ALBERT

Description: The purpose of this study is to explore the association between proximity to open space and adult renal function. This was a cross-sectional study. Adult residents of Taipei metropolis were recruited in the analysis. The proximity of each subject to open space was measured using the Geographic Information System. Residents were divided into two groups: with and without chronic kidney disease (CKD). We made univariable comparisons between the two groups. The logistic regression models were used to estimate the odds ratio of CKD. Forest plot was used to examine the effect of interaction between distance to open space and subgroup variable on CKD. A total number of 21,656 subjects with mean age 53.6 years were enrolled in the study. Of the subjects, 2226 (10.28%) had CKD. The mean and standard deviation of distance to open space were 117.23 m and 80.19 m, respectively. Every 100 m distance to open space was associated with an odds ratio of 1.071 for CKD. Subgroup analysis revealed that residents of female, without hypertension, or without impaired fasting glucose (IFG) living more than 200 m from open spaces have greater odds of CKD than those living less than 200 m. Conclusions: Proximity to open space was associated with a lower prevalence of CKD among adults in Taiwan. Such association was enhanced among females and healthy adults without hypertension or impaired fasting glucose (IFG).

Description: Population groups vulnerable to adverse effects of traffic-related air pollution correspond to children, pregnant women and elderly. Despite these effects, literature is limited in terms of studies focusing on these groups and a reason often cited is the limited information on their mobility important for exposure assessment. The current study presents a method for assessing individual-level exposure to traffic-related air pollution by integrating mobility patterns tracked by global positioning system (GPS) devices with dynamics of air pollutant concentrations. The study is based on a pool of 17 pregnant women residing in Hidalgo County, Texas. The traffic-related particulate matter with diameter of less than 2.5 micrometer (PM2.5) emissions and air pollutant concentrations are predicted using MOVES and AERMOD models, respectively. The daily average traffic-related PM2.5 concentration was found to be 0.32 µg/m3, with the highest concentration observed in transit (0.56 µg/m3), followed by indoors (0.29 µg/m3), and outdoor (0.26 µg/m3) microenvironment. The obtained exposure levels exhibited considerable variation between time periods, with higher levels during peak commuting periods, close to the US–Mexico border region and lower levels observed during midday periods. The study also assessed if there is any difference between traffic-related dynamic exposure, based on time-varying mobility patterns, and static exposure, based solely on residential locations, and found a difference of 9%, which could be attributed to the participants’ activity patterns being focused mostly indoors.

Description: The inoculation of beneficial microorganisms to improve plant growth and soil properties is a promising strategy in the soil amendment. However, the effects of co-inoculation with phosphate-solubilizing bacteria (PSB) and N2-fixing bacteria (NFB) on the soil properties of typical C-deficient soil remain unclear. Based on a controlled experiment and a pot experiment, we examined the effects of PSB (M: Bacillus megaterium and F: Pseudomonas fluorescens), NFB (C: Azotobacter chroococcum and B: Azospirillum brasilence), and combined PSB and NFB treatments on C, N, P availability, and enzyme activities in sterilized soil, as well as the growth of Cyclocarya Paliurus seedlings grow in unsterilized soil. During a 60-day culture, prominent increases in soil inorganic N and available P contents were detected after bacteria additions. Three patterns were observed for different additions according to the dynamic bacterial growth. Synergistic effects between NFB and PSB were obvious, co-inoculations with NFB enhanced the accumulation of available P. However, decreases in soil available P and N were observed on the 60th day, which was induced by the decreases in bacterial quantities under C deficiency. Besides, co-inoculations with PSB and NFB resulted in greater performance in plant growth promotion. Aimed at amending soil with a C supply shortage, combined PSB and NFB treatments are more appropriate for practical fertilization at intervals of 30–45 days. The results demonstrate that co-inoculations could have synergistic interactions during culture and application, which may help with understanding the possible mechanism of soil amendment driven by microorganisms under C deficiency, thereby providing an alternative option for amending such soil.

Description: Evidence shows that there are many work-related accidents and injuries happening in construction projects and governments have taken a series of administrative measures to reduce casualties in recent years. However, traditional approaches have reached a bottleneck due to ignoring market forces, and thus new measures should be conducted. This study develops a perspective of safety performance (SP) for construction projects in China and puts forward a conception of the safety information system by using several brainstorming sessions to strengthen the safety supervision of participants in the construction industry. This system provides rating information to the public, and bad performance contractors enter into a blacklist which will influence their economic activities. Considering the limited rationality of government and various contractors, this paper builds a reasonable evolutionary game model to verify the feasibility of the safety information system. The analysis results show that there is not a single set of evolutionarily stable strategies (ESSs), as different situations may lead to different ESSs. The efficiency of applying the safety information system (the blacklist) in the construction industry can be proved by reducing the government’s safety supervision cost and by enhancing construction safety at the same time.

Description: The Yezidis who represent a religious minority living in Northern Iraq were particularly affected by the persecution by ISIS (Islamic state of Iraq and Syria, syn.: ISIL—Islamic state of Iraq and the Levant) that gained power after 2013. This paper gives an overview of the events and the mental health consequences on the Yezidi community as well as associated influences on affected female Yezidis. Based on a systematic literature search, the aspects of “Persecution by ISIS and actual situation of the Yezidi community”, “Gender-specific aspects of the persecution and its consequences”, “Mental health of the affected women”, and “Cultural–historical and religious context” are worked out. Research indicates a high burden of health strain and mental health problems in the surviving Yezidi women, especially post-traumatic stress disorders (PTSD) and depression. Concerning transgenerational trauma, the recent genocide has revived past experiences in the history of the community. Like the narrow cultural and religious rules of the community, this can be both a resource and a burden. The actual extent of the attacks is neither predictable for the affected individuals nor for the community, consequences could also be passed onto descendants. Long-term care and support of the affected persons, their descendants, and the Yezidi community seems indispensable.

Description: This study aims to examine the association of adverse childhood experiences (ACE) with emotional and behavioral problems (EBP) among adolescents and the degree to which this association is stronger for more ACE. In addition, we assessed whether socioeconomic position (SEP) modifies the association of ACE with EBP. We obtained data from 341 adolescents aged 10–16 (mean age = 13.14 years; 44.0% boys), the baseline of a cohort study. We measured EBP with the strengths and difficulties questionnaire and socioeconomic position (SEP) with self-reported financial status. We used generalized linear models to analyze the association between ACE (0 vs. 1–2 vs. 3 and more) and EBP, and the modifying effect of SEP. Adolescents with 1–2 ACE (regression coefficient: 0.19; 95%-confidence interval (CI): 0.06–0.32) and with 3 ACE and over (0.35; 0.17–0.54) reported more overall problems compared with adolescents without ACE. Moreover, adolescents with 1–2 ACE (0.16; −0.01–0.32, and 0.16; 0.03–0.29) and with 3 and over ACE (0.33; 0.10–0.56, and 0.28; 0.09–0.47) reported more emotional problems and behavioral problems, respectively. The interactions of SEP with ACE were not significant. ACE are related to EBP among adolescents, with a clear dose-response association, and this association similarly holds for all SEP categories.

