ALBERT

Beschreibung: The aim of this study was to analyze the effects of a 24 week exergame intervention and 24 weeks of detraining on lower-limb strength, agility, and cardiorespiratory fitness in women with fibromyalgia (FM). It was performed as a single-blinded randomized controlled trial of 55 women with FM. University facilities were used. The 24 week exergame intervention was focused on mobility, postural control, upper- and lower-limb coordination, aerobic fitness, and strength. Participants performed 120 min of exergaming per week, which was divided into two sessions. Twenty-four weeks after the end of the intervention, participants were re-evaluated. A chair–stand test, 10 step stair test, and six-minute walk test were conducted to assess lower-body strength, agility, and cardiorespiratory fitness, respectively. The exergame intervention significantly improved lower-limb strength and cardiorespiratory fitness. However, no significant effects on agility were observed. After the detraining period, lower-limb strength and agility returned to their baseline level, but improvements in cardiorespiratory fitness were sustained over time. Exergaming was therefore shown to be beneficial for physical fitness in people with FM. However, exergames had to be played regularly to maintain the benefits. This long-term intervention (24 weeks) may have changed the lifestyle of women with FM, which could explain why cardiorespiratory fitness improvements remained after the detraining period. Future research should focus on lifestyle changes after long-term interventions.

Beschreibung: Background: The American family structure has changed in the past few decades due to a rise in the divorce rate and unmarried women with children. Research suggests a salary disparity between men and women, especially for those women after pregnancy. However, these studies were confined to individuals within traditional families, and there is a lack of information of income disparity and poverty status between single mothers and fathers. The current study explored the disparities in single-parent families based on the household income and the poverty status using a set of nationwide censor data. Methods: The current study used data from the 2011 and 2013 Panel Study of Income Dynamics (N = 1135). Multivariate regression models were used in the analysis. Results: The demographic characteristics of the weighted population showed that taxable income, total income, and poverty status were higher for single fathers than mothers, while non-work income was higher for single mothers than fathers. Single mothers were much more likely to be at the crisis category than single fathers. Multivariate analyses showed that gender, age, marital status, years of experience, and geographic region had effects on taxable income, and only gender, marital status, and region had effects on poverty status. Conclusions: The results suggest that vulnerable group of single mothers was acknowledged according to income and poverty status. Age, marital status, years of experience, and region would be the critical factors for predicting the income and poverty status for single parenthood.

Beschreibung: Road traffic crashes (RTCs) are one of the most critical public health problems worldwide. The WHO Global Status Report on Road Safety suggests that the annual fatality rate (per 100,000 people) due to RTCs in the Kingdom of Saudi Arabia (KSA) has increased from 17.4 to 27.4 over the last decade, which is an alarming situation. This paper presents an overview of RTCs in the Eastern Province, KSA, from 2009 to 2016. Key descriptive statistics for spatial and temporal distribution of crashes are presented. Statistics from the present study suggest that the year 2012 witnessed the highest number of crashes, and that the region Al-Ahsa had a significantly higher proportion of total crashes. It was concluded that the fatality rate for the province was 25.6, and the mean accident to injury ratio was 8:4. These numbers are substantially higher compared to developed countries and the neighboring Gulf states. Spatial distribution of crashes indicated that a large proportion of severe crashes occurred outside the city centers along urban highways. Logistic regression models were developed to predict crash severity. Model estimation analysis revealed that crash severity can be attributed to several significant factors including driver attributes (such as sleep, distraction, overspeeding), crash characteristics (such as sudden deviation from the lane, or collisions with other moving vehicles, road fences, pedestrians, or motorcyclists), and rainy weather conditions. After critical analysis of existing safety and infrastructure situations, various suitable crash prevention and mitigation strategies, for example, traffic enforcement, traffic calming measures, safety education programs, and coordination of key stakeholders, have been proposed.

Beschreibung: Daily life in today’s dynamic world requires fast adaptation of people’s behavior to new challenges emerged from environmental, health, urban housing, transportation, etc. problems. A strong and complex tool in changing behaviors, education consumes significant resources and requires time for effective impact. The present study proposes a roadmap, integrating advanced methods for industrial competitive development (QFD) in configuring efficient educational interventions for changing people’s behavior on special thematic areas, such as environment and recycling. A literature review on applicable behavioral theories led to more than 30 behavioral factors (constructs) targetable by education, their specific impact evaluation being the subject of a survey among education professionals. Finally, to reach a mapping of efficient interventions with low costs, high impact and fast results criteria, educational interventions and behavioral factors were correlated by the QFD method on three dimensions addressing: teachers and trainers, contents and tools, respectively the national & institutional level. The current research results are focused particularly on changing recycling behaviors, but the overall concept and methodology can be expanded to incorporate any preoccupation in the areas of environment and health, as long-term drivers of public well-being.

Beschreibung: This study aimed to get insight into adolescents’ views on help-seeking for emotional and behavioral problems. Fourteen focus groups were conducted. Two vignettes, depicting one healthy adolescent with few issues and one adolescent with severe psychosocial problems, were used to structure the focus groups. The focus groups were framed within a youth help-seeking model. Adolescents (mean age of 15.0 years) generally reported seeking help from friends or the internet for mild issues and from a person they trust like a parent or school mentor, for more severe problems. Adolescents correctly recognized the issues in vignette one as surmountable and the problems in vignette two as severe. A bond of trust with a help source was regarded as the main facilitator for the decision to seek help. Adolescents reported a preference for help sources who clearly displayed their expertise for the issue at hand and for informal help-sources, particularly friends.

Beschreibung: Climbing has become an increasingly popular sport, and the number of accidents is increasing in parallel. We aim at describing the characteristics of climbing accidents leading to severe (multisystem) trauma using data from the International Alpine Trauma Registry (IATR) and at reporting the results of a systematic review of the literature on the epidemiology, injury pattern, severity and prevention of climbing accidents. We found that climbing accidents are a rare event, since approximately 10% of all mountain accidents are climbing related. Climbing accidents mainly affect young men and mostly lead to minor injuries. Fall is the most common mechanism of injury. Extremities are the most frequently injured body part. However, in multisystem climbing-related trauma, the predominant portion of injuries are to head/neck, chest and abdomen. The fatality rate of climbing accidents reported in the literature varies widely. Data on climbing accidents in general are very heterogeneous as they include different subspecialties of this sport and report accidents from different regions. A number of risk factors are accounted for in the literature. Appropriate training, preparation and adherence to safety standards are key in reducing the incidence and severity of climbing accidents.

Beschreibung: We aimed to verify whether indirect-wave (I-wave) recruitment and cortical inhibition can regulate or predict the plastic response to paired associative stimulation with an inter-stimulus interval of 25 ms (PAS25), and also whether water immersion (WI) can facilitate the subsequent PAS25-induced plasticity. To address the first question, we applied transcranial magnetic stimulation (TMS) to the M1 hand area, while alternating the direction of the induced current between posterior-to-anterior and anterior-to-posterior to activate two independent synaptic inputs to the corticospinal neurons. Moreover, we used a paired stimulation paradigm to evaluate the short-latency afferent inhibition (SAI) and short-interval intracortical inhibition (SICI). To address the second question, we examined the motor evoked potential (MEP) amplitudes before and after PAS25, with and without WI, and used the SAI, SICI, and MEP recruitment curves to determine the mechanism underlying priming by WI on PAS25. We demonstrated that SAI, with an inter-stimulus interval of 25 ms, might serve as a predictor of the response to PAS25, whereas I-wave recruitment evaluated by the MEP latency difference was not predictive of the PAS25 response, and found that 15 min WI prior to PAS25 facilitated long-term potentiation (LTP)-like plasticity due to a homeostatic increase in cholinergic activity.

Beschreibung: The aim of this work is to develop a software to calculate the economic parameters so as to determine the feasibility of a floating offshore renewable farm in a selected location. The software can calculate the economic parameters of several types of offshore renewable energies, as follows: one renewable energy (floating offshore wind—WindFloat, tension leg platform (TLP), and spar; floating wave energy—Pelamis and AquaBuoy), hybrid offshore wind and wave systems (Wave Dragon and W2Power), and combined offshore wind and waves with different systems (independent arrays, peripherally distributed arrays, uniformly distributed arrays, and non-uniformly distributed arrays). The user can select several inputs, such as the location, configuration of the farm, type of floating offshore platform, type of power of the farm, life-cycle of the farm, electric tariff, capital cost, corporate tax, steel cost, percentage of financing, or interest and capacity of the shipyard. The case study is focused on the Galicia region (NW of Spain). The results indicate the economic feasibility of a farm of floating offshore renewable energy in a particular location in terms of its costs, levelized cost of energy (LCOE), internal rate of return (IRR), net present value (NPV), and discounted pay-back period. The tool allows for establishing conclusions about the dependence of the offshore wind resource parameters, the main distances (farm–shore, farm–shipyard, and farm–port), the parameters of the waves, and the bathymetry of the area selected.

Beschreibung: We investigated the impact of a sports activities program on metabolic syndrome (MetS) components and pre-MetS among adolescents. Blood samples, blood pressure, weight, height, body mass index, waist circumference, body fat percentage, frequency of food consumption, daily time in moderate-to-vigorous physical activity (MVPA), and sedentary behavior (SB) of 92 male adolescents aged 14–18 years (16.07 ± 0.93) were evaluated. From this initial sample, 36 participants (39.1%) were diagnosed with pre-MetS or MetS and were invited to participate in the intervention program. Twelve individuals diagnosed with pre-MetS or MetS agreed to participate in a recreational sports activities program lasting 14 weeks. The pre- and post-sport program comparison showed a reduction in total cholesterol, low-density lipoprotein, and non-high-density lipoprotein (HDL), and an increase in HDL and MVPA time in the intervention group. Sports activities accounted for 42% of the MVPA daily recommendation, and at the end of the intervention period, only seven subjects maintained a positive diagnosis for pre-MetS or MetS. This study showed that recreational sports activities had a significant impact on the lipid profile.

Beschreibung: The aim of the research was to verify the functional state of young football players using selected tests of the Functional Movement Screen (FMS) protocol, as well as the impact of the 12 weeks of functional training on the speed parameters. The research was conducted on 20 highly competitive young (U17) football players. Research project was conducted in two stages: in the first part of the study, the functional assessment was made by using the FMS test, then the measurement of the speed parameters was done with the Microgate photocells system. Results showed a significant improvement in the functional state of young football players: FMS 1 (45.2% of difference, p = 0.004), FMS 2 (24.3% of difference, p = 0.012), FMS 3 (48.5% of difference, p = 0.001). After the functional training program, there was also an improvement in the parameters of the acceleration and velocity: acceleration between 5–10 m and speed between 10–30 m shows significant improvement (expressed during covering a given distance) of the footballers, amounting to 0.02 s (2.4%) and 0.04 s (1.5%). But there was no improvement in acceleration between 0–5 m. An appropriate training schedule, based on FMS results, should be adopted in the annual training program to improve basic motor skills of the football players and minimize their injuries.

Beschreibung: Heart failure (HF) represents an important cardiovascular complication of type 2 diabetes mellitus (T2DM) associated with substantial morbidity and mortality, and is emphasized in recent cardiovascular outcome trials (CVOTs) as a critical outcome for patients with T2DM. Treatment of T2DM in patients with HF can be challenging, considering that these patients are usually elderly, frail and have extensive comorbidities, most importantly chronic kidney disease. The complexity of medical regimens, the high risk clinical characteristics of patients and the potential of HF therapies to interfere with glucose metabolism, and conversely the emerging potential of some antidiabetic agents to modulate HF outcomes, are only some of the challenges that need to be addressed in the framework of a team-based personalized approach. The presence of established HF or the high risk of developing HF in the future has influenced recent guideline recommendations and can guide therapeutic decision making. Metformin remains first-line treatment for overweight T2DM patients at moderate cardiovascular risk. Although not contraindicated, metformin is no longer considered as first-line therapy for patients with established HF or at risk for HF, since there is robust scientific evidence that treatment with other glucose-lowering agents such as sodium-glucose cotransporter 2 inhibitors (SGLT2i) should be prioritized in this population due to their strong and remarkably consistent beneficial effects on HF outcomes.

Beschreibung: Background: The use of a contaminated endoscope may lead to infections due to the transmission of potential pathogens from patient to patient. Methods: Post-reprocessing microbiological surveillance of four duodenoscopes was carried out over a three-year period in the Digestive Endoscopy Unit of an Italian hospital. Sampling of duodenoscopes was performed after the devices have been reprocessed. The initial phase of surveillance involved the contemporary evaluation of the four duodenoscopes; afterwards, microbiological surveillance proceeded at monthly intervals. Results: The initial phase of surveillance revealed that three duodenoscopes presented a high level of contamination with “high-concern” micro-organisms, some of which were multi-drug-resistant. The highest values of contamination regarded the species P. aeruginosa (2500 CFU/duodenoscope), K. pneumoniae (2580 CFU/duodenoscope), and A. baumannii (2600 CFU/duodenoscope). Since the cultures were repeatedly positive on three successive occasions, the contaminated devices were sent to the manufacturer for evaluation. Audits were carried out with the personnel responsible for reprocessing, which was aimed to optimize the procedures used, and subsequently, only one case of non-conformity was found. Conclusions: Our study highlighted both the potential risk of transmitting pathogens through the use of duodenoscopes and the importance of implementing a well-structured system of microbiological surveillance and training programs, in order to reduce the risk of spreading retrograde cholangiopancreatography (ERCP)-associated infections.

