ALBERT

Description: COVID-19 might have long-term mental health impacts. We aim to investigate the longitudinal changes in mental problems from initial COVID-19 peak to its aftermath among general public in China. Depression, anxiety and insomnia were assessed among a large-sample nationwide cohort of 10,492 adults during the initial COVID-19 peak (28 February 2020 to 11 March 2020) and its aftermath (8 July 2020 to 8 August 2020) using the Patient Health Questionnaire-9, Generalized Anxiety Disorder-7, and Insomnia Severity Index. We used generalized estimating equations and linear mixed models to explore factors associated with long-term mental health symptoms during COVID-19. During the five months, mental health symptoms remained consistently elevated (baseline 46.4%; follow-up 45.1%). Long-term depression, anxiety and insomnia were associated with several personal and work-related factors including quarantine (adjusted OR for any mental health symptoms 1.31, 95%CI 1.22–1.41, p 〈 0.001), increases in work burden after resuming work (1.77, 1.65–1.90, p 〈 0.001), occupational exposure risk to COVID-19 (1.26, 1.14–1.40, p 〈 0.001) and living in places severely affected by initial COVID-19 peak (1.21, 1.04–1.41, p = 0.01) or by a COVID-19 resurgence (1.38, 1.26–1.50, p 〈 0.001). Compliance with self-protection measures, such as wearing face masks (0.74, 0.61–0.90, p = 0.003), was associated with lower long-term risk of mental problems. The findings reveal a pronounced and prolonged mental health burden from the initial COVID-19 peak through to its aftermath in China. We should regularly monitor the mental health status of vulnerable populations throughout COVID-19.

Description: Malaysia implemented its first Movement Control Order (MCO) during the early phase of the COVID-19 pandemic to slow the transmission of the virus. This study aimed to explore the public perception of the MCO implementation and people’s experiences during this period. The study employed qualitative explorative in-depth interviews conducted with 23 Malaysian adults from various demographic backgrounds. Thematic analysis was performed using NVivo 12. Three main themes were identified: a period of information surge, heterogeneous emotional response, and attempts to adapt. During the MCO, the participants obtained information from multiple platforms. They suggested the need for clear and repeated instructions to avoid confusion and misinformation. They also acknowledged the importance of the MCO in breaking the chain of transmission and safeguarding high-risk groups; however, they also expressed that stricter enforcement from the authorities was warranted. The changes in the participants’ work–life routines, lack of physical interaction, and uncertainty about their health and the economy due to the MCO negatively impacted their psychological states. Despite these challenges, the participants attempted to adapt to life under the MCO in different ways. The findings imply that during a crisis, the public tends to seek clear and reliable information, experience emotional turmoil, and adapt to changes. The MCO implementation can be improved through an effective communication strategy and efforts to battle misinformation.

Description: The number of medically compromised dental patients is increasing every year with the increase in the super-aged population. Many of these patients have underlying psychiatric problems and diseases, which need to be recognized by dental professionals for better treatment outcomes. The aim of this narrative review article is to summarize the psychological and psychiatric backgrounds of medically compromised patients who are frequently visited and taken care of by dentists using findings from recent systematic reviews and meta-analyses. Anxiety and symptoms of depression, post-traumatic stress disorders, panic disorders, poor cognitive functions, and poor quality of life were some of the common psychological backgrounds in medically compromised patients. Additionally, the consequences of these psychological problems and the considerations that need to be taken by the dentist while treating these patients have been discussed. Dental professionals should be aware of and recognize the different psychological backgrounds of medically compromised dental patients in order to provide appropriate dental treatment and to prevent oral conditions from worsening.

Description: The number of fatalities in the construction industry is highest among all industries; thus, various losses in the form of fatalities in construction represent a significant factor for safety management. If a fatality occurs, it is important to estimate the overall loss, as a significant financial loss occurs for each project participant. However, in studies of the cost of accidents involving a fatality conducted abroad, the framework cannot be applied as it is because insurance types, systems, and legal cost systems differ by country. Therefore, we developed a framework for calculating the fatality loss considering various aspects of labor, industry, and regulations in Korea. This was done in four steps: (i) data collection and criteria selection; (ii) proposed framework development; (iii) conduct of questionnaire surveys for the case study; and (iv) analysis and evaluation of the case study. As a result of the data analysis after the case study of general construction companies, the total fatality loss was estimated to be 2,198,260 USD/person. The contributions of this study are the development of a framework composed of newly discovered items that can acquire reliable data in consideration of the properties of the construction industry.

Description: Objective. The main objective of this study was to investigate the relationship between poverty, religion, and suicidal thoughts among U.S. youth. The disparities regarding gender, race, and ethnicity with regard to suicidal thoughts were also assessed. Methods. A cross-sectional correlational research design was used for this study and a national representative sample of 1945 young adults aged 18 to 25 was selected from the 2014 National Survey on Drug Use and Health. Logistic regression analysis with interaction effects was utilized to determine if poverty and religion were associated with suicidal thoughts. Results. About 43 percent of the sample reported having suicidal thoughts when things got worse and this prevalence rate varied by gender and race/ethnicity with white males self-disclosing the highest rate of suicidal thoughts. After adjusting for demographic and socioeconomic characteristics, black males who lived up to two times the poverty line had a higher likelihood of suicidal thoughts (p = 0.011), and religion protected against suicidal thoughts (p = 0.012). Youth with lower education and poor health were more inclined to have suicidal thoughts than their peers. Conclusions. Suicide is the second leading cause of death for American young adults aged 18 to 25. Understanding these differences between social determinants of suicide can help public health researchers strategize how to make evidence-based recommendations for suicide prevention efforts.

Description: The aims of this study were (1) to design a user-friendly instrument to assess and optimize patient information material (PIM), (2) to develop an English version, and (3) to test its psychometric properties. The instrument was needed to optimize the top-down developed PIM of the psycho-oncological care programme isPO. First, a literature-based PIM checklist was developed by a team of patient representatives, cancer care experts and professional researchers. Next, the checklist’s reliability and validity were analysed by having cancer survivors assess the initial and optimized version of the isPO-leaflet. The User-friendly Patient Information Material Checklist (UPIM-Check), developed participatorily, was found to be effective for evaluating PIM. It uses a traffic light scale, and suggestions for improvement can be given for each criterion. Its reliability appeared to be excellent (α = 0.927). The optimized leaflet was rated significantly better than the initial one. The UPIM-Check is a reliable and valid instrument, which enables end-users (e.g., patients) to assess and optimize the quality of PIM according to scientific criteria and the needs of end-users. A bottom-up approach was essential for developing and validating the UPIM-Check. End-users constantly contributed with their specific knowledge. Thus, their position as co-researchers was significantly strengthened.

Description: Visual cognitive strategies in construction hazard recognition (CHR) signifies prominent value for the development of CHR computer vision techniques and safety training. Nonetheless, most studies are based on either sparse fixations or cross-sectional (accumulative) statistics, which lack consideration of temporality and yielding limited visual pattern information. This research aims to investigate the temporal visual search patterns for CHR and the cognitive strategies they imply. An experimental study was designed to simulate CHR and document participants’ visual behavior. Temporal qualitative comparative analysis (TQCA) was applied to analyze the CHR visual sequences. The results were triangulated based on post-event interviews and show that: (1) In the potential electrical contact hazards, the intersection of the energy-releasing source and wire that reflected their interaction is the cognitively driven visual area that participants tend to prioritize; (2) in the PPE-related hazards, two different visual strategies, i.e., “scene-related” and “norm-guided”, can usually be generalized according to the participants’ visual cognitive logic, corresponding to the bottom-up (experience oriented) and top-down (safety knowledge oriented) cognitive models. This paper extended recognition-by-components (RBC) model and gestalt model as well as providing feasible practical guide for safety trainings and theoretical foundations of computer vision techniques for CHR.

Description: This study empirically explored the activity profiles of Korean older adults by considering a wide range of activities simultaneously and further investigated the socioeconomic factors associated with activity profiles. Gender differences in activity profiles were examined in-depth. Latent class analysis (LCA) was used to identify activity profiles based on a nationally representative sample of older adults from the most recent two waves of the Korean Time Use Survey (n = 3034 for 2014 and n = 3960 for 2019). Multinomial logistic regression analysis was employed to further examine the factors associated with the activity profiles. The findings revealed four distinct activity groups, although there were differences in activity profiles between the two waves. Several sociodemographic factors, such as gender, age, assets and income, were significantly associated with the activity profiles. Findings from this study can inform policy makers seeking interventions that enhance the overall well-being of older adults through activity engagement.

Description: Psychological distress and psychosocial factors are studied in the sports context in players of various specialties, but are only little studied with coaches who carry out their work with these athletes; that is where we put the emphasis, trying to determine the perception of coaches on psychological distress and psychosocial risk factors that may influence their sports work in times of a pandemic. It is an ex post facto study with a single-group retrospective design, with a representative sample of 94 coaches out of a possible 109. The Kessler Psychological Distress Scale and the short version of the ISTAS21 Psychosocial Risk Assessment at Work Questionnaire were adapted to the sports context. The results show that the youngest, those with the least experience and level 1 and level 2 coaches show the highest levels of stress. According to the psychosocial risk assessment, level 1 and 2 coaches, with experience between 6 to 10 years, are in the risk zone. Therefore, it is important to work with a group of coaches who are in the psychosocial risk zone and with high levels of psychological discomfort in order to avoid mental, emotional and physical stress, for the good performance of their work in the best possible conditions.

Description: Suicide represents a very important issue in public health. For approaching attitudes toward suicide, we have developed an instrument that, following previous recommendations, assesses specific thoughts related to the perception of suicide utility in the press. First of all, we will test the psychometric properties of the scale we created ad hoc for assessing suicide utility perception. After that, we expect to find that the suicide utility perception in the press will have a statistically significant impact on positive attitudes toward terminally ill patients’ suicide (Hypothesis 1). In addition, this relationship will be mediated by suicide legitimation (Hypothesis 2). This mediation will be moderated by depressive symptomatology (Hypothesis 3). The sample was composed of 66 Spanish participants. Suicide legitimation was significantly related to the positive evaluation of terminally ill people’s euthanasia. Finally, when the levels of depression’s psychological concomitants increased, the support for terminally ill people’s euthanasia increased as well. Implications and limitations have been discussed.

Description: Patient-controlled epidural analgesia is widely used to control postoperative pain following major intra-abdominal surgeries. However, determining the optimal infusion dose that can produce effective analgesia while reducing side effects remains a task to be solved. Postoperative pain and adverse effects between variable-rate feedback infusion (VFIM group, n = 36) and conventional fixed-rate basal infusion (CFIM group, n = 36) of fentanyl/ropivacaine-based patient-controlled epidural analgesia were evaluated. In the CFIM group, the basal infusion rate was fixed (5 mL/h), whereas, in the VFIM group, the basal infusion rate was increased by 0.5 mL/h each time a bolus dose was administered and decreased by 0.3 mL/h when a bolus dose was not administered for 2 h. Patients in the VFIM group experienced significantly less pain at one to six hours after surgery than those in the CFIM group. Further, the number of patients who suffered from postoperative nausea was significantly lower in the VFIM group than in the CFIM group until six hours after surgery. The variable-rate feedback infusion mode of patient-controlled epidural analgesia may provide better analgesia accompanied with significantly less nausea in the early postoperative period than the conventional fixed-rate basal infusion mode following open gastrectomy.

Description: This paper analyzed the degradation pathways of petroleum hydrocarbon degradation bacteria, screened the main degradation pathways, and found the petroleum hydrocarbon degradation enzymes corresponding to each step of the degradation pathway. Through the Copeland method, the best inoculation program of petroleum hydrocarbon degradation bacteria in a polluted site was selected as follows: single oxygenation path was dominated by Streptomyces avermitilis, hydroxylation path was dominated by Methylosinus trichosporium OB3b, secondary oxygenation path was dominated by Pseudomonas aeruginosa, secondary hydroxylation path was dominated by Methylococcus capsulatus, double oxygenation path was dominated by Acinetobacter baylyi ADP1, hydrolysis path was dominated by Rhodococcus erythropolis, and CoA path was dominated by Geobacter metallireducens GS-15 to repair petroleum hydrocarbon contaminated sites. The Copeland method score for this solution is 22, which is the highest among the 375 solutions designed in this paper, indicating that it has the best degradation effect. Meanwhile, we verified its effect by the Cdocker method, and the Cdocker energy of this solution is −285.811 kcal/mol, which has the highest absolute value. Among the inoculation programs of the top 13 petroleum hydrocarbon degradation bacteria, the effect of the best inoculation program of petroleum hydrocarbon degradation bacteria was 18% higher than that of the 13th group, verifying that this solution has the best overall degradation effect. The inoculation program of petroleum hydrocarbon degradation bacteria designed in this paper considered the main pathways of petroleum hydrocarbon pollutant degradation, especially highlighting the degradability of petroleum hydrocarbon intermediate degradation products, and enriching the theoretical program of microbial remediation of petroleum hydrocarbon contaminated sites.