Description: Background: Canadian Inuit have transited from a physically active hunter-gatherer subsistence lifestyle into sedentary ways of life. The purpose of the current study was to measure physical activity levels among Nunavut Inuit adults, and explore the socio-cognitive and environmental factors influencing the number of steps taken per day. Method: Inuit and non-Inuit adults (N = 272) in Nunavut participated in a seven-day pedometer study during summer and winter seasons. Participants were asked to complete the Neighbourhood Environmental Walkability Scale (NEWS) and Behavioral Regulation in Exercise Questionnaire (BREQ-3). Data analyses included descriptive statistics, hierarchical linear regression, and tests of mediation effects. Results: Participants had limited to low activity at a rate of 5027 ± 1799 and 4186 ± 1446 steps per day, during summer and winter, respectively. There were no seasonal and age effects on the number of steps. Gender effects and community differences were observed. Perceived infrastructure and safety as well as land use mix diversity were found to be positive environmental correlates of steps taken, which were partially mediated by identified motivational regulation. Conclusion: Physical activity levels among Nunavut adults are generally low, but can be promoted by improving the external physical environment and internal motivational regulation.

Description: Two endemic fish in the upper Yangtze River, the Rock Carp (Procypris rabaudi) and Prenant’s Schizothoracin (Schizothorax prenanti), were used as research objects in this study to assess the effects of total dissolved gas (TDG) supersaturation on fish of varying sizes. Fish were exposed to TDG-supersaturated water at the levels of 145, 140, 135, 130, and 125%. The results showed that fish swam slowly, responded clumsily, and then exhibited spiral swimming performance after a period of exposure to TDG-supersaturated water. Fish exhibited exophthalmos, body swelling, gill bleeding, and caudal fin bleeding when they died in the TDG-supersaturated water. With the increase in TDG supersaturation, the tolerance capacity of fish to supersaturated TDG significantly reduced. At high supersaturation, the difference in survival time between species was not significant, while fish with smaller sizes showed greater tolerance capacity. At low supersaturation, the tolerance capacity of fish was mainly affected by species, and the influence of size was relatively small. With the decrease in TDG supersaturation, the catalase (CAT) activity first increased and then decreased. Rock Carp displayed significantly less activity than Prenant’s Schizothoracin on exposure to TDG-supersaturated water. At high supersaturation levels, the CAT activity of Prenant’s Schizothoracin of small size was greater than that of large Prenant’s Schizothoracin. In contrast, small Prenant’s Schizothoracin showed less CAT activity at low TDG levels than did large individuals.

Description: A ‘generation’ is an identifiable group sharing birth years and significant life events at critical developmental ages. There is a paucity of literature examining how parental cognitions and lifestyle behaviors differ by generation and whether generational differences are substantial enough to warrant consideration during the development of health interventions. This study compared generational differences in weight-related cognitions and lifestyle behaviors of mothers of young children who were categorized as Generation X (born 1965–1981, n = 158) and Generation Y (aka Millennials; born 1982–1999, n = 162). Survey results indicated that Generation X had significantly higher family affluence; thus, this was controlled in subsequent analyses. Analysis of covariance indicated that Millennials had more positive expectations about the benefits of engaging in healthy eating and physical activity than comparators, but not significantly so. Millennial mothers placed significantly higher value on physical activity for themselves than Generation X mothers, but both generations were neutral on the value of personal physical activity. No generational differences were noted in self-efficacy of mothers for promoting childhood obesity-prevention practices to children and self-efficacy for personally engaging in weight-protective behaviors. Millennial mothers had significantly more family meals/week, however generations did not differ on the value placed on family meals, where family meals were eaten, or whether media devices were used at mealtime. Few differences were noted between the generations for most child feeding behaviors, except that Millennials reported placing significantly less pressure on children to eat. Mothers’ modeling of weight-related behaviors as a means for children’s observational learning about healthy eating, physical activity, and sedentary behaviors did not differ by generational group. The eating behaviors of mothers differed little between generations. Millennial mothers allowed significantly more media devices in children’s bedrooms and personally engaged in more screen time daily than comparators. Overall, the two generational groups were more similar than different in weight-related cognitions as well as for personal and parenting lifestyle behaviors. The results suggest that tailoring interventions for individuals at a similar life-stage (e.g., mothers of young children) by generation may not be warranted.

Description: Limited progress in nutrition policy action is often blamed on the close relationships the food industry has with health policy decision-makers. This analysis sought to examine this belief through the analysis of health ministers’ diaries. Entries were downloaded from health ministers’ diaries from two states in Australia from January 2013 to June 2018. Entries were coded according to which interest group met with the minister or whether general parliamentary business was undertaken. Coding was also undertaken for any meeting topics related to nutrition policy. Analysis of health ministers’ diaries found that the food industry has limited documented interaction with the two state health ministers in Australia. Instead, medical associations, private hospitals and health services, and sporting associations (rugby league associations) had the most interactions with health ministers. Poor representation was seen on nutrition issues, and there was an apparent lack of nutrition advocates interacting with the health ministers. There are opportunities for nutrition advocates to increase their level of interaction with state health ministers. This could include building alliances with medical associations, as they are in a powerful position, to advocate directly to health ministers. Health ministers’ diaries can provide valuable insights into who is meeting officially with ministers. However, there are also limitations with the dataset.

Description: Background: All objects put into a child’s mouth could be hazardous in terms of trauma and toxic substance exposure. The aims of this study were to evaluate morphological characteristics of the primary teeth bite marks inflicted on various materials and to assess material wear using experimental model. Methods: Bite marks were analyzed on five materials: rubber, plastic, foil, wood, and silicone. In order to mimic children mouthing behavior an experimental setup has been designed using primary teeth placed in dentures and children’s equipment specimens. Results: Deciduous teeth make visible and recognizable traces when using physiological forces on all investigated materials. The most significant material loss was revealed in silicone samples, but it has been observed in all material groups, while mouthing with incisors using higher mastication forces were identified as significant predictors for material wear. There were no significant differences between type, species, and morphological-morphometric characteristics of the bite marks which are made by incisors, canines, and molars. Conclusions: In the range of physiological bite forces, deciduous teeth lead to wear of material from which toys are made while the analysis of bite marks in children equipment could give some information regarding the risk of trauma and exposure.

Description: Poor diet is a significant contributor to obesity and chronic disease. With all being more prevalent in rural than urban Australia, modifying the food environment is a potential intervention point to improve the health of rural populations. This review examined the applicability of measurement tools used in rural food environment research for rural Australia. Six electronic databases were searched for peer-reviewed literature, published in English between 2006 and 2018, including at least one objective measure of the Community or Consumer Food Environment in a rural or mixed rural/urban context. One-hundred and seventy-seven papers were returned after removal of duplicates, with a final review of 25. Most studies were cross-sectional, with one intervention study of quasi-experimental design. Nine studies employed a conceptual model; there was considerable variability in tools used; and few described psychometric testing. The most common attribute measured was price, followed by available healthy options. The findings of this review do not offer a suite of ‘gold standard’ measurement tools known to be reliable, valid and sensitive to change to assess the community or consumer food environments in rural Australian towns. However, recommendations are proposed to progress this important area of research within a rural context.

