle changes, affected everyday activities, and lack of motivation for daily activities and social interactions. We conclude that the ABC model allowed certain elements to emerge regarding the fatigue experience, highlighting its importance as a symptom in fibromyalgia. This additional analysis of the ABC model showed that fatigue can be described through the 4 U’s Rule, which is integrated by these four adjectives: (1) Unpredictable, (2) Uncontrollable, (3) Unseen, and (4) Unintelligible. Identifying these characteristics can contribute to a better understanding of fibromyalgia in addition to better treatment for these patients.

Beschreibung: Traumatic brain injury (TBI), a global public health concern, may lead to death and major disability. While various short-term, small-sample, and cross-sectional studies on TBI have been conducted in South Korea, there is a lack of clarity on the nationwide longitudinal TBI trends in the country. This retrospective study investigated the epidemiological TBI trends in South Korea, using a population-based dataset of the National Health Insurance (2008–2017). The crude and age adjusted TBI incidence and mortality values were calculated and stratified by age, sex, and TBI diagnosis. The age-adjusted incidence per 100,000 people increased until 2010 and showed a decreasing trend (475.8 cases in 2017) thereafter; however, a continuously decreasing age-adjusted mortality trend was observed (42.9 cases in 2008, 11.3 in 2017). The crude incidence rate increased continually in those aged 〉70 years across all the TBI diagnostic categories. The mortality per 100,000 people was significantly higher among participants aged ≥70 years than in the other age groups. We observed changing trends in the TBI incidence, with a continuously decreasing overall incidence and a rapidly increasing incidence and high mortality values in older adults. Our findings highlight the importance of active TBI prevention in elderly people.

Beschreibung: Little is known regarding the neuroanatomical correlates of patients with deficit schizophrenia or persistent negative symptoms. In this meta-analysis, we aimed to determine whether patients with deficit schizophrenia have characteristic brain abnormalities. We searched PubMed, CINAHL and Ovid to identify studies that examined the various regions of interest amongst patients with deficit schizophrenia, patients with non-deficit schizophrenia and healthy controls. A total of 24 studies met our inclusion criteria. A random-effects model was used to calculate a combination of outcome measures, and heterogeneity was assessed by the I2 statistic and Cochran’s Q statistic. Our findings suggested that there was statistically significant reduction in grey matter volume (−0.433, 95% confidence interval (CI): −0.853 to −0.014, p = 0.043) and white matter volume (−0.319, 95% CI: −0.619 to −0.018, p = 0.038) in patients with deficit schizophrenia compared to healthy controls. There is also statistically significant reduction in total brain volume (−0.212, 95% CI: −0.384 to −0.041, p = 0.015) and white matter volume (−0.283, 95% CI: −0.546 to −0.021, p = 0.034) in patients with non-deficit schizophrenia compared to healthy controls. Between patients with deficit and non-deficit schizophrenia, there were no statistically significant differences in volumetric findings across the various regions of interest.

Beschreibung: The purpose of the current study is to analyze the relationships between physical fitness, selective attention, and academic performance in pre-teens. The sample here consists of 135 participants between the ages of 10 and 12 (M = 11.05; SD = 0.61), with 39.26% female (n = 53) and 60.74% male (n = 82) participants. Horizontal and vertical jump distances, speed, and cardio-respiratory fitness were evaluated to assess physical fitness. The d2 Test of Attention was used to evaluate selective attention. In addition, data were obtained regarding participant academic performance by analyzing the academic performance. The results show significant relationships between the measures analyzed, highlighting positive associations between physical fitness, cognitive functioning, and academic performance. Thus, participants who were fitter scored better on tests of attention (Z133 = −4.07; p 〈 0.00007, Cohen’s d = 0.75, 95% CI (0.39, 1.11)) and concentration (t133 = −3.84; p 〈 0.0007, Cohen’s d = 0.69, 95% CI (0.33, 1.05)), as well as having higher academic performance (Z133 = −2.84; p 〈 0.0035, Cohen’s d = 0.39, 95% CI (0.04, 0.75)). Cardiorespiratory fitness was the measure of physical fitness that best explained these relationships. The results suggest that maintaining and improving the physical fitness of children and adolescents may help their brain function develop better.

Beschreibung: Background: Cervical cancer is one of the most common cancers in women and about 90% of cervical cancer can be reduced by regular screening. The Pap smear has been well in place as a primary cervical screening method since 1950s; however, coverage is still not optimal. This study explored the feasibility of HPV self-sampling in two under-screened population groups in Hong Kong (HK): never screened and not regularly screened females, to estimate the uptake rate and preference rate in the future. Materials and Methods: This was a cross-sectional study to explore the acceptability and feasibility of HPV self-sampling in two age groups: aged 25–35 and aged ≥45, which were reported as the highest proportion of the under-screened population in HK between 2017 and 2018. The study invited eligible women from an HPV study cohort to perform HPV self-sampling at home by themselves. The number of specimens returned from participants was recorded and used to determine the feasibility of HPV self-sampling in the community. The participants were asked to fill in the questionnaires before and after HPV self-sampling to indicate their attitudes, acceptability, and future preference for HPV self-sampling as an acceptable alternative primary cervical cancer screening method. Results: A total of 177 subjects participated in the present study and have achieved a good overall uptake rate of 73% (129/177) who returned the self-collected cervicovaginal sample for HPV testing. Among the under-screened population, there was a higher response rate in aged ≥45 than those aged 25–35. The findings also revealed that women who were under-screened, including those who have never been screened, were more likely to prefer HPV self-sampling than those who had regular screening. This study found that the acceptability of HPV self-sampling was fairly positive among the respondents. The findings also indicated that HPV self-sampling was not only beneficial to enhance their health awareness but also to promote the cervical cancer screening uptake rate, especially among the under-screened or never screened populations. Conclusions: HPV self-sampling would be a solution to overcome the perceived barriers in clinician-based screening. The findings also indicated that it could be feasible to use as an alternative primary cervical cancer screening.

Beschreibung: Public health recommendations and governmental measures during the new coronavirus disease (COVID-19) pandemic have enforced numerous restrictions on daily living including social distancing, isolation, and home confinement. While these measures are imperative to mitigate spreading of COVID-19, the impact of these restrictions on psychosocial health is undefined. Therefore, an international online survey was launched in April 2020 to elucidate the behavioral and lifestyle consequences of COVID-19 restrictions. This report presents the preliminary results from more than one thousand responders on social participation and life satisfaction. Methods: Thirty-five research organizations from Europe, North-Africa, Western Asia, and the Americas promoted the survey through their networks to the general society, in 7 languages (English, German, French, Arabic, Spanish, Portuguese, and Slovenian). Questions were presented in a differential format with questions related to responses “before” and “during” confinement conditions. Results: 1047 participations (54% women) from Asia (36%), Africa (40%), Europe (21%), and others (3%) were included in the analysis. Findings revealed psychosocial strain during the enforced COVID-19 home confinement. Large decreases (p 〈 0.001) in the amount of social activity through family (−58%), friends/neighbors (−44.9%), or entertainment (−46.7%) were triggered by the enforced confinement. These negative effects on social participation were also associated with lower life satisfaction (−30.5%) during the confinement period. Conversely, the social contact score through digital technologies significantly increased (p 〈 0.001) during the confinement period with more individuals (+24.8%) being socially connected through digital technology. Conclusion: These preliminary findings elucidate the risk of psychosocial strain during the early COVID-19 home confinement period in 2020. Therefore, in order to mitigate the negative psychosocial effects of home confinement, implementation of national strategies focused on promoting social inclusion through a technology-based solution is strongly suggested.

Beschreibung: The study portrays the social and health care master’s students’ (N = 19) perceptions on the changes in work practices due to digitalisation, with a special focus on online counselling. Furthermore, the data include thoughts on the impact digitalised interaction, i.e., online counselling, has on their work and professional identities. The students studied how the motivational interviewing method combined with a solution-focused counselling approach is applicable in online settings by using simulation pedagogy. The data consisted of students’ learning diaries. Furthermore, the data were analysed using inductive content analysis. The results show that the digitalisation of work practices demands blended professionalism, which allows the professional to work both face-to-face and online with clients. In addition, the education of social and health care professionals needs to address the lack of competences and skills in digitalised work practices and provide a conceptual and practical understanding of blended professionalism in the sector.

Beschreibung: In Japan’s response to the coronavirus disease 2019 (COVID-19), virus testing was limited to symptomatic patients due to limited capacity, resulting in uncertainty regarding the spread of infection and the appropriateness of countermeasures. System dynamic modelling, comprised of stock flow and infection modelling, was used to describe regional population dynamics and estimate assumed region-specific transmission rates. The estimated regional transmission rates were then mapped against actual patient data throughout the course of the interventions. This modelling, together with simulation studies, demonstrated the effectiveness of inbound traveler quarantine and resident self-isolation policies and practices. A causal loop approach was taken to link societal factors to infection control measures. This causal loop modelling suggested that the only effective measure against COVID-19 transmission in the Japanese context was intervention in the early stages of the outbreak by national and regional governments, and no social self-strengthening dynamics were demonstrated. These findings may contribute to an understanding of how social resilience to future infectious disease threats can be developed.

Beschreibung: This study examined postural control during single leg stance test with progressively increased balance-task difficulty in soccer players with unilateral transfemoral amputation (n = 11) compared to able-bodied soccer players (n = 11). The overall stability index (OSI), the anterior/posterior stability index, and the medial/lateral stability index during three balance tasks with increasing surface instability were estimated. The oculomotor and visuomotor contribution to postural control in disabled athletes was analyzed. Oculomotor function, simple and choice reaction times, and peripheral perception were assessed in a series of visuomotor tests. The variation in OSI demonstrated significantly greater increases during postural tests with increased balance-task difficulty in the able-bodied soccer players compared to amputees (F(2,40) = 3.336, p 〈 0.05). Ocular mobility index correlated (p 〈 0.05) with OSI in conditions of increasing balance-task difficulty. Moreover, speed of eye-foot reaction has positive influence (p 〈 0.05) on stability indexes in tasks with an unstable surface. Amputee soccer players displayed comparable postural stability to able-bodied soccer players. Disabled athletes had better adaptability in restoring a state of balance in conditions of increased balance-task difficulty than the controls. The speed of visuomotor processing, characterized mainly by speed of eye-foot reaction, significantly contributed to these results.

Beschreibung: Families play an important role in helping teenagers avoid using tobacco, cannabis, and opioids, but some parents may underestimate the risk of their children using those substances. This study aimed to determine parents’ perceived likelihood of their child initiating tobacco, cannabis, and opioid use, as well as the control they have in preventing their child from using those substances. We surveyed 427 parents of children aged 0–18 years old using the online Amazon Mechanical Turk platform in the spring of 2019. We measured participants’ perceived likelihood of their child initiating tobacco, cannabis, or opioid use before the age of 18 compared to other children, using a five-point Likert scale. This perceived likelihood was dichotomized between optimistic (less likely than average) and non-optimistic (average or more likely than average). Independent variables included parental tobacco use, perceived parental control, and perceived severity of the behavior. Participants with missing data and participants with children who had already initiated substance use were excluded from statistical analyses. Mean age of participants was 38.1 years (Standard Deviation 8.4); 67% were female. Level of parental optimism was 59% for cannabis, 77% for tobacco, and 82% for opioids. Perceived severity was significantly lower for cannabis use (71/100) than tobacco (90/100) and opioid use (92/100) (p 〈 0.001). Current smokers were less likely than never smokers to be optimistic about their child’s risk of initiating using tobacco (Adjusted Odds Ratio (AOR): 0.18 [95% Confidence Interval (CI) 0.10–0.34]) or cannabis (AOR: 0.21 [95% CI 0.12–0.38]). Parental perceived likelihood of a child initiating substance use represents an understudied and potential target for substance use prevention.

Beschreibung: Recent evidence suggests that traffic noise may negatively impact mental health. However, existing systematic reviews provide an incomplete overview of the effects of all traffic noise sources on mental health. We conducted a systematic literature search and summarized the evidence for road, railway, or aircraft noise-related risks of depression, anxiety, cognitive decline, and dementia among adults. We included 31 studies (26 on depression and/or anxiety disorders, 5 on dementia). The meta-analysis of five aircraft noise studies found that depression risk increased significantly by 12% per 10 dB LDEN (Effect Size = 1.12, 95% CI 1.02–1.23). The meta-analyses of road (11 studies) and railway traffic noise (3 studies) indicated 2–3% (not statistically significant) increases in depression risk per 10 dB LDEN. Results for road traffic noise related anxiety were similar. We did not find enough studies to meta-analyze anxiety and railway or aircraft noise, and dementia/ cognitive impairment and any traffic noise. In conclusion, aircraft noise exposure increases the risk for depression. Otherwise, we did not detect statistically significant risk increases due to road and railway traffic noise or for anxiety. More research on the association of cognitive disorders and traffic noise is required. Public policies to reduce environmental traffic noise might not only increase wellness (by reducing noise-induced annoyance), but might contribute to the prevention of depression and anxiety disorders.