Description: Autosomal dominant hypophosphatemic rickets (ADHR) is an extremely rare form of genetic rickets caused by mutations in the fibroblast growth factor 23 gene. ADHR is characterized by hypophosphatemia secondary to isolated renal phosphate wasting. Only a few cases of ADHR have been reported in the literature to date. We describe the case of a 17-month-old girl who presented with severe failure to thrive (length: −4.08 standard deviation (SD), weight: −2.2 SD) and hypotonia. Hypophosphatemia, decreased tubular phosphate reabsorption (69%), and rachitic lesions were found. Genetic analysis showed the heterozygous variant c.536G〉A (NM_020638.3:c.536G〉A) in exon 3 of the FGF23 gene, leading to the diagnosis of ADHR. She was treated with phosphate salts and oral alfacalcidol. After 4 years of treatment, at 5 years of age, the patient’s ADHR resolved spontaneously. Considering the lack of knowledge regarding ADHR, we reviewed the literature to describe the features of this rare and poorly understood disease. Eleven ADHR pediatric cases have been described thus far, with cases tending to be more common in females than males. Similar to the general population, two groups of patients with ADHR can be described depending on the mutations present: patients with an R179 and R176 mutation have early-onset of disease and higher frequency of rickets, and a milder and late-onset of disease, respectively. Symptoms and disease severity may fluctuate. Spontaneous remission may occur during the pediatric age.

Description: Perceptions of the harmfulness of tobacco products may be a determinant of smoking behaviors. This study aimed to: (1) assess the perception of harmfulness of various tobacco products and e-cigarettes in Poland as well as (2) to assess the awareness of the health effects of using tobacco and e-cigarettes. A cross-sectional survey was conducted in 2019 with a nationally representative sample of 1011 individuals aged 15 and over. In the studied group, 22.3% were smokers. Smokeless tobacco was most likely to be perceived as less harmful than cigarettes (25%), followed by water pipe (24.5%), heated tobacco products (22%), e-cigarettes (21.6%), slim cigarettes (17.1%), flavored cigarettes (except menthol ones) (16.1%), menthol cigarettes (15.6%) and cigarillos (12.6%). In this study, 10% of respondents denied that smoking causes serious diseases. Most of the respondents (88.9%) were aware that smoking causes lung cancer (88.9%), but only 70.4% were aware that smoking causes stroke. Smokers compared to non-smokers were less likely to declare that smoking causes a stroke (OR: 0.43, 95%CI: 0.31–0.59; p 〈 0.001) or myocardial infarction (OR: 0.41, 95%CI: 0.29–0.60; p 〈 0.001). There were no significant differences (p 〉 0.05) in the perception of harmfulness of various tobacco products and e-cigarettes by gender, age, or occupational status.

Description: Drowning is a leading cause of fatality among children in the United States, and pool/spa aquatic structures represent common locations of submersion incidents. This study employed narrative case review to understand characteristics related to permission, supervision, and precipitating events in childhood submersion incidents. Retroactive analysis of 1537 fatal and non-fatal submersion incidents among children age 13 years old and younger was conducted using the U.S. Consumer Products Safety Commission In-Depth Investigations dataset from 2000–2017. Narrative descriptions were coded according to the themes of permission, supervision, and precipitating events. In most (86%) incidents, the child did not have permitted water access, and 80% of narratives indicated the child was alone at time of incident. These attributes were significantly associated with a fatal outcome (No permission: OR 11.98, 95% CI 7.97–18.06; Alone: OR 34.93, 95% CI 19.69–61.96). The average length of inactive supervision time was 15.6 min; this duration significantly differed by non-fatal (3.2 min) and fatal (16.1 min) outcomes (p 〈 0.001). More than half of cases occurred under the supervision type of a parent (56%), followed by grandparents (14%) and childcare provider (10%). Submersion incidents with a non-parent supervisor were two times more likely to result in a fatal outcome (OR 1.87, 95% CI 1.07–3.64). The most frequently occurring precipitating events included outdoor play (46%), a social gathering (36%), and previous water play (15%). Narrative excerpts further illustrate how tragic submersion events can unfold quickly and unpredictably. Education campaigns should target all adults that supervise children and reiterate key findings in that many submersion incidents occur (1) without permitted pool use, (2) without active supervision, and (3) when a caregiver is distracted. Multiple strategies should be utilized to add layers of projection against submersion injury.

Description: This study classified the changes in alcohol use behavior among Korean adults and explored the related factors. The study used data from the 4th (2009) to 14th (2019) waves of the Korean Welfare Panel Study. The subjects were 8267 adults aged 19–60 years. Latent class growth analysis was used to classify the latent classes of alcohol use behavior among Korean adults, and logistic regression analysis was performed to identify the specific factors that form the classes. Additionally, the 11-year trajectories of major variables associated with alcohol use behavior for the derived classes were analyzed using growth mixture modeling. Four classes were identified according to the trajectories of alcohol use behavior. There were statistically significant differences in the trajectories of depression, self-esteem, satisfaction in family relationships, and satisfaction in leisure activities according to the class of alcohol use behavior. In particular, self-esteem and satisfaction in family relationships indicated distinctly decreasing trajectories in the low- to moderate-risk class, which suggested the need for longitudinal analysis of the factors that influence alcohol use behavior. Moreover, it is recommended that interventions for the prevention of high-risk drinking target not only individuals but also family units.

Description: The rehabilitation needs of COVID-19 survivors are increasingly recognized, with a focus on combating respiratory and neuromuscular dysfunctions. The aim here was to explore the perception of Austrian physiotherapists and physiotherapy students on post-COVID-19 rehabilitation care and to identify barriers for the application of sufficient rehabilitation. We analysed current knowledge and practical skills in respiratory physiotherapy, performing a cross-sectional national survey among physiotherapists working in outpatient settings and physiotherapy students in their last academic year of bachelor-level education in Austria. Out of 255 survey participants, one-third already had inquiries to treat post-COVID-19 patients, and the majority of respondents expected a further increased inflow of patients with rehabilitation needs (64.2%). Only 11.2% of respondents reported feeling sufficiently informed about post-COVID-19 rehabilitation. A total of 68.2% of students and up to 48.1% of physiotherapists favoured a COVID-19-specific adaptation already in the basic academic education, and 74.1% of survey participants indicated interest in attending specific training. Concerning respiratory physiotherapy, our data showed discrepancies between the estimation of the importance of specific examination and treatment techniques and the level of current experience. There is a clear lack of experience in implementing effective device-based respiratory therapy. Our data indicate an urgent need to develop new education and training programs with a focus on the interdisciplinary rehabilitation of patients with post-COVID-19 syndrome.

Description: This study’s objective was to describe the relationship between the main risk factors for oral cancer, including tobacco (in the form of cigarettes, smokeless tobacco (SLT), secondhand smoking (SS)), alcohol, and betel quid (BQ), and the occurrence of oral potentially malignant disorders (OPMDs). A community-based case-control study was conducted with a population of 1448 adults aged 40 years or above in northeastern Thailand. Patients aged 60 years or above (OR 1.79, p 〈 0.001) and female patients (OR 2.17, p 〈 0.001) had a significant chance of having OPMDs. Our multivariate analysis showed that the most potent risk factor for OPMDs occurrence was betel quid (BQ) (adjusted OR 4.65, p 〈 0.001), followed by alcohol (OR 3.40, p 〈 0.001). Even former users were at risk of developing OPMDs. The synergistic effect between these main risk factors was significantly shown in the group exposed to SLT, SS, BQ, and alcohol. The most potent synergistic effect was found in the group exposed to SLT, BQ and alcohol with the OR = 20.96.

Description: One strategy to promote physical activity (PA) is for health care providers to give exercise prescriptions (ExRx) that refer to community-based facilities. However, facilitators and barriers specific to urban programs in the US for under-resourced women are unknown. Thus the purpose of this formative research was to explore ExRx barriers and facilitators specific to US under-resourced women to inform future intervention targets and strategies. This mixed-methods community-engaged research was conducted in partnership with an urban women’s only wellness center that exchanged ExRx for free access (1–3 months). Qualitative semi-structured interviews and validated quantitative questionnaires (SF-12, International Physical Activity Questionnaire, Physical Activity Self-Efficacy, Physical Activity Stage of Change, and Barriers to Physical Activity, Social Support for Exercise, and Confusion, Hubbub, and Order Scale) were administered by phone and guided by the socio-ecological model. ExRx utilization was defined as number visits/week divided by membership duration. Means and percentages were compared between ≥1 visit/week vs.

Description: Allogeneic hematopoietic stem cell transplantation (alloHSCT) is one of the most commonly performed transplantation procedures nowadays. Despite the significant progress made in the treatment, alloHSCT is still associated with numerous complications also affecting the oral cavity. One of them is dentin hypersensitivity (DH)—a sharp, short-term pain that occurs when stimuli act on exposed dentin. Various authors point out that DH may result in a significantly lower quality of life, among other things by impeding the consumption of food as well as causing difficulties in daily oral hygiene. The aim of the study was a preliminary analysis of the incidence rate and severity of DH pain in adult patients during late period after alloHSCT. The impact of chronic graft-versus-host disease (cGvHD) and time after alloHCT were also considered. A total of 80 patients were examined. cGvHD was identified in 52 participants. The incidence rate and severity of DH pain was assessed on the basis of a questionnaire and a clinical examination. DH pain appeared a serious problem in late period after alloHSCT regardless of post-transplant time. DH primarily affected cGvHD patients. The prevention-treatment protocol for DH should be developed for this group.

Description: Social distancing was found to prevent COVID-19 contagion. Therefore, understanding the factors associated with the public’s adherence is important. Acknowledging the importance of emotional wellbeing regarding older people’s health, and understanding their emotional state during the pandemic, are crucial. This study assessed factors associated with older people’s adherence to social distancing and their emotional status. A cross-sectional online survey was conducted among 1822 respondents above the age of 60. Distancing adherence, negative emotion, trust, social support, threat perception, attitudes, and subjective norms were assessed, and a path analysis was performed. Adherence was positively associated with attitudes (β = 0.10; p 〈 0.001), and with subjective norms (β = 0.19; p 〈 0.001). Negative emotions were positively associated with threat perception (β = 0.33; p 〈 0.001), and negatively associated with social support (β = −0.13; p 〈 0.001) and subjective norms (β = −0.10; p 〈 0.001). Attitudes mediated the relationship of threat perception (95% CI = 0.009, 0.034), trust (95% CI = 0.008, 0.029), and social support (95% CI = 0.006, 0.023) with distancing adherence. Subjective norms mediated the relationship between threat perception (95% CI = 0.014, 0.034), trust (95% CI = 0.026, 0.055), and social support (95% CI = 0.002, 0.048) with distancing adherence. Subjective norms mediated the relationship between threat perception (95% CI = −0.022, −0.006), trust (95% CI = −0.034, −0.010), and social support (95% CI = −0.029, −0.009) with negative emotions. When promoting social distancing adherence, subjective norms and attitudes must be considered, as they play a role in promoting adherence and negative-emotion regulation.

Description: Bisphosphonates are widely used in the treatment of women at risk of osteoporotic hip fracture; however, the overall effectiveness of bisphosphonates in the prevention of osteoporotic fractures has not been studied in real life. To investigate whether the use of bisphosphonates in women aged 50 years and over is associated with a decrease in hospitalization for osteoporotic hip fractures, a historical prospective cohort study was conducted between 2009 and 2016 from a permanent representative sample consisting of 1/97 of the French health insurance beneficiaries. Bisphosphonate use was defined according to medication persistence and adherence regarding bisphosphonate dispensations. The primary outcome was the hospitalization rate for osteoporotic hip fracture. Among the 81,268 women included, 2005 were exposed to bisphosphonates. The median time of bisphosphonate exposure was 12 (IQR, 3–29) and 17 (IQR, 5–42) months for the persistence and adherence definitions, respectively. Exposure to bisphosphonates was not associated with a decrease in hospitalization for hip fracture: weighted HRadherence = 0.66 (95% CI, 0.33 to 1.33); HRpersistance = 0.77 (95% CI, 0.38 to 1.57). In real life, bisphosphonate use does not appear to reduce hospitalization for hip fractures, as to date, it is probably prescribed as primary prevention and for a duration too short to be effective.