Description: Plastic pollution is generated by the unsustainable use and disposal of plastic products in modern society, threatening economies, ecosystems, and human health. Current clean-up strategies have attempted to mitigate the negative effects of plastic pollution but are unable to compete with increasing quantities of plastic entering the environment. Thus, reducing inputs of plastic to the environment must be prioritized through a global multidisciplinary approach. Mismanaged waste is a major land-based source of plastic pollution that can be reduced through improvements in the life-cycle of plastics, especially in production, consumption, and disposal, through an Integrated Waste Management System. In this review paper, we discuss current practices to improve life cycle and waste management of plastics that can be implemented to reduce health and environmental impacts of plastics and reduce plastics pollution. Ten recommendations for stakeholders to reduce plastic pollution include (1) regulation of production and consumption; (2) eco-design; (3) increasing the demand for recycled plastics; (4) reducing the use of plastics; (5) use of renewable energy for recycling; (6) extended producer responsibility over waste; (7) improvements in waste collection systems; (8) prioritization of recycling; (9) use of bio-based and biodegradable plastics; and (10) improvement in recyclability of e-waste.

Description: Experts in diverse fields have investigated sound in cities throughout the United States. This research aims to examine sound levels and determine its contributors at the transit-oriented development (TOD) station and neighborhood levels by studying selected Dallas Area Rapid Transit (DART) light rail stations. A multilevel analysis was performed to model the likelihood of TOD stations and neighborhoods affecting sound levels, controlling for station amenities, socio-demographics and built environment characteristics. Sound measurements were sampled in three time intervals with 15 min sampling over weekdays and weekends at TOD and non-TOD stations by a type II SPL meter that was mounted on a small camera tripod at a height of 1.5 m, at a distance of 1.5 m from rails and curbs. The research team found that amenities, built environmental characteristics, and neighborhood features have significant implications on sound levels at both the TOD station and the neighborhood level, which affects quality of life (QoL). TOD stations that include more amenities have a greater level of significance on sound levels. Additionally, neighborhoods with a pervasive street grid configuration, public facilities, and built environment densities are significantly associated with a likelihood of high sound levels. Conversely, higher population densities and intersection densities decrease the likelihood of a high sound level environment. These patterns provide an arena for transportation, urban, and environmental planning and policymaking to generate transformative solutions and policies.

Description: The purpose of this study was to examine the effects of age and maturity on anthropometric and various fitness characteristics in young competitive female tennis players. Sixty-one players, aged 10.4–13.2 years (11.8 ± 0.8) were measured for standing and sitting heights, body mass, skinfolds, grip strength, and agility, and dichotomized into two age (U12 and U14) and maturity (earliest and latest) groups according to their chronological age and maturity status. The results revealed significant age effects for stature, sitting height, leg length, and hand grip in favor of the older players. Girls contrasting in maturation differed significantly for all anthropometric and physical performance variables except for body mass index (BMI), body fat percentage (BF%), and hexagon agility test. The earliest maturing group showed significantly higher values for anthropometric measures and better results in the hand grip test than the latest maturing group. After controlling for chronological age, differences were revealed between contrasting maturity groups in stature, sitting height, BF%, and the hand grip test. The findings highlight the age- and maturity-related trends in body size and muscular strength among young female tennis players in the pubertal period. Nevertheless, the differences in the body composition and agility of the contrasting age and maturity groups were negligible.

Description: Background: The present study’s objectives were to: (1) Identify and analyze the prevalence of poly-victims, and (2) determine how the levels of moral disengagement and the various defence mechanisms that victims use to explain abusive behavior might function as predictors of poly-bullying. Methods: The sample consisted of 1328 participants of from 9 to 14 years old. The instruments used were two questionnaires. One allows the prevalence of bullying and cyberbullying victims to be identified and analyzed. The other analyses the level of moral disengagement and the defence mechanisms to which the victims resort. Results: The results showed there to be a continuity of the role of victim in off-line and on-line contexts, turning those who are subject to these situations into poly-victims. The moral disengagement of these victims was found basically to be centered at two levels—a locus of behavior, and a locus of outcomes. Conclusions: Exposure to abuse that is continuous, of different types, and coming from different contexts must be perceived as a public health problem given the lack of effective tools to combat the situations of helplessness that the polyvictims experience.

Description: Adolescence and emerging adulthood are both stages in which romantic relationships play a key role in development and can be a source of both well-being and negative outcomes. However, the limited number of studies prior to adulthood, along with the multiplicity of variables involved in the romantic context and the considerable ambiguity surrounding the construct of well-being, make it difficult to reach conclusions about the relationship between the two phenomena. This systematic review synthesizes the results produced into this topic over the last three decades. A total of 112 studies were included, following the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA-P) guidelines. On the one hand, these works revealed the terminological heterogeneity in research on well-being and the way the absence of symptoms of illness are commonly used to measure it, while on the other hand, they also showed that romantic relationships can be an important source of well-being for both adolescents and emerging adults. The findings underline the importance of providing a better definition of well-being, as well as to attribute greater value to the significance of romantic relationships. Devoting greater empirical, educational, and community efforts to romantic development in the stages leading up to adulthood are considered necessary actions in promoting the well-being of young people.

Description: Dengue poses a significant public health threat and results in ~96 million clinical cases every year. Central America is a region burdened by neglected tropical diseases, including dengue. The primary vectors of dengue, Aedes aegypti and Aedes albopictus, are widely distributed in Honduras. Additionally, sustained and consistent mosquito control is lacking in the country. Successful control of container mosquitoes relies heavily on participation from community leaders, stakeholders, and the community itself. We conducted a pilot study in San Pedro Sula, Honduras where community leaders and stakeholders were trained on mosquito biology and control and were able to apply that knowledge to an underserved community in San Pedro Sula. Surveys to assess the number and type of containers in the community and the number of containers on the residence identified associations with select socioeconomic factors and other variables based on survey questions. The average number of containers on the premises was 15 (± 2.3) and the most prevalent containers (〉50%) were flowerpots, garbage, and toys, which could be targeted in mosquito control programs. This pilot study offers a framework for training community leaders and stakeholders to create a sustainable community-based vector control program for container mosquitoes.

Description: Observations of ocean pollutants are usually spatiotemporally dispersive, while it is of great importance to obtain continuous distribution of ocean pollutants in a certain area. In this paper, a dynamically constrained interpolated methodology (DCIM) is proposed to interpolate surface nitrogen concentration (SNC) in the Bohai Sea. The DCIM takes the pollutant transport advection diffusion equation as a dynamic constraint to interpolate SNCs and optimizes the interpolation results with adjoint method. Feasibility and validity of the DCIM are testified by ideal twin experiments. In ideal experiments, mean absolute gross errors between interpolated observations and final interpolated SNCs are all no more than 0.03 mg/L, demonstrating that the DCIM can provide convincing results. In practical experiment, SNCs are interpolated and the final interpolated surface nitrogen distribution is acquired. Correlation coefficient between interpolated and observed SNCs is 0.77. In addition, distribution of the final interpolated SNCs shows a good agreement with the observed ones.