Beschreibung: The primary purpose of this study was to describe obesity, body composition, convenience food consumption, physical activity, and muscle strength among Asian American youth compared to other racial/ethnic groups. The secondary purpose was to examine whether obesity, body composition, convenience food consumption, physical activity, and muscle strength differed by acculturation levels among Asian American youth. A secondary analysis was conducted using data from 12,763 children aged 2 to 17 years that participated in the 2011–2018 US National Health and Nutrition Examination Survey (NHANES). In the NHANES interview, acculturation, dietary behavior, and physical activity questionnaires were administered. The acculturation level was indicated by the language spoken at home. In the NHANES examination, anthropometry, dual-energy X-ray absorptiometry (DXA), and muscle strength assessments were conducted. Compared to non-Hispanic White American boys, Asian American boys had similar levels of obesity, central obesity, and fat mass. Among the five racial/ethnic groups examined, lean body mass, muscle mass, convenience food consumption, and daily physical activity were the lowest in the Asian group. More acculturated Asian American boys, but not girls, were more likely to be obese (OR = 3.28 (1.63, 6.60)). More acculturated Asian American youth more frequently consumed convenience food (1.4 more meals/month (1.2, 1.6)). This study highlights the obesity problem among Asian American boys, which worsens with acculturation to America. The study results also suggest that although Asian American youth consume less convenience food overall than non-Hispanic White American youth, increasing acculturation may negatively influence food choices.

Beschreibung: The novel coronavirus disease 2019 (COVID-19) is a global pandemic spreading worldwide, and Italy represented the first European country involved. Healthcare workers (HCWs) facing COVID-19 pandemic represented an at-risk population for new psychosocial COVID-19 strain and consequent mental health symptoms. The aim of the present study was to identify the possible impact of working contextual and personal variables (age, gender, working position, years of experience, proximity to infected patients) on professional quality of life, represented by compassion satisfaction (CS), burnout, and secondary traumatization (ST), in HCWs facing COVID-19 emergency. Further, two multivariable linear regression analyses were fitted to explore the association of mental health selected outcomes, anxiety and depression, with some personal and working characteristics that are COVID-19-related. A sample of 265 HCWs of a major university hospital in central Italy was consecutively recruited at the outpatient service of the Occupational Health Department during the acute phase of COVID-19 pandemic. HCWs were assessed by Professional Quality of Life-5 (ProQOL-5), the Nine-Item Patient Health Questionnaire (PHQ-9), and the Seven-Item Generalized Anxiety Disorder scale (GAD-7) to evaluate, respectively, CS, burnout, ST, and symptoms of depression and anxiety. Females showed higher ST than males, while frontline staff and healthcare assistants reported higher CS rather than second-line staff and physicians, respectively. Burnout and ST, besides some work or personal variables, were associated to depressive or anxiety scores. The COVID-19 pandemic represents a new working challenge for HCWs and intervention strategies to prevent burnout and ST to reduce the risk of adverse mental health outcomes are needed.

Beschreibung: The aim of this study was to identify a best practice method to cost the health benefits of active transport for use in infrastructure planning in New South Wales, Australia. We systematically reviewed the international literature covering the concept areas of active transport and cost and health benefits. Original publications describing a method to cost the health benefits of active transport, published in 2000–2019 were included. Studies meeting the inclusion criteria were assessed against criteria identified in interviews with key government stakeholders. A total of 2993 studies were identified, 53 were assessed for eligibility, and 19 were included in the review. The most commonly studied active transport modes were cycling (n = 8) and walking and cycling (n = 6). Exposures considered were physical activity, road transport related injuries and air pollution. The most often applied economic evaluation method was cost benefit analysis (n = 8), and costs were commonly calculated by monetising health outcomes. Based on evaluation of models against the criteria, a Multistate Life Table model was recommended as the best method currently available. There is strong and increasing interest in quantifying and costing the health benefits of active transport internationally. Incorporating health-related economic benefits into existing regulatory processes such as cost benefit analyses could provide an effective way to encourage the non-health sector to include health impacts in infrastructure measures.

Beschreibung: Rescue workers present an elevated risk for posttraumatic stress disorder (PTSD) and recently, research has begun to focus on coping styles and social support as protective factors in this population. Associations in the particular group of search and rescue dog handlers still lack evidence. The aim of the study is to investigate if functional cognitions and social support also decrease the risk for PTSD. Active voluntary rescue dog handlers (n = 116) rated levels of resilience, sense of coherence, and social acknowledgment (SAQ; subscales general disapproval, familial disapproval, recognition), in addition to a trauma checklist and PTSD symptoms. Linear regression analyses and two different graph models were calculated to explore associations, as well as potential pathways. Controlling for trauma exposure, the SAQ general disapproval emerged as the only significant predictor in the regression model. In the graph models, SAQ familial disapproval was linked to SAQ recognition and SAQ general disapproval. The latter, together with a sense of coherence manageability, affected PTSD re-experiencing symptoms through resilience. The findings are in line with earlier work. The study underlines the importance of targeting resilience and manageability, as well as enhancing social support in prevention programs for PTSD in canine search and rescue teams. Future research is warranted to further investigate model stability and replicate findings.

Beschreibung: Strokes are a time-dependent medical emergency. The training of emergency medical service (EMS) professionals is essential to ensure the activation of stroke codes with pre-notification, as well as a rapid transfer to achieve early therapy. New assessment scales for the detection of patients with suspected large vessel occlusion ensures earlier access to endovascular therapy. The aim of this study was to evaluate the impact on an online training intervention focused on the Rapid Arterial oCclusion Evaluation (RACE) scoring of EMS professionals based on the prehospital stroke code in Catalonia from 2014 to 2018 in a pre–post intervention study. All Catalonian EMS professionals and the clinical records from primary stroke patients were included. The Kirkpatrick model guided the evaluation of the intervention. Data were collected on the knowledge on stroke recognition and management, pre-notification compliance, activated stroke codes and time performance of EMS professionals. Knowledge improved significatively in most items and across all categories, reaching a global achievement of 82%. Pre-notification compliance also improved significantly and remained high in the long-term. Increasingly higher notification of RACE scores were recorded from 60% at baseline to 96.3% in 2018, and increased on-site clinical care time and global time were also observed. Therefore, the online training intervention was effective for increasing EMS professionals’ knowledge and pre-notification compliance upon stroke code activation, and the wide adoption of a new prehospital scale for the assessment of stroke severity (i.e., the RACE scale) was achieved.

Beschreibung: A substantial amount of attention has been devoted towards the potential sport legacy of the Olympic Games. In spite of the increasing academic interest in this topic, there is a knowledge gap as far as sport legacy is concerned by types of different sports. The authors bridge this gap by analysing the evolution of 43 different Olympic/Paralympic sport modalities in the two-year period after the London 2012 Olympics. By using data from the Active People Survey with a sample of 165,000 people annually, and considering some demographic variables and the effect of the economic environment, the paper aims to test the existence of a sport legacy. We have applied time series analysis and ARIMA models for controlling for economic influence and seasonal adjustment and for making comparisons among participation rates. The results show, for the total of the sports analysed, that there were 336,000 individuals who increased their frequency of participation, while there was no significant increase in the number of new participants in these sports. When we develop the analysis for types of sports, London 2012 is positively associated not only with the frequency of participation in some types of sport but also with an increase in the number of new sport participants. Gender and age differences are also detected. The results show the differences of sport legacy by type of sports. Moreover, this research has elucidated an important unrecognised aspect of the effect of the Olympic Games and perhaps major events: that they can become a major policy tool for reversing sporting inequalities.

Beschreibung: The proportion of females participating in long-distance races has been increasing in the last years. Although it is well-known that there are differences in how females and males face a marathon, higher research may be done to fully understand the intrinsic and extrinsic factors affecting sex differences in endurance performance. In this work, we used triaxial accelerometer devices to monitor 74 males and 14 females, aged 30 to 45 years, who finished the Valencia Marathon in 2016. Moreover, marathon split times were provided by organizers. Several physiological traits and training habits were collected from each participant. Then, we evaluated several accelerometry- and pace-estimated parameters (pacing, average change of speed, energy consumption, oxygen uptake, running intensity distribution and running economy) in female and male amateur runners. In general, our results showed that females maintained a more stable pacing and ran at less demanding intensity throughout the marathon, limiting the decay of running pace in the last part of the race. In fact, females ran at 4.5% faster pace than males in the last kilometers. Besides, their running economy was higher than males (consumed nearly 19% less relative energy per distance) in the last section of the marathon. Our results may reflect well-known sex differences in physiology (i.e., muscle strength, fat metabolism, VO2max), and in running strategy approach (i.e., females run at a more conservative intensity level in the first part of the marathon compared to males). The use of accelerometer devices allows coaches and scientific community to constantly monitor a runner throughout the marathon, as well as during training sessions.

Beschreibung: Background: This study compared the efficacy of two multi-component m-health interventions with a wait-list control group on body weight (primary outcome), and secondary outcomes of cardiovascular risk factors, lifestyle behaviours, and mental health. Methods: Three-arm randomised controlled trial (Enhanced: physical activity, diet, sleep, Traditional: physical activity, diet, Control) with assessments conducted at baseline, 6 and 12 months. Participants (n = 116) were overweight or obese adults aged 19–65 (M = 44.5 [SD = 10.5]). The 6-month intervention was delivered via a smartphone app providing educational materials, goal-setting, self-monitoring and feedback, and also included one face-to-face dietary consultation, a Fitbit and scales. The trial was prospectively registered and conducted between May 2017 and September 2018. Group differences on primary and secondary outcomes were examined between the Pooled Intervention groups (Pooled Intervention = Enhanced and Traditional) and Control groups, and then between Enhanced and Traditional groups. Results: Nineteen participants (16.4%) formally withdrew from the trial. Compared with the Control group, average body weight of the Pooled Intervention group did not differ at 6 (between-group difference = −0.92, (95% CI −3.33, 1.48)) or 12 months (0.00, (95% CI −2.62, 2.62)). Compared with the Control group, the Pooled Intervention group significantly increased resistance training (OR = 7.83, (95% CI 1.08, 56.63)) and reduced energy intake at 6 months (−1037.03, (−2028.84, −45.22)), and improved insomnia symptoms at 12 months (−2.59, (−4.79, −0.39)). Compared with the Traditional group, the Enhanced group had increased waist circumferences (2.69, (0.20, 5.18)) and sedentary time at 6 months (105.66, (30.83, 180.48)), and improved bed time variability at 12 months (−1.08, (−1.86, −0.29)). No other significant differences were observed between groups. Conclusions: Relative to Controls, the Pooled Intervention groups did not differ on body weight but improved resistance training, and reduced energy intake and insomnia symptom severity. No additional weight loss was apparent when targeting improvements in physical activity, diet and sleep in combination compared with physical activity and diet.

Beschreibung: Although bullying and cyberbullying have been widely studied in diverse geographical areas, the number of studies in isolated regions, located in rainforests such as the Peruvian Amazonia, is low. Most research has been conducted in wealthy, Western countries, although disadvantaged areas are usually the most affected by various problems. Thus, the aims of this study were to validate bullying and cyberbullying measurement instruments among adolescents in the Peruvian Amazonia, to determine the prevalence rates of bullying and cyberbullying among this population, and to examine how bullying and cyberbullying relate to self-esteem, empathy, and social skills. The sample included 607 students from the region of Loreto (Peruvian Amazonia) who completed self-report questionnaires. Both questionnaires used in the sample were found to have good psychometric properties. Results showed that bullying and cyberbullying are prevalent among teenagers in the Amazonia. Low self-esteem and high affective empathy predicted bullying victimization. Being a bully was related to high assertiveness. Being a bully-victim was related to low self-esteem and low assertiveness. Cybervictims showed higher cognitive empathy. Cyberbullies showed higher affective empathy in comparison to uninvolved adolescents. Having low self-esteem and higher affective empathy were related to being a cyberbully/victim. This study provides a validated questionnaire that can be used for research and practice in the Amazonia. Based on the current results, tailored anti-bullying and anti-cyberbullying interventions with components focused on self-esteem, empathy, and social skills should be implemented in Peruvian secondary schools.

Beschreibung: To analyze the association between prostate cancer (PCa) risk and night shift work, chronotype, and sleep duration in the context of a population-based case-control study of incident prostate cancer in Spain, a total of 465 PCa cases and 410 controls were analyzed. Selection criteria were: (i) age 40–80 years, and (ii) residence in the coverage area of the reference hospitals for ≥6 months before recruitment. Exposure variables were: (i) night shift work (permanent or rotating); (ii) chronotype: morning, neither, or evening (Munich ChronoType Questionnaire) and (iii) sleep duration according to the recommendations of the American National Sleep Foundation. PCa aggressiveness was determined according to the International Society of Urology Pathology classification. Adjusted odds ratios (aOR) and 95% confidence intervals (95% CI) were estimated using logistic regression models. Night shift work was associated with PCa, aOR = 1.47 (95% CI 1.02–2.11), especially for rotating night shifts, aOR = 1.73 (95% CI 1.09–2.75). The magnitude of the association between ever night work and PCa was higher in evening subjects with aOR = 3.14 (95% CI 0.91–10.76) than in morning chronotypes with an aOR = 1.25 (95% CI 0.78–2.00). Working night shifts, especially rotating night shifts, could increase PCa risk. This risk may be higher in people with an evening chronotype.