Description: Previous studies have shown that the physical functioning of older adults directly affects their depressive symptoms, and suicide is also closely associated with depression. This study determined the effects of physical functioning on depressive symptoms and suicidal ideation among older Korean adults. This study used data from the 2017 National Survey of Older Persons. Among the 10,299 participants in the entire data set, 10,083 participants were analyzed, excluding 216 participants who did not respond to the dependent variables. Data analyses included frequency, chi-squared tests, and binary logistic regression. The results indicated that physical functioning among older adults was associated with reduced depressive symptoms and suicidal ideation. Compared to the group that had non-limited activities of daily living (ADL) function, the group with limitations was 1.66 times more likely to show depressive symptoms (OR: 1.66, 95% CI: 1.36–2.02). Similar trends were observed in instrumental activities of daily living (IADL) (OR: 1.85, 95% CI: 1.58–2.16). When suicidal ideation was set as a dependent variable, IADL had a statistically significant impact (OR: 1.41, 95% CI: 1.14–1.74); however, ADL did not seem to have an impact. Moreover, both ADL (OR: 1.62, 95% CI: 1.35–1.94) and IADL (OR: 1.72, 95% CI: 1.49–1.97) had statistically significant effects when combined with depressive symptoms and suicidal ideation. Better physical functioning was associated with a reduction in depressive symptoms and suicidal ideation. This study emphasizes the importance of physical functioning when examining older adults’ mental health.

Description: The COVID-19 pandemic is a public health emergency concern and a challenge to students’ mental health due to changes in education and social isolation. The aim of this research was to expand knowledge about the relations that shape the level of anxiety amongst men and women who are studying during the pandemic in terms of the relations towards their sense of social support and their nutritional behaviors. A State–Trait Anxiety Inventory was used to measure anxiety level, alongside supplementary questions such as the feeling of support from close ones, concentration of attention on nutrition during the pandemic and externally derived factors (university, specialization). Analysis of the regression was applied to the examination of the dependency between the anxiety level (in both forms of its occurrence—as state-anxiety and as trait-anxiety). We observed that the pandemic situation affected a level of state-anxiety above average (mean value of 46–48 points) even when students felt social support. Nutrition habits and chosen education type are associated with trait-anxiety level, which was also elevated (mean values of 49–50 points). Chosen factors had a partial influence on the anxiety level of students, therefore their mental health should concern shaping positive nutrition habits and social support.

Description: As gestational diabetes, which is increasing steadily around the world, can cause complications in the mother and fetus, it is essential to change eating habits and eating behavior to prevent this. According to the 2020 American Diabetes Association recommendations, the food plan should be designed for the adequate calorie intake to achieve glycemic goals and consequently promote maternal and fetal health. Thus, the following study has used the qualitative theme analysis method to assess what it means for 28 South Korean women, who were diagnosed with gestational diabetes for the first time, to change their eating habits and behaviors. As a result, themes were derived related to reflection on daily life, formation of new relationships in the same group, efforts that must be made, rediscovery of couples, and lifestyles reborn as new roles. Based on the results of the study, it is shown that the study participants recovered the peace in their mental state after the crisis of gestational diabetes to pursue relaxation and ultimately higher quality of life by following the plan to fulfill healthy achievements, such as changing their eating habits and behaviors. Therefore, future research and support measures to help the healthy behaviors should be sought by comprehensively exploring the effects of women’s experiences in changing their eating habits and behaviors.

Description: Among the various factors that could influence health-related quality of life (HRQoL) in adolescence, body mass index (BMI) seems to play a key role as a main anthropometric parameter. The aim of this cross-sectional study was to determine, in a sample of Italian adolescents, whether HRQoL is associated with the different weight status categories (underweight, normal weight, overweight, obese), according to BMI cut-off points for children, even considering sex differences. Data were collected from 1707 adolescents (n = 828 males) in seven schools. HRQoL was analyzed using the Italian version of KIDSCREEN-52. Males were more overweight and obese than females (13% vs. 10% and 4% vs. 2%, p 〈 0.05, respectively). In females, BMI categories are associated with physical well-being (p 〈 0.05), emotion/mood (p 〈 0.05), self-perception (p 〈 0.001), financial resources (p 〈 0.05), and bullying behavior (p 〈 0.05). In males, weight status is linked to physical well-being dimension (p 〈 0.001) and perception of self (p 〈 0.05). Our results may suggest that there is an association between weight status categories and HRQoL, more pronounced in females than in males. Interestingly, the weight status correlated more with the psychological dimension mainly in females, whereas in males, a stronger association between weight and physical status was observed, suggesting that given the complex, multifaceted, and dynamic nature of relationship between health-related quality of life and weight status in adolescents, multiple factors must be considered.

Description: The treatment of chronic pelvic pain (CPP) with botulinum neurotoxin type A (BoNT/A) has increased lately, but more studies assessing its effect are needed. This study aimed to evaluate the evolution of patients after BoNT/A infiltration and identify potential responders to treatment. Twenty-four women with CPP associated with dyspareunia were treated with 90 units of BoNT/A injected into their pelvic floor muscle (PFM). Clinical status and PFM activity were monitored in a previous visit (PV) and 12 and 24 weeks after the infiltration (W12, W24) by validated clinical questionnaires and surface electromyography (sEMG). The influence of patients’ characteristics on the reduction in pain at W12 and W24 was also assessed. After treatment, pain scores and the impact of symptoms on quality of life dropped significantly, sexual function improved and sEMG signal amplitude decreased on both sides of the PFM with no adverse events. Headaches and bilateral pelvic pain were risk factors for a smaller pain improvement at W24, while lower back pain was a protective factor. Apart from reporting a significant clinical improvement of patients with CPP associated with dyspareunia after BoNT/A infiltration, this study shows that clinical characteristics should be analyzed in detail to identify potential responders to treatment.

Description: Temperature change is an important meteorological indicator reflecting weather stability. This study aimed to examine the effects of ambient temperature change on non-accidental mortality using diurnal temperature change (DTR) and temperature change between neighboring days (TCN) from two perspectives, intra-day and inter-day temperature change, and further, to explore seasonal variations of mortality, identify the susceptible population and investigate the interaction between temperature change and apparent temperature (AT). We collected daily data on cause-specific mortality, air pollutants and meteorological indicators in Shenzhen, China, from 1 January 2013 to 29 December 2017. A Quasi-Poisson generalized linear regression combined with distributed lag non-linear models (DLNMs) were conducted to estimate the effects of season on temperature change-related mortality. In addition, a non-parametric bivariate response surface model was used to explore the interaction between temperature change and AT. The cumulative effect of DTR was a U-shaped curve for non-accidental mortality, whereas the curve for TCN was nearly monotonic. The overall relative risks (RRs) of non-accidental, cardiovascular and respiratory mortality were 1.407 (95% CI: 1.233–1.606), 1.470 (95% CI: 1.220–1.771) and 1.741 (95% CI: 1.157–2.620) from exposure to extreme large DTR (99th) in cold seasons. However, no statistically significant effects were observed in warm seasons. As for TCN, the effects were higher in cold seasons than warm seasons, with the largest RR of 1.611 (95% CI: 1.384–1.876). The elderly and females were more sensitive, and low apparent temperature had a higher effect on temperature change-related non-accidental mortality. Temperature change was positively correlated with an increased risk of non-accidental mortality in Shenzhen. Both female and elderly people are more vulnerable to the potential adverse effects, especially in cold seasons. Low AT may enhance the effects of temperature change.

Description: We aimed to develop machine learning classifiers as a risk-prevention mechanism to help medical professionals with little or no knowledge of the patient’s languages in order to predict the likelihood of clinically significant mistakes or incomprehensible MT outputs based on the features of English source information as input to the MT systems. A MNB classifier was developed to provide intuitive probabilistic predictions of erroneous health translation outputs based on the computational modelling of a small number of optimised features of the original English source texts. The best performing multinominal Naïve Bayes classifier (MNB) using a small number of optimised features (8) achieved statistically higher AUC (M = 0.760, SD = 0.03) than the classifier using high-dimension natural features (135) (M = 0.631, SD = 0.006, p 〈 0.0001, SE = 0.004) and the automatically optimised classifier (22) (M = 0.7231, SD = 0.0084, p 〈 0.0001, SE = 0.004). Furthermore, MNB (8) had statistically higher sensitivity (M = 0.885, SD = 0.100) compared with the full-feature classifier (135) (M = 0.577, SD = 0.155, p 〈 0.0001, SE = 0.005) and the automatically optimised classifier (22) (M = 0.731, SD = 0.139, p 〈 0.0001, SE = 0.0023). Finally, MNB (8) reached statistically higher specificity (M = 0.667, SD = 0.138) compared to the full-feature classifier (135) (M = 0.567, SD = 0.139, p = 0.0002, SE = 0.026) and the automatically optimised classifier (22) (M = 0.633, SD = 0.141, p = 0.0133, SE = 0.026).

Description: Wildfires are increasing in frequency, size, and intensity, and increasingly affect highly populated areas. Wildfire smoke impacts cardiorespiratory health; children are at increased risk due to smaller airways, a higher metabolic rate and ongoing development. The objective of this systematic review was to describe the risk of pediatric respiratory symptoms and healthcare visits following exposure to wildfire smoke. Medical and scientific databases and the grey literature were searched from inception until December 2020. Included studies evaluated pediatric respiratory-related healthcare visits or symptoms associated with wildfire smoke exposure. Prescribed burns, non-respiratory symptoms and non-pediatric studies were excluded. Risk of bias was evaluated using the National Toxicology Program’s Office of Health Assessment and Translation Risk of Bias Rating Tool. Data are presented narratively due to study heterogeneity. Of 2138 results, 1167 titles and abstracts were screened after duplicate removal; 65 full text screens identified 5 pre-post and 11 cross-sectional studies of rural, urban and mixed sites from the USA, Australia, Canada and Spain. There is a significant increase in respiratory emergency department visits and asthma hospitalizations within the first 3 days of exposure to wildfire smoke, particularly in children 〈 5 years old.

Description: During the COVID-19 outbreak, college students experienced different periods of isolation on campus, which has had an impact on students’ mental health. Based on ART theory, this study randomly selected students at Northwest A&F University, Shaanxi, China and distributed questionnaires in order to evaluate the psychological recovery effect of campus environment during the epidemic. The results showed that: (1) There were significant differences in the psychological restoration of four types of campus environments. Blue space had the greatest effect, followed by green space and sports grounds, while grey space had the least. (2) Time of stay had a very significant impact on psychological restoration. Longer time of exposure is not necessarily correlated with a better recovery experience. (3) In the different campus environments, extent is easier to be perceived followed by fascination and compatibility, and the weakest is being away. At the time of stay level, no significant difference was found in the perception of compatibility. Time of stay was negatively correlated with fascination and compatibility. These findings can provide theoretical and practical bases for campus environmental planning and construction following the COVID-19 epidemic.

Description: The scientific literature on mental health has found an association between physical activity and emotional wellbeing and recommends active leisure activities as a way of keeping stress under control. The purpose of this research study is to analyze the level of anxiety, the symptoms of depression and the level of self-esteem of people practicing speleology, as well as possible gender differences. This paper also attempts to understand whether self-esteem is associated with the presence of symptoms of depression in speleologists and whether anxiety has a mediating effect. We conduct a cross-sectional and descriptive research study with a sampling of 105 adult speleologists. The results reveal that the total mediation model is applicable, as self-esteem has a significant indirect association with depression through trait anxiety, as well as a partial mediation model that is applicable through state anxiety. This means that speleologists with high levels of self-esteem, who appreciate and value themselves adequately, reveal lower levels of trait anxiety, and this negatively influences their levels of depression (that is, a lower level of depressive symptoms). At the same time, speleologists with high levels of self-esteem, who appreciate and value themselves adequately, also reveal lower levels of state anxiety, which again has a negative impact on their levels of depression (with fewer symptoms of depression). Emotions such as anxiety, self-esteem, depression and their collateral effects are international topics of interest, which are relevant for people from all sporting backgrounds; therefore, value should be placed on supporting and carrying out further research into this topic.

Description: Among brominated flame retardants (BFRs), polybrominateddiphenyl ethers (PBDEs) and hexabromocyclododecanes (HBCDs) were the most widely used in past decades. BFRs not being chemically bonded to polymers means they can easily leach from the products into the environment and bioaccumulate. Humans are exposed to flame retardants mainly through food consumption, especially fish and fish products. In the present study, the occurrence of PBDEs and HBCDs in freshwater fishes and crayfish from Lake Trasimeno (Umbria region, central Italy) was assessed according to monitoring plans recommended by European competent authorities. The dietary exposure of the central Italian population to such molecules was calculated, and the risk characterization and the benefit–risk evaluation were also assessed. A total of 90 samples were analyzed by means of gas and liquid chromatography associated with triple quadrupole mass spectroscopy. A total of 51% of samples were found positive for at least one of the congeners; the most frequently found molecule was BDE-47. The data on dietary exposure ranged from 0.138 to 1.113 pg/kg body weight/day for ∑PBDE and from 0.805 to 0.868 pg/kg body weight/day for ∑HBCD. The data show no health risks for the central Italian population consuming freshwater fish products from Lake Trasimeno in relation to exposure to PBDE and HBCD.