Description: This is the first meta-analytic review investigating what components and techniques of parent training programs for preventing or reducing child maltreatment are associated with program effectiveness. A literature search yielded 51 studies (N = 6670) examining the effectiveness of parent training programs for preventing or reducing child maltreatment. From these studies, 185 effect sizes were extracted and more than 40 program components and techniques were coded. A significant and small overall effect size was found (d = 0.416, 95% CI (0.334, 0.498), p 〈 0.001). No significant moderating effects were found for contextual factors and structural elements (i.e., program duration, delivery location, and delivery setting). Further, no significant moderating effects were found for most of the coded program components and techniques, indicating that these components are about equally effective. Only a few program components and techniques moderated program effectiveness, however these effects were negative. These results indicated that improving parental personal skills, improving problem solving skills, and stimulating children’s prosocial behavior should not be the main focus of parental training programs for preventing and reducing child maltreatment. This also holds for practicing new skills by rehearsal and giving direct feedback in program sessions. Further clinical implications and directions for future research are discussed.

Description: This study aims to explore the influence mechanism of cultural intelligence on work–family conflict for Chinese expatriates in cross-cultural non-profit organizations. Drawing on conservation of resources theory, this longitudinal study (six-month time lag) is the first to examine cultural intelligence as an antecedent of work–family conflict. The study also examines the mediating role of work engagement and the moderating role of leader–member exchange (LMX) in the cultural intelligence and work–family conflict relationship. The sample comprises 206 expatriate Chinese language teachers working at 45 Confucius Institutes in the US, Canada, and Russia. Results show that cultural intelligence not only reduces work–family conflict but also promotes expatriates’ work engagement. The higher the work engagement, the higher the work–family conflict experienced by expatriates. LMX moderates not only the positive relationship between work engagement and work–family conflict but also the indirect effect of cultural intelligence on work–family conflict through work engagement. Thus, the indirect effect of cultural intelligence on work–family conflict through work engagement is stronger with low (compared to high) LMX. This study’s findings provide implications for managers of cross-cultural non-profit organizations to better understand and solve expatriates’ work–family conflict problem.

Description: Measuring teacher mindfulness has implications for understanding and enhancing teachers’ well-being. This study therefore aimed to examine the psychometric properties of the Chinese version of the Mindfulness in Teaching Scale (MTS-C). Two independent samples (Sample 1 includes 151 in-service teachers, Sample 2 includes 229 pre-service teachers) completed the MTS-C and theoretically relevant measures (i.e., attitudes, self-esteem, self-efficacy, and life satisfaction). In addition, a subsample of Sample 2 completed the MTS-C again one month later. Results of exploratory factor analysis and confirmatory factor analysis supported the two-factor model of the MTS-C. The MTS-C was generally associated with the concurrent measures. Furthermore, the scale also demonstrated good internal consistency and test–retest reliability. These findings suggest that the MTS-C is a reliable and valid tool for research and practical applications among Chinese teachers.

Description: Conservative interventions for addressing prenatal and postnatal ailments have been described in the research literature. Research results indicated that maternity support belts assist with reducing pain and other symptoms in these phases; however, compliance in wearing maternity support belts is poor. To combat poor compliance, commercial manufacturers designed dynamic elastomeric fabric orthoses (DEFO)/compression garments that target prenatal and postnatal ailments. This systematic review aimed to identify, critically appraise, and synthesize key findings on the effectiveness, the feasibility, and the acceptability of using DEFO to manage ailments during pre-natal and postnatal phases of care. Electronic databases were systematically searched to identify relevant studies, resulting in 17 studies that met the eligibility criteria. There were variations in DEFO descriptors, including hosiery, support belts, abdominal binders and more, making it difficult to compare findings from the research articles regarding value of DEFO during prenatal and/or postnatal phases. A meta-synthesis of empirical research findings suggests wearing DEFOs during pregnancy has a significant desirable effect for managing pain and improving functional capacity. Further research is required to investigate the use of DEFOs for managing pain in the postnatal period and improving quality life during prenatal and postnatal care.

Description: Our understanding of how multiple health-behaviours co-occur is in its infancy. This study aimed to: (1) identify patterns of physical activity, diet, sitting, and sleep; and (2) examine the association between sociodemographic and health-risk indicators. Pooled data from annual cross-sectional telephone surveys of Australian adults (2015–2017, n = 3374, 51.4% women) were used. Participants self-reported physical activity, diet, sitting-time, sleep/rest insufficiency, sociodemographic characteristics, smoking, alcohol use, height and weight to calculate body mass index (BMI), and mental distress frequency. Latent class analysis identified health-behaviour classes. Latent class regression determined the associations between health-behaviour patterns, sociodemographic, and health-risk indicators. Three latent classes were identified. Relative to a ‘moderate lifestyle’ pattern (men: 43.2%, women: 38.1%), a ‘poor lifestyle’ pattern (men: 19.9%, women: 30.5%) was associated with increased odds of a younger age, smoking, BMI ≥ 30.0 kg/m2, frequent mental distress (men and women), non-partnered status (men only), a lower Socioeconomic Index for Areas centile, primary/secondary education only, and BMI = 25.0–29.9 kg/m2 (women only). An ‘active poor sleeper’ pattern (men: 37.0%, women: 31.4%) was associated with increased odds of a younger age (men and women), working and frequent mental distress (women only), relative to a ‘moderate lifestyle’ pattern. Better understanding of how health-behaviour patterns influence future health status is needed. Targeted interventions jointly addressing these behaviours are a public health priority.

Description: Background: Chronic exposure to occupational stress may lead to negative health consequences. Creating less stressful work environments and making employees physically and psychologically more resilient against stress are therefore two major public health concerns. This study examined whether cardiorespiratory fitness moderated the association between occupational stress, cardiovascular risk, and mental health. Methods: Stress was assessed via the Effort-Reward Imbalance and Job Demand-Control models in 201 police officers (36% women, Mage = 38.6 years). Higher levels of blood pressure, blood lipids, blood sugar, and unfavorable body composition were considered as cardiovascular risk factors. Burnout, insomnia and overall psychological distress were used as mental health indicators. Cardiorespiratory fitness was assessed with a submaximal bicycle test. Results: High cardiorespiratory fitness levels were associated with a reduced cardiometabolic risk, whereas high stress levels were associated with better mental health. Among participants who perceived a high Effort-Reward Imbalance, those with high fitness levels showed lower overall cardiovascular risk scores than their colleagues with low fitness levels. Conclusions: Work health programs for police officers should consider the early screening of burnout, sleep disturbances, and overall mental wellbeing. To increase cardiovascular health, including fitness tests in routine health checks and promoting physical activity to further increase cardiorespiratory fitness appears worthwhile.

Description: The physiological role and relevance of the mechanisms sustaining circadian rhythms have been acknowledged. Abnormalities of the circadian and/or sleep-wakefulness cycles can result in major metabolic disorders or behavioral/professional inadequacies and stand as independent risk factors for metabolic, psychiatric, and cerebrovascular disorders and early markers of disease. Neuroimaging and clinical evidence have documented functional interactions between autonomic (ANS) and CNS structures that are described by a concept model (Central Autonomic Network) based on the brain-heart two-way interplay. The circadian rhythms of autonomic function, ANS-mediated processes, and ANS/CNS interaction appear to be sources of variability adding to a variety of environmental factors, and may become crucial when considering the ANS major role in internal environment constancy and adaptation that are fundamental to homeostasis. The CNS/ANS interaction has not yet obtained full attention and systematic investigation remains overdue.