Beschreibung: A great deal of attention has been paid lately to release of phthalate esters (PAEs) from polyethylene terephthalate (PET) bottles into PET bottled drinking water due to their potential endocrine-disrupting effects. Three kinds of PAEs, including diethyl phthalate (DEP), dimethyl phthalate (DMP) and dibutyl phthalate (DBP), were detected in 10 popular brands of PET bottles in Beijing, ranging from 101.97 μg/kg to 709.87 μg/kg. Meanwhile, six kinds of PAEs, including DEP, DMP, DBP, n-butyl benzyl phthalate (BBP), di-n-octyl phthalate (DOP) and di(2-ethylhexyl) phthalate (DEHP), were detected in PET bottled water, ranging from 0.19 μg/L to 0.98 μg/L, under an outdoor storage condition, while their concentrations ranged from 0.18 μg/L to 0.71 μg/L under an indoor storage condition. Furthermore, the concentrations of PAEs in brand D and E bottles were slightly increased when the storage time was prolonged. In addition, the concentrations of PAEs in commercial water contained in brand B and H bottles and pure water contained in brand E and G bottles were also slightly increased with the increase of storage temperature. Interestingly, DBP mainly contributed to the increased PAEs levels in simulation water. These results suggest that a part of the PAEs in PET bottled water originated from plastic bottles, which was related to the storage time and temperature. However, the PAEs in PET bottled water only pose a negligible risk to consumers if they follow the recommendations, such as storage at a common place (24 °C), away from sun and in a short period of time.

Beschreibung: Introduction: Patients’ satisfaction was extensively researched over the last decades, given its role in building loyalty, compliance to treatment, prevention, and eventually higher levels of wellbeing and improved health status. Patients’ feedback on the perceived quality of health services can be incorporated into practice; therefore, understanding factors and mechanisms responsible for patients’ satisfaction allows providers to tailor targeted interventions. Method: A questionnaire assessing patients’ perception of the quality of health services was administered to a country-representative sample of 1500 Romanian patients. Using a partial least squares—path modeling approach (PLS-PM), with cross-sectional data, we developed a variance-based structural model, emphasizing the mediating role of trust and satisfaction with various categories of health services. Results: We confirmed the mediating role of trust in shaping the relationship between the procedural accuracy of health professionals, along with the perceived intensity of their interaction with patients, and patients’ experienced quality of the health services. We confirmed the mediating role of satisfaction by the categories of services in the relationship between waiting time on the premises, attention received, and the perceived reliability of the information received, as predictors, and the experienced quality of the health services. In addition, indirect assessment of patients’ satisfaction is a good predictor for direct assessment, thereby affirming the idea that the results of the two types of evaluations converge. Discussions: One of the most efficient solutions to increase both patients’ satisfaction and their compliance is to empower the communication dimension between patients and health practitioners. Given the non-linear relationships among variables, we advocate that, unless the nature of the relationships between satisfaction and its predictors is understood, practical interventions could fail. The most relevant variable for intervention is the degree of attention patients perceive they received. We suggest three methods to turn waiting time into attention given to patients.

Beschreibung: The availability of practical tools to assess dietary knowledge and adherence is essential to evaluate the effectiveness of dietary interventions. The aims of this paper were to develop reliable dietary knowledge and adherence questionnaires, suitable for Lebanese adolescents and their parents, and to estimate the feasibility of conducting studies involving such participants in the school-based setting. Eight Lebanese high schools participated in this study (involving 220 adolescents aged 15–18 years). Self-administered dietary knowledge and adherence questionnaires (the Dietary Knowledge Questionnaire (DKQ) and the Dietary Adherence Questionnaire (DAQ), respectively) were completed by the high school students and their parents. A 24 h recall was additionally administered for the adolescents by a dietitian and a trained interviewer at school, in order to validate the adolescents’ answers in the DAQ. The cognitive interview method was used to qualitatively evaluate the questionnaires. The resulting Cronbach’s alpha ranged from 0.61 to 0.78 for the adolescent questionnaires and from 0.46 to 0.89 for the parental ones. In addition, 23 items (out of 25) of the adolescent DAQ matched with the administered 24 h recall. A significant negative correlation was found between the knowledge score (DKQ) and the unhealthy items of the adolescent DAQ. There was a significant positive correlation between the DKQ of the parents and the knowledge score of their children. This is the first study of dietary questionnaires involving Lebanese high school students from different regions, while also including their parents.

Beschreibung: Seven participants had a diagnosis of dementia; the number of excluded participants differed based on different exclusion processes, and there was missing data of one participant with a dementia diagnosis [...]

Beschreibung: To date, the research that examines food accessibility has tended to ignore ethnic food outlets. This void leaves us with a limited understanding of how such food stores may, or may not, impact food security. The study discussed herein addressed this by conducting a geospatial assessment of ethnic food outlet accessibility in two U.S. cities: Flint and Grand Rapids, Michigan. We used Geographic Information Systems (GIS) tools to create a revealed accessibility index for each food outlet, and used the index to determine access within active travel service areas. We utilized an ordinary least squares regression (OLS), and two local models: spatial autoregression (SAR) and geographically weighted regression (GWR) to enhance our understanding of global and localized relationships between outlet accessibility and type (while controlling for known covariates). The results show that the local models outperformed (R2 max = 0.938) the OLS model. The study found that there was reduced access to ethnic restaurants in all service areas of Grand Rapids. However, in Flint, we observed this association in the bicycling areas only. Also notable were the influences that demographic characteristics had on access in each city. Ultimately, the findings tell us that nuanced planning and policy approaches are needed in order to promote greater access to ethnic food outlets and reduce overall food insecurity.

Beschreibung: In the next century, global warming, due to changes in climatic factors, is expected to have an enormous influence on the interactions between pathogens and their hosts. Over the years, the rate at which vector-borne diseases and their transmission dynamics modify and develop has been shown to be highly dependent to a certain extent on changes in temperature and geographical distribution. Schistosomiasis has been recognized as a tropical and neglected vector-borne disease whose rate of infection has been predicted to be elevated worldwide, especially in sub-Saharan Africa; the region currently with the highest proportion of people at risk, due to changes in climate. This review not only suggests the need to develop an efficient and effective model that will predict Schistosoma spp. population dynamics but seeks to evaluate the effectiveness of several current control strategies. The design of a framework model to predict and accommodate the future incidence of schistosomiasis in human population dynamics in sub-Saharan Africa is proposed. The impact of climate change on schistosomiasis transmission as well as the distribution of several freshwater snails responsible for the transmission of Schistosoma parasites in the region is also reviewed. Lastly, this article advocates for modelling several control mechanisms for schistosomiasis in sub-Saharan Africa so as to tackle the re-infection of the disease, even after treating infected people with praziquantel, the first-line treatment drug for schistosomiasis.

Beschreibung: The 2008 international financial crisis triggered a heated discussion of the relationship between public health and the economic environment. We test the relationship between the credit cycle and happiness using the fixed effects model and explore the transmission channels between them by adding the moderating effect. The results show the following empirical regularities. First, the credit cycle has a negative correlation with happiness. This means that credit growth will reduce the overall happiness score in a country/region. Second, the transmission channels between the credit cycle and happiness are different during credit expansion and recession. Life expectancy and generosity can moderate the relationship between the credit cycle and happiness only during credit expansion. GDP per capita can moderate this relationship only during credit recession. Social support, freedom, and positive affect can moderate this relationship throughout the credit cycle. Third, the total impact of the credit cycle on happiness will become positive by the changes in the moderating effects. In general, we can improve subjective well-being if one of the following five conditions holds: (1) with the adequate support from the family and society, (2) with enough freedom, (3) with social generosity, (4) with a positive and optimistic outlook, and (5) with a high level of GDP per capita.

Beschreibung: Inadequate child physical growth and cognitive development share common individual-level risk factors. Less understood is how outcomes co-cluster at the community level and to what extent certain community-level characteristics influence the clustering. This study aims to quantify the extent to which child growth and development co-occur across communities, and to identify community-level characteristics associated with the clustering of the two development dimensions. We used longitudinal data from 1824 children (aged 5 years) across 98 communities in Andhra Pradesh, India in round 2 (2006) of the Young Lives study, who were followed up 3 years later in round 3 (2009). A multivariate, multilevel statistical model was estimated wherein the responses were nested within individuals, and communities. We used z-scores of height-for-age, weight-for-age, Peabody Picture Vocabulary Test, and a mathematics test in 2009 as outcome variables. At the community level, we included compositional variables representing community characteristics while controlling for child socio-demographic characteristics at the individual level. At the community level, children’s physical growth and cognitive development were strongly correlated (coefficient: 0.55–0.76) and, even after controlling for individual-level covariables, a more pronounced correlation was shown at the community level than individual level correlation. Greater local healthcare resources were associated with better physical growth. More local programs run by government and NGOs/charities were associated with higher child language skills. Local social problems were inversely associated with math scores. Our study showed that physical growth and cognitive development tended to be clustered and co-occurred within communities as well as individual children.

Beschreibung: Bullying affects thousands of teenagers worldwide and has devastating consequences. Various studies suggest that the personality of teenagers is a risk profile for bullying. The aim of this study was to analyse the relationship between the personality of teenagers aged 14 to 16 years from three education centres located in the province of Seville (Spain) and bullying in any of its victim or aggressor roles. A multi-centre cross-sectional observational descriptive study was conducted in three education centres in the province of Seville (Spain). The sample consisted of 93 students. In order to measure the two main variables, the Bull-S test was used for bullying, and the EPQ-J questionnaire was used for personality traits. A descriptive and correlation analysis was performed between variables. The results showed that 14% (n = 13) of the sample were detected as victims and another 14% (n = 13) were detected as aggressors. Statistically significant differences were found between neuroticism (p = 0.044; Phi = 0.615), sincerity (p = 0.016; V de Cramer = 0.474), and anti-social behaviour (p = 0.007; Phi = 0.620) with the variables victim/aggressor. Bullies are typically males who score high on neuroticism and anti-social behaviour, with a tendency towards social dissimulation.

Beschreibung: Due to the importance of understanding the relationship between agricultural growth and environmental quality, we analyzed how high-quality agricultural development can affect carbon emissions in Northwest China. Based on the concept of the environmental Kuznets curve, this study uses provincial panel data from 1993 to 2017 to make empirical analyses inflection point changes and spatio-temporal differences in agricultural carbon emissions. The highlights of our findings are as follows: (1) In Northwest China, there is an inverse N-shape curve, and the critical values are 3578 yuan/hm2 and 45,738 yuan/hm2, respectively. (2) For 2017, the agricultural economic intensity was 50,670 yuan/hm2, exceeding the critical value (high inflection point) of 45,738 yuan/hm2. (3) Ningxia, Gansu, and Qinghai have not reached the turning point. Having comparable climate, natural conditions, and overall environmental factors, these three provinces would reach the turning point at similar time periods. (4) The average value in agricultural carbon emission intensity in the region is 767.79 kg/hm2, and the order based on intensity is Xinjiang 〉 Shaanxi 〉 Ningxia 〉 Gansu 〉 Qinghai.

Beschreibung: Despite the growing interest in extreme sports around the world, researchers have rarely investigated the complex factors that have led to a developed commitment to extreme sports in recent years. Precisely, the social identity of ultramarathoners remains a research niche. The aim of the article is to analyze the impact of a sports event on shaping social identity of ultramarathon runners on the example of Karkonosze Winter Ultramarathon (held in Poland). The qualitative method used in the article—interviews with runners—made it possible to examine the factors that create social identity, among which the motives for participation, sports subculture, and the authenticity of the experience play a key role. The first part of the article describes the theoretical aspects of social identity in sport. The second, empirical part presents the research results supplemented by the statements of the contestants. In this case, the subject of analysis is the motives for participation in a winter ultramarathon and their characteristics. Lastly, the article analyzes the subculture of ultramarathoners and the experience of contestants’ authenticity. The investigated winter ultramarathon created the perfect space for creation, deepening and celebrating the social identity of ultramarathoners assessed as a value in itself. The article enriches the present knowledge about the motivation of ultramarathoners because, unlike the results of quantitative research, it presents in-depth responses of runners who were not always concerned by existing research questionnaires.

Beschreibung: How, apart from by conveying professional knowledge, can university medical education nurture and improve the gender competency of medical students and thereby create an LGBT+ friendly healthcare environment? This study explored the use of game-based teaching activities in competency-based teaching from the perspective of competency-based medical education (CBME) and employed a qualitative case-study methodology. We designed an LGBT+ Health and Medical Care course in a medical school. Feedback was collected from two teachers and 19 medical students using in-depth interviews and thematic analysis was used to analyze the collected data. The findings of this study were as follows: (1) Games encouraged student participation and benefited gender knowledge transmission and transformation through competency learning, and (2) games embodied the idea of assessment as learning. The enjoyable feeling of pressure from playing games motivated students to learn. Using games as both a teaching activity and an assessment tool provided the assessment and instant feedback required in the CBME learning process. Game-based teaching successfully guided medical students to learn about gender and achieve the learning goals of integrating knowledge, attitudes, and skills. To fully implement CBME using games as teaching methods, teaching activities, learning tasks, and assessment tools, teachers must improve their teaching competency. This study revealed that leading discussions and designing curricula are key in the implementation of gender competency-based education; in particular, the ability to lead discussions is the core factor. Game-based gender competency education for medical students can be facilitated with discussions that reinforce learning outcomes to achieve the objectives of gender equality education and LGBT+ friendly healthcare. The results of this study indicated that game-based CBME with specific teaching strategies was an effective method of nurturing the gender competency of medical students. The consequent integration of gender competency into medical education could achieve the goal of LGBT+ friendly healthcare.