Beschreibung: Background: National School Lunch Program (NSLP) standards have improved school lunch dietary quality (DQ), however, further improvements could be made. Acceptability and feasibility of higher DQ are potential barriers. Thus, the purpose is to compare acceptability and feasibility of best practice (BPSL, optimizing DQ) with typical school lunches (TSL, meeting minimum NSLP standards) served separately and concurrently. Methods: Forty elementary school-aged participants were recruited for a randomized crossover trial. Participants attended three meal conditions (MC) choosing one of two meal types—MC1) BPSL1/BPSL2, MC2) TSL1/TSL2, MC3) BPSL/TSL. Acceptability included taste test surveys, weighted plate waste assessments, and hunger scales. Feasibility included meal cost, time, and skill and equipment requirements. Results: There were no significant differences in total taste test score, average total plate waste, or change in hunger (ps 〉 0.017) before or after adjusting for covariates. TSL was selected significantly more often in MC3 (TSL = 83.3%, BPSL = 16.7%, p = 0.001). Meal cost (p = 0.783) and skill and equipment requirements were not significantly different between meal types. BPSL required significantly longer preparation time (TSL = 60 ± 25 min, BPSL = 267 ± 101 min, p = 0.026). Conclusions: Results indicate few differences in acceptability and feasibility between BPSL and TSL. This study could inform decision and policy-makers seeking to improve school lunch DQ and acceptance of higher DQ meals.

Beschreibung: The study aimed to investigate the correlations among immune, haematological, endocrinological markers and fitness parameters, and assess if the physiological parameters could be a predictor of fitness values. Anthropometric, physical evaluations (countermovement jump—CMJ, 10 m sprint, VO2max, repeated sprint ability—RSA total time and index) and determination of blood (IL-6, IL-10, IL-17A and tumour necrosis factor) and salivary (testosterone and cortisol) samples parameters in 28 young male soccer players (age: 13.0 ± 0.2 years, body mass index (BMI): 19.5 ± 2.2 kg/m2) were analysed. To evaluate the dependence of the variables related to athletic performance, multiple linear regression with backward stepwise elimination was considered. A significant regression equation was found in CMJ (F(5,16) = 9.86, p 〈 0.001, R2 adjusted = 0.679) and in the RSA index (F(5,16) = 15.39, p 〈 0.001, R2 adjusted = 0.774) considering only five variables, in a 10 m sprint (F(4,17) = 20.25, p 〈 0.001, R2 adjusted = 0.786) and in the RSA total time (F(4,17) = 15.31, p 〈 0.001, R2 adjusted = 0.732) considering only four variables and in VO2max (F(9,12) = 32.09, p 〈 0.001, R2 adjusted = 0.930) considering nine variables. Our study suggests the use of regression equations to predict the fitness values of youth soccer players by blood and saliva samples, during different phases of the season, short periods of match congestion or recovery from an injury.

Beschreibung: The purpose of this article is to study whether the position occupied by footballers on the pitch influences their life duration. It is known that various types of sporting activity (endurance, resistance, or mixed) may influence lifespan in different ways. However, there is a paucity of data regarding the role of different positions played in team sports such as football. Our research was based on elite international football players born before 1923 who took part in the first three football World Cups (n = 443) or played in the 1946/1947 season in the leading clubs of the main European leagues (n = 280). Goalkeepers were characterized by a 5–8-year longer life duration compared to their colleagues playing in other positions (World Cup: 82.0 ± 7.0 vs. 74.0 ± 8.0, p = 0.0047; European leagues: 83.0 ± 7.5 vs. 78.0 ± 8.0, p = 0.0023), with an absence of differences between defenders, midfielders, and forwards. Moreover, in both of the analyzed subgroups, the rate of survival until the 85th birthday was significantly higher among goalkeepers than among field players (p = 0.0102 and p = 0.0048, for both studied groups, respectively).

Beschreibung: In developing countries, markets are the main supply of horticultural products to populations, but this can pose a public health challenge due to the risk of the fecal-oral transmission of gut pathogens. This transmission is strongly associated with inadequate public sanitation or low standards of personal and domestic hygiene, and their prevalence can cause gastrointestinal diseases, which are the third leading cause of death in Mozambique. This study aims at assessing the risk for public health of horticultural products supply chain, from the farmers-vendors to the consumers, in municipal markets in Maputo-City, Mozambique. Surveys (75) were conducted on vendors and an observational analysis was performed in the markets under study. The results showed that 62% of the vendors had access to water from boreholes or artisanal sources and the issue “access to water” was significantly different between markets (p = 0.004). Of the vendors who wash their products (53.3%), only 7.5% use tap-water for this purpose, with the difference in attitudes being statistically significant between vendors in the markets (p = 0.035). The majority (60.4%) said that vegetables and fruits can cause diseases due to pesticides and only 31.3% believe that the diseases may be related to poor hygiene. Despite the vendors’ low knowledge of Good Hygiene Practices (GHP), we noticed that women have better practical assimilation of GHP when compared to men (p = 0.008). Although Maputo’s markets are struggling to achieve quality hygiene standards in a reliable and sustainable manner, their resources are limited and significantly different (p = 0.044) from market to market, and this problem remains a concern for the public-health authorities of the city. In conclusion, the provision of adequate drinking water and sewage disposal systems, together with education for health of vendors, can reduce the risk of contamination of fresh food by the more common organisms causing diarrhea in children, including intestinal parasites.

Beschreibung: With the emergence of the novel SARS-CoV-2 and the disease it causes; COVID-19, compliance with/adherence to protective measures is needed. Information is needed on which measures are, or are not, being undertaken. Data collected from the COVID Impact Survey, conducted by the non-partisan and objective research organization NORC at the University of Chicago on April, May, and June of 2020, were analyzed through weighted Quasi-Poisson regression modeling to determine the association of demographics, socioeconomics, and health conditions with protective health measures taken at the individual level in response to COVID-19. The three surveys included data from 18 regional areas including 10 states (CA, CO, FL, LA, MN, MO, MT, NY, OR, and TX) and 8 Metropolitan Statistical Areas (Atlanta, GA; Baltimore, MD; Birmingham, AL; Chicago, IL; Cleveland and Columbus, OH; Phoenix, AZ; and Pittsburgh, PA). Individuals with higher incomes, insurance, higher education levels, large household size, age 60+, females, minorities, those who have asthma, have hypertension, overweight or obese, and those who suffer from mental health issues during the pandemic were significantly more likely to report taking precautionary protective measures relative to their counterparts. Protective measures for the three subgroups with a known relationship to COVID-19 (positive for COVID-19, knowing an individual with COVID-19, and knowing someone who had died from COVID-19) were strongly associated with the protective health measures of washing hands, avoiding public places, and canceling social engagements. This study provides first baseline data on the response to the national COVID-19 pandemic at the individual level in the US. The found heterogeneity in the response to this pandemic by different variables can inform future research and interventions to reduce exposure to the novel SARS-CoV-2 virus.

Beschreibung: The objective of this study is to assess the effect of alcohol consumption, anxiety, and food restriction before and after consuming alcohol and body image on the risk of anorexia and bulimia in college students from Tijuana, Baja California, through predictive statistical models. A quantitative, descriptive, and cross-sectional design and a non-probabilistic sample of 526 college students from Tijuana, Baja California, México were used. Application of the scales (with acceptable psychometric properties) was conducted in classrooms. Through path analyses, four models were found with adequate indicators of goodness of fit: (1) risk of anorexia in women [Chi Square (X2) = 5.34, p = 0.376, Adjusted Determination Coefficient (R2)= 0.250]; (2) anorexia risk for men (X2 = 13.067, p = 0.192, R2 = 0.058); (3) risk of bulimia in women (X2 = 3.358, p = 0.645, R2 = 0.202); and bulimia risk for men (X2 = 14.256, p = 0.075, R2 = 0.284). The findings provide empirical evidence for the food and alcohol disturbance model.

Beschreibung: Background: The monitoring of bioaerosol concentrations in the air is a relevant endeavor due to potential health risks associated with exposure to such particles and in the understanding of their role in climate. In this context, the atmospheric concentrations of bacteria were measured from January 2018 to May 2020 at Saclay, France. The aim of the study was to understand the seasonality, the daily variability, and to identify the geographical origin of airborne bacteria. Methods: 880 samples were collected daily on polycarbonate filters, extracted with purified water, and analyzed using the cultivable method and flow cytometry. A source receptor model was used to identify the origin of bacteria. Results: A tri-modal seasonality was identified with the highest concentrations early in spring and over the summer season with the lowest during the winter season. Extreme changes occurred daily due to rapid changes in meteorological conditions and shifts from clean air masses to polluted ones. Conclusion: Our work points toward bacterial concentrations originating from specific seasonal-geographical ecosystems. During pollution events, bacteria appear to rise from dense urban areas or are transported long distances from their sources. This key finding should drive future actions to better control the dispersion of potential pathogens in the air, like persistent microorganisms originating from contaminated areas.

Beschreibung: The food environment is well documented as an important emphasis for public health intervention. While theoretical models of the relationship between the food environment and dietary outcomes have been proposed, empirical testing of conceptual models has been limited. The purpose of this study was to explore which factors in nutrition environments are significantly associated with dietary outcomes in two urban, low-income, and minority food desert communities. This study analyzed cross-sectional data based on 796 participants from the Food in Our Neighborhood Study. Participants were recruited based on a random sample of addresses in neighborhood study areas, Philadelphia, PA (n = 393) and Trenton, NJ (n = 403). Main dietary outcomes were Healthy Eating Index (HEI) scores and fruit and vegetable consumption subscores computed from ASA24® assessments. Exploratory factor analysis was conducted and yielded a model of four factors with 22 items. Among four factors that emerged, three factors (Perceptions of Neighborhood Food Availability; and Household Food Challenges) were significantly correlated with dietary outcomes. My Store’s Quality and Perceptions of Neighborhood Food Availability were positively correlated with vegetable consumption subscore. The Household Food Challenges factor was negatively correlated with both vegetable subscore and overall HEI score (i.e., more household challenges were associated with lower dietary scores). These findings confirmed the importance of perceived nutrition environments and household food challenges in predicting dietary outcomes among residents of two urban, low-income, and minority food desert communities.

Beschreibung: The low efficiency of the closed-loop supply chain in construction and demolition waste (CDW) recycling has restricted the green development of China’s construction industry. Additionally, the government’s reward–penalty mechanism has a huge influence on green development. This study aimed to investigate the effect of green development performance (GDP) and the government’s reward–penalty mechanism on the decision-making process of production and recycling units, as well as to reveal the optimal strategies under different conditions. Therefore, the strategies’ evolutionary paths of production and recycling units were investigated by using evolutionary game theory. Firstly, an evolutionary game model between production units and recycling units was proposed under the government’s reward–penalty mechanism. Then, the evolutionary stability strategies in different scenarios were discussed. Finally, the effects of the relevant parameters on the evolutionary paths of the game model were analyzed using numerical simulations. The main conclusions are as follows. (1) When the range of GDP changes, the evolutionary stable strategy changes accordingly. GDP plays a positive role in promoting the high-quality development of the CDW recycling supply chain, but an increase in GDP can easily lead to the simultaneous motivation of free-riding. (2) The government’s reward–penalty mechanism effectively regulates the decision-making process of production and recycling units. An increase in the subsidy rate and supervision probability helps to reduce free-riding behavior. Moreover, the incentive effect of the subsidy probability on recycling units is more obvious, while the effect of the supervision probability on improving the motivation of active participation for production units is more remarkable. This paper not only provides a decision-making basis to ensure production and recycling units to make optimal strategy choices under different conditions but also provides a reference for the government to formulate a reasonable reward–penalty mechanism that is conducive to a macro-control market.

Beschreibung: Honey is an extensively utilized sweetener containing sugars and water, together with small quantities of vitamins, minerals, fatty acids, amino acids and proteins. Naturally produced by honeybees (Apis mellifera) from floral nectar, honey is increasingly sold as a health food product due to its nutritious features. Certain honeys are retailed as premium, trendy products. Honeybees are regarded as environmental monitors, but few reports examine the impact of environment on Australian honey trace elements and minerals. In higher density urban and industrial environments, heavy metals can be common, while minerals and trace elements can have ubiquitous presence in both agricultural and urban areas. Honey hives are traditionally placed in rural and forested areas, but increasingly the trend is to keep hives in more urban areas. This study aimed to determine the levels of 26 minerals and trace elements and assess elemental differences between honeys from various regional Queensland and Australian sources. Honey samples (n = 212) were acquired from markets, shops and supermarkets in Queensland while urban honeys were purchased online. The honey samples were classified into four groups according to their regional sources: urban, rural, peri-urban and blend honey. Elemental analyses of honey were performed using ICP-MS and ICP-OES after microwave and hot block digestion. Considerable variations of essential trace elements (Co, Cu, Cr, Fe, Mn, Mo and Zn) and mineral levels (Ca, K, Mg, Na and P) were found in honeys surveyed. There were significant differences (p 〈 0.05) between urban and rural honey samples for B, Na, P, Mn, K, Ca and Cu. Significant differences (p 〈 0.05) were also found between blend and urban honey samples for K, Cu, P, Mn, Sr, Ni, B and Na. Peri-urban versus urban honeys showed significant differences in P, K and Mn. For rural and peri-urban honeys, the only significant difference (p 〈 0.05) was for Na. Toxic heavy metals were detected at relatively low levels in honey products. The study revealed that the Queensland/Australian honey studied is a good source of K and Zn and would constitute a good nutritional source of these elements.