Description: Osteoporosis is a growing concern for an aging society. The study aimed to estimate the prevalence of older adults who were at risk of osteoporosis and explore factors associated with osteoporosis. The relationship between the risk of osteoporosis, chronic conditions and disability was also explored. We hypothesized that respondents with high risk index of osteoporosis would be associated with greater disability. Participants aged 60 years and above (N = 2565) who were representative of Singapore’s multiethnic population were recruited. The Osteoporosis Self-Assessment Tool for Asians (OSTA) was used to classify the risk of osteoporosis. Information on sociodemographic details and chronic diseases were collected, while severity of disability was measured using the World Health Organization Disability Assessment Schedule 2.0. The overall prevalence of the respondents who were at risk of osteoporosis was 52%. Those belonging to an older age, Chinese, female, never married or widowed, lower education and retired were associated with a higher risk of osteoporosis. A diagnosis of diabetes or hypertension was a protective factor against the risk of osteoporosis. High risk of osteoporosis was not associated with disability. Our findings highlighted specific factors associated with the risk of osteoporosis that could be useful for the prevention of osteoporosis and fractures.

Description: Background: The 30 s chair stand test is often used to evaluate physical fitness in chronic pain populations. In patients with fibromyalgia, physical fitness is closely related to pain, quality of life, and fear of falling. However, the reliability of this test has only been evaluated concerning the number of repetitions. Objective: To evaluate the test–retest reliability of the 30 s chair stand test in women with fibromyalgia (n = 30), using data from the contact and non-contact time registered with an automatic chronometer (chronojump). Methods: Participants carried out the 30 s chair stand test twice with five minutes as a rest period, while an automatic chronometer recorded the time elapsed in contact with the chair (impulse phase) and not in contact (non-contact phase). Number and fear of falls in the last year and in the last six weeks were also recorded. Results: The reliability of duration of both phases was good. A relationship between these results and the number and fear of falling was also found. Conclusion: The analysis of movement phases in the 30 s chair stand test showed a good reliability in females with fibromyalgia, providing further useful information about the onset of muscle fatigue during the test.

Description: The satisfaction of the patient is believed to be one of the preferred results of healthcare, and it is directly connected with the usage of health services. This study aimed to assess how doctor services, nurses’ services, and waiting time predict patient satisfaction (PS) with the service delivery of healthcare in Southern Punjab, Pakistan. The study used an exploratory research method, in which 1000 participants were selected, and used a random technique, in which 850 responses were received. Multiple regression analysis and a confirmatory factor were employed to analyze the collected data. The findings showed that doctor services (β = 0.232; p = 0.01), nurses services (β = 0.256; p = 0.01), and waiting time (β = 0.091; p = 0.03) had positive significant impacts on PS, while registration services (β = 0.028; p = 0.390) had an insignificant association with PS. Hence, a significant gap existed in the registration services that were totally ignored in hospitals of Pakistan which needed proper considerations for improvements.

Description: The concept of ecosystem services (ES) supply and demand has attracted increasing attention in science and policy making because it effectively links ecosystem services to human well-being. The imbalance of ES supply and demand in urban areas has become a key issue in regional sustainable development. In this context, we calculated ES supply and demand for Wuhan City, China, using the ES supply and demand ratio (ESDR) and the comprehensive ES supply–demand ratio (CESDR) to express the relationship between ES supply and demand. Ecological zoning was proposed according to the spatial differentiation of the ES supply–demand relationship, and policy recommendations are made. The results show that from the perspective of total ES supply and demand, the water yield supply (SWY), grain yield supply (SGY), and recreation services supply (SRS) are greater than the water yield demand (DWY), grain yield demand (DGY), and recreation services demand (DRS), and that the climate regulation supply (SCR) is less than the climate regulation demand (DCR). From a spatial perspective, there are imbalances and mismatches in ES supply and demand, especially in urban central areas. The values of SWY, SGY, SCS, and SRS per unit area are less than their respective demand values, and the area of mismatch has expanded with the gradual increase of the built-up area. The spatial pattern of ES supply and demand is circular, with the form of “deficit zone–relative equilibrium zone–surplus zone”, which corresponds to “urban central area–near suburbs–distant suburbs and rural areas”.

Description: Background: Specialist electronic cigarette (e-cigarette) shops, known as vape shops, provide access to a less harmful alternative to smoking. This study aimed to understand customers’ experiences of vaping and vape shops, and the extent to which smoking cessation advice is and should be provided in these shops. Methods: We conducted telephone interviews with 22 customers recruited in vape shops in the East Midlands region of England. Interviews explored participants’ smoking histories, reasons for using e-cigarettes, the role of vape shops in their e-cigarette use, and whether smoking cessation was discussed in vape shops. Interviews were analysed following framework approach principles. Results: Most respondents regarded e-cigarettes as a quitting tool and reported very positive experiences of vaping. Vape shops were central to participants’ positive experiences, in that they provided access to a wide variety of high-quality products and reliable product information and advice. The shop staff engendered a sense of loyalty in customers which, together with the community of other vapers, created a network that helped to support e-cigarette use. Vape shops were not regarded as a setting in which cessation advice was generally provided but were acknowledged as potentially appropriate places to provide quitting support. Conclusions: Vape shops have the potential to play an important role in tobacco harm reduction, which could be increased if their service model were to extend to help smokers to quit.

Description: The World Health Organization (WHO) determines infertility as a disease of the reproductive system defined clinically by the failure to achieve a clinical pregnancy after 12 months or more of regular unprotected sexual intercourse. Estimates indicate that the problem of infertility in the world is continuing to grow. The aim of the study was to compare approaches to disease in partners of both sexes diagnosed with infertility. The study was conducted among 61 couples treated for infertility using an original questionnaire developed by the authors. The Chi square independence test was used for statistical analysis. Both men and women responded to the diagnosis of infertility with negative emotions. Regardless of sex, sadness and anxiety were the dominant feelings associated with the diagnosis of infertility. Women believed in the success of the treatment to a greater extent than men. Mainly women attempted to talk openly about the problem of infertility, while men were more restrained in this respect. Women accepted the assisted reproductive technologies (ART) to a greater extent than men, but men would accept childlessness more often than women.

Description: We propose a new paradigm with three historical stages for an optimal parenting style (i.e., indulgent parenting style), which extends the traditional paradigm of only two stages (i.e., authoritarian and authoritative parenting styles). The three stages concur, at the same time, in different environments, context, and cultures. We studied the third stage for optimal parent–child relationships through the offspring’s personal and social well-being, with four adolescent samples from 11 to 19 years old (52.2% girls) from Spain (n = 689), the United States (n = 488), Germany (n = 606), and Brazil (n = 672). The offspring’s personal well-being was measured through self-esteem (academic, social, emotional, family, and physical), while social well-being was measured with the internalization of self-transcendence (universalism and benevolence) and conservation values (security, conformity, and tradition). The parent–child parenting style was measured through parental warmth and strictness, and the adolescents’ parents were classified into one of four groups (indulgent, authoritarian, authoritative, and neglectful). Remarkably, the greatest personal well-being was found for adolescents raised with higher parental warmth and lower parental strictness (i.e., indulgent), and the greatest social well-being was found for adolescents raised with higher parental warmth (i.e., indulgent and authoritative; p 〈 0.05 for all countries). Consistently, poorer personal well-being and social well-being were associated with less parental warmth (i.e., authoritarian and neglectful). Findings suggest that the parent–child relationships analyzed have a common pattern associated with personal and social well-being that coincide with a proposed third stage.