Beschreibung: Objectives: Fragmented healthcare in China cannot meet the needs of the growing number of type 2 diabetes patients. The World Health Organization proposed an integrated primary care approach to address the needs of patients with chronic conditions. This study aims to measure type 2 diabetes patients’ preferences for urban integrated primary care in China. Methods: A discrete choice experiment was designed to measure type 2 diabetes patient preferences for seven priority attributes of integrated care. A two-stage sampling survey of 307 type 2 diabetes mellitus (T2DM) patients in 16 community health stations was carried out. Interviews were conducted to explore the reasons underpinning the preferences. A logit regression model was used to estimate patients’ willingness to pay and to analyze the expected impact of potential policy changes. Results: Travel time to care providers and experience of care providers are the most valued attributes for respondents rather than out-of-pocket cost. Attention to personal situation, the attentiveness of care providers, and the friendliness and helpfulness of staff were all related to interpersonal communication between patients and health care providers. Accurate health information and multidisciplinary care were less important attributes. Conclusions: The study provides an insight into type 2 diabetes patients’ needs and preferences of integrated primary care. People-centered interventions, such as increasing coverage by family doctor and cultivating mutual continuous relationships appear to be key priorities of policy and practice in China.

Beschreibung: Osteoarthritis (OA) is one of the most common causes of rehabilitation benefits and senior disability. It generates high costs of treatment and increasing demand for medical staff and care of geriatric profile. The aim of the study was to determine the relationship between health evaluation and satisfaction with medical services among individuals with OA in rehabilitation outpatient clinics. The survey was carried out from June 2017 to May 2018, among patients being provided with services of five outpatient rehabilitation clinics in Lublin. The surveyed group comprised 328 respondents. The following tools were utilized: the List of Health Criteria (LHC), the Multidimensional Health Locus of Control Scale (version B) (MHLC), the authors’ own questionnaire compiled for the study, and the Servperf Method. According to the respondents, the most important health criterion is “not to experience any ailments” (M = 1.56). In an assessment of a clinic, the respondents rated neatness (cleanliness) of the staff highest (M = 4.38) and the appearance of a building where a clinic is located lowest (M = 3.42). The better the evaluation of medical services in an outpatient rehabilitation clinic in comparison to other settings, the better the evaluation of the quality of service (rho S = 0.593; p 〈 0.000). The study conducted in outpatient rehabilitation clinics showed great demand for outpatient specialist care of geriatric profile. Undoubtedly, there is need for continuation and expansion of studies on patients with OA in other rehabilitation settings.

Beschreibung: (1) Background: Diabetes mellitus is a common health problem in Saudi Arabia, causing a huge burden for individuals, families, and communities. The objectives of the current study were to determine the prevalence and risk factors of type 2 diabetes mellitus among a semi-urban population of Saudi Arabia. (2) Research methods: The research design was cross-sectional, and the research was conducted in five primary health care centers (PHCC) in Majmaah, Saudi Arabia. The sample size was calculated as 353. A pre-tested questionnaire was used to collect data after obtaining ethical approval. Blood samples were taken to assess glucose levels and other variables. SPSS version 21 was used to analyze data. (3) Results: The prevalence of type 2 diabetes mellitus was 34.6%. The disease was more prevalent among the older respondents compared with the younger age groups (44.6% versus 15.6%). We found that females acquire the disease at a slightly higher rate than males (34.9% versus 34.2%), but this difference is not statistically significant. The sociodemographic risk factors of the disease were as follows: old age (44%), business and private occupation (38.5%), divorced or widowed (56.3%), and low income (42.4%). The health behaviors factors were as follows: overweight or obese status (42.3%), high triglycerides (TG) (43.4%), low high-density lipoprotein (HDL) (37.3%), and high total cholesterol (23.7%). There was a statistically significant difference in these risk factors between patients with and without diabetes. (4) Conclusion: The prevalence of type 2 diabetes mellitus among the semi-urban population of Saudi Arabia is high. The disease is more prevalent among elderly respondents and is associated with obesity, high TG, low HDL, and high total cholesterol.

Beschreibung: Background: Screening methods for childhood obesity are based largely on the published body mass index (BMI) criteria. Nonetheless, their accuracy in African children is largely unknown. The diagnostic accuracies of the World Health Organization (WHO), the Centers for Disease Control and Prevention (CDC), and the International Obesity Taskforce (IOTF) BMI-based criteria in defining obesity using deuterium dilution as a criterion method in a sample of Ghanaian children are presented. Methods: Data on anthropometric indices and percent body fat were collected from 183 children aged 8–11 years. The sensitivity, specificity, and predictive values were calculated. The overall performance of the BMI criteria was evaluated using the receiver operating characteristics area under the curve (AUC). Results: Overall sensitivity of WHO, CDC, and IOTF were 59.4% (40.6–76.3), 53.1% (34.7–70.9), and 46.9% (29.1–65.3) respectively. The overall specificity was high, ranging from 98.7% by WHO to 100.0% by IOTF. The AUC were 0.936 (0.865–1.000), 0.924 (0.852–0.995), and 0.945 (0.879–1.000) by the WHO, CDC, and IOTF criteria respectively for the overall sample. Prevalence of obesity by the WHO, CDC, IOTF, and deuterium oxide-derived percent body fat were 11.5%, 10.4%, 8.2%, and 17.5% respectively, with significant positive correlations between the BMI z-scores and percent body fat. Conclusions: The BMI-based criteria were largely specific but with moderate sensitivity in detecting excess body fat in Ghanaian children. To improve diagnostic accuracy, direct measurement of body fat and other health risk factors should be considered in addition to BMI.

Beschreibung: Immersive virtual environments (IVEs) were used to test the effects of biodiversity on recovery from induced stress. Three natural environments and one urban environment were used to represent ordinal levels of biodiversity (none, low, moderate, and high). The four IVEs comprised visual, auditory, and olfactory stimuli. An additional high biodiversity IVE without auditory or olfactory stimuli was also included to study the effects of multisensory stimulation per se on recovery from stress and perceptions of biodiversity. Following stress induction via a novel IVE Trier Social Stress Test (TSST-IVE), heart rate and five self-reported well-being measures were used to assess participants’ recovery after immersion in one of the five IVEs. The results showed consistent well-being responses across both self-reported and physiological measures, suggesting biodiversity does directly affect human well-being. However, the relationship was not linear. For most measures of well-being, stress recovery was least effective in the urban IVE, consistent with past research. The low biodiversity IVE elicited the greatest improvement in all well-being measures except self-reported calmness. One could speculate that the landscape features of the least biodiverse IVE may elicit subconscious preferences toward savanna-like landscapes, as suggested by previous studies. The IVE depicting a moderate level of biodiversity was the least restorative of the natural environments. A multisensory experience was associated with better recovery in all measures of well-being than a visual-only experience, and perceptions of landscape components significantly differed between two identical nature scenes when auditory and olfactory stimuli were removed. Nuances in the data and implications of the findings are discussed. The results signal a need for caution and question the assumption that cultural ecosystem services align with positive outcomes for biodiversity conservation.

Beschreibung: Ethylene oxide (EtO) is a known carcinogen and mutagen associated with increased incidence of breast and blood cancers. The largest medical sterilization facility in Michigan had been assessed by the U.S. Environmental Protection Agency as imposing an additional cancer risk greater than one in one thousand in nearby neighborhoods. This prompted the Michigan Department of Environmental Quality (now referred to as the Department of Environment, Great Lakes, and Energy) to conduct an air quality modeling study of the ambient EtO impacts of the sterilization facility, followed by 24 h Summa canister sampling and TO-15 analysis in two phases. Inverse modeling of the measured 24 h EtO concentrations during the second phase yielded estimates of 594 lbs/year for the facility’s total emissions of EtO and 0.247 µg/m3 for the urban background concentration. The inverse-modeled emissions are similar to reported emissions by the facility operator based on indoor air measurements and simple mass balance assumptions, while the inferred background concentration agrees with estimates from other field investigations. The estimated peak 24 h exposure to EtO caused by the sterilization facility in nearby neighborhoods was 1.83 μg/m3 above the background level, corresponding to an additional cancer risk of approximately one in one hundred, if assumed to represent annual mean exposure.

Beschreibung: Prolonged sitting is related to a sedentary inactive lifestyle and related to obesity and many metabolic problems caused by inactivity. The problem gets more serious for people who spent most of their work time in a seated position like students or office workers. In this study, we provided standing desk and stool to the local public high school and observed the changes in their behavior in terms of physical activity using tri-axial accelerometer before and after intervention. Previously published study using the same dataset under the larger project reported increased physical activity during school hours. In this study, we extracted more diverse features directly from the raw data instead of using data processed by the software that manufacturer provided. Hence, we were able to analyze the same features (sedentary, physically active time) as well as sleep-related variables. Of the interest, sleep is another important feature that can tell us about participants’ health conditions. Even if the intervention contributed to updating their behavioral patterns, the result might be nullified in the long run if their sleep pattern was compromised. The quantity and quality of sleep was not changed after the intervention. Therefore, the efficacy of standing desks has been confirmed again.

Beschreibung: : Purpose: To improve numerical simulation of the non-contact tonometry test by using arbitrary Lagrangian-Eulerian deforming mesh in the coupling between computational fluid dynamics model of an air jet and finite element model of the human eye. Methods: Computational fluid dynamics model simulated impingement of the air puff and employed Spallart–Allmaras model to capture turbulence of the air jet. The time span of the jet was 30 ms and maximum Reynolds number was Re=2.3×104, with jet orifice diameter 2.4 mm and impinging distance 11 mm. The model of the human eye was analysed using finite element method with regional hyperelastic material variation and corneal patient-specific topography starting from stress-free configuration. The cornea was free to deform as a response to the air puff using an adaptive deforming mesh at every time step of the solution. Aqueous and vitreous humours were simulated as a fluid cavity filled with incompressible fluid with a density of 1000 kg/m3. Results: Using the adaptive deforming mesh in numerical simulation of the air puff test improved the traditional understanding of how pressure distribution on cornea changes with time of the test. There was a mean decrease in maximum pressure (at corneal apex) of 6.29 ± 2.2% and a development of negative pressure on a peripheral corneal region 2–4 mm away from cornea centre. Conclusions: The study presented an improvement of numerical simulation of the air puff test, which will lead to more accurate intraocular pressure (IOP) and corneal material behaviour estimation. The parametric study showed that pressure of the air puff is different from one model to another, value-wise and distribution-wise, based on cornea biomechanical parameters.

Beschreibung: To investigate the quality of life (QOL) of menopausal Emirati women aged 40–64 years and determine its relationship with their sociodemographic characteristics. A community-based cross-sectional study was conducted on 70 Emirati women using multistage stratified clustered random sampling. The participants were interviewed face-to-face using a structured questionnaire comprising sociodemographic variables, reproductive characteristics, and the Menopause-Specific Quality of Life (MENQOL) questionnaire. The most common symptom among the study participants was ‘aching in the muscles’. The participants had a moderate level of bothersome symptoms; in addition, vasomotor symptoms were reported by 61%, while sexual symptoms were only reported by one-third of the participants. There were no significant differences between the menopausal status in any of the four domains of the MENQOL questionnaire. Additionally, there were no significant differences between the mean scores of the four MENQOL domains and all predictors. This study highlights the importance of educating women about menopause and its symptoms.

Beschreibung: Background: In spite of the reduced exposure level, and its ban in numerous countries, compensation claims for asbestos-related diseases are far from decreasing. Methods: We used retrospective exposure assessment techniques to explore respiratory function and a computerized tomography (CT) scan in relation to past asbestos exposure in 115 male workers retired from an acrylic and polyester fiber plant. Based, on detailed information on exposure circumstances, we reconstructed a cumulative exposure estimate for each patient. Results: Time-weighted average exposure in our study population was 0.24 fibers/ml (95% confidence inteval (CI) 0.19–0.29), and the average cumulative exposure was 4.51 fibers/mL-years (95% CI 3.95–5.07). Exposure was elevated among maintenance workers, compared to other jobs (p = 0.00001). Respiratory function parameters did not vary in relation to the exposure estimates, nor to CT scan results. Risk of interstitial fibrosis showed a significant upward trend (Wald test for trend = 2.62, p = 0.009) with cumulative exposure to asbestos; risk associated with 5.26 fibers/mL-years or more, was 8-fold (95% CI 1.18–54.5). Conclusions: Our results suggest that a CT scan can detect pleuro-parenchymal lung alterations at asbestos exposure levels lower than previously thought, in absence of respiratory impairment. Further studies are required to validate our techniques of retrospective assessment of asbestos exposure.