Beschreibung: The prevalence of hypertension among women in Korea aged 65 years or older is 61.7%. Past research has emphasized the importance of health-promoting behaviors in hypertension management for the elderly. The purpose of this cross-sectional study was to identify the effects of self-efficacy, depression, trait anger, and anger expression on the health-promoting behaviors of elderly women with hypertension. Self-report questionnaires were completed by 208 women aged 65 and older (age range: 65 to 85) diagnosed with hypertension by physicians and living in the communities of G city and N city of Gyeonggi-do in South Korea. A hierarchical regression analysis revealed that exercise (β = 0.36, p 〈 0.001) had the most significant effect on health-promoting behaviors, followed by depression (β = −0.31, p 〈 0.001), trait anger (β = 0.21, p = 0.002), anger control (β = 0.20, p 〈 0.001), religion (β = 0.18, p = 0.001), and self-efficacy (β = 0.18, p = 0.003). Trait anger and anger control were identified to have a more significant effect on health-promoting behaviors than self-efficacy. Thus, health-promoting behaviors were influenced by exercise, depression, anger, religion, and self-efficacy. It is necessary to implement a nursing intervention strategy which pays attention to these factors to improve health-promoting behaviors of Korean community-dwelling elderly women.

Beschreibung: This study used the Korean National Health Insurance (NHI) claims database from 2011 to 2017 to estimate the incidence and the incidence-based cost of cervical cancer and carcinoma in situ of cervix uteri (CIS) in Korea. The primary outcome was the direct medical cost per patient not diagnosed with cervical cancer (C53) or CIS (D06) 2 years prior to the index date in the first year after diagnosis. A regression analysis was conducted to adjust for relevant covariates. The incidence of cervical cancer tended to decrease from 2013 to 2016, while that of CIS increased. In particular, the incidence rate of CIS in women in their 20 s and 30 s increased by 56.8% and 28.4%, respectively, from 2013 to 2016. The incidence-based cost of cervical cancer and CIS was USD 13,058 and USD 2695 in 2016, respectively, which increased from 2013. Multivariate regression analysis suggested that age was the most influential variable of the cost in both patient groups, and the cost was highest in those aged over 60, i.e., the medical cost was significantly lower in younger women than their older counterparts. These findings suggest that targeting younger women in cervical cancer prevention is a reasonable option from both economic and public health perspectives.

Beschreibung: Background: In this study, medical and socio-demographic characteristics of foreign language patients in prehospital emergency medical care are analyzed and compared with non-foreign language patients. Methods: We performed retrospective chart review of rescue operations in four emergency medical service stations in Northern Germany over seven months as part of the DICTUM Rescue study (DRKS00016719). We performed descriptive analyses including test statistics and used partial correlation to adjust for patients’ sex and age. Results: Patients with limited German proficiency were served in 2.2% of all 7494 covered rescue operations. On average, these patients were two decades younger than their German speaking counterparts. There were significantly more patients with limited German proficiency with gynecological and obstetric problems, especially births, as well as psychiatric disorders, especially suicide attempts. Conclusions: Our findings suggest that the existing preventive programs for pregnant women and people at risk of suicide do not sufficiently reach patients with limited German proficiency. Additionally, giving birth and psychiatric breakdowns are exceptional and sensitive situations, both for patients and the paramedic staff, where the ability to communicate safely appears to be of enormous importance to enable safe treatment.

Beschreibung: Japan has the highest life expectancy in the world. However, this does not guarantee an improved quality of life. There is a gap between life expectancy and healthy life expectancy. This study aimed to reveal the features of healthy life expectancy across all secondary medical areas (n = 344) in Japan and examine the relationship among healthcare resources, life expectancy, and healthy life expectancy at birth. Data were collected from Japan’s population registry and long-term insurance records. Differences in healthy life expectancy by gender were calculated using the Sullivan method. Maps of healthy life expectancy were drawn up. Descriptive statistics and correlation analysis were used for analysis. The findings revealed significant regional disparities. The number of doctors and therapists, support clinics for home healthcare facilities and home-visit treatments, and dentistry expenditure per capita were positively correlated with life expectancy and healthy life expectancy (correlation coefficients 〉 0.2). They also revealed gender differences. Despite controlling for population density, inequalities in healthy life expectancy were observed, highlighting the need to promote social policies to reduce regional disparities. Japanese policymakers should consider optimal levels of health resources to improve life expectancy and healthy life expectancy. The geographical distribution of healthcare resources should also be reconstituted.

Beschreibung: Health-promoting behaviors help prevent chronic illness. Health-promoting behaviors of nursing students can affect not only their own health, but also the health of their future patients, for whom they can act as role models. Nursing students should participate in health-promoting behaviors; however, nursing students often have unhealthy behaviors. This study aimed to investigate the factors affecting health-promoting behaviors in nursing students. A descriptive, self-report survey of 304 nursing students from three universities in South Korea was conducted. Subjects’ general characteristics, health perceptions, health concerns, and health-promoting behaviors were collected. Of the total participants, 90.1% were female and the mean age was 20.4 years. The mean score for health-promoting behaviors was 2.47, higher than the midpoint. The mean for the subscale of physical activity among health-promoting behaviors was the lowest. The main factors affecting health-promoting behaviors were gender, health perceptions, health concern, and time per week spent searching online for health-related information. The main factors affecting physical activity were gender, health concern, and time per week spent searching online for health-related information. Based on the study findings, it is recommended that a program to empower nursing students to perform health-promoting behaviors be incorporated into the nursing education curriculum with regard to unique needs based on gender. Specifically, it would be effective to develop programs that are easily accessible via the Internet.

Beschreibung: For many centuries, hunter-gatherer societies relied on subsistence practices and traditional diets. However, forces of globalization have increased market involvement, thereby fueling the nutrition transition of hunter-gatherer societies. We review the academic literature on market involvement of hunter-gatherer societies in the Western Amazon and its consequences on diet, health and well-being. First, we elaborate on four main determinants of market involvement (accessibility, monetary income, wild meat trade and social capital), showing how each determinant draws individuals toward or away from markets. Thereafter, we discuss how these determinants alter diet, health and well-being. Our results add to the understanding of the complex relations between market involvement, dietary change, health and well-being of indigenous societies. Furthermore, they bring to light that additional research is needed on the topic to support decision-makers and help preserve indigenous values.

Beschreibung: Disease prevention is a multifaceted construct that has been widely studied. Nevertheless, in spite of its importance, it is still not sufficiently considered by the general population. Since the reasons for this lack of consideration are not yet fully understood, we created an Online Prevention Survey (OPS) to investigate the role of both sociodemographic and psychological factors in predicting individuals’ spontaneous participation in secondary prevention programs. The results revealed that younger people, men, manual workers, unemployed people, and those who do not regularly practise physical activity were less likely to spontaneously participate in such programs. Furthermore, an analysis of the psychological determinants of the willingness to participate in secondary prevention programs showed that depressive symptoms negatively predict it, while an individual’s perception of receiving high social support acts as a positive predictor. Based on these results, we suggest the need for implementing new tailored approaches to promote prevention initiatives to those segments of the population which are more reluctant to spontaneously undertake prevention paths.

Beschreibung: Rising adult asthma prevalence (AAP) rates and asthma emergency room (AER) visits constitute a large burden on public health in Utah (UT), a high-altitude state in the Great Basin Desert, USA. This warrants an investigation of the characteristics of the counties with the highest asthma burden within UT to improve allocation of health resources and for planning. The relations between several predictor environmental, health behavior and socio-economic variables and two health outcome variables, AAP and AER visits, were investigated for UT’s 29 counties. Non-parametric statistical comparison tests, correlation and linear regression analysis were used to determine the factors significantly associated with AER visits and AAP. Regression kriging with Utah small area data (USAD) as well as socio-economic and pollution data enabled local Moran’s I cluster analysis and the investigation of moving correlations between health outcomes and risk factors. Results showed the importance of desert/mining dust and socio-economic status as AAP and AER visits were greatest in the south of the state, highlighting a marked north–south divide in terms of these factors within the state. USAD investigations also showed marked differences in pollution and socio-economic status associated with AAP within the most populous northern counties. Policies and interventions need to address socio-economic inequalities within counties and between the north and south of the state. Fine (PM2.5) and coarse (PM10) particulate matter monitors should be installed in towns in central and southern UT to monitor air quality as these are sparse, but in the summer, air quality can be worse here. Further research into spatiotemporal variation in air quality within UT is needed to inform public health interventions such as expanding clean fuel programs and targeted land-use policies. Efforts are also needed to examine barriers to routine asthma care.

Beschreibung: Local governments and Health Boards are seeking to develop integrated services to promote well-being. Social participation and physical activity are key in promoting well-being for older people. The Health Precinct is a community hub in North Wales that people with chronic conditions are referred to through social prescribing. To improve community-based assets there is a need to understand and evidence the social value they generate. Data collection took place October 2017–September 2019. Social Return on Investment (SROI) analysis was used to evaluate the Health Precinct. Stakeholders included participants aged 55+, participants’ families, staff, the National Health Service and local government. Participants’ health and well-being data were collected upon referral and four months later using the EQ-5D-5L, Campaign to End Loneliness Scale and the Rosenberg Self-Esteem Scale. Family members completed questionnaires at four months. Baseline data were collected for 159 participants. Follow-up data were available for 66 participants and 38 family members. The value of inputs was £55,389 (attendance fees, staffing, equipment, overheads), and the value of resulting benefits was £281,010; leading to a base case SROI ratio of £5.07 of social value generated for every £1 invested. Sensitivity analysis yielded estimates of between 2.60:1 and 5.16:1.

Beschreibung: Paddy mesocosms comprising of rice (Oryza sativa), snail (Pomacea canaliculata), and worm (Tubifex tubifex) were used to assess the damage caused by two acids (HNO3 and H2SO4) at predicted no-effect concentration (PNEC) and hazardous concentration for 50% of species (HC50) levels. In the fourth week, the fresh weight and shoot height of O. sativa at H2SO4-HC50 were reduced by 83.2% and 30.3%, respectively. Wilted leaves (%) at HC50 were approximately twice that at PNEC. No P. canaliculata and T. tubifex were recovered at HC50. At H2SO4-PNEC, the length and weight of P. canaliculata were reduced by 7.4% and 25.9%, respectively, whereas fewer adult (46.5%) and juvenile (84%) T. tubifex were recovered. In the 20th week, rice growth and productivity were correlated with initial pH (pHi) and nitrogen levels. Poor correlation with chlorophyll at the active tillering stage suggests the disturbance of nutrient uptake by roots. Partial least squares path modeling (PLS-PM) results further supported that the pHi directly affects grain yield and quality, as well as plant growth. The indirect effect via intervening fourth-week-variables was also substantial. Therefore, it is important to measure initial pH upon acid spill to estimate the risk to the paddy ecosystem. Information on the change in soil properties associated with acidity will also aid in predicting the yield and quality of grain to be harvested.

Beschreibung: This study examines how an occupational commitment and a fun work environment serve as important mechanisms that influence the job demands–turnover intentions relationship. On the basis of the job demands–resources model, the study explored the relationship between job demands, occupational commitment, fun at work, and turnover intention. The hypotheses were (1) that job demands would be positively associated with predicted turnover intention; (2) that occupational commitment would mediate the job demands–turnover intention link and (3) that a fun environment would moderate the relationship between job demands and occupational commitment and between job demands and turnover intention. The study sampled 294 seafarers using an online survey, and applied descriptive, correlative analysis and the PROCESS Macro to test the hypotheses. Findings provide preliminary support for the three hypotheses, and contribute to a better understanding of the mechanism determining seafarers’ turnover intention. The results suggest the importance of holding appropriate group activities on-board to help seafarers alleviate fatigue and stress.