Description: Depression is a common mental disease that impacts people of all ages and backgrounds. To meet needs that cannot otherwise be met, people with depression or who tend to suffer from depression often gather in online depression communities. However, since joining a depression community exposes members to the depression of others, the impact of such communities is not entirely clear. This study therefore explored what happens when people with depression gather in Sina Weibo’s Depression Super Topic online community. Through website crawling, postings from Depression Super Topic were compared with postings from members’ regular timelines with respect to themes, emotions disclosed, activity patterns, and the number of likes and comments. Topics of distilled postings covering support, regulations, emotions and life sharing, and initiating discussions were then coded. From comparison analysis, it was found that postings in the Depression Super Topic community received more comments and disclosed more emotions than regular timelines and that members were more active in the community at night. This study offers a picture of what occurs when people with depression gather online, which helps better understand their issues and therefore provide more targeted support.

Description: The aim of this study was to examine changes in depression, stress and social support levels before and during the COVID-19 pandemic in women living in Mexico City. We studied 466 women enrolled in the Programming Research in Obesity, Growth, Environment and Social Stressors (PROGRESS) study who completed the Edinburgh Depression Scale (EDS) questionnaire prior (2018–2019) and during the lockdown period of the pandemic (May–November 2020). Psychosocial stress and social support for both time periods were ascertained using the Crisis in Family Systems (CRISYS) questionnaire and the Social Support Network (SSN) Scale, respectively. Associations between stress, social support and change in EDS score/depression were analyzed using generalized linear models adjusting for covariates. Higher stress (〉median) during the pandemic was associated with an increase in EDS score (β: 2.13; 95% CI (1.06, 3.19), p 〈 0.001), and higher odds of depression (OR: 3.75; 95% CI (2.17, 6.50), p 〈 0.001), while social support was associated with lower odds of depression (OR: 0.56, 95% CI (0.32, 0.97), p = 0.037). Higher levels of stress during the pandemic were associated with depression. Social support may act as a buffer for the effects of psychosocial stress. Future studies should examine the long-term effects of stress associated with the pandemic on mental and overall health.

Description: This study explored the impact of COVID-19 on migrant workers in Vietnam, using a cumulative risk assessment (CRA) framework which comprises four domains (workplace, environment, individual and community). A cross-sectional study was conducted. Data were collected in 2020 through a self-administered questionnaire with 445 domestic migrant workers in two industrial zones in two northern provinces (Bac Ninh and Ninh Binh) in Vietnam. The majority of migrant workers were female (65.2%), aged between 18 and 29 years old (66.8%), and had high school or higher education level qualifications. Most migrant workers had good knowledge about preventive measures (〉90%) and correct practices on COVID-19 prevention (81.1%). Three health risk behaviors were reported: 10% of participants smoked, 25% consumed alcohol and 23.1% were engaged in online gaming. In terms of workplace, occupational working conditions were good. Noise was the most commonly reported hazard (29%). Regarding environment, about two-thirds of migrant workers lived in a small house (

Description: Six Sigma has been widely used in the health field for process or quality improvement, constituting a quite profusely investigated topic. This paper aims at exploring why some studies have more academic and societal impact, attracting more attention from academics and health professionals. Academic and societal impact was addressed using traditional academic metrics and alternative metrics, often known as altmetrics. We conducted a systematic search following the PRISMA statement through three well-known databases, and identified 212 papers published during 1998–2019. We conducted zero-inflated negative binomial regressions to explore the influence of bibliometric and content determinants on traditional academic and alternative metrics. We observe that the factors influencing alternative metrics are more varied and difficult to apprehend than those explaining traditional impact metrics. We also conclude that, independently of how the impact is measured, the paper’s content, rather than bibliometric characteristics, better explains its impact. In the specific case of research on Six Sigma applied to health, the papers with more impact address process improvement focusing on time and waste reduction. This study sheds light on the aspects that better explain publications’ impact in the field of Six Sigma application in health, either from an academic or a societal point of view.

Description: Effective medical teamwork can improve the effectiveness and experience of care for staff and patients, including safety. Healthcare organizations, and especially primary care clinics, have sought to improve medical teamwork through improved layout and design, moving staff into shared multidisciplinary team rooms. While co-locating staff has been shown to increase communication, successful designs balance four teamwork needs: face-to-face communications; situational awareness; heads-down work; perception of teamness. However, precautions for COVID-19 make it more difficult to conduct face-to-face communications. In this paper we describe a model for understanding how layout affects these four teamwork needs and describe how the perception of teamwork by staff changed after COVID-19 precautions were put in place. Observations, interviews and two standard surveys were conducted in two primary care clinics before COVID-19 and again in 2021 after a year of precautions. In general, staff felt more isolated and found it more difficult to conduct brief consults, though these perceptions varied by role. RNs, who spent more time on the phone, found it convenient to work part time-from home, while medical assistants found it more difficult to find providers in the distanced clinics. These cases suggest some important considerations for future clinic designs, including greater physical transparency that also allow for physical separation and more spaces for informal communication that are distanced from workstations.

Description: Background: The frail elderly are prone to falls and fractures, which can result in dependency, disability, admission to institutions, and even death. They are at increased risk of frailty due to decreased physical activity, cognitive decline, and depression. Some evidence suggests that music therapy with physical activities may be particularly beneficial. Objective: This study aimed to investigate the intervention effect of music therapy with physical activities (MTPA) on frail elderly in the community. Methods: A quasi-experimental design was adopted. We selected 10 community care centers in southern Taiwan, in which elderly people over the age of 65 were assigned to a MTPA group and a comparison group after obtaining their informed consent. The MTPA group performed group music activities once a week for 120 min for 12 weeks, while the comparison group only continued with their daily activities. Instruments in this study included the Kihon Checklist, Senior Fitness Test (with Body Mass Index (BMI) and seven physical fitness items), Mini-Mental Status Examination (MMSE), and Geriatric Depression Scale Short Form (GDS-SF). Results: A total of 132 community elders agreed to participate in this study, and 122 completed both the pretest and posttest, with 62 in the music therapy group and 60 in the comparison group. The results of ANCOVA showed that after intervention, except for BMI, the Kihon frailty assessment, seven fitness scores individually and in total, MMSE, and depression showed significant improvements in the music therapy group relative to the comparison group (all p 〈 0.05). Conclusion: MTPA can improve the frailty index, cognitive function, depression, and physical fitness index in the community elderly. The results of this study can be used as a reference for the design of activities for the community elderly, to provide them with appropriate activities, improve their physical functions, and improve or delay their disability.

Description: The Chinese government has made great efforts to improve the scale efficiency of land through various measures during recent years, hoping to realize the coordinated developing goal of promoting agricultural benefits and protecting the environment. Statistics show that China’s land scale efficiency has steadily increased, but agricultural nonpoint source (NPS) pollution has also increased, which seems contrary to the expected outcome. Can increasing scale efficiency really curb agricultural NPS pollution? This study uses provincial-level data from China, together with a panel model and spatial econometric model, to investigate the relationship between scale efficiency and agricultural NPS pollution. It is found that the increase of scale efficiency aggravates the agricultural NPS pollution, and the conclusion still holds after considering spatial effect. The results of spatial analysis shows that the agricultural NPS pollution is spatially dependent. Further decomposition of the spatial effect shows that the scale efficiency not only intensifies the local agricultural NPS pollution, but also has a spillover effect (though not statistically significant) on agricultural NPS pollution in the surrounding areas. It is worth noting that financial policy, raising wage income and upgrading industrial structure can effectively curb agricultural NPS pollution in this region and adjacent areas, which also deserves our attention in the control of agricultural NPS pollution. In addition, it is necessary to make financial and fiscal support policies specifically for the governance of agricultural NPS pollution, adjust the distorted prices of input factors such as chemicals and pesticide, and accelerate the transformation of small-sized farmers to family farms, in order to maximize the inhibitory effect of scale efficiency on relieving agricultural NPS pollution.

Description: Limited research exists on the mental health (MH) of grocery store workers (GSWs), who have been on the frontlines throughout the COVID-19 pandemic. A disaster MH conceptual model incorporating demographics, disaster exposure and threat (COVID-19 fear and workplace threat perception), perceived stress, and social support (lack of from family and friends) was utilized to predict MH outcomes (anxiety, depression, and post-traumatic stress symptoms; PTSS) of GSWs. GSWs (n = 842) were recruited through a regional union in California. The participants were diverse (62.1% female) and were 18–69 years of age (M = 41.5, SD = 13.9). They completed an online survey regarding COVID-19 fear, workplace threat perception, perceived stress, lack of social support, and workplace needs/recommendations for support. Three hierarchical linear regression models were run assessing each MH outcome. Thematic analysis coding and an inductive approach were utilized for analyzing open-ended responses of workplace needs/recommendations. Females and younger GSWs (ages 18–29 years old) on average, reported higher MH symptoms than males and older age groups, respectively. COVID-19 fear and perceived stress were significant predictors of anxiety, while COVID-19 fear, workplace threat perception, and perceived stress significantly predicted depression and PTSS, explaining almost half of the variance for each model. Social support and demographics were not predictive of MH outcomes. Almost half of GSWs (40%) requested increased safety protections in the workplace. Feelings of fear of COVID-19, threat in the workplace, and overall perceived stress are predictive of GSWs’ MH outcomes. Increasing feelings of safety in the workplace and reducing stress may lessen MH symptoms.

Description: The social sciences are essential to include in the fight against both public health challenges of antimicrobial resistance (AMR) and COVID-19. In this scoping review, we document what social science knowledge has been published about the social relationship between COVID-19 and AMR and which social science interventions are suggested to address this social relationship. We analysed 23 peer-reviewed articles published between 2019 and 2021. Results emphasize that changes in antibiotic prescription behaviour, misinformation, over-burdened health systems, financial hardship, environmental impact and gaps in governance might increase the improper access and use of antibiotics during the COVID-19 pandemic, increasing AMR. The identified social sciences transformation strategies include social engagement and sensitisation, misinformation control, health systems strengthening, improved infection prevention and control measures, environmental protection, and better antimicrobial stewardship and infectious diseases governance. The review emphasizes the importance of interdisciplinary research in addressing both AMR and COVID-19.

Description: Work-related musculoskeletal disorders (WMSDs) are among the most common disorders in any work sector and industry. Ergonomic risk assessment can reduce the risk of WMSDs. Motion capture that can provide accurate and real-time quantitative data has been widely used as a tool for ergonomic risk assessment. However, most ergonomic risk assessments that use motion capture still depend on the traditional ergonomic risk assessment method, focusing on qualitative data. Therefore, this article aims to provide a view on the ergonomic risk assessment and apply current motion capture technology to understand classical mechanics of physics that include velocity, acceleration, force, and momentum in ergonomic risk assessment. This review suggests that using motion capture technologies with kinetic and kinematic variables, such as velocity, acceleration, and force, can help avoid inconsistency and develop more reliable results in ergonomic risk assessment. Most studies related to the physical measurement conducted with motion capture prefer to use non-optical motion capture because it is a low-cost system and simple experimental setup. However, the present review reveals that optical motion capture can provide more accurate data.

Description: The multitude of national strategies used against the COVID-19 pandemic makes it necessary to review and synthesize them in order to identify potential gaps and shortcomings, and to help prioritize future control efforts. This systematic mapping review is aimed at identifying the coronavirus pandemic management strategies adopted by France, Tunisia, and Germany during the early stage of the COVID-19 outbreak. A set of government websites in addition to the PubMed and Google Scholar databases were searched to identify scientific articles and institutional documents related to the national strategies of the three countries up until July 2020. The references included were mapped and narratively synthesized based on the pillars of the Monitoring and Evaluation Framework of the Strategic Preparedness and Response Plan defined by the World Health Organization. Of the 2765 records screened, 65 documents were included in the study. The analysis of these documents showed that Germany was the first country to implement mass screening of cases and that France was the first country to implement measures to impose general containment at the national level. It also showed that Tunisia was the only country to have imposed the confinement of passengers on repatriation flights in dedicated containment centers and at the expense of the state.

Description: In this paper, we employ a directional distance function to estimate the opportunity cost arising from environmental regulations in China’s industrial sector. The change of opportunity cost is decomposed mathematically into two components including technical change and input change. Our results show that the opportunity cost attributed to environmental regulation is nil in some regions. The change of opportunity cost is marginal at the national level, as the positive effect of technical change is canceled out by the negative impact of input change on opportunity cost. Built on our mathematical decomposition, we further estimate the effects of environmental regulations on opportunity cost using a mediation model. It shows that environmental regulation has a significantly positive direct effect and a significantly negative indirect effect through foreign direct investment on opportunity cost. Our findings suggest, firstly, that inward FDI in China’s industrial sector represents relatively dirty production technology; and, secondly, industrial production has transited towards a less carbon-intensive input mix. This paper, therefore, provides new insights for the recent dynamics of carbon abatement performance of China’s industrial sector with policy implications.

Description: The purpose of this meta-analysis study was to investigate the effectiveness of psychological skills training interventions for archery players in Korea. A total of 17 research papers examining the effects of psychological skills training interventions were selected for data analysis. To analyze the data, the Comprehensive Meta-Analysis (CMA) software program was used. The results of this study were as follows: The overall effect size of psychological skills training interventions for archery players was ES = 0.469 (Hedges’ g), which was a small effect size. The major factors that influenced the effects of psychological skills training interventions for archery players appeared to be the player level and training period. In particular, adult players and longer periods of training had bigger effect sizes. The results of this study demonstrate that psychological skills training for archery players is effective and show that the player level and training period are crucial factors in the psychological skills training design. Based on these findings, some implications for future research are discussed.