Beschreibung: Absenteeism can clearly have a negative impact on academic performance among university students. Certain experiences or symptoms such as menstrual pain are very common in women and can lead to absenteeism. The current study was aimed at examining the presence of menstrual experiences or symptoms and their impact upon absenteeism among healthy (illness-free) female university nursing students in Spain. A total of 299 students participated in this research, which was a descriptive cross-sectional, observational study. An ad hoc online questionnaire was used based on sociodemographic and gynecological data, together with the noted menstrual experiences; the most prevalent of which were bloating, which affected 87.3% of students; dysmenorrhea and irritability, which affected 76.3%; and fatigue, which affected 70.6%. Students with dysmenorrhea had a 6.95 higher (odds ratio (OR) 6.95; 95% confidence interval (CI) 3.39–14.25) odds of absenteeism; in those who reported dizziness, the odds of absenteeism was 4.82 times higher (OR 4.82; 1.76–13.23); in those who manifested nausea and vomiting, the percentage of absenteeism was 3.51 higher (OR 3.51; 95% CI 1.51–8.15); in those who presented sleep alterations, the odds were 2.95 higher (OR 2.95; 95% CI 1.39–6.25); and for those who felt depressed the odds were 2.18 times higher (OR 2.18; 95% CI 1.21–3.94) Absenteeism was found to be more likely in women with dysmenorrhea. However, in addition, higher odds of absenteeism were also found in women with nausea and vomiting, dizziness, sleep disorders, and those who feel depressed. These menstrual experiences can be considered a relevant problem among young women, leading to absenteeism, and a negative influence on academic performance. It is essential to raise awareness of the socioeconomic impact of absenteeism and establish new strategies for improving menstrual experiences.

Beschreibung: Burnout has adverse effects on the health and work-related outcomes of employees. Nevertheless, little is known about effective ways of reducing burnout complaints and facilitating full return to work, which defines rehabilitation. This study consists of a systematic review of the effects of combined interventions (i.e., both person-directed and organization-directed). It also includes the identification and description of mediators of change, thereby explaining how combined interventions do or do not work. Seven electronic databases were searched for English peer-reviewed publications: the Psychology and Behavioral Sciences Collection; PsycARTICLES; Web of Science; Scopus; SocINDEX; PubMed; and PsycINFO, using various combinations of search terms (e.g., burnout AND intervention). Out of 4110 abstracts published before 29 September, 2019, 10 studies (reporting the effects of nine combined interventions) fulfilled the inclusion criteria, which were defined using PICOS criteria (participants, interventions, comparators, outcomes and study design). Although the risk of bias of the included studies is high, all combined interventions were effective in facilitating rehabilitation. Results suggest that involving employees in decision-making and enhance their job control and social support, while eliminating stressors, explain the effectiveness of the intentions. With caution, workplace health promotion practitioners are encouraged to use these findings to tackle burnout among employees.

Beschreibung: Pregnancy and lactation involve two aspects that are socially and culturally associated with women. However, there are a few biological differences between male and female breast tissue. Lactation and pregnancy are viable processes that do not depend on sex. Even for the latter, it is only necessary to have an organ capable of gestation. Ways to favor mammogenesis and lactogenesis in trans* women have been established. There are protocols to promote lactation in trans* women, usually used for adoptive mothers or those whose children have been born through gestational surrogacy. Chestfeeding a baby could be the cause of feelings as diverse as gender dysphoria in the case of trans* men, and euphoria and affirmation of femininity in trans* women. This study involves a review of the available scientific literature addressing medical aspects related to pregnancy and lactation in trans* individuals, giving special attention to nursing care during perinatal care. There are scarce studies addressing care and specifically nursing care in trans* pregnancy and lactation. Our study indicates the factors that can be modified and the recommendations for optimizing the care provided to these individuals in order to promote and maintain the lactation period in search of improvement and satisfaction with the whole process.

Beschreibung: Background: The aim of this study was to explore the relationship between one’s maternal attachment style and one’s self-image as a mother, image of one’s mother as a mother, and bond with the child over a period of several months. Methods: A total of 86 women took part in the study The Adjective Check List (ACL), Postpartum Bonding Questionnaire (PBQ), Maternal–Fetal Attachment Scale (MFAS), and a modified version of the Experiences in Close Relationships (ECR) were used. Two measurements were used: during pregnancy and about six months after the birth of the child. Results: In terms of their self-image as mothers, the women had higher results the first time they took the questionnaire, regardless of their attachment style. An interaction effect was found between attachment style and the ‘need for changes’ scale. The image of one’s mother as a mother depended on the level of avoidance in attachment, regardless of the measurement. An interaction effect was found between attachment style and the scale of ‘personal adaptation’. There was a correlation between the bond with the child during pregnancy, the bond following birth, and the style of maternal attachment; the main predictor of the bond with the child after birth is the bond with the child during the pregnancy. Conclusion: Those who provide care for pregnant women and new mothers should be aware of the complex psychological processes in the transition to motherhood, have knowledge about perinatal mental health, and when necessary, refer women to specialists such as support groups for new mothers, trained midwives, psychologists, psychotherapists, or psychiatrists.

Beschreibung: The happy-productive worker thesis (HPWT) assumes that happy employees perform better. Given the relevance of teams and work-units in organizations, our aim is to analyze the state of the art on happy-productive work-units (HPWU) through a systematic review and integrate existing research on different collective well-being constructs and collective performance. Research on HPWU (30 studies, 2001–2018) has developed through different constructs of well-being (hedonic: team satisfaction, group affect; and eudaimonic: team engagement) and diverse operationalizations of performance (self-rated team performance, leader-rated team performance, customers’ satisfaction, and objective indicators), thus creating a disintegrated body of knowledge about HPWU. The theoretical frameworks to explain the HPWU relationship are attitude–behavior models, broaden-and-build theory, and the job-demands-resources model. Research models include a variety of antecedents, mediators, and moderating third variables. Most studies are cross-sectional, all propose a causal happy–productive relationship (not the reverse), and generally find positive significant relationships. Scarce but interesting time-lagged evidence supports a causal chain in which collective well-being leads to team performance (organizational citizenship behavior or team creativity), which then leads to objective work-unit performance. To conclude, we identify common issues and challenges across the studies on HPWU, and set out an agenda for future research.

Beschreibung: The present study aimed to analyze differences in the electroencephalogram (EEG) power spectrum (theta, alpha, and beta) between participants who won (winning group) and those who lost (losing group) in three different chess games: against their same Elo (100% chess games), 25% over their Elo (125% chess games), and 25% under their Elo (75% chess games). EEG was assessed at baseline and during the chess games. Method: 14 male chess players (age: 35.36 ± 13.77 and Elo: 1921 ± 170) played three games of 3 min, plus two additional seconds per move, while EEG was assessed. There were three difficulty levels (75%, 100%, and 125%), with two games (one with white pieces and another with black pieces) per level. The winning group showed higher theta power in the frontal, central, and posterior brain regions when difficulty increased (p-value

Beschreibung: The Integrated Multimorbidity Care Model (IMCM), developed by the Joint Action on Chronic Diseases and Promoting Healthy Ageing across the Life Cycle (JA-CHRODIS), proposes a set of 16 multidimensional components (i.e., recommendations) to improve the care of persons with multimorbidity in Europe. This study aimed at analyzing the potential applicability of the IMCM. We followed a qualitative approach that comprised two phases: (1) The design of a case study based on empirical clinical data, which consisted of a hypothetical woman with multimorbidity, type 2 diabetes mellitus, mental health, and associated social problems, and (2) the creation of a consensus group to gather the opinions of a multidisciplinary group of experts and consider the potential applicability of the IMCM to our case study. Experts described how care should be delivered to this patient according to each model component, suggested the use of specific rating scales and tools to assess her needs in a comprehensive and regular way, and pointed our crucial health and social resources to improve her care process. Experts also highlighted patient-centered, integrated and tailored care as one of the keystones of quality healthcare. Our results suggest that the IMCM is applicable in complex patients with multimorbidity.

Beschreibung: Precious memories (PM) is a life review intervention for depression in older adults with no to mild cognitive decline that has been implemented in multiple nursing homes (NHs) in the Netherlands. Previous research suggested its relevance but questioned its applicability. Therefore, this research aimed to (1) investigate the applicability of PM, and (2) increase its applicability, if necessary. Intervention mapping (IM) was used to achieve these goals: process evaluation through semi-structured interviews with psychologists (n = 11) and clients (n = 2) to identify potential improvements for PM and to set an improvement goal (IM-step 1); three focus groups with stakeholders (n = 20) to specify behaviors necessary to reach the improvement goal (IM-step 2); and selection of behavior change techniques and applications to facilitate attainment of these behaviors (IM-step 3). Results showed that psychologists perceived a high drop-out rate, which was partly due to PM being provided to clients that did not belong to the target group. Although PM was generally considered relevant, psychologists articulated its longer-term effects should be improved. To improve PM’s applicability, concrete maintenance strategies were developed aiming to maintain clients’ well-being by stimulating positive contact with others. Future research must pilot, implement and evaluate these strategies.

Beschreibung: The mental health of birth parents has gained attention due to the serious negative consequences for personal, family, and child outcomes, but depression and anxiety in adoptive parents remains under-recognized. Using a prospective, longitudinal design, we investigated anxiety and depression symptoms in 96 British adoptive parents over four time points in the first four years of an adoptive placement. Depression and anxiety symptom scores were relatively stable across time. Growth curve analysis showed that higher child internalizing scores and lower parental sense of competency at five months post-placement were associated with higher initial levels of parental depressive symptoms. Lower parental sense of competency was also associated with higher initial levels of parental anxiety symptoms. Parents of older children and those with higher levels of parental anxiety and sense of competency at five months post-placement had a steeper decrease in depressive symptoms over time. Support for adoptive families primarily focuses on child adjustment. Our findings suggest that professional awareness of parental mental health post-placement may be necessary, and interventions aimed at improving parents’ sense of competency may be beneficial.

Beschreibung: Background: Adults with body image dissatisfaction (BID) are more likely to be depressed, anxious, and suicidal when compared to those without intense dissatisfaction over their appearance. The current study aimed to estimate the prevalence and factors associated with BID among out-patients with mental illness in Singapore. Methods: Data was collected from 310 psychiatric out-patients using a self-administered questionnaire. Measurements used were socio-demographic characteristics, Body Mass Index scores, Body Shape Questionnaire, Binge Eating Scale, Eating Attitudes Test, Beck’s Depression Inventory, Beck’s Anxiety Inventory and Alcohol Use Disorders Identification Test. Results: A prevalence of 30.9% of BID was established among psychiatric out-patients in Singapore. Being female, having higher BMI scores, binge eating behavior, eating disorders, and those diagnosed with depression were positively associated with BID. Conclusion: BID is prevalent among those with psychiatric illnesses which could lead to a higher degree of psychological distress and the emergence of eating disorders.

Beschreibung: Purpose: To describe a technique intended to transfer of the intermaxillary and occlusal relationships in a fully digital environment from a complete denture to an implant-supported 3D-printed hybrid prosthesis (an acrylic resin complete fixed dental prosthesis supported by implants). Methods: In edentulous cases, the physiological mandibular position should be determined before the immediate loading procedures. In some cases, the use of interim removable prostheses for a few weeks could be useful to test the new occlusion in centric relation and to verify the prosthetic project. When the correct intermaxillary relationships are achieved, it is difficult to transfer them from the provisional to the final prostheses, as impressions or scans of edentulous arches do not have reference points for intermaxillary records. This paper presents a complex case and the technique used to transfer information from a complete denture to an implant-supported prosthesis with a digital workflow. A prosthetic stent has been used to scan the edentulous mandibular arch and to record the intermaxillary relation. Results: The delivery of the hybrid implant-supported prostheses was carried out with no problems and minimal occlusal adjustments. The patient was extremely satisfied with the treatment and the situation remained stable at the 1-year follow up. Conclusions: The approach described in the present article predictably maintains prosthetic information and allows the delivery of a final implant-supported restoration with the same occlusal relationship as the one tested with the provisional diagnostic dentures.

Beschreibung: The combination of poor diet and exposure to secondhand smoke may increase hemoglobin A1c (HbA1c) levels, but few studies have explored this interaction. We explored an interaction among 574 never-smoking adults from the Singapore Chinese Health Study. At baseline (age 59 ± 8 years), intakes of omega-3 polyunsaturated fatty acids, vitamin C, vitamin E and fiber were estimated using a modified food frequency questionnaire. At follow-up (age 64 ± 9 years), HbA1c and cotinine were measured. A product term between cotinine (above or below the median value) and each nutrient (high or low intake) was included in separate linear regression models with HbA1c as the outcome. HbA1c among those with high cotinine and low omega-3 polyunsaturated fatty acids intakes were higher than would be expected due to the individual effects alone (p-for-interaction = 0.05). Among those with lower intakes of omega-3 polyunsaturated fatty acids, high cotinine levels were associated with 0.54% higher HbA1c levels (95% confidence interval [CI]: 0.02, 1.06). Conversely, among those with higher intakes of omega-3 polyunsaturated fatty acids, HbA1c differ not differ by exposure (−0.09%; 95% CI: −0.45, 0.30). No evidence of interaction was observed for other nutrients. Diets high in omega-3 polyunsaturated fatty acids may ameliorate secondhand smoke-induced increases in HbA1c.

Beschreibung: Background: Past research shows that psychosocial stress and distress predict sedentary behavior and physical activity, but few studies focus on pregnant women. Our objective was to analyze relationships between psychosocial stress and distress with sedentary behavior and physical activity among pregnant women in Canada. Methods: We analyzed objectively-measured sedentary behavior and physical activity at 16–18, 24–26, and 32–24 weeks pregnancy in a sociodemographically diverse cohort of 70 women in Montreal, Canada. Participants completed the Perceived Stress Questionnaire and wore an accelerometer for 3 days that quantified sitting time and steps per day. We used univariate general linear models to analyze relationships between perceived stress with sedentary behavior and physical activity at each evaluation. To assess generalizability, we analyzed relationships between psychological distress with self-reported leisure-time sedentary behavior and daily energy expenditure in transportation and leisure physical activities among a sample representative of 166,095 women in the Canadian Community Health Survey. Results: In the Montreal cohort, we observed a positive association between perceived stress and sitting time, with small to moderate effect sizes (partial η2 = 0.08–0.16). We observed negative relationships between perceived stress and steps per day at the first two evaluations only, with small to moderate effect sizes (partial η2 = 0.08–0.11). Relationships for sedentary behavior were similar in the nationwide sample, but with smaller effect sizes (partial η2 = 0.02). There were no relationships between distress and physical activity in the nationwide sample. Conclusion: Psychosocial stress represents one risk factor for sedentarity, with relationships evident throughout pregnancy and at the population level. Relationships with physical activity are less consistent, but stress might represent a risk factor for low physical activity in early to mid-pregnancy. Results might guide the development of more comprehensive interventions targeting stress, sedentarity, and physical activity. In particular, integrating psychosocial health into interventions to reduce sedentarity, and including concrete guidelines on sedentary behavior in psychosocial health interventions, might be prioritized.