Beschreibung: Activity-based workplaces (ABWs) are implemented with possible implications for health, well-being, and work satisfaction in the workplace. Drawing on the theoretical framework, i.e., sense of coherence (SOC), the aim was to investigate how indicators pf SOC—meaningfulness, manageability and comprehensibility—are associated with, or function as barriers or facilitators for, health, well-being and work satisfaction during relocation to an ABW. We followed the implementation of ABWs at the Swedish Transport Administration (2018–2019). Questionnaires were administered before (n = 536), 3 months (n = 409) and 9 months (n = 373) after relocation. Focus group interviews (15) were conducted before and after. Data were analyzed using repeated measures ANOVA and content analysis. Relocation to an ABW was associated with a reduced work satisfaction (physical p 〈 0.001; psychosocial p 〈 0.001), and minor changes in health and occupational well-being during relocation (p 〉 0.001). The reduction in work satisfaction was smaller among employees with high meaningfulness in the relocation process (p 〈 0.001). All SOC indicators were positively associated with overall health, well-being and work satisfaction (p 〈 0.001). Interviews suggested that meaningfulness was facilitated by participation in the presented activities and that communication before relocation was crucial. The results indicate that organizations implementing ABWs should promote perceived meaningfulness in the process to mitigate possible declines in satisfaction with the physical and psychosocial work environment.

Beschreibung: Rice blast caused by Magnaporthe oryzae is one of the most serious rice diseases worldwide. Biological control is gaining popularity as a promising method for the control of this disease; however, more effective microbial strains with strong adaptability in rice fields need to be identified. Here, we report for the first time the successful identification of biocontrol bacterial strains from frozen soils of the soda saline-sodic land. We isolated 82 bacterial strains from rice fields in the western Songnen Plain of China, one of the three major soda saline soils in the world. Five of the isolated strains exhibited strong inhibition to M. oryzae growth. The potential strains were identified as Bacillus safensis JLS5, Pseudomonas koreensis JLS8, Pseudomonas saponiphila JLS10, Stenotrophomonas rhizophila JLS11 and Bacillus tequilensis JLS12, respectively, by 16s RNA gene sequence analysis. The antagonistic assay and the artificial inoculation tests showed that JLS5 and JLS12 could effectively inhibit conidial germination and pathogenicity of the rice blast fungus, both preventively and curatively. The suppression of pathogenicity was further confirmed by greenhouse experiments, showing the effectiveness of JLS5 and JLS12 as a potential biological control agents of M. oryzae. The potential application of these cold-tolerant strains for rice blast control in cold regions is discussed. Our data suggest that soda saline-sodic soils are a rich source for biocontrol strain isolation.

Beschreibung: The frontline nurses’ experience of nursing with overstretched resources in acute care setting can affect their health and well-being. Little is known about the experience of registered nurses faced with the care of a patient outside their area of expertise. The aim of this paper is to explore the phenomenon of nursing the outlier patient, when patients are nursed in a ward that is not specifically developed to deal with the major clinical diagnosis involved (e.g., renal patient in gynecology ward). Using a hermeneutic phenomenological approach, eleven individual face-to-face in-depth interviews were conducted with registered nurses in New South Wales, Australia. The study identified that each nurse had a specialty construct developed from nursing in a specialized environment. Each nurse had normalized the experience of specialty nursing and had developed a way of thinking and practicing theorized as a “care ladder”. By grouping and analyzing various “care ladders” together, the nursing capacities common to nurses formed the phenomenological orientation, namely “the composite care ladder”. Compared to nursing specialty-appropriate patients, nursing the outlier patient caused disruption of the care ladder, with some nurses becoming less capable as they were nursing the outlier patient. Nursing the outlier patient disrupted the nurses’ normalized constructs of nursing. This study suggests that nursing patients in specialty-appropriate wards will improve patient outcomes and reduce impacts on the nurses’ morale.

Beschreibung: Policymakers and urban designers strive to implement the increasing evidence about the positive association between urban green space (UGS) and health in policy. In Almere, The Netherlands, the Regenboogbuurt (“Rainbow Quarter”) neighbourhood is currently being revitalized. The research team was asked to deliver design principles for the improvement of UGS in this neighbourhood to benefit the health of its residents. However, robust studies that demonstrate what UGS criteria offer what particular benefit for what target group are scarce. This paper contributes to the need for more evidence-based UGS design by presenting the approach we used to develop UGS design principles for Regenboogbuurt. Demographic information, health statistics, residents’ opinions, and data about the current use of UGS were analysed to choose target groups and to formulate health benefit goals. We also developed a model for assessing the health benefits of UGS. For two age groups (those aged 10–24 and 40–60), stimulating physical health and social cohesion, respectively, were determined to be the goals of improving UGS. UGS design principles were then assessed based on the existing literature. These principles will be taken into account when this area is revitalized in 2021. Thus, there will be an opportunity to measure whether these design principles did indeed contribute to residents’ health.

Beschreibung: The authors wish to make the following corrections to this paper [...]

Beschreibung: The current pool of data investigating the effects of a single resistance exercise session on endothelial function is divergent and inconclusive. Therefore, the purpose of the present study was to evaluate the effect of a single resistance exercise session on flow-mediated dilation (FMD) in trained individuals. Eleven healthy, young, recreationally resistance-trained individuals participated in the study. After determining the resistance exercise workload, the participants performed three sets of 10–12 repetition of leg press and leg extension exercises. By using ultrasound equipment, brachial artery FMD was assessed before (PRE) and 30 min after (POST) the resistance exercise protocol or resting (control) to evaluate endothelial function. A significant reduction in FMD response (PRE: 5.73% ± 1.21% vs. POST: 4.03% ± 1.94%, p 〈 0.01) after resistance exercise was observed, accompanied by a large effect size (d = 1.05). No significant difference was observed in FMD in the control condition (PRE: 5.82% ± 1.19% vs. POST: 5.66% ± 1.24%, p = 0.704). Additionally, no significant difference in baseline brachial artery diameter between resistance exercise (PRE: 3.30 ± 0.32 vs. POST: 3.40 ± 0.34 mm, p = 0.494) and resting (PRE: 3.64 ± 0.41 vs. POST: 3.67 ± 0.62 mm, p = 0.825) was observed. Our findings showed that a single resistance exercise session induced a reduction in FMD in resistance-trained individuals.

Beschreibung: Chronic arsenic (As) exposure is a critical public health issue. The As metabolism can be influenced by many factors. The objective of this study is to verify if these factors influence As metabolism in four Italian areas affected by As pollution. Descriptive analyses were conducted on 271 subjects aged 20–49 in order to assess the effect of each factor considered on As methylation. Percentages of metabolites of As in urine, primary and secondary methylation indexes were calculated as indicators for metabolic capacity. The results indicate that women have a better methylation capacity (MC) than men, and drinking As-contaminated water from public aqueducts is associated with poorer MC, especially in areas with natural As pollution. In areas with anthropogenic As pollution occupational exposure is associated with a higher MC while smoking with a poorer MC. Dietary habits and genetic characteristics are probably implicated in As metabolism. BMI, alcohol consumption and polymorphism of the AS3MT gene seem not to influence As MC. Arsenic metabolism may be affected by various factors and in order to achieve a comprehensive risk assessment of As-associated disease, it is crucial to understand how these factors contribute to differences in As metabolism.

Beschreibung: The grant number in the acknowledgement was incorrect [...]

Beschreibung: Many studies have examined the negative effects of work-family conflict on society, organizations, and individuals. Nonetheless, alleviating employee work-family conflict is a topic worthy of further investigation. Few studies examine the antecedent variables of work-family conflict from personal skill and Guanxi perspectives. Studies that test the moderating role of family-friendly practices at the organization level are also rare. Accordingly, we collected data from 404 employees of 51 organizations. The research data are time-lagged and multileveled. The results of hierarchical linear model (HLM) show: (1) Employee political skill negatively affects employee perceived work-family conflict; (2) Employee political skill positively affects supervisor-subordinate Guanxi; (3) Supervisor-subordinate Guanxi partially mediates the relationship between employee political skill and employee work-family conflict (that is, employees can use their political skill to build high-quality supervisor-subordinate Guanxi, further reducing their perceived work-family conflict); (4) Organization family-friendly practices negatively moderate the relationship between supervisor-subordinate Guanxi and work-family conflict (that is, in organizations with high level family-friendly practices, the negative relationship between supervisor-subordinate Guanxi and work-family conflict becomes weak); Furthermore, by coding with Mplus software (Muthen & Muthen, Los Angeles, CA, USA), we also find: (5) Organization family-friendly practices moderate the indirect effect of employee political skill on employee work-family conflict. The results have both theoretical and empirical implications. Further research directions are addressed at the end.

Beschreibung: In this study, the indoor air quality (IAQ) was investigated in a subway station with fully enclosed platform screen doors in Beijing, China. Eight indoor air pollutants, including PM2.5, PM10, SO2 (sulfur dioxide), NO2 (nitrogen dioxide), NH3 (ammonia), CO (carbon monoxide), CH2O (formaldehyde) and TVOC (total volatile organic compound), were measured for six consecutive days in October 2019. The results indicated that the IAQ in the subway station was basically stable at good levels for most times during the whole measurement period. All eight indoor air pollutants were far below their corresponding maximum allowable concentrations, except for the PM2.5 concentrations, which occasionally exceeded the concentration limits. The concentrations of indoor air pollutants in the subway station were basically within the corresponding standards. The correlation analyses showed that outdoor air pollutants have important influences on indoor air pollutants. The concentrations of PM10, PM2.5, SO2, NO2 and CO in the subway station were positively correlated with their corresponding outdoor concentrations. PM10 was statistically significantly correlated with the passenger flow and train frequency, but the other air pollutants were less impacted by the passenger flow and train frequency.

Beschreibung: Duchenne muscular dystrophy (DMD) is a severe muscle-wasting disease. Although the lack of dystrophin protein is the primary defect responsible for the development of DMD, secondary disease complications such as persistent inflammation contribute greatly to the pathogenesis and the time-dependent progression of muscle destruction. The immunoproteasome is a potential therapeutic target for conditions or diseases mechanistically linked to inflammation. In this study, we explored the possible effects of ONX-0914 administration, an inhibitor specific for the immunoproteasome subunit LMP7 (ß5i), on motor performance, muscular pathology and protein degradation in 7-week old MDX mice, an age when the dystrophic muscles show extensive degeneration and regeneration. ONX-0914 (10 mg/kg) was injected subcutaneously on Day 2, 4, and 6. The mice were evaluated for physical performance (walking speed and strength) on Day 1 and 8. We show that this short-term treatment of ONX-0914 in MDX mice did not alter strength nor walking speed. The physical performance findings were consistent with no change in muscle inflammatory infiltration, percentage of central nuclei and proteasome content. Taken together, muscle structure and function in the young adult MDX mouse model are not altered with ONX-0914 treatment, indicating the administration of ONX-0914 during this critical time period does not exhibit any detrimental effects and may be an effective treatment of secondary complications of muscular dystrophy after further investigations.

Beschreibung: This study examines Korean college students’ rates and the severity of various negative consequences resulting from the frequency and quantity of alcohol consumption and the unique factors that are affecting this problem in the Korean context in comparison to other countries. It assesses how much gender, age and other associated respondent characteristics mediate alcohol use and the resulting negative consequences among the population. A stratified representative sample of 4803 valid student respondents attending 82 colleges participated in the alcohol consumption survey, of which 95% reported drinking in past 12 months. Drinking is measured by the Alcohol Use Disorders Identification Test-Consumption (AUDIT-C) screening tool. Based on this test, composite scores for each participant were computed and students were grouped into four risk groups: (a) nondrinkers, (b) light drinkers, (c) moderate drinkers and (d) heavy drinkers. Outcome measures include 21 validated items evaluating self-reported alcohol-related negative consequences. Rates of negative consequences are reported for each drinking risk group stratified by gender. Descriptive statistics, stepwise regression, multivariate linear regression and MANOVA tests were used to analyze the data. The study found that female respondents in the sample who consumed alcohol in the past 12 months drank 11.5 percent less than males (AUDIT-C score μ = 6.0 and 6.7, respectively), and there was a greater proportion of females (5.1 percent) who were nondrinkers than males (4.6 percent). Yet, when females drank, they experienced 11.8 percent more negative consequences on average than males (μ = 1.9 and 1.7, respectively). The study attempts to explain this apparent contradiction. The self-reported rates for many individual negative consequences also varied discernibly by gender. The study concludes with suggestions for how alcohol prevention on Korean college campuses would benefit from targeting females and males differently.

Beschreibung: This paper exhibits a thorough review of the use of impedimetric sensors for the analysis of food quality. It helps to understand the contribution of some of the major types of impedimetric sensors that are used for this application. The deployment of impedimetric sensing prototypes has been advantageous due to their wide linear range of responses, detection of the target analyte at low concentrations, good stability, high accuracy and high reproducibility in the results. The choice of these sensors was classified on the basis of structure and the conductive material used to develop them. The first category included the use of nanomaterials such as graphene and metallic nanowires used to form the sensing devices. Different forms of graphene nanoparticles, such as nano-hybrids, nanosheets, and nano-powders, have been largely used to sense biomolecules in the micro-molar range. The use of conductive materials such as gold, copper, tungsten and tin to develop nanowire-based prototypes for the inspection of food quality has also been shown. The second category was based on conventional electromechanical circuits such as electronic noses and other smart systems. Within this sector, the standardized systems, such as electronic noses, and LC circuit -based systems have been explained. Finally, some of the challenges posed by the existing sensors have been listed out, along with an estimate of the increase in the number of sensors employed to assess food quality.