Description: (1) Background: The reliability of disease surveillance may be restricted by sensitivity or ability to capture all disease. Objective: To quantify under-reporting and concordance of recording persons with tuberculosis (TB) in national TB surveillance systems: the Infectious Disease Reporting System (IDRS) and Tuberculosis Information Management System (TBIMS). (2) Methods: This retrospective review includes 4698 patients identified in 2016 in China. County staff linked TB patients identified from facility-specific health and laboratory information systems with records in IDRS and TBIMS. Under-reporting was calculated, and timeliness, concordance, accuracy, and completeness were analyzed. Multivariable logistic regression was used to examine factors associated with under-reporting. (3) Results: We found that 505 (10.7%) patients were missing within IDRS and 1451 (30.9%) patients were missing within TBIMS. Of 171 patient records reviewed in IDRS and 170 patient records in TBIMS, 12.3% and 6.5% were found to be untimely, and 10.7% and 7.1% were found to have an inconsistent home address. The risk of under-reporting to both IDRS and TBIMS was greatest at tertiary health facilities and among non-residents; the risk of under-reporting to TBIMS was greatest with patients aged 65 or older and with extrapulmonary TB (EPTB). (4) Conclusions: It is important to improve the reporting and recording of TB patients. Local TB programs that focus on training, and mentoring high-burden hospitals, facilities that cater to EPTB, and migrant patients may improve reporting and recording.

Description: Urinary incontinence (UI) is a significant social problem. According to the World Health Organization, UI affects as much as 30% of premenopausal women and 60% of postmenopausal women. Urinary incontinence can lead to certain problems that negatively affect a woman’s sex life. They result from the fact that certain processes take place in the body during intercourse. As a result of orgasm, the intra-abdominal pressure increases, which in women with urinary incontinence can cause an uncontrolled leakage of urine. The discomfort that this causes, in turn, lowers sexual attractiveness, as well as causes embarrassment. The study involved 50 patients hospitalized in the period from February to May 2019 at the Gynecology Department of the Independent Public Healthcare Center of the Ministry of the Interior and Administration in Wrocław. All patients underwent surgical treatment of stress urinary incontinence using the transobturator tape (TOT) method. To assess sexuality, the international standardized Female Sexual Function Index (FSFI) questionnaire. Analysis of the results obtained from the FSFI questionnaire shows that the operation significantly affects the reduction in pain sensation during intercourse, a reduction in the sensation of sexual arousal, and a worsening vaginal wetness. Stress urinary incontinence significantly affects women’s sex life.

Description: Chronic pain and dysautonomic symptoms deteriorate Systemic sclerosis (SSc) patients’ health-related quality of life with serious repercussions on social life and even on sleep. Heart Rate Variability (HRV) analysis can identify cardiovascular autonomic control impairment in subclinical condition. The aim of the present observational cross-sectional study was to assess the relationship between dysautonomic symptoms, quality of life status and cardiovascular autonomic profile. ECG and respiration were recorded at rest in 20 SSc patients. HRV analysis was performed using two different approaches: Linear spectral analysis and non-linear symbolic analysis. Pain was evaluated using the Numeric Rating Scale (NRS) and 3 questionnaires were administered for the evaluation of sleep quality (PSQI), mood tone (PHQ-9) and disability (HAQ). We found that sleep impairment was related to sympathetic predominance at rest measured as low-frequency/high-frequency ratio (LF/HF) (r = 0.48 and p = 0.033); poorer sleep quality was related to higher pain values (r = 0.48 and p = 0.034) and depressive symptoms (r = 0.82 and p 〈 0.01); higher pain scores were related to higher cardiovascular vagal modulation and higher disability indexes (r = 0.47 and p = 0.038 & r = 0.55 and p = 0.012, respectively). In conclusion dysautonomia and chronic pain showed a severe impact on sleep quality and disability with a consequent worsening of depressive symptom in our cohort of SSc patients.

Description: Providing refugees with psychosocial support is particularly important considering the high level of mental health problems prevalent in this population. A psychosocial walk-in clinic operating within a state reception and registration center in Germany has been supporting mentally burdened refugees since 2016. This study focused on patients’ perspectives on their mental health burden, the psychosocial walk-in clinic, and future help seeking. We conducted interviews with n = 22 refugees attending the walk-in clinic from March to May 2019. Qualitative analysis focused on the following four topics: (1) mental burden from the patients’ perspective, (2) access to the psychosocial walk-in clinic, (3) perception of counseling sessions, and (4) perception of follow-up treatment. The results show that the majority of interviewees were burdened by psychological and somatic complaints, mostly attributed to past experiences and post-migratory stress. Therapeutic counseling and psychiatric medication were found to be particularly helpful. Most of the participants felt motivated to seek further psychosocial support. Key barriers to seeking psychosocial help included shame, fear of stigma, and lack of information. Overall, the psychosocial walk-in clinic is a highly valued support service for newly arrived refugees with mental health issues.

Description: This research aims to assess the natural occurrence of patulin (PAT) in selected citrus fruits from central cities of Punjab and Pakistan’s northern cities. A total of 2970 fruit samples from 12 citrus cultivars were examined using liquid chromatography fitted with a UV detector. The detection limit (LOD) and quantification limit were 0.04 and 0.12 µg/kg, respectively. About 56% of samples of citrus fruits from Punjab’s central cities, Pakistan, were found to be contaminated with PAT, with values ranging from 0.12 to 1150 µg/kg in samples from central Punjab cities. Furthermore, 31.7% of samples of citrus fruits from northern cities of Pakistan were contaminated with PAT, with values ranging from 0.12 to 320 µg/kg. About 22.1% of citrus fruit samples had PAT levels greater than the suggested limits established by the European Union (EU). The dietary intake levels of PAT ranged from 0.10 to 1.11 µg/kg bw/day in the central cities of Punjab, Pakistan, and 0.13 to 1.93 µg/kg bw/day in the northern cities of Pakistan.

Description: Guidance regarding the decision to remove an adolescent from athletic competition immediately following an acute concussive injury and the safe return of play in the short term is widely accepted and supported by clinical evidence, local institutional policies, and state and federal laws. There is considerably less guidance regarding the decision to permanently retire an adolescent athlete for medical reasons due to concussive injuries. In this article, we discuss the clinical and non-clinical considerations that should guide clinicians in discussions regarding the adolescent athlete’s permanent retirement by emphasizing the ethical obligation to protect the child’s right to an open future as possibly determinative in otherwise ambiguous cases.

Description: Chile has a serious public health problem due to the high prevalence of both unhealthy dietary patterns and mental illnesses. Given that dietary quality is positively associated with the quality of mental health, it is urgent that healthy dietary patterns be promoted among Chileans. The WHO recommends the use of mass media for the dissemination of knowledge about mental health. Since health news affect people’s attitudes and health behaviors, this study analyzed the coverage by three Chilean online newspapers with the largest readership regarding the relation between diet and mental health in 2016. A previously constructed corpus of 2551 news items about food was analyzed quantitatively. The results show that the relevance of the topic diet and mental health was low in all three newspapers. The most frequent type of information was on “foods” and not “nutrients” that “benefit”—not that “damage”—mental health. The quality of the news was poor as a narrow range of sources was found. An individual responsibility frame predominated in the information to the detriment of a public health frame.

Description: Developing urban low-carbon traffic is an effective measure to reduce traffic carbon emissions, which are important parts of greenhouse gas. In order to understand the development characteristics and regular patterns of urban low-carbon traffic, we present a game model that enables us to predict the possible range of travel mode choice and the impact of low-carbon awareness. Through chaos analysis and simulation of the model, the authors come to realize that the proportions of travel mode choice can reach an equilibrium under a certain urban traffic system. This equilibrium is related to low-carbon awareness and the situation of the urban traffic system. The research we have done suggests that in small cities with undeveloped traffic systems, the most effective measure to achieve urban low-carbon traffic is to increase the comprehensive costs of high-carbon travel. However, in big cities with developed traffic systems, raising low-carbon awareness of residents can greatly increase the proportion of low-carbon travelers and improve the stability of travel mode choice. The results could provide development strategies and policy suggestions for urban low-carbon traffic and reduce the adverse impact of urban traffic emissions on public health.

Description: Plant tissue culture has led to breakthroughs in understanding and applying the fundamental knowledge towards harnessing more from plants. Microbial contamination is one of the serious problems limiting the successful extrapolation of plant tissue culture practices. Sources of in vitro contamination include culture containers, media, explants, equipment, the environment of the culture room and transfer area, and operating personnel. The successful initiation of in vitro culture mostly depends on surface sterilization of explants because this is the primary source. Usually, surface sterilization is done using chemicals, or toxic nanomaterials, this is the first time such an approach has been demonstrated. Numerous surface microflora attached to plant surfaces grow faster than the cultured explants and release phytotoxic substances into the culture media, hindering positive outcomes. In the current work, for the first time, the applicability of turmeric and benzoin resin-based fumigation of explants is demonstrated. The results showed that fumigation methods for surface sterilization were promising and could lead to fifty and even 100% contamination-free plant tissue culture. Nanoparticulate carbon was identified in the turmeric and benzoin smoke and coined the key player in the surface sterilization effect. These studies open a whole new avenue for the use of fumigation-based methods for riddance of microbial contamination.

Description: The coordinated development of the economy, resources, and environment is a key aspect of sustainable development. China’s rapid agricultural modernization has been accompanied by the continuous growth of rural economic aggregate and carbon emissions from the planting industry. However, the quantitative relationship between these two factors and its internal mechanism are not yet fully understood. In this paper, the Intergovernmental Panel on Climate Change (IPCC) method is used to calculate the carbon emissions of the planting industry in China from 1998–2019. Based on this, the Tapio decoupling analysis model was constructed to study the decoupling relationship between economic development and carbon emissions of the planting industry in China from 1998–2019 and the associated spatial and temporal evolution patterns. The effect of the complete decomposition model (without residuals), in terms of carbon emissions from the planting industry, on the process of economic development and its transmission mechanism are introduced. The results show that: (1) The carbon emissions of the planting industry in China increased with the economic development occurring from 1998–2005, where agricultural economic development was highly dependent on resource factors and the environment. The growth trend of carbon emissions of the planting industry slowed from 2006 to 2019, while economic development has gradually realized the decoupling of carbon emissions from the planting industry. (2) From 1998–2019, in Heilongjiang, Sichuan, and Hunan, the economic development was given priority, showing strong and negative decoupling with carbon emissions from farming. The economic development in most regions were given priority, showing strong decoupling with carbon emissions from farming. Up to 2019, decoupling was observed with a significant trend of spatial agglomeration. (3) Economic scale effects had a positive influence on the carbon emissions of the planting industry, while the technology effect and population effect had an inhibiting influence on the carbon emissions of the planting industry. The key policy implication of this paper is that improvement of the quality of economic development serves as the premise for the transformation of the economic development mode. It is necessary to reasonably regulate the economic growth rate and expansion scale, reduce resource consumption and pollutant emission technology, and to make full use of resources, in order to provide a basis for the formulation of reasonable emission reduction policies. An effective way to realize the sustainable development of the agricultural economy would be to improve the technical efficiency, control the population scale appropriately, and optimize the agricultural industrial structure.

Description: Business organisations are subject to high pressure to ensure their sustainability and competitiveness. In the case of healthcare institutions, moreover, there are unique characteristics where human resource management is of vital importance. The workforce in these institutions is at a critical moment where the shortages of qualified staff, burnout, or job dissatisfaction represent some of the detrimental aspects for the performance of the organisation, and more importantly, they diminish the quality of patient care. The promotion of organisational commitment is positioned as one of the tools that organisations have to face this problem. This paper aims to increase knowledge about research trends that analyse organisational commitment in healthcare institutions. To this end, using bibliometric techniques, a sample of 448 publications on this subject from journals indexed in Web of Science between 1992 and 2020 is analysed. The results obtained suggest a growing interest in this subject and a visible concern for the management of human resources in these institutions. Research has focussed mainly on organisational factors related to nursing staff. The most analysed topics have been job satisfaction, the implications of stress and high turnover, burnout syndrome, and the possibility of leaving the job. On the other hand, issues emerged such as empowerment in the workplace and others related to organisational management such as quality of service or performance. Finally, there is a lack of research that deals more deeply with other groups working in health centres, such as doctors or administrative staff. There is also a need for further development in the analysis of the implications of the ideological psychological contract in relation to normative organisational commitment in the field of healthcare organisations. The contribution of this work focusses on expanding knowledge about commitment in healthcare organisations and creating points of support for future research as well as helping healthcare managers make decisions in HR management.