Beschreibung: Backpacks for transporting school loads are heavily utilized by children, and their mechanical advantages have been allowing children to transport heavy loads. These heavy loads may increase ground reaction forces (GRFs), which can have a negative effect on joints and bone health. The aim of this study was to investigate the effect of backpacks on the GRFs generated by children during walking, running, and jumping. Twenty-one children from the fifth (G-5, n = 9) and ninth (G-9, n = 12) grades walked, ran, and jumped over a force plate. When walking, the G-5 had GRF increments in the first (17.3%; p 〈 0.001) and second (15.4%; p 〈 0.001) peak magnitude, and in the total integral of the vertical force (20%; p 〈 0.001), compared to the control condition (i.e., no backpack), and the G-9 had increments of 10.4%, 9%, and 9% (p 〈 0.001), respectively. The G-9 did not prolong their total stance time (p 〉 0.05), unlike the G-5 (p = 0.001). When running, total stance time increased 15% (p 〈 0.001) and 8.5% (p 〈 0.001) proportionally to the relative load carried, in the G-5 and G-9, respectively. Peak GRF did not increase in any group when running or landing from a jump over an obstacle. It was found that GRF was affected by the backpack load when walking and running. However, when landing from a jump with the backpack, schoolchildren smoothed the landing by prolonging the reception time and thus avoiding GRF peak magnitudes.

Beschreibung: Contact with companion animals has been suggested to have important roles in enhancing child development. However, studies focused on child development and pet ownership at a very early age are limited. The purpose of the current study was to investigate child development in relation to pet ownership at an early age in a nationwide prospective birth cohort study: the Japan Environment and Children’s Study. Associations between cat and dog ownership at six months and infant development at 12 months of age were examined in this study. Infant development was assessed using the Ages & Stages QuestionnairesTM (ASQ-3) at 12 months. Among participants of (Japan Environment and Children’s Study) JECS, those with available data of cat and dog ownership at six months and data for the ASQ-3 at 12 months were included (n = 78,868). Having dogs showed higher percentages of pass in all five domains measured by ASQ-3 (communication, gross motor, fine motor, problem-solving, and personal-social) compared to those who did not have dogs. Significantly decreased odds ratios (ORs) of developmental delays were observed in association with having dogs in all fix domains (communication: OR = 0.73, gross motor: OR = 0.86, fine motor: OR = 0.84, problem-solving: OR = 0.90, personal-social: OR = 0.83). This study suggested that early life dog ownership may reduce the risks of child developmental delays.

Beschreibung: Numerous epidemiological studies have shown associations between short-term ambient air pollution exposure and various health problems. The time-stratified case-crossover design is a popular technique for estimating these associations. In the standard approach, the case-crossover model is realized by using a conditional logistic regression on data that are interpreted as a set of cases (i.e., individual health events) and controls. In statistical calculations, for each case record, three or four corresponding control records are considered. Here, the case-crossover model is realized as a conditional Poisson regression on counts with stratum indicators. Such an approach enables the reduction of the number of data records that are used in the numerical calculations. In this presentation, the method used analyzes daily counts on the shortest possible time-window, which is composed of two consecutive days. The proposed technique is positively tested on four challenging simulated datasets, for which classical time-series methods fail. The methodology presented here also suggests that the length of exposure (i.e., size of the time-window) may be associated with the severity of health conditions.

Beschreibung: Background: Maternal Depression (MD) has been implicated in the etiology of obesity. The present study investigated MD and both child fruit/vegetable consumption (FVC) and household food insecurity (FI) in an early childhood population. Methods: This cross-sectional study was conducted in Arkansas, United States, in 26 Head Start centers. Teachers obtained the Family Map (FM), an interview assessment tool used by Head Start staff to identify potential risk factors that affect child learning and development. The FM contains a two-item screener of parent depression—the Patient Health Questionaire-2, two questions about family FI, and two questions about FVC. The FM was completed in 693 households. Chi square analyses and logistic regressions utilizing adjusted and unadjusted odds ratios were utilized to compare differences in risk for children of mothers with no symptoms compared to mothers with low- or high-level depressive symptoms. Results: Children whose mothers had high MD were 2.90 (CI: 1.21–7.00) and 7.81 (CI: 3.71–16.45) times more likely to be at risk for low FVC and FI, respectively, compared to children of mothers with no MD. Similar findings but at lower magnitude were found for mothers with low symptoms of MD in comparison with mothers with no MD—both for Low FVC (1.57 times more likely; CI: 1.01–2.45) and FI (2.14 times more likely; CI: 1.28–3.58). The results presented are Odds Ratios from the multivariable adjusted models. Conclusions: Implications for the etiology of obesity, prevention/intervention efforts, and future research are offered, including recommended addition of maternal depression and household FI screening in early childhood programs.

Beschreibung: The aim of the study was to assess temporal trends in health risks related to most common persistent contaminants, including polychlorinated biphenyls (PCBs), dichloro-diphenyl-trichloroethanes (DDTs), lead (Pb), as well as mercury (Hg) among indigenous peoples living in coastal areas of Chukotka in Arctic Russia. This is examined in relation to exposure pathways and a range of social and behavioral factors capable of modifying the exposure to these contaminants, including place of residence, income, traditional subsistence, alcohol consumption, and awareness of risk prevention. The primary exposure pathway for PCBs is shown to be the intake of traditional foods, which explained as much as 90% of the total health risk calculated employing established risk guidelines. Nearly 50% of past DDT-related health risks also appear to have been contributed by contaminated indoor surfaces involving commonly used DDT-containing insecticides. Individuals who practiced traditional activities are shown to have experienced a 4.4-fold higher risk of exposure to PCBs and a 1.3-fold higher risk for DDTs, Pb, and Hg. Low income, high consumption of marine mammal fat, alcohol consumption, and lack of awareness of health risk prevention are attributed to a further 2- to 6-fold increase in the risk of PCBs exposure. Low socioeconomic status enhances the health risks associated with exposure to the persistent contaminants examined.

Beschreibung: A global report found that the quality of dying in Hong Kong lagged behind that of other high-income economies. This study aims to examine the service gaps by conducting a qualitative exploratory study from multiple stakeholders’ perspectives. Purposive and snowball sampling strategies were used to maximize variation in the sample. We interviewed 131 participants, including patients, family members, health care providers, administrators, lawyers, and policy makers. The situation analysis helped identify the facilitators and barriers at individual, organizational, and socio-cultural levels that affect service development. Findings showed that awareness on palliative and end-of-life care is growing, but the existing care is limited in terms of acceptability, coverage, variation in practices, continuity, and sustainability. A number of policy, economic, socio-cultural, environmental, and legal factors were also found to hinder service development. Findings of this study demonstrated that the development of palliative and end-of-life care services involved a paradigm shift relating to society as a whole. The overarching theme is to formulate a government-led policy framework. Furthermore, a public health approach has been advocated to create a supportive environment for service development.

Beschreibung: Land use conversion could directly or indirectly influence heavy metal geochemistry by changing soil properties. The aim of this study was to explore the effect of land use conversion on surface soil heavy metal contamination in the karst plateau lakeshore wetlands of Southwest China. Based on this, a total of 120 soil samples were collected from 30 sites from different types of land uses (farmlands, grasslands and woodlands) around a lake in Suohuangcang National Wetland Park in August 2017. Contents of As, Cd, Cu, Cr, Hg, Pb and Zn were analyzed, and soil heavy metal contamination was assessed in all three land use types. Results showed that land use transformation from farmland to grassland or woodland was not conducive to the release of soil heavy metal. Surface soil of all three land use types have been moderately polluted by As, Cr, Pb, and Zn, and grassland and woodland also had moderate Cd contamination. The pollution load index (PLI) results revealed low heavy metal contamination in grassland and woodland but no contamination in farmland. Although the integrated contamination in the studied region did not pose a serious potential ecological risk (RI 〈 150), it might affect human health through the water supply and food chain. Therefore, it is necessary to monitor and control As, Cd, Cr, Pb, and Zn concentrations of surface soil through controlling pollutants, improving waste treatment, as well as strengthening supervision and management in the vicinity of the Suohuangcang National Wetland Park.

Beschreibung: The objectives of this work were two-fold: Firstly, to identify the profiles of disruptive behaviours and motivation in secondary school physical education students using cluster analysis; and secondly, to analyse the interaction of the profiles with school satisfaction and perceived teaching competence. A group of 758 secondary school students (54.2% female) between the ages of 13 and 18 (M = 15.22, DT = 1.27) participated in the study by responding to the following scales: The Disruptive Behaviours in Physical Education Questionnaire, The School Satisfaction Scale, The Sport Motivation Scale adapted to Physical Education, and the Evaluation of Teaching Competencies Scale in Physical Education. The cluster analysis established two distinct profiles: High levels of disruptive behaviours and low levels of disruptive behaviours. The results showed that the students with the high disruptive behaviours profile were mostly boys, having low levels of intrinsic motivation and high levels of amotivation and misbehaviour in the classroom. In contrast, those students with the low disruptive behaviours profile were mostly girls, having the highest levels of intrinsic motivation and the lowest levels in all the disruptive behaviours. It was shown that students exhibiting the worse classroom behaviours were more bored in school, while those students with better behaviour perceived greater teaching competence.

Beschreibung: Biochar obtained by pyrolysis of the fiber plant kenaf was mixed with bismuth ferrite (BiFeO3) in a chitosan-containing acetic acid solution, magnetized, and modified to prepare a chitosan-crosslinked BiFeO3/biochar coupled magnetic material. The adsorption properties of the composite were investigated using methylene blue dissolved in water, and the effects of external conditions, such as pH, methylene blue concentration, reaction time, and temperature, on the adsorption performance were studied. The adsorption data were fitted and analyzed with kinetic and isotherm models, and the results showed that the BiFeO3/biochar coupled magnetic material effectively adsorbed methylene blue. The amounts adsorbed onto this magnetic material increased with increasing initial methylene blue concentration, reaction time, and temperature, and the adsorption performance improved under neutral and alkaline conditions. The pseudo-first-order kinetic and Langmuir isotherm models satisfactorily fitted the adsorption data, showing that the adsorption of methylene blue involved both chemical and physical adsorption. The maximum adsorption capacity of methylene blue onto the BiFeO3/biochar coupled magnetic material reached 18.942 mg·g−1 at 25 °C, confirming the excellent dye binding activity of this material.

Beschreibung: Background: The stigma of mental illness causes delays in seeking help, and often compromises victims’ therapeutic relationships with healthcare providers. The knowledge, attitudes, and behavioural responses of future healthcare professionals toward individuals with mental illnesses are explored here to suggest steps that will reduce mental illness stigma in healthcare providers. Methods: A generic qualitative approach—Qualitative Description—was used. Eighteen students from nine healthcare programs at a Canadian University participated in individual semi-structured interviews. Participants answered questions regarding their knowledge, attitudes, and behavioural responses towards individuals with mental illnesses. Thematic content analysis guided the data analysis. Results: Four main themes were constructed from the data: positive and negative general perceptions toward mental illness; contact experiences with mental illnesses; mental illness in a healthcare setting; and learning about mental illness in healthcare academia. Conclusions: Students showed well-rounded mental health knowledge and mostly positive behaviours toward individuals with mental illnesses. However, some students hold stigmatizing attitudes and do not feel prepared through their academic experiences to work with individuals with mental illnesses. Mental health education can reduce the stigma toward mental illness and improve the care delivered by healthcare professionals.

Beschreibung: This paper aims to examine the mediating role of organizational trust in the relationship between ethical leadership and young teachers’ work engagement, and the moderating effect of supervisor–subordinate (S–S) guanxi. S–S guanxi is a special interpersonal relationship in Chinese organizations. The sample in this study comprises 205 young teachers from 15 Chinese universities. The results reveal that organizational trust mediates the relationship between ethical leadership and young teachers’ work engagement. Moreover, S–S guanxi strengthens the positive relationship between organizational trust and young teachers’ work engagement, and the indirect effect of ethical leadership on young teachers’ work engagement through organizational trust. Based upon these findings, several theoretical and practical implications are discussed.

Beschreibung: The study provides direct evidence of the goals of food-industry-driven public relations (PR) campaigns. Two PR requests for proposals created for The Coca-Cola Company (Coke) were analysed. One campaign related to the 2016 Rio Olympic Games, the other related to the 2013–2014 Movement is Happiness campaign. Supplementary data were obtained from a search of business literature. The study found that Coke specifically targeted teenagers and their mothers as part of the two PR campaigns. Furthermore, Coke was explicit in its intentions to build allies, particularly with key media organisations, and to marginalise opposition. This study highlights how PR campaigns by large food companies can be used as vehicles for marketing to children, and for corporate political activity. Given the potential threats posed to populations’ health, the use of PR agencies by food companies warrants heightened scrutiny from the public-health community, and governments should explore policy action in this area.