Beschreibung: Adolescent courtship is emerging as an important developmental process which impacts social balance and adjustment in the teenage years. Both the cultural context and different individual competencies seem to determine the success or failure of this process. However, there is little research focusing on the direct relationship between interpersonal skills and adolescent courtship, possibly due to the lack of suitable instruments to measure it. This study takes this process further by adapting a multifactorial measurement of Interpersonal Competence to the framework of adolescent courtship (Adolescent Interpersonal Competence Questionnaire for Courtship (AICQc)), and by analyzing these skills according to gender and age. A total of 1584 adolescents (48.9% girls and 51.1% boys) between the ages of 12 and 17 who were in compulsory secondary education participated in the study. Based on the factor model proposed by Buhrmester et al., the Confirmatory Factor Analysis showed the validity of the instrument and a high internal consistency for five independent domains of competence: (a) initiating relationships; (b) assertiveness and the ability to say no; (c) self-disclosure; (d) providing emotional support; and (e) resolving conflicts. Age, as measured by the school year, was found to be a key factor in this regard. The results are discussed in terms of assessing interpersonal competence for relationships. There has been little research into this type of interpersonal competence and it is a key factor in facing the important developmental task for first-time couples of choosing a partner and managing adolescent courtship.

Beschreibung: Traffic violations usually caused by aggressive driving behavior are often seen as a primary contributor to traffic crashes. Violations are either caused by an unintentional or deliberate act of drivers that jeopardize the lives of fellow drivers, pedestrians, and property. This study is aimed to investigate different traffic violations (overspeeding, wrong-way driving, illegal parking, non-compliance traffic control devices, etc.) using spatial analysis and different machine learning methods. Georeferenced violation data along two expressways (S308 and S219) for the year 2016 was obtained from the traffic police department, in the city of Luzhou, China. Detailed descriptive analysis of the data showed that wrong-way driving was the most common violation type observed. Inverse Distance Weighted (IDW) interpolation in the ArcMap Geographic Information System (GIS) was used to develop violation hotspots zones to guide on efficient use of limited resources during the treatment of high-risk sites. Lastly, a systematic Machine Learning (ML) framework, such as K Nearest Neighbors (KNN) models (using k = 3, 5, 7, 10, and 12), support vector machine (SVM), and CN2 Rule Inducer, was utilized for classification and prediction of each violation type as a function of several explanatory variables. The predictive performance of proposed ML models was examined using different evaluation metrics, such as Area Under the Curve (AUC), F-score, precision, recall, specificity, and run time. The results also showed that the KNN model with k = 7 using manhattan evaluation had an accuracy of 99% and outperformed the SVM and CN2 Rule Inducer. The outcome of this study could provide the practitioners and decision-makers with essential insights for appropriate engineering and traffic control measures to improve the safety of road-users.

Beschreibung: Out-of-hospital infant cardiopulmonary arrest is a fatal and uncommon event. High mortality rates and poor neurological outcomes may be improved by early cardiopulmonary resuscitation (CPR). The ongoing debate over two different infant CPR techniques, the two-thumb (TT) and the two-finger (TF) technique, has remained, especially in terms of the adequate compression depth, compression rate, and hands-off time. In this article, we searched three major databases, PubMed, EMBASE (Excerpta Medica database), and CENTRAL (Cochrane Central Register of Controlled Trials), for randomized control trials which compared the outcomes of interest between the TT and TF techniques in infant CPR. The results showed that the TT technique was associated with higher proportion of adequate compression depth (Mean difference (MD): 19.99%; 95%, Confidence interval (CI): 9.77 to 30.22; p 〈 0.01) than the TF technique. There was no significant difference in compression rate and hands-off time. In our conclusion, the TT technique is better in terms of adequate compression depth than the TF technique, without significant differences in compression rate and hands-off time.

Beschreibung: This study aimed to evaluate the effect of types of horticultural activities among elderly individuals in a senior citizen learning camp. We arranged four horticultural activities: Grass Doll, Kokedama, Rocky Leaf Prints, and Herb Tasting and Smelling. Twenty-seven senior citizens (60 to 76 years) were recruited to participate. We assessed their physiological and mental state before and after the activities by measuring heart rate variability (HRV), pulse rate, blood pressure, salivary amylase activity (SAA), and Profile of Mood States (POMS). Results showed that SAA was significantly lower after the Rocky Leaf Prints, Herb Tasting and Smelling, and Kokedama. Pulse rate had a downward trend after the four horticultural activities. The ratio of low frequency (LF) over high frequency (HF) results showed that the Rocky Leaf Prints had a larger downward trend, followed by Herb Tasting and Smelling. POMS scores indicated significant improvement for Rocky Leaf Prints and Herb Tasting and Smelling. The types including artistic creation and food tasting were promising methods for psychological relaxation, stress reduction, and vigor enhancement for elderly persons. Findings showed that the impact of activities involving contact with plants was more significant in short-term activities. We hope this study can help plan the horticultural activities of the elderly in the future.

Beschreibung: The management of cattle manure (CM) has become increasingly challenging because its production continues to rise, while the regulations on manure management have become increasingly stringent. In Korea, most farms produce CM as a dry mixture with lignocellulosic bedding materials (mainly sawdust), making it impractical to treat CM by anaerobic digestion. To address this problem, this study examined whether anaerobic co-digestion with food waste (FW) and pig manure (PM) could be an effective approach for the treatment of CM. The batch anaerobic digestion tests at different CM: FW: PM mixing ratios showed that more methane was produced as the FW fraction increased, and as the CM fraction decreased. The response surface models describing how the substrate mixing ratio affects the methane yield and synergistic effect (methane yield basis) were successfully generated. The models proved that the methane yield and synergistic effect respond differently to changes in the substrate mixing ratio. The maximum 30-day methane yield was predicted at 100% FW, whereas the maximum 30-day synergy index was estimated for the mixture of 47% CM, 6% FW, and 47% PM (total solids basis). The synergy index model showed that CM, FW, and PM could be co-digested without a substantial loss of their methane potential at any mixing ratio (30-day synergy index, 0.89–1.22), and that a possible antagonistic effect could be avoided by keeping the FW proportion less than 50%. The results suggest that co-digestion with PM and FW could be flexibly applied for the treatment and valorization of CM in existing anaerobic digestion plants treating FW and PM.

Beschreibung: Drawing on social identity theory, this study examines the effect of servant leadership on university teachers’ innovative behavior through the self-concept constructs of perceived insider status and organization-based self-esteem, and the moderating effect of leader–member exchange (LMX). This moderated mediation model was tested with two waves of data from 269 university teachers in China. Results reveal that the self-concept constructs mediate the relationship between servant leadership and university teachers’ innovative behavior. Moreover, LMX strengthens the relationship between servant leadership and the self-concept constructs, as well as the indirect effect of servant leadership on university teachers’ innovative behavior through the self-concept constructs. Findings suggest that servant leadership is related to increased innovative behavior due to its positive influence on the self-concept of university teachers and it highlights the importance of developing a favorable supervisor–subordinate relationship.

Beschreibung: Carotid intima–media thickness (IMT), plaque, and stenosis are widely used as early surrogate markers of subclinical atherosclerosis and strong predictors of future deaths and cardiovascular events. Albuminuria is an indicator of generalized endothelial dysfunction that speeds up atherosclerosis. However, previous studies reporting these associations cannot rule out the confounding effect of albuminuria. We aimed to examine the independent and joint relationships between IMT markers and 10-year mortality in community-dwelling Taiwanese adults. This work was a community-based prospective cohort study consisting of 2956 adults aged at least 30 years recruited in 2007 and followed up through 2019. Cox proportional hazard regression models were used to examine associations of these subclinical atherosclerosis markers with mortality. During an average of 9.41 years of follow up, 242 deaths occurred. The mortality rate was 8.70 per 1000 person-years. Compared with those with carotid IMT less than 1.0 mm, persons with severely increased carotid IMT (≥2.0 mm) had an increased risk for death (hazard ratio (HR): 1.79; 95% confidence interval (CI): 1.07, 3.00). Compared with those without carotid plaque, persons with carotid plaque were more likely to have an increased risk for death (1.65; 1.21–2.32). Compared with those with carotid stenosis less than 25%, persons with carotid stenosis of 25–36% had a significant increased risk for death (1.57; 1.12–2.22). Considering these three IMT markers along with the traditional risk factors (c-statistic: 0.85) significantly increased their predictive ability of mortality compared with any individual variable’s predictive ability (all p-values 〈 0.001 for comparisons of c-statistic values). Carotid IMT measures, including IMT thickness, carotid plaque, and carotid stenosis were significant independent predictors of mortality. Our study supports evidence of blood pressure-related media thickening markers to assess future mortality risks in Chinese adults of general population.

Beschreibung: The clinical course of problematic smartphone use (PSU) remains largely unknown due to a lack of longitudinal studies. We recruited 193 subjects with smartphone addiction problems for the present study. After providing informed consent, the subjects completed surveys and underwent comprehensive interviews regarding smartphone usage. A total of 56 subjects among the 193 initially recruited subjects were followed up for six months. We compared baseline characteristics between persistent addicted users and recovered users at the end of the 6-month follow-up. Persistent problematic smartphone users displayed higher baseline smartphone addiction severity and were more prone to develop mental health problems at the follow-up. However, baseline depressive or anxiety status did not significantly influence the course of PSU. PSU behaved more like an addictive disorder rather than a secondary psychiatric disorder. Harm avoidance, impulsivity, higher Internet use, and less conversation time with mothers were identified as poor prognostic factors in PSU. Lower quality of life, low perceived happiness, and goal instability also contributed to persistent PSU, while recovery increased these scores as well as measures of self-esteem. These findings suggest that the Matthew effect is found in the recovery of PSU with better premorbid psychosocial adjustment leading to a more successful recovery. Greater clinical resources are required for interventions in vulnerable populations to modify the course of this increasingly prevalent problematic behavior worldwide.

Beschreibung: As entrepreneurial interest is believed to represent a causal factor increasing entrepreneurship, research has begun to explore how family systems affect youth entrepreneurial interests. In the present study, we attempt to identify different types of family influence on the entrepreneurial interests of young people. A questionnaire was used to obtain data from 1633 Spanish adolescents (15 to 18 years old) and another questionnaire was used to obtain data from 839 parents. Principal component analysis identified unique family types and revealed that they have differential associations to entrepreneurial interest among youth. These findings reaffirm the influence of family on the entrepreneurial ecosystem and the promotion of an entrepreneurial family culture. This study further suggests that early attention should focus on the detection of entrepreneurial interest among youth so that actions can be implemented in the families to incentivize an entrepreneurial family culture.

Beschreibung: To improve air quality in urban centers, vehicle Inspection and Maintenance (I/M) programs were created to identify highly polluting vehicles and force them to undergo mechanical maintenance. In this context, a methodology, based on a single measurement campaign using a Remote Sensing Device (RSD), is presented in this work to assess the reduction in vehicles emissions obtained from implementing I/M programs. As a case study, an RSD campaign was carried out in Mexico, specifically in Monterrey’s Metropolitan Area (MMA). Approximately 0.4% of the vehicles registered in this region were sampled under similar conditions to those found in I/M programs. The results obtained suggested that 39% of the vehicles would not comply with the current national regulations for circulating vehicles. Following a conservative scenario, the implementation of a vehicle I/M program in this urban center has the potential of reducing the current mass emissions of HC, CO and NO in approximately 69%, 42% and 28%, respectively.

Beschreibung: Individuals with abdominal obesity and metabolic syndrome (MetS) have augmented risk of all-cause mortality. Lifestyle interventions are effective to treat MetS, however, there are periods during the year in which exercise programs are discontinued and improper dietary habits reappear (e.g., Christmas holidays). We aimed to analyze if exercise-training during Christmas holidays would avoid body-weight gains and cardiometabolic deterioration in MetS individuals, using a randomized control trial. Thirty-eight men with MetS undergoing exercise training were randomly allocated to either continue (TRAIN group, n = 16) or discontinue (HOLID group, n = 22) training, during the three weeks of Christmas. Anthropometrics (body weight, fat, and waist circumference), fasting blood metabolites (glucose, insulin, triglycerides, and cholesterol concentrations) and exercise maximal fat oxidation (FOMAX) and oxygen uptake (VO2PEAK) were determined before and after Christmas. Both groups were similar at baseline in all parameters (p 〉 0.05). HOLID group increased body weight (91.3 ± 13.0 to 92.0 ± 13.4 kg, p = 0.004), mean arterial pressure (94.0 ± 10.6 to 97.1 ± 8.9 mmHg, p = 0.026), blood insulin (10.2 ± 3.8 to 12.5 ± 5.4 µIU·mL−1, p = 0.003) and HOMA (3.2 ± 1.3 to 4.1 ± 2.3, p = 0.003). In contrast, TRAIN prevented those disarrangements and reduced total (170.6 ± 30.6 to 161.3 ± 31.3 mg·dL−1, p = 0.026) and low-density lipoprotein cholesterol (i.e., LDL-C, 104.8 ± 26.1 to 95.6 ± 21.7 mg·dL−1, p = 0.013). TRAIN also prevented the reductions in exercise FOMAX and VO2PEAK that was observed in the HOLID group (p = 0.002). In conclusion, exercise training during Christmas, prevents body weight gains and the associated cardiovascular (increase in blood pressure and LDL-C) and metabolic (reduced insulin sensitivity) health risks are an optimal non-pharmacological therapy for that period of the year.