Description: As the novel coronavirus disease (COVID-19) spreads worldwide, quarantine guidelines are being constantly updating to prevent the transmission of this virus. Regardless of which country international students live in, they might receive limited crucial quarantine guidelines from that country’s government. The purpose of this study was to identify factors influencing the preventive practice of international students in South Korea during the COVID-19 pandemic. This was a cross-sectional descriptive study. Data were collected from international students in three universities from July 10 to July 31 in 2020. A total of 261 international students participated in the survey, using an online questionnaire. Data were analyzed by independent t-test, one-way ANOVA, Pearson correlation coefficients, and multiple regression analysis. Preventive practice during the COVID-19 pandemic was affected by duration of stay in Korea (β = −0.21, p 〈 0.001), attitudes (β = 0.22, p = 0.001), and trust in Korea’s quarantine system (β = 0.33, p 〈 0.001). This study showed that attitudes and trust in the quarantine system could affect personal preventive practice during the outbreak of a highly contagious disease such as COVID-19.

Description: Inflammatory bowel diseases (IBD), such as Crohn’s disease and ulcerative colitis, are multifactorial inflammatory disorders of the gastrointestinal tract, characterised by abdominal cramps, bloody diarrhoea, and anaemia. Standard therapies, including corticosteroids or biologicals, often induce severe side effects, or patients may develop resistance to those therapies. Thus, new therapeutic options for IBD are urgently needed. This study investigates the therapeutic efficacy and safety of two plant-derived ligands of the aryl hydrocarbon receptor (AhR), quercetin (Q), and indol-3-carbinol (I3C), using a translationally relevant mouse model of IBD. Q and I3C are administered by gavage to C57BL/6 wild-type or C57BL/6 Ahr-/- mice suffering from chronic colitis, induced by dextran sulphate sodium (DSS). The course of the disease, intestinal histopathological changes, and in-situ immunological phenotype are scored over 25 days. Our results show that both Q and I3C improved significantly clinical symptoms in moderate DSS colitis, which coincides with a significantly reduced histopathological score. Even in severe DSS colitis I3C, neither Q nor the therapy control 6-thioguanine (6-TG) can prevent a fatal outcome. Moreover, treatment with Q or I3C restored in part DSS-induced loss of epithelial integrity by induction of tight-junction proteins and reduced significantly gut inflammation, as demonstrated by colonoscopy, as well as by immunohistochemistry revealing lower numbers of neutrophils and macrophages. Moreover, the number of Th17 cells is significantly reduced, while the number of Treg cells is significantly increased by treatment with Q or I3C, as well as 6-TG. Q- or I3C-induced amelioration of colitis is not observed in Ahr-/- mice suggesting the requirement of AhR ligation and signalling. Based on the results of this study, plant-derived non-toxic AhR agonists can be considered promising therapeutics in IBD therapy in humans. However, they may differ in terms of efficacy; therefore, it is indispensable to study the dose-response relationship of each individual AhR agonist also with regard to potential adverse effects, since they may also exert AhR-independent effects.

Description: Introduction: Protein profiling allows the determination of the presence of proteins marking various stages of the disease, and differentiates between people at risk of various diseases. In type 1 diabetes, protein profiling had been previously used to find blood markers other than islet autoantibodies to indicate the pancreatic beta cell destruction process and to reflect the progression of type 1 diabetes mellitus (T1DM). However, T1DM is an auto-immune disease and its clinical presentation changes in time of its duration. The aim of the study: To find differences in protein profiles in patients with type 1 diabetes according to diabetes control (HbA1c 〉 7%) and with presence of diabetic complications or obesity. It may help to identify subgroups of patients who may need a better clinical supervision and individualized treatment. Material and methods: A group of 103 patients with auto-immunologically confirmed T1DM, and meeting the following inclusion criteria: Caucasian race, duration of diabetes 〉5 years, were used in the study. Criteria of exclusion: past or present cancer (treated with chemo-/radiotherapy), diseases of the liver (ALT 〉 3 × ULN) except for people with simple hepatic steatosis, chronic renal disease (eGFR 〈 30 mL/1.73 m2/min), and acute inflammation (CRP 〉 5 mg/dL). The study group was divided in terms of the presence of chronic complications, obesity, or poor metabolic control (HbA1c 〉 7%). Protein profiling was completed by using the MALDI-TOF MS (matrix-assisted laser desorption/ionization-time of flight mass spectrometry) analyzer. Results: Differentiating proteins were identified in all of the groups. The groups burdened with complications, obesity, and poor metabolic control were characterized by increased levels of fibrinogen, complement C4 and C3. Conclusion: The groups of type 1 diabetes patients burdened with complications, obesity, and poor metabolic control were characterized by increased levels of fibrinogen, complement C4 and C3. Further detailed studies are necessary to determine more subtle changes in the proteomic profile of patients with type 1 diabetes.

Description: Emotional intelligence plays a critical role in adolescence since it involves a change towards psychological, social, and sexual maturity; a stage in which the foundations of intimate social relationships are established. Emotional competences regulate the quality of these relationships in adolescence and can provide protection against or facilitate the use of violence within them. Based on the above, this study aims to analyze the relationship between emotional intelligence and violence exercised, received, and perceived by adolescents in dating relationships. A sample of 254 subjects (43.1% men and 56, 9% women) between 12 and 18 years old was analyzed through the Emotional Intelligence Questionnaires of BarOn ICE:NA and Violence Exercised Perceived and Received by Adolescents VERA. The results of the research have shown that there is a significant and inverse relation between the dimensions of emotional intelligence and the violence exercised by adolescents in their dating relationships, and a positive and significant relation between emotional intelligence and the perception of violent behavior. For this reason, the importance of educating people about emotional intelligence from childhood within both the academic and family sphere is highlighted. This is fundamental to preventing the appearance of such violent behaviors and promoting an adequate adaptation to the environment.

Description: Long-term care coverage is not integrated into an individual’s retirement strategy. It is an additional public health service that is not considered into private pension funds. Nevertheless, this coverage is not sufficient due to the problems of financial sustainability of the public pension systems. However, there are large sums in pension plans dedicated to paying retirement pensions that can be transformed into support for long-term care coverage. This paper develops a mechanism of pension transformation through the different mortality of the beneficiary when becoming a dependent beneficiary. This mechanism allows the beneficiary to convert their pension to LTC support at their own choice, without increasing the cost of the private pension scheme. The proposed model provides consistency in the pension that a retiree receives and adapts it to a retiree’s life expectancy: the retiree receives a higher pension when he/she needs it most.

Description: Previous studies have highlighted the potential health effects of phthalate exposure, such as atopic dermatitis and asthma. However, evidence supporting the association between phthalate exposure and atopic dermatitis is limited and based on data collected from Western populations. This study aimed to analyze the association between phthalate exposure and atopic dermatitis in Korean adolescents aged 12–17 years using a nationally representative dataset. We conducted a cross-sectional study using a publicly available dataset from the third Korean National Environmental Health Survey (n = 797). We divided the study participants into four quartiles according to urinary phthalate metabolite concentrations. The odds ratio of having atopic dermatitis was calculated using the first quartile as the reference group in binary logistic regression. We found that in the logistic regression model, both the urinary Mono-(2-ethyl-5-carboxypentyl) phthalate (MECCP; OR: 1.81; CI: 1.01–3.25) and Mono-benzyl phthalate (MBzP; OR: 1.81; CI: 1.01–3.25) concentrations in the highest quartile were positively associated with atopic dermatitis. The atopic dermatitis group had a significantly higher mean urinary MECCP and MBzP concentration. In the future, longitudinal studies involving repeated measurements are warranted to analyze the long-term effects of phthalate.

Description: The objective of this study was to assess the soil pollution on an industrial wasteland, where coal-tar was processed in the period between 1880 and 1997, and subsequent to assess the decline in the content of phenols and polycyclic aromatic hydrocarbons (PAHs) during enhanced natural attenuation. The soil of the investigated area was formed from a layer of uncompacted fill. Twelve sampling points were established in the investigated area for collecting soil samples. A study conducted in 2015 did not reveal any increase in the content of heavy metals, monoaromatic hydrocarbons (BTEX), and cyanides. However, the content of PAHs and phenols was higher than the content permitted by Polish norms in force until 2016. In the case of PAHs, it was observed for individual compounds and their total contents. Among the various methods, enhanced natural attenuation was chosen for the remediation of investigated area. Repeated analyses of the contents of phenols and PAHs were conducted in 2020. The results of the analyses showed that enhanced natural attenuation has led to efficient degradation of the simplest substances—phenol and naphthalene. The content of these compounds in 2020 was not elevated compared to the standards for industrial wastelands. The three- and four-ring hydrocarbons were degraded at a lower intensity. Based on the mean decrease in content after 5-year enhanced natural attenuation, the compounds can be arranged in the following order: phenols 〉 naphthalene 〉 phenanthrene 〉 fluoranthene 〉 benzo(a)anthracene 〉 chrysene 〉 anthracene.

Description: The formation of the water rights trading price is an important part of the water rights trading system. In order to continuously and dynamically reflect the social–economic development changes and water resource scarcity, herein, we discuss the dynamic adjustment of the water rights trading price from the perspective of water resource scarcity value analysis. First, we constructed the water resource scarcity evaluation index system from the four dimensions of the water resource natural endowment, the water resource supply, the water resource demand, and the water environment, and then we constructed the water resource scarcity index calculation model of the transferor, the transferee, and the comprehensive water resource scarcity index calculation model of both parties of the trading. Second, by analyzing the 30 comparable water rights trading cases in China since 2016, we established the response function of the water rights trading price to the water resource scarcity index, and then we analyzed the impact mechanism of the water resource scarcity index on the water rights trading price. Third, based on the two factors of “the water resource scarcity value” and “the capital time value,” we constructed a dynamic price adjustment model of water rights trading for different adjustment factors, so as to adjust the water rights trading price scientifically. Finally, we took the water rights trading in Helan County (Helan) of Ningxia Hui Autonomous Region (Ningxia) as an example. The research shows that: (1) During the trading period of water rights in Helan, the water resource scarcity index rises, and the water rights trading price should be increased year-by-year. Additionally, there are certain differences in the water rights trading price changes with the adjustment of different elements. Among them, considering the adjustment of “the water resource scarcity value” element, the water rights trading price of Helan should be increased from 1.0940 to 2.8574 CNY/m³ during the water rights trading period; (2) there are differences in the water rights trading cost under different payment modes, among which the annual payment mode increased the most, i.e., from 2.7350 × 108 to 7.4500 × 108 CNY. This study suggests exerting a regulating effect of the water scarcity value on the water rights trading price, so as to promote the construction of a more equitable and long-term water rights trading market.

Description: Research on crisis management focuses on pre-planning for disasters in order to understand potential barriers. However, one significant barrier to crisis response is that organizations may come together in unplanned configurations during crisis response. This means that significant opportunities exist for understanding the process by which individuals learn, collaborate, and create new systems during crises. In this case report, we present the case of face shield production by a university, academic medical center, and community partners during the supply chain collapse of the early COVID-19 pandemic with the aim of identifying the relationships that formed during the COVID-19 response, so that this case of relationship formation and participant experiences might inform similar disaster response challenges in the future. Thirteen participants responded to an in-depth questionnaire designed to simulate an asynchronous in-depth interview. Respondents reported on the activities of 80 individuals from 38 units/organizations, providing insight into communication challenges and resolutions. Responses were analyzed using thematic analysis, highlighting roles and relationships among participants. The findings grant insight into the experience of learning from crisis response efforts, responding to recent calls for social scientific work on COVID-19 responses.

Description: The Israel National Sera Bank (INSB) was established in 1997 in the Israel Center for Disease Control. The purpose of the INSB was to provide policymakers with data on the immunity status of the Israeli population against vaccine-preventable diseases, and on the extent and characteristics of exposure to emerging and re-emerging infectious diseases. The aim of this paper is to describe the methods, representativeness, and challenges in maintaining the INSB. The INSB comprises residual sera collected in six laboratories. By the end of 2019, 138,898 samples had been deposited in the INSB. These include samples from four community laboratories: 30.7% from the National Blood Service, 22.2% from Haifa and the Western Galilee, 21.7% from Soroka, and 0.7% from Jerusalem; and from two medical center laboratories: 18.6% from Schneider and 6.1% from Mayanei Hayeshua. The demographic characteristics of the sample at the end of 2019 closely resembled those of the general population. The main challenges addressed in maintaining the INSB relate to its representativeness, the possibility of repeated donors, costs, stability of antibody levels after long-term storage, ethical aspects, and the data available for each sample. The INSB is a unique, powerful, and necessary tool for assessing population immunity levels, based on serum samples collected over a long period of time.