Beschreibung: Among adolescents, heavy video game use and socializing online may be valued socially by peers, depending on gender and age, which can increase life satisfaction. However, heavy video gaming may also be linked to symptoms of Internet Gaming Disorder, which can decrease life satisfaction. Overall, when symptoms of Internet Gaming Disorder are present, do subjects experience decreased or increased life satisfaction, all other things being equal? The aim of this study was to explore the association between Internet Gaming Disorder symptoms and life satisfaction, while controlling for gender, age, and other conditions that may impact life satisfaction. More than 2000 adolescents filled out an anonymous questionnaire at school, and 43 patients in a care center filled out the same questionnaire. Sociodemographic characteristics, family life conditions, use of screens (videos, video games, and social networks), mental health screenings, and a life satisfaction measure were collected. Distribution of participants’ characteristics was provided, and stratified multivariate analyses by young male, older male, young female, and older female school populations were carried out. Results suggested that Internet Gaming Disorder symptoms had similar prevalence before and after the age of 15 in males (21% vs. 19%) and in females (6% vs. 7%) respectively and was significantly associated with decreased life satisfaction in older males, even after adjusting for parental support, depression, and economic conditions. Associations between symptoms of Internet Gaming Disorder and life satisfaction may be different depending on adolescent gender and age group.

Beschreibung: The purpose of the study was to map and describe the healthcare utilization databases (HUDs) available in Italy’s 19 regions and two autonomous provinces and develop a tool to navigate through them. A census of the HUDs covering the population of a single region/province and recording local-level data was conducted between January 2014 and October 2016. The characteristics of each HUD regarding the start year, data type and completeness, data management system (DMS), data protection procedures, and data quality control adopted were collected through interviews with the database managers using a standard questionnaire or directly from the website of the regional body managing them. Overall, 352 HUDs met the study criteria. The DMSs, anonymization procedures of personal identification data, and frequency of data quality control were fairly homogeneous within regions, whereas the number of HUDs, data availability, type of identification code, and anonymization procedures were considerably heterogeneous across regions. The study provides an updated inventory of the available regional HUDs in Italy and highlights the need for greater homogeneity across regions to improve comparability of health data from secondary sources. It could represent a reference model for other countries to provide information on the available HUDs and their features, enhancing epidemiological studies across countries.

Beschreibung: To investigate the parameters of eye movement between ophthalmologists and optometrists while diagnosing digital fundus photographs, sixteen participants (eight ophthalmologists and eight optometrists) were recruited in this study. Every participant’s eye movement during diagnosis of a randomized set of fundus photographs displayed on an eye tracker were recorded. Fixation metrics (duration, count and rate) and scan path patterns were extracted from the eye tracker. These parameters of eye movement and correct diagnosis score were compared between both groups. Correlation analyses between fixation metrics and correct diagnosis score were also performed. Although fixation metrics between ophthalmologists and optometrists were not statistically different (p 〉 0.05), these parameters were statistically different when compared between different area of interests. Both participant groups had a similar correct diagnosis score. No correlation was found between fixation metrics and correct diagnosis score between both groups, except for total fixation duration and ophthalmologists’ diagnosis score of diabetic retinopathy photographs. The ophthalmologists’ scan paths were simpler, with larger saccades, and were distributed at the middle region of the photographs. Conversely, optometrists’ scan paths were extensive, with shorter saccades covering wider fundus areas, and were accumulated in some unrelated fundus areas. These findings indicated comparable efficiency and systematic visual search patterns between both the groups. Understanding visual search strategy could expedite the creation of a novel training routine for interpretation of ophthalmic diagnostic imaging.

Beschreibung: Hazardous chemical accidents (HCAs) seriously endanger public life, property, and health. Human and organizational factors are important causes of many kinds of accidents. In order to systematically explore the influencing factors of unsafe behaviors in HCAs in China, the method of human factors analysis and classification system based on the Bayesian network (BN-HFACs) was introduced. According to the 39 investigation reports of HCAs in China, the origin Bayesian network (BN) was obtained and the failure sensitivity of every node in BN was calculated. The results have shown that hazardous material environment (1.63) and mechanical equipment (0.49) in the level of preconditions of unsafe behavior have the same direction failure effect with operation error, while there is no factor has the same direction failure effect with operation violate. Some factors in organization influence and unsafe supervision, such as organization climate (0.34), operation guidance (0.37), planned operation (0.22), and legal supervision (0.19), are also important reasons for operational errors, while resource management (0.12), hidden investigation (0.18) and legal supervision (0.13) have an impact on operation violates. Moreover, there are still close relationships between other hierarchical elements, such as the operation guidance effect on the hazardous material environment (6.60), and the organizational climate has the most obvious impact on other factors at the level of organizational factors. Based on the above research conclusions, suggestions for individual, enterprise, and government were put forward, respectively, and the limitations of this study were also clarified.

Beschreibung: Objectives: Mind–body exercise has been generally recognized as a beneficial strategy to improve mental health in those with Chronic Obstructive Pulmonary Disease (COPD). However, to date, no attempt has been made to collate this literature. The aim of the present study was to systematically analyze the effects of mind–body exercise for COPD patients with anxiety and depression and provide scientific evidence-based exercise prescription. Methods: both Chinese and English databases (PubMed, the Cochrane Library, EMBASE, Web of Science, Google Scholar, Chinese National Knowledge Infrastructure, Wanfang, Baidu Scholar) were used as sources of data to search randomized controlled trials (RCT) relating to mind–body exercise in COPD patients with anxiety and depression that were published between January 1982 to June 2019. 13 eligible RCT studies were finally used for meta-analysis. Results: Mind–body exercise (tai chi, health qigong, yoga) had significant benefits on COPD patients with anxiety (SMD= −0.76, 95% CI −0.91 to −0.60, p=0.04, I2=47.4%) and depression (SMD= −0.86, 95% CI −1.14 to −0.58, p=0.000, I2=71.4%). Sub-group analysis indicated that, for anxiety, 30–60 min exercise session for 24 weeks of health qigong or yoga had a significant effect on patients with COPD who are more than 70 years and have more than a 10-year disease course. For depression, 2–3 times a week, 30–60 min each time of health qigong had a significant effect on patients with COPD patients who are more than 70 years old and have less than a 10-year disease course. Conclusions: Mind–body exercise could reduce levels of anxiety and depression in those with COPD. More robust RCT are required on this topic.

Beschreibung: This study analyzes the direct relationships between classroom and family context and adolescent students’ life satisfaction (LS) and the indirect relationships between these same variables through adolescents’ academic, family, and social self-concept from a gender perspective. In the theoretical model, we assume that the quality of the parent—child relationship affects adolescents’ LS both directly and indirectly through their self-concept. We assume that the quality of the classroom climate also affects adolescents’ LS through their self-concept. The sample consisted of 2373 adolescents (49.8% girls) aged 12 to 18 years (mean (M) = 14.69, standard deviation (SD) = 1.82). A structural equation model was tested to analyse the relationship between the variables. Subsequently, multigroup analysis was performed to determine the structural invariance of the model as a function of gender. The chi square and T-student test was 71.66. Results revealed a direct positive relationship between family environment and LS. Family and classroom environment were indirectly related to LS through their relationship with academic, family, and social self-concept. The result of multigroup analysis supports the structural invariance of the model in both sexes; therefore, the expected relationships are the same for boys and girls, making the model more generalizable and applicable. The practical and theoretical implications are discussed.

Beschreibung: Our aim is to assess the smoking cessation and vaping cessation activity, including quit attempts and willingness to quit among university students in Central and Eastern Europe, as well as to investigate personal characteristics associated with smoking cessation and vaping cessation attempts. Data were collected by questionnaire which included 46 questions on cigarette and e-cigarette use. Questionnaires were obtained from 14,352 university students (aged 20.9 ± 2.4 years; cooperation rate of 72.2%). For the purposes of this analysis, only data from exclusive cigarette smokers (n = 1716), exclusive e-cigarette users (n = 129), and dual users (216) were included. Of all cigarette smokers, 51.6% had previously tried to quit smoking and 51.5% declared a willingness to quit cigarette smoking in the near future. Among all e-cigarette users only 13.9% had ever tried to quit using the e-cigarette and 25.2% declared a willingness to give up using e-cigarette in the near future. The majority of the group did not use pharmacotherapy to quit cigarette (87.5%) or e-cigarette (88.9%) use. Our results indicate that while most university students have some desire to quit conventional smoking, those who use e-cigarettes do not have the same desire.

Beschreibung: The aim of this study was to investigate facilitating and hindering factors when implementing a physical activity (PA)-promoting program among office workers moving to a flex office, by conducting a process evaluation. Additionally, we evaluated self-reported and perceived PA behaviors. With a mixed methods design, analyses were based upon data from interviews with 70 employees and repeated questionnaires from 152 employees. The PA-promoting program was fully implemented and supported by management. There was a strong health promoting culture, encouraging PA in the organization already at the start of the study. The lecture and the office design were rated as the most motivating program components. The use of stairs, breaks during meetings and social acceptance for standing and walking at work increased. Employees described a strive for variation, and how managers, the office environment, productivity and ergonomic aspects influenced sedentary behavior (SB) and PA. The need for the PA-promoting program was questioned, and the timing of the program was debated. To conclude, a strong organizational health culture combined with a facilitating physical environment can create sustainable positive PA behaviors in office settings. A thorough understanding of organizational needs and a participatory process are needed to tailor organizational interventions to decrease SB.

Beschreibung: Weight-based teasing (WBT) by family members is commonly reported among youth and is associated with eating and mood-related psychopathology. Military dependents may be particularly vulnerable to family WBT and its sequelae due to factors associated with their parents’ careers, such as weight and fitness standards and an emphasis on maintaining one’s military appearance; however, no studies to date have examined family WBT and its associations within this population. Therefore, adolescent military dependents at-risk for adult obesity and binge-eating disorder were studied prior to entry in a weight gain prevention trial. Youth completed items from the Weight-Based Victimization Scale (to assess WBT by parents and/or siblings) and measures of psychosocial functioning, including the Beck Depression Inventory-II, The Rosenberg Self-Esteem Scale, and the Social Adjustment Scale. Eating pathology was assessed via the Eating Disorder Examination interview, and height and fasting weight were measured to calculate BMIz. Analyses of covariance, adjusting for relevant covariates including BMIz, were conducted to assess relationships between family WBT, eating pathology, and psychosocial functioning. Participants were 128 adolescent military dependents (mean age: 14.35 years old, 54% female, 42% non-Hispanic White, mean BMIz: 1.95). Nearly half the sample (47.7%) reported family WBT. Adjusting for covariates, including BMIz, family WBT was associated with greater eating pathology, poorer social functioning and self-esteem, and more depressive symptoms (ps ≤ 0.02). Among military dependents with overweight and obesity, family WBT is prevalent and may be linked with eating pathology and impaired psychosocial functioning; prospective research is needed to elucidate the temporal nature of these associations.

Beschreibung: Community-level action may be required to achieve the levels of sanitation uptake necessary for health gains. Evidence suggests that collective action is influenced by collective efficacy (CE)—a group’s belief in its abilities to organize and execute action to achieve common goals. The extent to which it is necessary to fully contextualize existing CE measurement tools, in order to conduct meaningful assessments of the factors influencing CE perceptions, is not well understood. This study examines the value added of contextualizing an existing CE measurement tool using qualitative formative research. We employed a modified grounded theory approach to develop a contextualized CE framework based on qualitative data from rural Cambodian villages. The resulting framework included sub-constructs that were pertinent for the rural Cambodian context for which an existing, hypothesized framework did not account: perceived risks/benefits, action knowledge, shared needs/benefits, and external accountability. Complex confirmatory factor analyses indicated that contextualized models fit the data better than hypothesized models for women and men. This study demonstrates that inductive, qualitative research allows community-derived factors to enhance existing tools for context-specific CE measurement. Additional research is needed to determine which CE factors transcend contexts and could, thus, form the foundation of a general CE measurement tool.

Beschreibung: We tested the hypothesis that thermal behavior alleviates thermal discomfort and accelerates core temperature recovery following low intensity exercise. Methods: In a 27 0 C, 48 6% relative humidity environment, 12 healthy subjects (six females) completed 60 min of exercise followed by 90 min of seated recovery on two occasions. Subjects wore a suit top perfusing 34 ± 0 °C water during exercise. In the control trial, this water continually perfused throughout recovery. In the behavior trial, the upper body was maintained thermally comfortable by pressing a button to receive cool water (3 2 °C) perfusing through the top for 2 min per button press. Results: Physiological variables (core temperature, p ≥ 0.18; mean skin temperature, p = 0.99; skin wettedness, p ≥ 0.09; forearm skin blood flow, p = 0.29 and local axilla sweat rate, p = 0.99) did not differ between trials during exercise. Following exercise, mean skin temperature decreased in the behavior trial in the first 10 min (by −0.5 0.7 °C, p 〈 0.01) and upper body skin temperature was reduced until 70 min into recovery (by 1.8 1.4 °C, p 〈 0.05). Core temperature recovered to pre-exercise levels 17 31 min faster (p = 0.02) in the behavior trial. There were no differences in skin blood flow or local sweat rate between conditions during recovery (p ≥ 0.05). Whole-body thermal discomfort was reduced (by −0.4 0.5 a.u.) in the behavior trial compared to the control trial within the first 20 min of recovery (p ≤ 0.02). Thermal behavior via upper body cooling resulted in augmented cumulative heat loss within the first 30 min of recovery (Behavior: 288 92 kJ; Control: 160 44 kJ, p = 0.02). Conclusions: Engaging in thermal behavior that results in large reductions in mean skin temperature following exercise accelerates the recovery of core temperature and alleviates thermal discomfort by promoting heat loss.