Beschreibung: Background: Mothers and daughters struggle to talk about breast cancer risk. Even less attention is paid to environmental determinants of cancer. Third-party online approaches can be helpful navigating these conversations. The aim of this study was to obtain feedback from mothers exposed to a social media intervention (“mommy bloggers”) and identify their preferences for message-design approaches that could help them talk to their daughter(s) about environmental breast cancer risk. Methods: We conducted semi-structured interviews with 50 mothers. A thematic analysis was conducted using the constant comparative method. Results: Mothers identified four approaches to message design that could help facilitate mother–daughter communication about environmental breast cancer risk. These included two action-oriented approaches that centered on getting the conversation started and keeping the conversation going and two approaches based on lifespan factors to promote daughters’ engagement by using age-appropriate language and visuals and focusing on developmentally specific lifestyle behaviors. Mothers also provided recommended strategies within each approach. Conclusions: Mothers identified various approaches interventionists can utilize to overcome barriers to talking to daughters about environmental breast cancer risk. To promote mother–daughter communication, the messages should be action-oriented to facilitate interaction, but also developed with lifespan and developmental considerations in mind to engage daughters.

Beschreibung: Background: Depression and osteoporosis are severe public health problems. There are conflicting findings regarding the influence of depression on bone metabolism. The aim of the presented study was to compare bone turnover markers and vitamin D levels between patients treated for depression and healthy controls. Patients and Methods: We determined a concentration of osteocalcin, carboxy-terminal telopeptide of type I collagen (β-CTX), 25-hydroxyvitamin D (25OHD) and 1,25(OH)2D3 in 99 patients, aged 46.9 ± 11 years, treated for depression, as well as in 45 healthy subjects. Depressive status was determined with the Hamilton Depression Scale (HDRS). Results: In patients treated for depression, we demonstrated significantly lower osteocalcin concentrations (p 〈 0.03) and higher concentration of β-CTX (result on the border of significance; p = 0.08). Those relationship were stronger in women. The level of 25OHD and 1,25(OH)2D3 did not differ significantly between the examined groups. We observed a negative correlation between the 25OHD and HDRS score after treatment in all patients treated for depression and in subgroups of women and subjects with recurrent depression. Conclusions: Our results indicate that depression is related to disturbances in bone metabolism, especially in women and patients with recurrent depression, suggesting its role in context of osteoporosis development.

Beschreibung: Studies on the association between infant and young child feeding (IYCF) practices and diarrhoea across regional India are limited. Hence, we examined the association between IYCF practices and diarrhoea in regional India. A weighted sample of 90,596 (North = 11,200, South = 16,469, East = 23,317, West = 11,512, Central = 24,870 and North-East = 3228) from the 2015–2016 National Family Health Survey in India was examined, using multivariate logistic regressions that adjust for clustering and sampling weights. The IYCF indicators included early initiation of breastfeeding (EIBF), exclusive breastfeeding (ExcBF), predominant breastfeeding (PBF), bottle feeding (BotF), continued breastfeeding (BF) at one-year, continued BF at two years, children ever breastfed and the introduction of solid, semi-solid or soft foods (ISSSF). Diarrhoea prevalence was lower among infants who were BF within one-hour of birth and those who were exclusively breastfed. Multivariate analyses revealed that continued BF at one and two years, and infants who were introduced to complementary foods had a higher prevalence of diarrhoea. EIBF and ExcBF were protective against diarrhoea in the regions of North, East and Central India. PBF, BotF and ISSSF were risk factors for diarrhoea in Central India. Continued BF at two years was a risk factor for diarrhoea in Western India. Findings suggested that EIBF and ExcBF were protective against diarrhoea in Northern, Eastern and Central India, while PBF, BotF, continued BF at two years and ISSSF were risk factors for diarrhoea in various regions in India. Improvements in IYCF practices are likely to reduce the burden of diarrhoea-related morbidity and mortality across regions in India.

Beschreibung: Influenza is a serious public health issue, as it can cause acute suffering and even death, social disruption, and economic loss. Effective forecasting of influenza outpatient visits is beneficial to anticipate and prevent medical resource shortages. This study uses regional data on influenza outpatient visits to propose a two-dimensional hierarchical decision tree scheme for forecasting influenza outpatient visits. The Taiwan weekly influenza outpatient visit data were collected from the national infectious disease statistics system and used for an empirical example. The 788 data points start in the first week of 2005 and end in the second week of 2020. The empirical results revealed that the proposed forecasting scheme outperformed five competing models and was able to forecast one to four weeks of anticipated influenza outpatient visits. The scheme may be an effective and promising alternative for forecasting one to four steps (weeks) ahead of nationwide influenza outpatient visits in Taiwan. Our results also suggest that, for forecasting nationwide influenza outpatient visits in Taiwan, one- and two-time lag information and regional information from the Taipei, North, and South regions are significant.

Beschreibung: The study aimed to determine if oral hygiene influences not only oral health but also potentially metabolic disorders such as overweight or obesity. Participants were 94 patients: 40 with increased body mass and 54 with normal body mass. The methods included dental examination, a questionnaire concerning hygienic habits and an assessment of selected salivary inflammatory markers. The new parameter named “cleaning index” (describing the interaction between average time of tooth brushing in minutes and its frequency per day) significantly correlated with Body Mass Index (RSpearman = 0.300). The multivariate regression model incorporating cleaning index, approximal plaque index, receptor 1 for tumor necrosis factor-alpha (TNFα-R1) and interleukin-15 (IL-15) had a high power to predict overweight or obesity (AUC = 0.894). Patients with poor oral hygiene (approximal plaque index 〉40%) were more than eight times more likely to suffer from obesity than patients with good oral hygiene. Cleaning index higher than 4 decreased the odds by about 85%. Oral hygiene habits, adjusted by salivary concentrations of selected inflammatory markers may allow predicting effectively overweight or obesity risk. Early proper dental prophylaxis and treatment could lead to the better prevention of metabolic disorders.

Beschreibung: Background: In recent years the role of school principals is becoming increasingly complex and responsible. Methods: This study was voluntarily attended by 419 Italian school principals who were administered the Psychological Stress Measurement (MSP), Mindfulness Organizing Scale (MOS), Polychronic-Monochronic Tendency Scale (PMTS), and the Scale of Emotions at Work (SEW). Results: The study has produced a path analysis model in which the relationships between the main predictors of principals’ work discomfort were explained. The effect of depressive anxiety on perceived discomfort (ß = 0.517) found a protective mediator in the mindfulness component that recognizes the sharing as a fundamental operational tool (ß = −0.206), while an increasing sense of effort and confusion could significantly amplify the experience of psychological discomfort associated with the exercise of school leadership (ß = 0.254). Conclusions: The model developed in this study suggests that focusing on organizing mindfulness can be a valuable guideline for interventions.

Beschreibung: Parents are a crucial part in the care of children with pediatric cataract. The aim of this study was to explore and explain sense of coherence, family self-efficacy, perceived social support, fatigue and parent reported experiences (PREM), in order to improve clinical care. Questionnaires were sent to the parents of children registered in the Swedish national Pediatric Cataract Register, PECARE, from 2006–2019 (n = 506). The response rate was 46% (n = 231), 185 mothers and 44 fathers with a mean age of 40.39 years (SD ± 6.41 years). In total, 38% of the parents reported severe fatigue, and mothers were more burdened than fathers. Sense of coherence was strongly related to fatigue, especially among parents of children with bilateral cataract. Mental fatigue and reduced motivation explained 45% of the variation in sense of coherence. Being taken seriously by the ophthalmological clinic explained over 60% of the variation in satisfaction with care when controlled for parents’ age and gender. In conclusion, fatigue is important to take in consideration when interacting with parents of children with cataract, especially those with bilateral cataract. Being taken seriously is the key marker of satisfaction with care and support from professionals. In addition to fatigue, the parents’ age and life situation affect how they perceive their own, as well as the professionals’ effort, and should be considered when tailoring family-centered care.

Beschreibung: Swimming is a form of physical activity and a life-saving skill. However, only a few studies have identified swimming ability classifiers in preschool children. This pilot cross-sectional study aimed to find anthropometric (AM) and motor competence (MC) predictors of swimming ability in preschool children, by building classifiers of swimming ability group (SAG) membership. We recruited 92 children (girls n = 45) aged 5–6 years and took the AM and MC measurements in accordance with the reference manual and using the KTK battery test (motor quotient, MQ), respectively. A linear discriminant analysis tested a classification model of preschoolers’ swimming ability (SAG: POOR, GOOD, EXCELLENT) based on gender, age, AM, and MC variables and extracted one significant canonical discriminant function (model fit: 61.2%) that can differentiate (group centroids) POOR (−1.507), GOOD (0.032), and EXCELLENT (1.524). The MQ total was identified as a significant classifier, which absolutely contributed to the discriminant function that classifies children’s swimming ability as POOR (standardized canonical coefficient: 1.186), GOOD (1.363), or EXCELLENT (1.535) with an accuracy of 64.1%. Children with higher MQ total ought to be classified into higher SAG; thus, the classification model of SAG based on the MQ total is presented.

Beschreibung: (1) Background: In the context of a child with Type 1 Diabetes Mellitus (T1DM), the rearrangement of the family’s lifestyle can account for an increased risk of experiencing psychosocial problems for both child and parents. Those few studies on pediatric diabetes, which focused on parents’ perception of children’s psychological strengths and weaknesses, reported significantly higher rates of children’s emotional and conduct problems associated with an imbalance in the Hemoglobin A1c (HbA1c). The main aim of this paper was to assess the role of parental perception of children’s psychosocial symptoms as a mediator of the perceived parenting stress, considering mother and father separately. (2) Methods: The study involved 12 parent couples (Mothers Mage = 40.25, SD = 6.58; Fathers Mage = 42.5, SD = 6.38) of children with T1DM aged between 7 and 11 years (Mage = 8.8, SD = 0.996). Parents completed questionnaires such as the Strengths and Difficulties Questionnaire for parents and their perspective of their child, and the Parenting Stress Index–Short Form. (3) Results: Mothers and fathers had significant differences in the perception of their child’s internalizing symptoms. Specifically, mothers present a greater perception of the mentioned symptoms compared to fathers. Mediation models showed that only for fathers’ perception of the child conduct problems has a significant role between the fathers’ perception of dysfunctional interaction with the child and the HbA1c. (4) Conclusions: The current study provides useful evidence also for clinical settings, suggesting that an interesting interplay between parenting stress, perception of children’s symptoms and glucometabolic control should be taken into consideration.

Beschreibung: During the Japan International Cooperation Agency (JICA) partnership program in Mongolia, six times between October 2017 and October 2019, education for caries prevention, a questionnaire of daily oral health behavior, and an oral examination for parents and children aged 0–5 years old were done. The target parent population were middle socio-economic class families. In total, there were 2223 participants. The caries prevalence measured in October 2017, January, April, and October 2018, and April and October 2019, was 78.0% (95% CI: 74.2–81.4); 79.4% (73.7–84.4); 80.8% (76.2–84.9); 76.4% (70.1–82.0); 89.3% (85.3–92.6); and 82.6% (79.3–85.6), respectively. Compared to October 2017, in October 2019, the deft of three years old was significantly decreased (p 〈 0.01) and that of four years old was also decreased (p = 0.085). For the prevention of early childhood caries (ECC), daily oral health behaviors are important. In 2019, compared with the percentage of 0–5 years old in 2017, the frequency of tooth cleaning per day, parents cleaning after children, and parents watching during children’s tooth cleaning were significantly increased (p 〈 0.01). Unfortunately, the frequency of sugary—snack intake per day showed an increased tendency (p 〈 0.05). The baby teeth decayed, extracted and filled (deft) index at three and/or four years old in October 2019 was correlated with the childrens’ background characteristics, such as parent educational attainment, frequency of sweets intake, frequency of daily tooth cleaning, and parental cleaning of children’s teeth. The effects of the JICA program were recognized.

Beschreibung: Good manufacturing practice (GMP) is advocated and implemented as a standardized procedure for manufacturing dietary supplements. However, in Japan as a case, only half of the manufacturers in this field so far adopt it. To address this issue, the present study aims to explore the effect of key characteristics of a company on the adoption of and compliance with GMP for dietary supplements. The focus is on the effect of expertise in the pharmaceutical industry. The relationships between company characteristics and the adoption of GMP were analyzed for 90 manufacturers in the dietary supplement industry in Japan. A binomial logistic regression analysis showed that each of the following three factors had a positive and significant effect on the company’s adoption of GMP: company size in terms of revenue (odds ratio = 1.04, p = 0.019), possession of a manufacturing license for pharmaceutical products (13.7, p = 0.003), and number of own product categories manufactured (3.93, p = 0.00009). These findings strongly suggest that the company’s manufacturing capability of pharmaceutical products works as a key driver for the better adoption of a quality standard in the dietary supplement industry in Japan. Few considerations were made for conditions of the adoption and implementation of GMP. The present study empirically contributes by providing key clues for issues in the dietary supplement industry and by forming a theoretical base for policymakers and the regulatory authorities.