Description: Background: Dental health is an important factor in daily life routines and is closely associated with maintaining a health-related quality of life. This study examined denture procedure changes after implementation of the National Health Insurance (NHI) Coverage of Dentures for the elderly. Methods: We used the “Korean Community Health Survey (KCHS)” developed by the Korea Centers for Diseases Control and Prevention. We analyzed the association between policy implementation and dental health-related outcomes using difference-in-differences (DID) analysis to compare patients aged ≥75 with those 65–74 years before and after coverage. Results: A comparison of age groups and coverage periods showed that patients aged ≥75 years had higher (OR: 1.038, 95% CI: 1.021–1.055) procedure rates after coverage. In particular, elderly patients on medical aid had significantly higher denture procedure rates, while those without oral health screening were more likely to have denture procedures. Conclusions: This study determined the impact of the NHI Coverage of Denture procedure policy for the elderly and found increased denture treatments in the elderly. This policy appeared to positively affect older patients by increasing denture procedures for low-income and medical aid beneficiaries. Hence, the government needs to increase oral health examination and dental health policies for the elderly.

Description: The authors wish to correct the following erratum in this paper [...]

Description: Aims: The purpose of this study is to analyze the effect of the perceived coercion of people with mental illness living in a community on their therapeutic satisfaction and life satisfaction, mediated by therapeutic relationships. Methods: We evaluated several clinical variables (symptoms, psychosocial functioning, and insight), levels of perceived coercion, therapeutic relationships, therapeutic satisfaction, and life satisfaction in 185 people with mental illness (Mean age = 47.99, standard deviation (SD) = 12.72, male 53.0%, female 45.9%) who live in the community and use community-based mental health programs. The data collected were analyzed to test the proposed hypotheses using structural equation modeling (SEM). Results: The correlation analysis of all variables showed that clinical variables had statistically significant correlations with therapeutic relationship, therapeutic satisfaction, and life satisfaction, but no significant correlation with perceived coercion. Furthermore, perceived coercion was found to have significant predictive power for treatment satisfaction and life satisfaction mediated by therapeutic relationship. Specifically, the lower the perceived coercion, the better the therapeutic relationship. This, in turn, has a positive effect on the therapeutic satisfaction and life satisfaction of participants. Conclusion: Based on these findings, we suggest strategies to minimize coercion in a community.

Description: Heavy load carrying of water, firewood, and sand/stones is a ubiquitous activity for women living in developing countries. Although the intra-abdominal pressure associated with heavy load carrying is hypothesized to increase the risk of pelvic organ prolapse (POP) among women, relevant epidemiologic data are lacking. We conducted a comparative study involving two exploratory cross-sectional studies among convenience samples of women carrying heavy loads, with different characteristics: (1) as part of their activities for daily living, in Shinyanga region, Tanzania; and (2) working as sand miners in Pokhara, Nepal. Women were categorized has having “low” or “high” load-carrying exposures based on the measured weights of the loads being carried at the time of the survey, as well as on self-reported duration and frequency of load carrying. A summary score for lower abdominal discomfort suggestive of POP was generated using questions from the Pelvic Organ Prolapse Distress Inventory (POPDI-6). Women with higher load carrying exposures had on average higher discomfort scores in both Tanzania (adjusted prevalence difference (PDa) = 3.7; 95% CI: −3.8–11.3; p = 0.33) and Nepal (PDa = 9.3; 95% CI: −4.9–23.6; p = 0.18). We identified trends suggestive of an association between increasing heavy load carrying exposures and symptoms of lower abdominal discomfort. Our findings underscore the need for larger epidemiologic studies of the potential adverse reproductive health effects of heavy load carrying activities on women in developing countries.

Description: To examine the exercise-induced release of cardiac troponin T (cTnT) in adolescent and adult swimmers. Thirty-two trained male (18 adolescents, 14 adults) swam at maximal pace in a 45 min distance trial, and blood samples were drawn before, immediately and 3 h after exercise for subsequent cTnT analysis and comparison. Having comparable training experience and baseline values of cTnT (p = 0.78 and p = 0.13), adults exercised at lower absolute and relative intensity (p 〈 0.001 and p 〈 0.001, respectively), but presented higher immediate cTnT after exercise than adolescents (p 〈 0.001). Despite that, peak concentrations were observed at 3 h post exercise and peak elevations were comparable between groups (p = 0.074). Fourteen (44%) apparently healthy subjects exceeded the cutoff value for myocardial infarction (MI). Adolescents presented a delayed elevation of cTnT compared with adults, but achieved similar peak values.

Description: Background: The objective of this study is to determine the validity and reliability of the Caregiver Strain Index (CSI) for women during the postpartum period. Methods: This is a validation study of a measurement instrument. This study includes 212 women over the age of 19 who gave birth from March to September 2019 in Maternal and Child Hospital of Jaén (Spain). The items of the CSI were adapted for newborn care. Content validity was measured by five experts, calculating the index of agreement (Aiken’s V). Criterion validity was assessed by correlations with scores of other tools that measure constructs related to burden (Edinburgh Postpartum Depression Scale, State-Trait Anxiety Questionnaire, SOC-13 and Duke-UNC-11). Construct validity was determined by the known-groups method. Internal consistency was measured using Cronbach’s Alpha, and stability was analysed using the intraclass correlation coefficient (ICC). Results: Regarding content validity, an Aiken’s V of 1.00 (p = 0.032) was obtained. Regarding criterion validity, the correlation analyses showed statistically significant coefficients between the scores of the questionnaire and those of the sense of coherence (r = −0.447, p 〈 0.001), depressive symptoms (r = 0.429, p 〈 0.001), social support (rho = −0.379, p 〈 0.001) and anxiety symptoms (r = 0.532, p 〈 0.001). The known-groups method showed statistically significant differences in the mean of subjective burden between the groups (depressive symptoms, anxiety symptoms, sense of coherence and social support). The total scale obtained a Cronbach’s alpha value of 0.710. The ICC was 0.979. Conclusions: The adapted CSI is a valid and reliable screening tool for the subjective burden in women during the puerperium. The adapted CSI can play an important role as a guide to detect the subjective burden in women during the puerperium.

Description: As the Internet evolves in urban communities, its consequences on mental distress have drawn significant research attention. We examine the relationships of mental distress with neighborhood environment and Internet use among older adults, using data from a representative sample of 2036 adults aged older than 60 years in Shanghai, China. We assess mental health with a 10-item scale from the Symptom Checklist 90 and Internet use with a 4-item scale and obtain information of neighborhood environment from an online map platform. Results from multilevel models show that both neighborhood environment and Internet use are significantly related to mental distress. Moreover, a worse neighborhood environment may strengthen the correlation between Internet use and mental distress, indicating the strong moderating role of the neighborhood environment. Thus, promoting Internet use among elderly people might result in a reduction in the prevalence of mental distress in disadvantaged neighborhoods.

Description: Studies have examined the impact of social determinants of health on the health behaviors and health statuses of ethnic minority adolescents. This study examines the subjective health of this population by examining the direct effects of multicultural adolescents’ subjective socioeconomic status (SES) and the sequential mediating effects of their dietary behaviors and perceived stress. We utilized secondary data of 500 middle school students from multicultural families who participated in the 15th Korean Youth Health Behavior Survey, 2019. Information about SES, perceived stress, subjective health status, and dietary behavior (measured by the breakfast intake frequency during the prior week) were utilized. For the relationship between the SES and the subjective health status, we confirmed the sequential mediating effects of breakfast frequency and perceived stress using SPSS 25.0 and PROCESS macro with bootstrapping. The results showed that SES had a direct effect on subjective health status and indirectly influenced subjective health status through the sequential mediating effect of breakfast frequency and perceived stress. However, SES had no direct effects on perceived stress. These findings emphasize that broadening the community-health lens to consider the upstream factor of SES when preparing health promotion interventions is essential to achieving health equity for vulnerable populations.

Description: Studies to date that have focused on the well-being of the athlete have been based on the hedonic point of view. However, there is a second point of view: eudemonia. Therefore, the present study aims to validate and adapt the Eudemonic Well-Being Scale to the sport context. The study involved 2487 from several sport clubs. Several confirmatory factor analyses were carried out and showed that the six-factor questionnaire was the one with the best fit indices. These results show that the scale is in relation to the original scale (from Spain) and to Waterman’s theoretical model.

Description: (1) Polybrominated diphenyl ethers (PBDEs) were widely produced in the United States until 2004 but remain highly persistent in the environment. The potential for PBDEs to disrupt normal neuroendocrine pathways resulting in depression and other neurological symptoms is largely understudied. This study examined whether PBDE exposure in pregnant women was associated with antenatal depressive symptomatology. (2) Data were collected from 193 African American pregnant women at 8–14 weeks gestation. Serum PBDEs and depressive symptoms were analyzed and a mixture effect was calculated. (3) Urban pregnant African American women in the Southeastern United States had a high risk of depression (27%) compared to the National average. Increased levels of PBDEs were found. BDE-47 and -99 exposures are significantly associated with depressive symptomatology in the pregnant cohort. The weighted body burden estimate of the PBDE mixture was associated with a higher risk of mild to moderate depression using an Edinburgh Depression Scale cutoff score of ≥10 (OR = 2.93; CI 1.18, 7.82). (4) Since antenatal depression may worsen in postpartum, reducing PBDE exposure may have significant clinical implications.

Description: Background: Liver Imaging Reporting and Data Systems (LI-RADS) Treatment Response Algorithm (TRA) was created to provide a standardized assessment of hepatocellular carcinoma (HCC) following loco regional therapy. The aim of this study was to compare sensitivity of standard MRI protocol versus abbreviated protocol (only T1-Weigthed fat suppressed (FS) sequences pre- and post-contrast phase) in the detection of ablated area according to LI-RADS Treatment Response (LR-TR) categories. Methods: From January 2015 to June 2020, we selected 64 patients with HCC, who underwent Radiofrequency ablation (RFA) or Microwave ablation (MWA) treatment. According to inclusion criteria, 136 pathologically proven treated HCC (median 2, range 1–3 per patient; mean size 20.0 mm; range 15–30 mm) in 58 patients (26 women, 32 men; median age, 74 years; range, 62–83 years) comprised our study population. For each ablated area, abbreviated protocol, and standard Magnetic Resonance Imaging (MRI) studies were independently and blindly assessed in random order within and between three expert radiologists. Each radiologist assessed the ablated area by using the following categories: “LR-TR Non-viable” = 1; “LR-TR Equivocal” = 2 and “LR-TR Viable” = 0. Results: According to the concordance between MRI and Contrast enhancement ultrasound (CEUS) among 136 treated HCCs, 115 lesions were assessed as non-viable or totally ablate and 21 as viable or partially ablate. The accuracy for standard MRI protocol and abbreviated MRI protocol for predicting pathologic tumor viability of a consensus reading was 98.6% (sensitivity = 100%; specificity = 98.3%; positive predictive value = 91.3% and negative predictive value = 100%). No differences were found in sensitivity or specificity between standard MRI LR-TR viable and abbreviated MRI LR-TR viable categories (p value 〉 0.05 at McNemar test). Conclusion: The abbreviated dynamic protocol showed similar diagnostic accuracy to conventional MRI study in the assessment of treated HCCs, with a reduction of the acquisition study time of 30% respect to conventional MRI.

Description: Background: Acute Lymphoblastic Leukemia (ALL) is the most common pediatric cancer. ALL and its treatment cause altered bone-mineral homeostasis, which can contribute to musculoskeletal late adverse effects (LAEs). With the increasing number of childhood cancer survivors, LAEs are reported often, and are aggravated by inactive lifestyles. A telerehabilitation program is proposed to strengthen the muscle–bone complex and prevent future impairment. Objective: This study aimed to explore and better understand patient and parent experience of a telerehabilitation program after completion of ALL treatment. Methods: ALL survivors (n = 12), 75% girls, 7.9 to 14.7 years old, within six months to five years of treatment, were recruited to participate in the proposed study, along with a parent. The 16-week group program included 40 potential home-based physical activities, with monthly progression, supervised by a kinesiologist, through an online telerehabilitation platform. Patients could be included in the study if they joined during the first month of intervention of their group (minimum 12 weeks of intervention). A semi-structured post-intervention interview was conducted with the patients and their parent during the final assessment, along with a review of the kinesiologist’s clinical notes, to obtain a portrait of the participants’ experience with the telerehabilitation program. Overarching themes were identified by one author and confirmed by two senior authors before extracting the various aspects of each theme. Results: Of the 12 patients recruited, three were excluded from the analysis because they did not complete the minimum 12 weeks of intervention (one = relapse, one = failure to meet technical requirements, and one = abandoned due to parent’s disinterest). The nine patients who completed the program (six girls; 10.93 ± 2.83 years) had a mean adherence of 89%. The overarching themes identified were the program modalities (group approach with patient–parent paired training, supervised by a kinesiologist), the telerehabilitation system, the participants’ perception of the benefits, and recommendations and suggestions from the families. Both patients and parents expressed very high satisfaction with the program and perceived benefits. Conclusion: Participants appreciated the program and reported they would all recommend it to other families in similar situations. The telerehabilitation method of service delivery was perceived by some as decisive in choosing to participate, while the supervision and intra- and inter-family interactions were the motivating factors that were key to program adherence.