Description: Occupational exposure to grain dust is associated with both acute and chronic effects on the airways. However, the aetiology of these effects is not completely understood, mainly due to the complexity and variety of potentially causative agents to which workers are exposed during cereals process. In this study, we characterized the mycobiome during different steps of wheat processing—harvesting, grain unloading and straw handling—and compared it to mycobiomes of domestic environments—rural and urban. To do so, settled dust was collected at a six month interval for six weeks in the close proximity of 142 participants, 74 occupationally exposed to wheat dust—freshly harvested or stored—and 68 not occupationally exposed to it. Fungal community composition was determined in those samples by high-throughput sequencing of the primary fungal barcode marker internal transcribed spacer 1 (ITS1). The comparison of different mycobiomes revealed that fungal richness, as well as their composition, was much higher in the domestic environment than at the workplace. Furthermore, we found that the fungal community composition strongly differed between workplaces where workers handled freshly harvested wheat and those where they handled stored wheat. Indicator species for each exposed population were identified. Our results emphasize the complexity of exposure of grain workers and farmers and open new perspectives in the identification of the etiological factors responsible for the respiratory pathologies induced by wheat dust exposure.

Description: This study aims to identify the ongoing physical and psychological health vulnerabilities of the readymade garment (RMG) factory workers involved in the Rana Plaza building collapse in 2013, along with their experiences within the current socioeconomic and political contexts of Bangladesh. Seventeen Rana Plaza survivors participated in unstructured, face-to-face, in-depth interviews. Interviews were thematically analyzed using Haddon’s matrix to examine pre-event, event, and post-event injury experiences. The collapse of the Rana Plaza building resulted in significant physical and emotional trauma for those who survived the event. The majority of the participants were forced to attend work on the day of the collapse. Participants reported physical health complaints related to bone injuries/fractures and amputation, severe headache, kidney problems, and functional difficulties. In addition to the reported physical health issues, the participants revealed psychological health issues including trauma, depression and suicidal ideation, sleep disorders, anxiety, and sudden anger. Participants described barriers to their potential for re-employment in the RMG sector and outlined their limited access to free healthcare for follow-up treatment. Those who survived the collapse of the Rana Plaza building continue to experience significant adverse physical and emotional outcomes related to the disaster. Yet, they have little recourse to ensure the availability of adequate health care and rehabilitation. Given the international reliance on the Bangladeshi RMG industry, continued pressure to ensure care is provided for these survivors, and to reduce the risk of future disasters, is necessary.

Description: Brain breaks is a physical activity (PA) video designed for school settings that is used to stimulate student’s health and learning. The purpose of this study is to measure the effects of brain breaks on motives of participation in PA among primary school children in Malaysia. Purposive sampling was used to divide 159 male and 176 female students aged 10 to 11 years old, mean (standard deviation (SD)) = 10.51 (0.50), from two schools in Kelantan, Malaysia into intervention (n = 183) and control (n = 152) groups. Students undertook brain breaks activities on school days (five minutes per session) spread out for a period of four months. Mixed factorial analysis of variance (ANOVA) was used to test the students’ motives of participation in PA for pre-, mid-, and post-tests using the Physical Activity and Leisure Motivation Scale-Youth-Malay (PALMS-Y-M). Mixed factorial ANOVA showed significant changes in enjoyment, F(2, 392) = 8.720, p-value (ηp2) = 0.001 (0.043); competitiveness, F(2, 195) = 4.364, p-value (ηp2) = 0.014 (0.043); appearance, F(2, 392) = 5.709, p-value (ηp2) = 0.004 (0.028); and psychological condition, F(2, 392) = 4.376, p-value (ηp2) = 0.013 (0.022), whereas mastery, affiliation, and physical condition were not significant (p 〈 0.05). Further post-hoc analysis revealed a significant downward trend in the control group (p 〈 0.05). Brain breaks is successful in maintaining students’ motives for PA in four of the seven factors.

Description: Tobacco supply remains a pressing challenge to tobacco control. Tobacco remains a dominant cash crop in many low- and middle-income countries, despite the evidence suggesting that it is not as profitable as industry claims and is harmful to health and the environment. In order to implement successful and sustainable alternative livelihood interventions, it is important to understand why farmers continue to grow tobacco. This study explores this question from the perspective of farmers in Indonesia and Philippines. This study was informed by interpretive description methodology. Data was collected through focus group discussions (FGDs) (n = 7) with farmers (n = ~60). The FGDs were audio recorded, transcribed verbatim, and then translated into English. An inductive thematic analysis of the data was conducted to identify and categorize the reason provided by participants. We identified two overarching themes: (1) perceived viability (profitability, ready market, and environmental factors) and (2) financial context. Financial context included lumpsum payments and access to financial loans and credit facilities in light of their lack of capital. These results highlight that, in addition to identifying viable alternatives to tobacco, institutional factors such as improved access to credit and well-developed supply chains are key to the successful uptake of alternative livelihoods.

Description: There is a growing interest in quality issues associated with hospital care, with readmissions (rehospitalizations) being one of the main areas of interest. Retrospective data from a 914-bed university hospital in Bydgoszcz, Poland, was used to identify 30-day readmissions in 2015. We developed a catalogue of reasons for rehospitalization and differentiated between planned and unplanned readmissions, as well as those related and unrelated to index (initial) hospitalization. Multilevel logistic regression was used to determine factors associated with readmission risk. A total of 12.5% of patients were readmitted within 30 days of being discharged. The highest readmission rates were identified in pediatric, transplantation, and urology patients. The highest share of readmissions was due to the specific nature of a disease and its routine treatment practice. Almost two-thirds of readmission cases were classified as unplanned and related to the index hospitalization. The following characteristics were associated with a higher risk of rehospitalization: female gender, residing 〉35 km from the hospital, longer than average and very short stays at index admission, higher comorbidity score, and admission to a high-volume hospital sector. Due to the importance of quality issues in health policy, the topic should be further pursued to identify evidence-based practices that would improve hospitals’ performance.