Beschreibung: This study has three objectives: to examine whether adolescents who perceive themselves as overweight differ from others in terms of offline victimization at school, cybervictimization, self-esteem, and difficulties relating to peers; to examine the possible effects of offline and cybervictimization on self-esteem and difficulties relating to peers; and to examine the possible moderating role of perceiving oneself as overweight on those effects. Previously validated questionnaires were applied to a sample of 3145 adolescents in Asturias (Spain). Descriptive, inferential, correlational, and structural equation analyses were performed. Adolescents who perceived themselves as overweight reported being victims of both offline victimization and most forms of cybervictimization to a greater extent than those who did not perceive themselves as overweight. They also reported lower self-esteem and more peer difficulties (shyness or social anxiety). In both groups of adolescents, victimization and cybervictimization were correlated with each other, both types of victimization had direct, negative effects on self-esteem, and self-esteem in turn had a direct, negative effect on peer difficulties. Furthermore, offline victimization had a direct, positive effect on peer difficulties. Perceiving oneself as overweight moderated the effect of self-esteem on peer difficulties. In adolescents perceiving themselves as overweight, low self-esteem was a stronger risk factor of peer difficulties than in the rest of the adolescents. With high overall self-esteem there were no significant differences in peer difficulties between the adolescents perceiving themselves as overweight and the rest of the adolescents.

Beschreibung: The incorrect carriage of schoolbags and heavy bags may result in back pain (BP) in adolescents. Our objective was to assess the problem of BP and associated factors among adolescents. This was a cross-sectional study targeting intermediate and secondary school adolescents in Abha City, Saudi Arabia. An anonymous questionnaire for BP was used. Student body weight and the weight of their full schoolbag were measured. The study included 876 adolescents. An overall prevalence of BP of 39.4% (95% CI: 35.3–43.7) was found. Upper BP (UBP), middle BP (MBP), and lower BP (LBP) amounted to 14.5%, 13.4%, and 11.5%, respectively. Associated significant factors with MBP were carrying the bag on one side compared to on the back (adjusted odds ratio (aOR) = 2.13, 95% CI: 1.20–3.73) and being at intermediate level compared to secondary (aOR = 1.56, 95% CI: 1.04–2.40). On the other hand, gender and schoolbag weight/body weight percent were not found to be significantly associated with MBP. None of the studied factors were significantly associated with overall BP, UBP, or LBP. BP is a prevalent among adolescents in southwest Saudi Arabia. One-sided schoolbag carriage is a significant associated factor for middle back pain. Parents and teachers should encourage students to consider the correct way to carry schoolbag.

Beschreibung: Walking is the most accessible form for seniors to engage in daily light or moderate physical activity. Walking activity depends on both individual and environmental factors, the latter including how walkable a given setting is. Recent papers have pointed at the relevance of also considering meteorological conditions in relation to the walking behavior of older adults. This paper explores the combined effect of neighborhood walkability, temperature and rain on daily walking time among seniors residing in Barcelona. Daily walking time was extracted from 7-day GPS (Global Positioning System) devices and accelerometer data of 227 seniors residing in the Barcelona Metropolitan Region (Spain). Temperature and rain data were extracted from official governmental weather stations. Mixed-effects linear regression models were adjusted to test the combined association between weather and walkability on daily walking time. Neighborhood walkability is positively associated with walking time among seniors, while rain generally deters it. Additionally, this study demonstrates that temperature and rain modify the effect of residential walkability on senior walking activity: low temperatures are particularly associated with lower walking activity among those residing in low walkable areas, while the presence of rain presents a negative association with walking time in high walkable environments. The combined effect of walkability and weather should be considered both in design actions that aim at improving walking infrastructure and also in prevention programs aimed at encouraging daily walking among seniors.

Beschreibung: The need for physical activity for health promotion is recognized, yet young adults still perform insufficient physical activity. Smartphone health programs can be applied easily without time and space constraints, and various mobile health programs based on smartphone applications have recently been developed and applied. This study aimed to measure the effects of mobile smartphone-based health programs on physical activity and obesity outcomes in young adults through a systematic review and meta-analysis. We searched publications in English through electronic databases up to May 2019. Studies were included that provided interventions to improve physical activity using smartphone applications for young adults. After assessing study quality, data were extracted and synthesized concerning whether smartphone interventions affect health outcomes including physical activity and weight using Meta-Analysis software. Four randomized controlled studies and a quasi-experimental study were analyzed. They provided information related to health management, diet, physical activity, and personalized feedback using smartphone applications. The meta-analysis showed that smartphone-based health interventions significantly affect weight loss and increase physical activity. This study provides modest evidence for using smartphone health programs to improve young adults’ physical activity, weight control, and body mass index (BMI). Future research is needed to understand long-term effects and the reliability of increasing physical activity through smartphone health programs.

Beschreibung: Research suggests that physical activity can be used as an intervention to increase cognitive function. Yet, there are competing views on the cognitive effects of physical activity and it is not clear what level of consensus exists among researchers in the field. The purpose of this study was two-fold: Firstly, to quantify the scientific consensus by focusing on the relationship between physical activity and cognitive function. Secondly, to investigate if there is a gap between the public’s and scientists’ interpretations of scientific texts on this topic. A two-phase study was performed by including 75 scientists in the first phase and 15 non-scientists in the second phase. Participants were asked to categorize article abstracts in terms of endorsement of the effect of physical activity on cognitive function. Results indicated that there was a 76.1% consensus that physical activity has positive cognitive effects. There was a consistent association between scientists’ and non-scientists’ categorizations, suggesting that both groups perceived abstracts in a similar fashion. Taken together, this study provides the first analysis of its kind to evaluate the level of consensus in almost two decades of research. The present data can be used to inform further research and practice.

Beschreibung: Advances in virtual reality present opportunities to relive experiences in an immersive medium that can change the way we perceive our life stories, potentially shaping our realities for the better. This paper studies the role of virtual reality as a tool for the creation of stories with the concept of the self as a narrator and the life of the self as a storyline. The basis of the study is the philosophical notion of the self-narrative as an explanatory story of the events in one’s life that constitutes the notion of one’s self. This application is suitable for cases when individuals need to recreate their self, such as during recovery after traumatic events. The analysis of the effects of virtual reality shows that it enables a person to engage in a process of deeper self-observation to understand and explain adverse events and to give meaning to these events to form a new story, which can complement the therapeutic outcomes of exposure treatments. This study proposes concrete examples of immersive scenarios used to reconstruct personal stories. Several possible levels of experience are proposed to suggest that recovery can be achieved through the gradual retelling of the self-narrative, addressing all of the underlying narratives. Considering the ethical challenges that might arise, this paper explores the ways in which immersion in virtual reality can benefit a person’s view toward life as a story and his or her self as its author, comparing this idea with previous research on the application of virtual reality for trauma treatment. The analysis also emphasizes the perception of narrative authorship in virtual reality as an essential method for recovering the self-narrative and improving a patient’s mental health during self-actualization.

Beschreibung: Chronotype reflects an individual’s preferred time of the day for an activity/rest cycle and individuals can be classified as a morning, intermediate, or evening type. A growing number of studies have examined the relationship between chronotype and general health. This review aimed to map current evidence of the association between chronotype and dietary intake among the adult population. A systematic search was conducted across five databases: EBSCO Host, Medline & Ovid, Pubmed, Scopus, and The Cochrane Library. The inclusion criteria were adult subjects (more than 18 years old), and included an assessment of (i) chronotype, (ii) dietary behaviour/nutrient intake/food group intake, and (iii) an analysis of the association between chronotype and dietary behaviour/nutrient intake/food group intake. A total of 36 studies were included in the review. This review incorporated studies from various study designs, however, the majority of these studies were based on a cross-sectional design (n = 29). Dietary outcomes were categorized into three main groups, namely dietary behaviour, nutrient intake, and specific food group intake. This scoping review demonstrates that evening-type individuals are mostly engaged with unhealthy dietary habits related to obesity and were thus hampered in the case of weight loss interventions. Hence, this review has identified several dietary aspects that can be addressed in the development of a personalised chrono-nutrition weight loss intervention.

Beschreibung: Ensuring students’ access to safe drinking water at school is essential. However, many schools struggle with aging infrastructure and subsequent water safety problems and have turned to bottled water delivery systems. Little is known about whether such systems are feasible and effective in providing adequate student water access. This study was a mixed-methods investigation among six schools in an urban district in the U.S. with two types of water delivery systems: (1) tap water infrastructure, with updated water fountains and bottle fillers, and (2) bottled water coolers. We measured students’ water consumption and collected qualitative data from students and teachers about their perceptions of school drinking water. Student water consumption was low—between 2.0 (SD: 1.4) ounces per student and 2.4 (SD: 1.1) ounces per student during lunch. Students and teachers reported substantial operational hurdles for relying on bottled water as a school’s primary source of drinking water, including difficulties in stocking, cleaning, and maintaining the units. While students and teachers perceived newer bottle filler units positively, they also reported a distrust of tap water. Bottled water delivery systems may not be effective long-term solutions for providing adequate school drinking water access and robust efforts are needed to restore trust in tap water.

Beschreibung: Particulate matter with a diameter less than 2.5 µm (PM2.5), one of the main sources of air pollution, has increasingly become a concern of the people and governments in China. Examining the socioeconomic factors influencing on PM2.5 concentration is important for regional prevention and control. Previous studies mainly concentrated on the economically developed eastern coastal cities, but few studies focused on inland cities. This study selected Chengdu Plain Economic Zone (CPEZ), an inland region with heavy smog, and used spatial econometrics methods to identify the spatiotemporal distribution characteristics of PM2.5 concentration and the socioeconomic factors underlying it from 2006 to 2016. Moran’s index indicates that PM2.5 concentration in CPEZ does have spatial aggregation characteristics. In general, the spatial clustering from the fluctuation state to the stable low state decreased by 1% annually on average, from 0.190 (p 〈 0.05) in 2006 to 0.083 (p 〈 0.1) in 2016. According to the results of the spatial Durbin model (SDM), socioeconomic factors including population density, energy consumption per unit of output, gross domestic product (GDP), and per capita GDP have a positive effect on PM2.5 concentration, while greening rate and per capita park space have a negative effect. Additionally, those factors have identified spatial spillover effects on PM2.5 concentration. This study could be a reference and support for the formulation of more efficient air pollution control policies in inland cities.

Beschreibung: Fresh fruits and vegetables are a cornerstone of a balanced diet; their consumption has health, environmental, ethical, and economic implications. This pilot study aimed to: (i) measure fruit and vegetable consumption; (ii) understand consumer perceptions of the perceived importance of regionally grown fresh fruit and vegetables (RGFFV); and (iii) identify the barriers and enablers of access and consumption of RGFFV. The study took place in Tasmania (TAS) and South Western Australia (SWA). A 54-item survey included questions relating to purchasing and consumption patterns; barriers and enablers related to access and consumption of RGFFV; and sociodemographic information. Survey data were analyzed using Chi-square test and binary logistic regression. A total of n = 120 TAS and n = 123 SWA adult respondents participated. SWA respondents had higher intakes of fruit (p 〈 0.001) and vegetables (p 〈 0.001). Almost all respondents (97%) rated purchasing of RGFFV as important. Top enablers included produce freshness (97%), and to financially support local farmers (94%) and the local community (91%). Barriers included limited seasonal availability of the produce (26%), the belief that RGFFV were expensive (12%) and food budgetary constraints (10%). Recommendations include broader marketing and labelling of seasonal RGFFV; increasing ‘buy local’ campaigns; consumer information about how RGFFV benefits producers and communities; and pricing produce according to quality.

Beschreibung: Objective: With the participation of private hospitals in the health system, improving hospital efficiency becomes more important. This study aimed to evaluate the technical efficiency of public and private hospitals in Beijing, China, and analyze the influencing factors of hospitals’ technical efficiency, and thus provide policy implications to improve the efficiency of public and private hospitals. Method: This study used a data set of 154–232 hospitals from “Beijing’s Health and Family Planning Statistical Yearbooks” in 2012–2017. The data envelopment analysis (DEA) model was employed to measure technical efficiency. The propensity score matching (PSM) method was used for matching “post-randomization” to directly compare the efficiency of public and private hospitals, and the Tobit regression was conducted to analyze the influencing factors of technical efficiency in public and private hospitals. Results: The technical efficiency, pure technical efficiency and scale efficiency of public hospitals were higher than those of private hospitals during 2012–2017. After matching propensity scores, although the scale efficiency of public hospitals remained higher than that of their private counterparts, the pure technical efficiency of public hospitals was lower than that of private hospitals. Panel Tobit regression indicated that many hospital characteristics such as service type, level, and governance body affected public hospitals’ efficiency, while only the geographical location had an impact on private hospitals’ efficiency. For public hospitals in Beijing, those with lower average outpatient and inpatient costs per capita had better performance in technical efficiency, and bed occupancy rate, annual visits per doctor, and the ratio of doctors to nurses also showed a positive sign with technical efficiency. For private hospitals, the average length of stay was negatively associated with technical efficiency, but the bed occupancy rate, annual visits per doctor, and average outpatient cost were positively associated with technical efficiency. Conclusions: To improve technical efficiency, public hospitals should focus on improving the management standards, including the rational structure of doctors and nurses as well as appropriate reduction of hospitalization expenses. Private hospitals should expand their scale with proper restructuring, mergers, and acquisitions, and pay special attention to shortening the average length of stay and increasing the bed occupancy rate.