Description: Limited information is available on the morphological characteristics of adult female footballers, therefore the aim of this article was to examine if there are position-specific differences in the morphological characteristics of sub-elite female football players and to establish normative standards for this level of female football players. The morphological features of 101 sub-elite female football players (age: 21.8 ± 2.7 years) were assessed. Twenty anthropometric sites were measured for body composition and somatotype. The average value of body fat percentage was 20.8 ± 5.7%. The somatotype of the overall group was 4.0–2.4–2.1. Significant (p ≤ 0.05) differences were found between goalkeepers and outfield players in morphological characteristics. Goalkeepers were taller (166.2 ± 8.4 cm), heavier (66.5 ± 5.1 kg), possessed the highest body fat percentage (17.2 ± 6.2%) and showed higher values for all skinfold (sum of 6 skinfolds = 125.6 ± 45.9 cm), breadth, girth and length measurements. However, there were very few practically worthwhile differences between the outfield positions. Positional groups did not differ (p ≤ 0.05) in somatotype characteristics either. The study suggests that at sub-elite level there are mainly differences between goalkeepers and outfield players, but outfield players are homogeneous when comparing morphological characteristics. These results may serve as normative values for future comparisons regarding the morphological characteristics of female football players.

Description: Outdoor play and independent, neighborhood activity, both linked with healthy childhood development, have declined dramatically among Western children in recent decades. This study examines how social, cultural and environmental factors may be hindering children’s outdoor and community-based play. A comprehensive survey was completed by 826 children (aged 10–13 years) and their parents from 12 schools (four each urban, suburban and rural) from a large county in Ontario, Canada. Five multilevel regression models, controlling for any school clustering effect, examined associations between outdoor play time per week and variable sets representing five prevalent factors cited in the literature as influencing children’s outdoor play (OP). Models predicted that younger children and boys were more likely to spend time playing outdoors; involvement in organized physical activities, other children nearby to play with, higher perception of benefits of outdoor play, and higher parental perceptions of neighborhood social cohesion also predicted more time in outdoor play. Time outdoors was less likely among children not allowed to play beyond home without supervision, felt they were ‘too busy’ with screen-based activities, and who reported higher fears related to playing outdoors. Study findings have important implications for targeting environmental, cultural and policy changes to foster child-friendly communities which effectively support healthy outdoor play.

Description: Objective: The aim of the study was to analyze the feet of rheumatoid arthritis (RA) patients, to determine the degree to which both feet were affected, primarily analyzing the severity of RA in both feet looking at structure and morphology, and secondly looking at the symmetry in terms of the anthropometrics and posture. Method: This cross-sectional study was conducted from January to December 2018. The data from 229 patients with RA and with foot pain and no RA recruited (Granada, Spain) were analyzed. Two researchers independently interviewed the patients to obtain the study data. The clinical data were obtained using specific foot health and quality of life questionnaires and a validated platform for foot measurement. Anthropometric measurements were obtained by means of a foot measurement platform and the Foot Posture Index (FPI). The bivariate analysis was performed with the Student’s t test and the non-parametric Wilcoxon test. The level of significance was established at p 〈 0.05. Results: In the RA group, anthropometric measurements revealed significant differences between the left and right feet in 13 of the 23 parameters considered, as follows: (non-load-bearing) foot length, length of the first metatarsophalangeal joint, maximum height of the internal longitudinal arch, and width of the midfoot (p 〈 0.001, p = 0.038, p 〈 0.001, and p = 0.037 respectively); and Foot Posture Index (p = 0.001). Conclusions: In patients with RA, statistically significant differences were found in the Foot Posture Index and in several parameters related to foot structure and morphology. From this, we conclude that from a morphological, structural, and postural standpoint, a pattern of symmetric joint involvement should not be viewed as a specific criterion for RA in the foot.

Description: The 2020 summer Olympic and Paralympic Games in Tokyo were postponed to July–September 2021 due to the coronavirus disease 2019 (COVID-19) pandemic. While COVID-19 has emerged as a monumental health threat for mass gathering events, heat illness must be acknowledged as a potentially large health threat for maintaining health services. We examined the number of COVID-19 admissions and the Tokyo rule for emergency medical care, in Tokyo, from March to September 2020, and investigated the weekly number of emergency transportations due to heat illness and weekly averages of the daily maximum Wet Bulb Globe Temperature (WBGT) in Tokyo in the summer (2016–2020). The peak of emergency transportations due to heat illness overlapped the resurgence of COVID-19 in 2020, and an increase of heat illness patients and WBGT has been observed. Respect for robust science is critical for the decision-making process of mass gathering events during the pandemic, and science-based countermeasures and implementations for COVID-19 will be warranted. Without urgent reconsiderations and sufficient countermeasures, the double burden of COVID-19 and heat-related illnesses in Tokyo will overwhelm the healthcare provision system, and maintaining essential health services will be challenging during the 2021 summer Olympic and Paralympic Games.

Description: Health inequalities are differences in health experiences and outcomes which arise through the everyday circumstances of people’s lives and the appropriateness of the systems put in place to support them [...]

Description: Recently, with the onset of the COVID-19 pandemic, several lockdown and stay-at-home regulations have been implemented worldwide. In this regard, loneliness has been identified as the signature mental health consequence of this pandemic. The aim of this study is to explore the associations among loneliness, hopelessness, depression, ego-resilience and life satisfaction in a random sample of young adults (N = 337) at a university in the Western Cape of South Africa. Parallel and serial mediation analysis supported the hypothesis that loneliness is associated with hopelessness, which in turn is associated with depression, and that ego-resilience mediates the association between all the negative indices of psychological well-being and life satisfaction. These findings suggest that mental health interventions that boost ego-resilience and target loneliness may help in dealing with the mental health consequences of COVID-19.

Description: Lockdowns during the COVID-19 pandemic increase the risk of social isolation and loneliness, which may affect mental wellbeing. Therefore, we aimed to investigate associations between social isolation and loneliness with depressive symptoms in the German old-age population during the first COVID-19 lockdown. A representative sample of randomly selected individuals at least 65 years old (n = 1005) participated in a computer-assisted standardized telephone interview in April 2020. Sociodemographic data, aspects of the personal life situation, attitudes towards COVID-19 and standardized screening measures on loneliness (UCLA 3-item loneliness scale), depression (Brief Symptom Inventory/BSI-18), and resilience (Brief Resilience Scale/BRS) were assessed. Associations were inspected using multivariate regression models. Being lonely, but not isolated (β = 0.276; p 〈 0.001) and being both isolated and lonely (β = 0.136; p 〈 0.001) were associated with higher depressive symptoms. Being isolated, but not lonely was not associated with depressive symptoms. Thus, the subjective emotional evaluation, i.e., feeling lonely, of the social situation during lockdown seems more relevant than the objective state, i.e., being isolated. Normal (β = −0.203; p 〈 0.001) and high resilience (β = −0.308; p 〈 0.001) were associated with lower depressive symptoms across groups. Therefore, strengthening coping skills may be a support strategy during lockdowns, especially for lonely older individuals.

Description: Risk assessment is a legal obligation for all companies in most countries worldwide. It aims to control the quality of working conditions and avoid externalizing the consequences of accidents and resulting costs to society. This work discusses the need for an adequate interpretation of the zero-risk concept from a technical-preventive perspective to assess occupational risks in construction sites. A critical analysis of several risk assessment methodologies was carried out, focusing on the evaluation criteria of little or no-risk situations. The verification of the results was made through a case study. The perception of health and safety risks by workers is very different from that of the evaluators. Often, when workers identify a situation as low-risk or even zero-risk, the evaluator assesses the same context as maximum risk. Given the workers’ and the evaluators’ responses, the Preventive Action Method establishes a new parameter, the Environment Congruence. This parameter is based on the perception of the preventive environment and gives more importance to the evaluators’ decision. When preventive action is optimal, the risk is low in all preventive observation settings. In conclusion, this study justifies the non-nullity of the risk and the difficulty of assessing zero-risk in construction sites. Therefore, evaluations with qualitative and quantitative non-risk approaches should be discarded.

Description: The MERS-CoV spread in South Korea in 2015 was not only the largest outbreak of MERS-CoV in the region other than the Middle East but also a historic epidemic in South Korea. Thus, investigation of the MERS-CoV transmission dynamics, especially by agent-based modeling, would be meaningful for devising intervention strategies for novel infectious diseases. In this study, an agent-based model on MERS-CoV transmission in South Korea in 2015 was built and analyzed. The prominent characteristic of this model was that it built the simulation environment based on the real-world contact tracing network, which can be characterized as being scale-free. In the simulations, we explored the effectiveness of three possible intervention scenarios; mass quarantine, isolation, and isolation combined with acquaintance quarantine. The differences in MERS-CoV transmission dynamics by the number of links of the index case agent were examined. The simulation results indicate that isolation combined with acquaintance quarantine is more effective than others, and they also suggest the key role of super-spreaders in MERS-CoV transmission.

Description: Some population groups could be especially vulnerable to the effects of population ageing. The Global Activity Limitation Indicator (GALI) has been proposed as a measure of disability, but it has not been used in minority groups. The aim of this study is to estimate the prevalence of disability using the GALI and to analyse its determinants in immigrant and Roma populations. Data from the Spanish National Health Survey 2017 and the National Health Survey of the Roma Population 2014 were used, including adults aged 50 and above. Prevalence of disability was estimated, and odds ratios were calculated using logistic regression models to assess the association between disability and demographic, socioeconomic, and health variables. The prevalence of disability was estimated at 39.4%, 30.6%, and 58.7% in the native, immigrant, and Roma populations, respectively. Gender was a common determinant for the native and Roma populations. On the other hand, among immigrants, the risk of disability increased over the time residing in Spain. There were significant interactions with age and gender in the native population. Disability has different determinants in the three population groups. Public health measures to protect the Roma population and immigrants’ health should be considered.

Description: Affective disorders promote poorer outcomes in hemodialysis patients. According to the presence or not of depression/anxiety in these patients, aims were to analyze differences in sociodemographic, clinical and/or psychological factors and to identify predictors. One hundred eighty-six hemodialysis patients were classified based on their depression/anxiety status. Basal characteristics showed differences between groups where mainly male sex (Depression: OR 0.2; Anxiety: OR 0.3) albumin (Depression: OR 0.1; Anxiety: OR 0.2) and calcium levels (Depression: OR 0.5; Anxiety: OR 0.4), impaired quality of life (Depression: OR 1.4; Anxiety: OR 1.2) and psychological inflexibility (Depression: OR 1.3; Anxiety: OR 1.2) were associated (all p 〈 0.01) to these mental conditions. Multivariate models showed that worse quality of life (OR 1.3; p 〈 0.001) predicted depression while marital status (with a partner; OR 0.3; p = 0.025) and albumin levels (OR 0.1; p = 0.027) were protective factors. Depression represented a risk factor for anxiety (OR 1.2; p = 0.001), although calcium levels (OR 0.5; p = 0.039) would protect this state. Interestingly, psychological inflexibility predicted both disorders (Depression: OR 1.2, p 〈 0.001 and Anxiety: OR 1.1; p = 0.002). Results highlight the relevance of well-trained multidisciplinary hemodialysis units to control the influence of these factors on the presence of depression/anxiety, and thus, their impact on the patients’ outcomes.

Description: Knowledge of physical activity (PA) can be considered a predictor of public health for society. Thus, this study aims to show content validity of the “Knowledge Questionnaire on World Health Organization (WHO) Recommendations on PA and Health” (CUAFYS-A) and reference values on adults’ knowledge of the WHO recommendations on PA. This is a quantitative, non-experimental, descriptive, and cross-sectional study, in which 579 adults completed an online questionnaire with demographic data. The questionnaire was made up of 9 items to measure PA related to knowledge. For the elaboration of the items of the questionnaire a disciplinary team formed it and for the analysis of results, a descriptive analysis of these was applied. Then an inferential analysis was performed, content validity, construct validity, and reliability were analyzed. The CUAFYS-A after its content analysis, obtained appropriate results in terms of pertinence and relevance; additionally, it showed Cronbach’s alpha coefficient of 0.62. Thereby, it was concluded the CUAFYS-A questionnaire proved to be a valid and reliable instrument to show reference values and to evaluate the knowledge of adults of PA and health according to the WHO recommendations.

Description: Presenteeism not only poses an economic cost to organizations but also generates reduced work efficiency and quality. The purpose of this study was to examine the connections between occupational stress, public service motivation (PSM), health, and presenteeism. A total of 981 nurses from 109 public hospitals in Jilin Province in China were enrolled in our study. Model 5 in the PROCESS micro was employed in order to verify the mediating effect of PSM and the moderating effect of nurses’ health on the relationship between occupational stress and presenteeism, and simple slope analysis was used to further determine the moderating effect. Both challenge stress and hindrance stress had a positive impact on presenteeism among nurses. PSM is a mediating variable between occupational stress and presenteeism. Health moderates the path between challenge stress and presenteeism, with the association being significant for nurses with low levels of health. Future policy making should focus on preventing presenteeism by reducing excessive stress, enhancing PSM, and improving nurse health and wellness.