Description: Outdoor air pollution is associated with respiratory infections and allergies, yet the role of innate lymphoid cells (ILCs) in pathogen containment and airway hyperresponsiveness relevant to effects of air pollutants on ILCs is poorly understood. We conducted a systematic review to evaluate the available evidence on the effect of outdoor air pollutants on the lung type 1 (ILC1) and type 2 ILCs (ILC2) subsets. We searched five electronic databases (up to Dec 2018) for studies on the effect of carbon monoxide (CO), sulfur dioxide (SO2), nitrogen dioxide (NO2), diesel exhaust particles (DEP), ozone (O3), and particulate matter (PM) on respiratory ILCs. Of 2209 identified citations, 22 full-text papers were assessed for eligibility, and 12 articles describing experimental studies performed in murine strains (9) and on human blood cells (3) were finally selected. Overall, these studies showed that exposure to PM, DEP, and high doses of O3 resulted in a reduction of interferon gamma (IFN-γ) production and cytotoxicity of ILC1. These pollutants and carbon nanotubes stimulate lung ILC2s, produce high levels of interleukin (IL)-5 and IL-13, and induce airway hyperresponsiveness. These findings highlight potential mechanisms by which human ILCs react to air pollution that increase the susceptibility to infections and allergies.

Description: This research investigated the distribution and contribution of polycyclic aromatic hydrocarbons (PAHs) and nitro-polycyclic aromatic hydrocarbons (NPAHs) bound to particulate matter (PM) emitted from open burning of rice straw (RS) into the atmosphere in the north of Vietnam. The experiments were conducted to collect PM2.5 and total suspended particulates (TSP) prior to and during burning in the period of 2016–2018 in suburban areas of Hanoi. Nine PAHs and 18 NPAHs were determined using the HPLC-FL system. The results showed that the proportion of RS burning seasonally affects the variation of PAHs emission in atmospheric environment. The levels of nine PAHs from RS burning were 254.4 ± 87.8 µg g−1 for PM2.5 and 209.7 ± 89.5 µg g−1 for TSP. We observed the fact that, although fluoranthene (Flu) was the most abundant PAH among detected PAHs both in PM2.5 and TSP, the enrichment of Flu in TSP from burning smoke was higher than that in PM2.5 while the contribution of benzo[a]pyrene (BaP) and indeno[1,2,3- cd]pyrene (IDP) in PM2.5 from burning smoke were much higher than those in TSP. This research found that 1-nitropyrene (1-NP) and 6-nitrochrysene (6-NC) emit from RS burning with the same range with those from wood burning. The 2-nitrofluorene (2-NF) and 2-nitropyrene (2-NP) released from RS burning as the secondary NPAHs. This research provides a comprehensive contribution characterization of PAHs and NPAHs in PM with different size emitted from traditional local rice straw burning in the north of Vietnam. The results help to clarify the environmental behavior of toxic organic compounds from RS burning in Southeast Asia.

Description: The objective of the study was to evaluate the impact of a program based on the Teaching Personal and Social Responsibility (TPSR) on the variables of responsibility, basic psychology needs, motivation, satisfaction with life and the intention to be physically active, as well as the differences of gender. The participants were 85 students (experimental group n = 35, 17 girls and control group n = 50, 28 girls). The students of the experimental group received the TPSR for 8 months within the physical education subject. The findings indicated an improvement in the experimental group in terms of personal responsibility and in the case of female students, in basic psychological needs and intrinsic motivation. In conclusion, the TPSR program can be integrated into the physical education curriculum in order to improve the personal responsibility of students and fulfill their motivation and satisfaction of basic psychological needs.

Description: Econometrics and input–output models have been presented to construct a joint model (i.e., an EC + IO model) in the paper, which is characterized by incorporating the uncertainty of the real economy with the detailed departmental classification structure, as well as adding recovery period variables in the joint model to make the model dynamic. By designing and implementing a static model, it is estimated that the indirect economic loss for the transportation sector caused by representative haze pollution of Beijing in 2013 was 23.7 million yuan. The industrial-related indirect losses due to the direct economic losses incurred by haze pollution reached 102 million yuan. With the constructed dynamic model, the cumulative economic losses for the industrial sectors have been calculated for the recovery periods of different durations. The results show that: (1) the longer the period that an industrial department returns to normal output after haze pollution has impacted, the greater the cumulative economic loss will be; (2) when the recovery period is one year, the cumulative economic loss value computed by the dynamic EC + IO model is much smaller than the loss value obtained by the static EC + IO model; (3) the recovery curves of industrial sectors show that the recovery rate at the early stage is fast, while it is slow afterwards. Therefore, the governance work after the occurrence of haze pollution should be launched as soon as possible. This study provides a theoretical basis for evaluating the indirect economic losses of haze pollution and demonstrates the value of popularization and application.

Description: I was born in 1947 and had autism with speech delay until age four. I am now a college professor of animal science. Horse activities enabled me to make friends through a shared interest in horses. This paper describes the benefits that I experienced from working with horses and my friendships and work skills. A close friendship developed with another student through both riding and horse craft projects. Keeping employment is a serious problem for many people with Autism Spectrum Disorder (ASD). The responsibility of caring for horses and cleaning stalls every day taught me good work skills. My experiences suggest that there were valuable outcomes from working with horses. This may be a beneficial intervention to include in programming for youth with ASD.

Description: Individual perceptions of green space quality are essential when a user considers engaging in activities. This national-scale study provides insights into Norwegians’ quality perceptions of municipal green space, visit frequency and motivations for engaging in different activities. We applied regression analysis to investigate how various factors affect the outcome variables, quality perceptions and visit frequency from a sample of the Norwegian adult population. Results reveal that Norwegians perceive their green spaces as having good quality, and higher quality perceptions have a positive influence on green space visits. Half of the respondents visited green spaces out of intrinsic motives in high-quality environments providing fresh air, experiences of nature and quietness. It is essential, however, to take into account that less reported activity mirrors groups of respondents who least often visit green spaces.

Description: Background: Given the risk of physical and psychosocial health that emerge in adolescents that are continuing into adulthood, identifying and addressing early signs of health-related quality of life (HRQoL) decline provides an opportunity to ensure that young people have a healthier progression through adolescence. Aim: To investigate the association between demographic characteristics, lifestyle health behaviours, and HRQoL of adolescents who live in Asia Pacific region, including Hong Kong in China, Beijing in China, Akashi in Japan, Seoul in South Korea, and Bangkok in Thailand. Methods: A cross-sectional self-reported survey carried out in a sample of 2296 adolescents that were aged 9–16 years (mean= 12.0; standard deviation [SD] = 1.63) was conducted in the five cities of the Asia Pacific region between January and August 2017. Demographic characteristics, adolescent lifestyle behaviours, and HRQoL were measured with demographic questionnaire, Adolescent Lifestyle Questionnaire’s (ALQ) seven domains and Paediatric Quality of Life’s (PedsQL 4.0) global score, respectively. Mixed multilevel model (MMLM) was used to fit the data. Results: After adjusting the demographic variables, one score increase in ALQ physical participation, nutrition, social support, and identity awareness are associated with an increase in PedsQL global score. On the contrary, one score increase in ALQ health practices is associated with a decrease in the PedsQL global score. The estimated mean of PedsQL global score of South Korea, Beijing, and Japan were better, while the score of Thailand and Hong Kong were poorer. Conclusions: Differentiating the impacts of promoting health behaviours among different countries can help in better understanding the health needs of adolescents in each country, especially in the Asia Pacific region, so that adequate and relevant resources can be allocated to reduce health-risk taking behaviours among this vulnerable group for health-promoting strategies.