Beschreibung: In this paper we propose a scalable platform for real-time processing of Social Media data. The platform ingests huge amounts of contents, such as Social Media posts or comments, and can support Public Health surveillance tasks. The processing and analytical needs of multiple screening tasks can easily be handled by incorporating user-defined execution graphs. The design is modular and supports different processing elements, such as crawlers to extract relevant contents or classifiers to categorise Social Media. We describe here an implementation of a use case built on the platform that monitors Social Media users and detects early signs of depression.

Beschreibung: Household expenditure surveys, routinely conducted in low—and middle-income countries (LMICs), usually include questions pertaining to recent household expenditures on key food groups. When child anthropometrics are also available, such expenditure data can provide insights into household food purchasing patterns that are associated with subsequent child growth measures. We used data from 6993 children, born around 2001, from Ethiopia, India, Peru, and Vietnam, from the Young Lives younger cohort. We compared associations between two weeks of household food expenditures (in PPP—Purchasing Power Parity adjusted dollars) on food groups and child height-for-age-Z score (HAZ) at subsequent time points to assess longitudinal associations. Total food expenditures, rural/urban residence, maternal and paternal schooling, and child sex were included in our adjusted models because they may affect the relations between household food group expenditures and future child HAZ. In Ethiopia, India, and Peru every extra PPP$ spent on fats was associated with 0.02–0.07 higher future HAZ. In Vietnam every extra PPP$ spent on starches, was significantly associated with a 0.01 lower future HAZ. Across countries, different patterns of food expenditure and procurement may be differentially critical for predicting child HAZ. Our results demonstrate how expenditures on specific food groups can be associated with children’s linear growth. This study provides additional evidence of the utility of longitudinal household food expenditure data in understanding child nutritional status.

Beschreibung: Implant design evolved alongside the development of implant therapy. The purpose of this finite element analysis (FEA) study was to analyze the influence of different implant designs on the stress and strain distribution to the implants and surrounding bone. Three implant designs with the same length and diameter were used. The three-dimensional geometry of the bone was simulated with a cortical bone of three different thicknesses and two medullar bone densities: low density (150 Hounsfield units) and high density (850 Hounsfield units). A 30° oblique load of 150 N was applied to the implant restoration. Displacement and stress (von Mises) results were obtained for bone and dental implants. The strain and stress distributions to the bone were higher for the tissue-level implant for all types of bone. The maximum principal strain and stress decreased with an increase in cortical bone thickness for both cancellous bone densities. The distribution of the load was concentrated at the coronal portion of the bone and implants. All implants showed a good distribution of forces for non-axial loads, with higher forces concentrated at the crestal region of the bone–implant interface. Decrease in medullar bone density negatively affects the strain and stress produced by the implants.

Beschreibung: Health disparities in diabetes management and control are well-documented. The objective of this study is to describe one diabetes education program delivered in the United States in terms of the RE-AIM (Reach, Effectiveness, Adoption, Implementation, and Maintenance) Planning and Evaluation Framework. Questionnaires, clinical data, and administrative records were analyzed from 8664 adults with diabetes living in South Texas, an area characterized by high health disparities. The Diabetes Education Program delivered was a professionally led 12-month program involving 8 h of in-person workshop education followed by quarterly follow-up sessions. Changes in average blood glucose levels over the past 3 months (e.g., A1c levels) were the primary clinical outcome. Descriptive and multiple generalized linear mixed models were performed. This community-based initiative reached a large and diverse population, and statistically significant reductions in A1c levels (p 〈 0.01) were observed among participants with Type 2 diabetes at 3 months. These reductions in A1c levels were sustained at 6-, 9-, and 12-month follow-up assessments (p 〈 0.01). However, considerable attrition over time at follow-up sessions indicate the need for more robust strategies to keep participants engaged. For this diabetes education program, the RE-AIM model was a useful framework to present study processes and outcomes.

Beschreibung: Aim: In this study we have investigated the problem of cost effective wireless heart health monitoring from a service design perspective. Subject and Methods: There is a great medical and economic need to support the diagnosis of a wide range of debilitating and indeed fatal non-communicable diseases, like Cardiovascular Disease (CVD), Atrial Fibrillation (AF), diabetes, and sleep disorders. To address this need, we put forward the idea that the combination of Heart Rate (HR) measurements, Internet of Things (IoT), and advanced Artificial Intelligence (AI), forms a Heart Health Monitoring Service Platform (HHMSP). This service platform can be used for multi-disease monitoring, where a distinct service meets the needs of patients having a specific disease. The service functionality is realized by combining common and distinct modules. This forms the technological basis which facilitates a hybrid diagnosis process where machines and practitioners work cooperatively to improve outcomes for patients. Results: Human checks and balances on independent machine decisions maintain safety and reliability of the diagnosis. Cost efficiency comes from efficient signal processing and replacing manual analysis with AI based machine classification. To show the practicality of the proposed service platform, we have implemented an AF monitoring service. Conclusion: Having common modules allows us to harvest the economies of scale. That is an advantage, because the fixed cost for the infrastructure is shared among a large group of customers. Distinct modules define which AI models are used and how the communication with practitioners, caregivers and patients is handled. That makes the proposed HHMSP agile enough to address safety, reliability and functionality needs from healthcare providers.

Beschreibung: A higher chance of carrying out a successful full pulpotomy may depend on whether the coronal restoration can be completed within a single appointment. The development of chairside CAD/CAM (Computer Aided Design and Manufacturing) technology has made it possible to carry out indirect restoration of endodontically treated teeth in a single session. This study aimed to evaluate the long-term outcome of a full pulpotomy with Biodentine™ immediately covered with a chairside CAD/CAM endocrown on teeth affected by pulpitis and deep carious lesions. The investigation involved a cohort of 30 molars that were treated by pulpotomy and CAD/CAM endocrown. Clinical and radiological examinations were scheduled at 1, 6, and 12 months postoperatively. Overall, all treatments were effective at any time during the follow-up. The results of this study need to be confirmed with a longer-term follow-up to allow for comparison with the literature. This original combination of endodontic and restorative treatments provides an Endo-prosthetic continuum in a single session, with the objective of long-term success in terms of tooth health.

Beschreibung: Background: The aim of the present work is the elaboration of a systematic review of existing research on physical fitness, self-efficacy for physical exercise, and quality of life in adulthood. Method: Using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement guidelines, and based on the findings in 493 articles, the final sample was composed of 37 articles, which were reviewed to show whether self-efficacy has previously been studied as a mediator in the relationship between physical fitness and quality of life in adulthood. Results: The results indicate that little research exists in relation to healthy, populations with the majority being people with pathology. Physical fitness should be considered as a fundamental aspect in determining the functional capacity of the person. Aerobic capacity was the most evaluated and the 6-min walk test was the most used. Only one article shows the joint relationship between the three variables. Conclusions: We discuss the need to investigate the mediation of self-efficacy in relation to the value of physical activity on quality of life and well-being in the healthy adult population in adult life.

Beschreibung: An increased incidence of temporomandibular disorders (TMD) among patients with sleep apnea (SA) has been reported. However, the association between TMD and SA has not been demonstrated in a large-scale study. This population-based cohort study with the Taiwan National Health Insurance (NHI) Research Database aimed to understand the association between SA and TMD. We identified adult patients with suspected SA (identified with diagnostic codes) and excluded those diagnosed with TMD prior to SA. Patients with SA diagnosis after polysomnography were also identified as probable SA patients. The index dates were the dates of their initial SA diagnosis. Ten control subjects were matched, by age and sex, to each SA patient, and were assigned the same index dates as the SA patients. In total, 10,408 suspected SA patients (including 4105 probable SA patients) matched to 104,080 control subjects (including 41,050 subjects matched to the probable SA patients) in this study. The TMD incidence rate was significantly higher in the SA patients than in the control subjects (2.8 vs. 1.0 per thousand-patient-year in probable SA patients vs. the corresponding control subjects, with an adjusted incidence rate ratio [95% confidence interval] = 2.5 [2.3–2.7], p 〈 0.0001). SA patients significantly showed a higher cumulative incidence of TMD than the corresponding control subjects (p 〈 0.0001). Multivariable Cox regression analysis revealed SA as an independent risk factor for the development of TMD (adjusted hazard ratio = 2.5 [1.7–3.7], p 〈 0.0001). In summary, this study confirmed an increased TMD incidence in the SA patients. While treating TMD patients, dentists should pay careful attention to the potential underlying SA.

Beschreibung: The purpose of this study was to devise a classification and lateral window design method based on implants and to evaluate whether these classifications and methods are applicable to clinical practice. When applying the maxillary sinus elevation technique using the lateral window, possible situations were classified into four: (A) two or more sites for implants are required for maxillary sinus augmentation, (B) a single implant is required when there are no adjacent teeth, (C) a single implant is required when one adjacent tooth is present at the mesial or distal area, and (D) a single implant is required when both mesial and distal adjacent teeth are present. In order to verify whether this classification can be used in all situations, 76 patients who underwent maxillary sinus elevation with a lateral window were selected and investigated. Of them, 47 (62%) were included in Group A, 9 (12%) in Group B, 8 (11%) in Group C, and 12 (15%) in Group D. Lateral window designing in the lateral approach of sinus augmentation can be classified into four clinical situations. There were no unclassified cases. This classification and window positioning method can be applied to most cases.

Beschreibung: Health promotion campaigns are used to raise awareness about health issues with the purpose of improving health outcomes and community wellbeing. They are important for increasing community awareness of health behavior changes. In the application of health promotion, social marketing can be used to influence changes in individual behavior. Social marketing encourages the social behavioral change of the target audience. This social behavioral change refers to the behavior of a certain number of target audiences, not just individual behavior. This research identified various social marketing success criteria to improve the performance of health promotion using decision-making method. Fuzzy decision-making trial and evaluation laboratory (F-DEMATEL) is a structural causal relation method that has been verified effectual in congregating the viewpoints of professionals and thus providing information of greater reliability in various areas. F-DEMATEL method helps to identify the core problems and direction of improvement in complex systems by quantifying the degree to which criteria attributes interact with each other. This research applied F-DEMATEL to evaluate the complex interrelation success criteria of social marketing in order to effectively implement health promotion. Several effective criteria were derived from this research. These influential criteria are “Designing effective Communication message”, “Meeting the needs of beneficiaries”, “Providing more benefit than cost”, “Marketing mix elements”, “Customer orientation”, “Organizational advantage” and “Market selection”. The practitioner must consider the needs of the recipients to accomplish a successful social marketing campaign in health promotion. Moreover, the practitioner also has to design an attractive message and marketing mix strategy to communicate the benefits of the behavioral change to the target audience. Besides, the message delivered by the known organization increases the success of social marketing in promoting healthy lifestyle. This study provides important information for the non-profit organization about selecting the significant criteria to lead to the success of the campaign.

Beschreibung: Aspects of the living environment can affect health and wellbeing of children and adolescents. Whereas most previous studies assessed the more distant residential urban environment, less is known on possible effects of the close environment. The present study investigated associations of the proportion of streets and green spaces in the immediate urban living environment (50, 100 and 400 m around the home) with media use, outdoor activity, overweight/obesity and emotional problems in two samples of younger (age 3–10, n = 395) and older children (age 10–19, n = 405). Independently of socioeconomic parameters, a higher proportion of streets was associated with overweight/obesity (in younger and older children), higher media use (in younger children), less outdoor activity and more emotional problems (in older children). Older children’s outdoor activity in winter increased with increasing proportions of green spaces. The observations suggest that the immediate urban living environment is a factor that can affect leisure behavior and health in children.

Beschreibung: Public health engagement in the communication, discussion, and development of climate change policies is essential for climate change policy decisions and discourse. This study examines how the existing governance approaches impact, enable, or constrain the inclusion, participation, and deliberation of public health stakeholders in the climate change policy discourse. Using the case study of the Canadian Province of Ontario, we conducted semi-structured, key informant interviews of public health (11) and non-public health (13) participants engaged in climate change policies in the province. The study results reveal that engagement and partnerships on climate change policies occurred within and across public health and non-public health organizations in Ontario. These engagements impacted public health’s roles, decisions, mandate, and capacities beyond the climate change discourse; enabled access to funds, expertise, and new stakeholders; built relationships for future engagements; supported knowledge sharing, generation, and creation; and advanced public health interests in political platforms and decision making. However, public health’s participation and deliberation were constrained by a fragmented sectoral approach, a lack of holistic inter-organizational structures and process, political and bureaucratic influences, irregular and unestablished communication channels for public health integration, and identities and culture focused on functions, mandates, biased ideologies, and a lack of clear commitment to engage public health. We conclude by providing practical approaches for integrating public health into climate change discourse and policymaking processes and advancing public health partnerships and collaborative opportunities.