Beschreibung: This mixed-methods study explored ways to enhance the emergency response abilities of workers in long-term care services for the elderly. Based on different service types, we identify emergency situations and the response abilities of workers in long-term care services. Results indicated that there are more emergency situations in care facilities than in home care services. However, 71.3% of respondents in facilities said emergency response abilities were low compared to 44.2% of workers in home care services. Qualitative research identified six categories and 16 themes based on emotions experienced during emergencies and the challenges in determining solutions. The study confirms that there is a difference in emergency incidences and the coping abilities of workers in facilities and home services with high emergency incidence rates. Developing and applying guidelines for emergency response management by service type is recommended.

Beschreibung: The aims were to determine Spanish women’s expectations about exclusive breastfeeding (EB) and the effect of expectations and other factors on EB during the first 6 months. A prospective cohort study was conducted with 236 participants. Variables were maternal age, marital status, occupation, expectations about breastfeeding, knowledge about breastfeeding, type of delivery, type of feeding, and duration of EB. Data were collected through three personal interviews, at the hospital (before delivery) and in two telephone calls in the first and sixth months postpartum. Average age was 32.3 years (SD = 5.3); average duration of EB was 2.73 months (SD = 2.49). Of 236 women who had decided to breastfeed before birth, 201 (85.2%) offered EB after delivery. Achievement of expectations was most influenced by the decision to continue breastfeeding ‘as long as I can’ (OR: 5.4; CI: 2.0–14.6) and previous experience (OR: 3.2; CI: 1.2–8.5). Knowledge of breastfeeding acquired from relatives (OR: 9.2; CI: 3.0–27.9), caesarean delivery (OR: 4.6; CI: 1.7–12.8) and maternal age (36–40 years old) (OR: 7.5; CI: 1.8–30.9) were associated with failure to achieve EB. Achievement of EB may depend on a woman’s confidence in her ability to do so and on knowledge obtained in the social environment.

Beschreibung: This paper is an extension of work originally presented to pHealth 2019—16th International Conference on Wearable, Micro and Nano Technologies for Personalized Health. To provide an efficient decision support, it is necessary to integrate clinical decision support systems (CDSSs) in information systems routinely operated by healthcare professionals, such as hospital information systems (HISs), or by patients deploying their personal health records (PHR). CDSSs should be able to use the semantics and the clinical context of the data imported from other systems and data repositories. A CDSS platform was developed as a set of separate microservices. In this context, we implemented the core components of a CDSS platform, namely its communication services and logical inference components. A fast healthcare interoperability resources (FHIR)-based CDSS platform addresses the ease of access to clinical decision support services by providing standard-based interfaces and workflows. This type of CDSS may be able to improve the quality of care for doctors who are using HIS without CDSS features. The HL7 FHIR interoperability standards provide a platform usable by all HISs that are FHIR enabled. The platform has been implemented and is now productive, with a rule-based engine processing around 50,000 transactions a day with more than 400 decision support models and a Bayes Engine processing around 2000 transactions a day with 128 Bayesian diagnostics models.

Beschreibung: This paper describes a study of the relationship between undesired road traffic externalities and residential price values in the Spanish city of Madrid. A large database was gathered, including the price and characteristics of 21,634 flats and road traffic intensity at 3904 different points across the city. The results obtained by a hedonic model suggest that both distance from the traffic measurement point and average daily traffic are significantly related to the price of residential properties, even after controlling for structural and neighbourhood variables. Distance to traffic areas has a positive impact on dwelling prices, whilst these are negatively related to traffic intensity.

Beschreibung: Background and objectives: Sex education is a necessity and a right of young people in Angola. However, this education is deficient or even absent in various subsystems and, therefore, the impact of an educational intervention on human biology and sexuality was addressed. Materials and methods: This quasi-experimental study employed a non-equivalent control group, pre-test post-test design. It was conducted with students from three secondary schools (6th to 12th grade, two public and one private) in Huambo (Angola), between June and December 2017. First, a questionnaire was distributed to assess the students’ knowledge on aspects related to sexual maturation, psychological development, gynecological organs’ anatomy, human fertilization, contraception, and risks of unprotected sexuality. Then, an educational program was developed by the principal investigator along with the school’s moral and civic education and biology teachers selected for a group of students (experimental group, EG); the others constituted the control group (CG). Classes were held on non-working days, on Saturday mornings (8:00 to 10:00 a.m.), so as not to interfere with the school calendar. The initial questionnaire was redistributed two months later to assess the impact of the intervention. Results: Of the 589 individuals included (mean age of 16.8 ± 2.5 years), 56.7% were males. EG (n = 241) consisted of students from the public school and CG (n = 348) by students from public and private schools. The last part of the questionnaire consisted of 30 questions to assess students’ knowledge, and in 23 of these questions, both groups showed no differences at baseline. After the intervention, the EG showed significant improvements (p 〈 0.05), while the CG revealed only slight improvements. Conclusions: Students from Huambo province have a significant lack of knowledge on human biology and sexuality. Rigorous development and evaluation of interventions addressing multiple individual and environmental level factors is needed, notably for effective education in human biology and sexuality.

Beschreibung: Enabling parents to create a smoke-free home is one of the key ways that children’s exposure to second-hand smoke (SHS) can be reduced. Smoke-free home interventions have largely targeted mothers who smoke, and there is little understanding of the barriers and facilitators that fathers experience in creating a smoke-free home. Systematic searches combining terms for fathers, homes, and SHS exposure were run in April 2019 in Web of Science’s Citation Indices, PsycINFO, and PubMed for English-language studies published since 2008. The searches identified 980 records for screening, plus 66 records from other sources. Twelve studies reported in 13 papers were included in this scoping review. Eight of the studies were conducted in Asian countries (five in China, one in India, one in Japan, and one in Iran), three were conducted in Canada, and one in Turkey. Findings were extracted in verbatim text for thematic analysis. The review identified that attitudes and knowledge, cultural and social norms, gender power relations, and shifting perceptions and responsibilities related to fatherhood can impact on fathers’ views of their role in relation to creating and maintaining a smoke-free home. There were too few published studies that had assessed smoke-free home interventions with fathers to draw conclusions regarding effective approaches. Research is clearly needed to inform our understanding of fathers’ roles, successes and challenges in creating and maintaining a smoke-free home, so that father-inclusive rather than mother-led interventions can be developed to benefit entire households and improve gender equity as well as health.

Beschreibung: This contribution aims to investigate the influence of monthly total rainfall variations on malaria transmission in the Limpopo Province. For this purpose, monthly total rainfall was interpolated from daily rainfall data from weather stations. Annual and seasonal trends, as well as cross-correlation analyses, were performed on time series of monthly total rainfall and monthly malaria cases in five districts of Limpopo Province for the period of 1998 to 2017. The time series analysis indicated that an average of 629.5 mm of rainfall was received over the period of study. The rainfall has an annual variation of about 0.46%. Rainfall amount varied within the five districts, with the northeastern part receiving more rainfall. Spearman’s correlation analysis indicated that the total monthly rainfall with one to two months lagged effect is significant in malaria transmission across all the districts. The strongest correlation was noticed in Vhembe (r = 0.54; p-value =

Beschreibung: Background: Contact lenses (CLs) are more popular than spectacles for vision correction amongst the youth. Knowledge about the risks of wearing CLs is critical especially for those with poor access to public health education. This study investigates the patterns of use and level of knowledge about CL wear amongst teenagers living in rural areas in Selangor, Malaysia using a set of validated questionnaires. Methods: A total of 8500 self-administered questionnaires were distributed in eight selected secondary schools. The results were analysed using descriptive statistics. Results: A total of 2474 (29%) completed questionnaires were collected. The mean age of the respondents was 14.8 ± 1.5 years, and approximately 7.2% were CL wearers. The majority of the wearers were females (76.0%) and wore soft CLs (92.2%). Cosmetic purposes (58.1%) and comfort (24.6%) were the main reasons for wearing CLs. Many of the respondents purchased their lenses from optical shops (50.1%) and beauty accessory shops (15.6%), and approximately 10% did not disinfect their lenses properly. Regarding knowledge about CL care, approximately 56% of the respondents responded correctly. Conclusion: Half of the respondents do not have sufficient knowledge about the risks of wearing CLs. Thus, aggressive public health education aimed at teenagers is needed to prevent improper CL usage.

Beschreibung: Thus far, there have been no studies adapting the Mandarin 36-Item Short Form Health Survey (the SF-36) questionnaire for assessment of the health-related quality of life (HRQOL) of medical students in China. This study aimed to explore the feasibility of that form and analyse its impact factors. The study involved 498 randomly sampled medical students stratified by their academic majors, and general information was collected. The effective response rate was 83.53%. Split-half reliability coefficients and Cronbach’s α coefficients of seven dimensions were more than 0.7 with the exception of the social function (SF) dimension. Spearman’s correlation analysis results were basically in accord with the theoretical construction of the SF-36. The HRQOL of the students was scored from 43.83 (the RE dimension) to 93.34 (the PF dimension). The primary impact factors affecting the HRQOL of medical students included major, sleep quality, degree of physical exercise, post-exercise status, relationship with roommate, and satisfaction with family. These findings suggested that the Mandarin SF-36 was reliable for measuring the HRQOL, that the HRQOL of medical students in a Chinese university was relatively poor, and that its improvement requires concerted efforts.

Beschreibung: The uptake of vasectomy in many countries in sub-Saharan Africa is low. In Eswatini, a kingdom with strong patriarchal norms, the use of vasectomy is at 0.3%. This is despite great efforts to introduce vasectomy and involve men in reproductive health. This study explored the views of men about the acceptability of vasectomy and their willingness to adopt vasectomy as a family planning option. Focus group discussions were conducted with adult men recruited from health facilities located in rural, semi urban, and urban areas in two of the regions of Eswatini. A thematic approach was used to analyze the data. The acceptability of and intention to use vasectomy as a family planning option was very low. Cultural beliefs, societal norms, lack of knowledge about the procedure for vasectomy, and misconceptions influenced the acceptability of vasectomy greatly. The participants could not grasp the concept of a family planning method that is as permanent as vasectomy. However, the decisions to accept or reject vasectomy were influenced by their misconceptions and fears about vasectomy and were not based on facts. To address the need to involve men in reproductive health and improve the acceptability and adoption of vasectomy, planning should be conducted with them and informed by their understanding of their needs.

Beschreibung: The aim of the present study is twofold: (1) to identify a factor structure between variables-interest in broad science topics, perceived information and communications technology (ICT) competence, environmental awareness and optimism; and (2) to explore the relations between these variables at the country level. The first part of the aim is addressed using exploratory factor analysis with data from the Program for International Student Assessment (PISA) for 15-year-old students from Singapore and Finland. The results show that a comparable structure with four factors was verified in both countries. Correlation analyses and linear regression were used to address the second part of the aim. The results show that adolescents’ interest in broad science topics can predict perceived ICT competence. Their interest in broad science topics and perceived ICT competence can predict environmental awareness in both countries. However, there is difference in predicting environmental optimism. Singaporean students’ interest in broad science topics and their perceived ICT competences are positive predictors, whereas environmental awareness is a negative predictor. Finnish students’ environmental awareness negatively predicted environmental optimism.

Beschreibung: Objectives: Fall preventive programs aim to reduce risks for mortality from fall-related injuries among older adults. However, the covariation between personal perceptions of falls and factors and confidence of self-management in falls (CSMoF) is still under-studied despite its importance to fall prevention. We aimed to investigate the relative contribution of CSMoF in relation to fall risk self-perceptions while controlling for demographics and self-reported health and functioning. Method: Participants were 691 older adults recruited from Area Agency on Aging at Arlington, Texas (females = 76.1%, mean age = 76.23, SD = 6.44, with chronic condition = 79.5%). They completed measures of physical functioning, CSMoF, fall risk perceptions and fear of falls. Results: Regression analyses indicated that fear of fall was the most predictive factor of CSMoF among older persons, accounting for about 25% of the variance. Physical function measures of age, chronic illnesses of metabolism, sensory impairment, and health status were also significant predictors of the CSMoF, but to a lesser extent than fear of falls and fall perceptions. The interaction of perception of falls and fall experience attenuated CSMoF, with physical functioning limitations. Conclusion: The joint effects of perception of falls and fear of falls likely explain CSMoF among older adults more than physical functional indicators. Fall prevention programs for older adults should prioritize to address modifiable subjective factors of fall perceptions, fear of falls, and CSMoF across health and functioning statuses.

Beschreibung: Gobeil’s model is one of the most widely used models to identify lead (Pb) pollution sources in the environment. It is based on a set of equations involving Pb isotope fractions. Although a well-established numerical method, Gobeil’s model is often unable to provide an accurate estimation of each pollution sources’ contribution. This paper comprehensively examines the drawbacks of Gobeil’s model based on a numerical analysis and proposes a revised numerical method that provides a more accurate estimation of Pb pollution sources. Briefly, the mathematical inaccuracy of Gobeil’s model mainly lies in the misinterpretation of “lead fingerprint ratio balance.” To address this problem, the new analytic model relies on the mass balance of total lead in the contaminated sites, and uses a set of linear equations to obtain the contribution of each pollution source based on the lead fingerprint. A subsequent case study from an industrial park in Guanzhong area of Shaanxi Province in China shows that we can calculate the lead contribution rates accurately with the new model.