Description: Background: The use of electronic cigarettes (e-cigarettes) is gaining popularity, so it is important to evaluate physicians’ understanding of e-cigarettes. This study assessed the beliefs, attitudes, and confidence in e-cigarette counseling among Chinese physicians and explored the factors related to asking patients about e-cigarette use. Methods: Physicians from across China were invited to participate in a questionnaire survey using the platform provided by DXY (www.dxy.cn) in 2018. In total, 1023 physicians completed the online survey. Descriptive analyses were used to characterize the participants, and multivariate logistic regression analyses were applied to identify predictors of physicians’ asking about patients’ e-cigarette use. Results: Only 46.3% of respondents agreed that e-cigarettes had adverse health effects, and 66.8% indicated that e-cigarettes can be regarded as a type of smoking cessation treatment. We found that 61.3% thought it was important to discuss e-cigarettes with patients, and 71.7% reported feeling confident about their ability in counseling about e-cigarettes. Respondents who had used e-cigarettes (OR = 2.05; 95% CI: 1.16–2.63), had received training about e-cigarettes (OR = 3.13; 95% CI: 2.17–4.52), or were confident about their ability to answer patients’ question about e-cigarettes (OR = 2.45; 95% CI: 1.65–3.65) were more likely to ask patients about e-cigarette use. Physicians who showed a supportive attitude toward using e-cigarettes to quit smoking (OR = 0.79; 95% CI: 0.63–0.99) were less likely to ask about patients’ e-cigarettes use frequently. Conclusions: Chinese physicians appeared to ignore the adverse health effects of e-cigarettes, and considered e-cigarettes as a smoking cessation treatment. Comprehensive training and regulations are needed to help physicians incorporate the screening of e-cigarette use into routine practice and provide patients truthful information as new data emerge.

Description: Although type 2 diabetes mellitus (T2DM) has been traditionally viewed as an intractable chronic medical condition, accumulating evidence points towards the notion that a complete remission of T2DM is feasible following a choice of medical and/or surgical interventions. This has been paralleled by increasing interest in the establishment of a universal definition for T2DM remission which, under given circumstances, could be considered equivalent to a “cure”. The efficacy of bariatric surgery in particular for achieving glycemic control has highlighted surgery as a candidate curative intervention for T2DM. Herein, available evidence regarding available surgical modalities and the mechanisms that drive metabolic amelioration after bariatric surgery are reviewed. Furthermore, reports from observational and randomized studies with regard to T2DM remission are reviewed, along with concepts relevant to the variety of definitions used for T2DM remission and other potential sources of discrepancy in success rates among different studies.

Description: While recent efforts have been made to understand the bladder health experiences, perceptions, and knowledge of cisgender adolescent females and women, virtually nothing is known about the bladder health experiences of people who identify as sexual and gender minorities (SGMs). A community-based participatory research approach using a focus group methodology to engage 36 adult participants who identify as SGM, including individuals who identify as gender non-conforming, queer, transgender (trans) men, or lesbian, in one of six focus group discussions on bladder health. Using directed content qualitative data analysis from the six unique focus groups, three interrelated themes were revealed: gender socialization of voiding behavior and toilet environment culture producing identity threats, and risks to gender affirmation; consequences of hetero-cis normative bathroom infrastructure necessitating adaptive voiding behaviors; and, physical and psychosocial consequences of chronic anxiety and fear are associated with voiding experiences. Insight on how SGMs navigate voiding behaviors, toilet experiences, and health care seeking is needed to assure that bladder health promotion activities are inclusive of this population’s needs.

Description: Since the start of the HIV and AIDS epidemic, very little research has been conducted on the older persons’ provision of HIV-related care to adult children. This is despite the fact that a large proportion of adults who die of AIDS-related illnesses stay with their elderly parents during the terminal stage of their illnesses. This paper explores how older persons in rural settings experience caring for their adult children with AIDS-related illnesses. In-depth interviews took place with older persons aged 60 years and above. The qualitative data analysis was informed by thematic approach to identify and report themes using inductive approach. The paper found that the older persons undertake the caring role without resources and support. As a result, they are burdened with having to care for adult children with AIDS-related illness. Fatigue arising from the hard work of physically caring for their sick adult children day and night adds to the physical burden on the older persons. Older persons will continue to carry the burden of caring for people with AIDS-related illnesses due to the increase in the number of new infections in South Africa. There is a need to involve them in HIV/AIDS programmes; their experience and wisdom would surely contribute positively and assist in addressing HIV prevention.

Description: By defining the connotation of land use eco-efficiency, land use eco-efficiency from 2003 to 2015 was calculated on the basis of the mixed directional distance function, and its spatial convergence analyzed using a spatial econometric model. Results showed that (1) the land use eco-efficiency in most regions of China was relatively ineffective—only Guangdong and Guangxi were relatively effective—and the spatial distribution of efficiency levels in each region was polarized. (2) Sigma and beta convergences were observed in land use eco-efficiency in China, and land use eco-efficiency in each province had an influence on the other. (3) The convergence rate of the eastern region was the same as that of the national region (0.164). The convergence rates of the central, western, and northeast regions were 0.181, 0.183, and 0.189, respectively, which were all higher than the national convergence rate. (4) Scientific and technological strength and industrial structure significantly promoted the improvement of land use eco-efficiency and steady development of land use in China.

Description: Background: Awareness of physical activity guidelines are low, particularly the “forgotten guidelines” of strength and balance. Increasing awareness of guidelines, but also of appropriate local services that can be utilised, is an important step towards active ageing. Co-creation can inform tailored service provision to potentially increase uptake and adherence. The aim was to co-create recommendations to redesign and promote local leisure services, emphasising strength and balance activity provision. Method: Twenty-four ageing and older adults engaged in 10 co-creation workshops. Workshops consisted of interactive tasks, and fieldwork tasks were undertaken externally. Data were collected using field notes, worksheet tasks and facilitator reflections and were analysed using qualitative content analysis. Results: Retention and adherence rates were 92% and 85%. Co-creators cited group cohesion, scientific input from experts and perceived knowledge development as enjoyable elements of the process. Four key themes emerged from analysis: (1) localised strategies for awareness raising, (2) recruitment of volunteer champions to increase uptake and maintenance, (3) accessibility of activities, including what they are and when they are, and (4) evaluation of impact. Conclusion: This has been the first study, to our knowledge, to utilise co-creation for informed leisure service provision improvement. Future work should aim to implement these recommendations to ascertain what impact these themes might make.

Description: Background: Studies have linked some bacterial infections with an increased likelihood for development of dementia. However, there is a paucity of data on the relationship between dementia and leptospirosis. In view of this, we conducted a retrospective cohort study to determine whether leptospirosis is a risk factor for dementia. Methods: Data were collected from the Taiwan National Health Insurance Research Databases (2000–2010) to investigate the incidence of and risk factors for dementia in patients with leptospirosis. Patients with leptospirosis who did not have a history of dementia were enrolled in the study. For each leptospirosis patient, four controls were randomly selected after frequency matching of age, sex, and index date. Cox proportional hazard regression models were used for the analyses of dementia risk. Results: A greater risk of dementia was observed in the leptospirosis cohort than in the non-leptospirosis cohort both in patients without any comorbidity (adjusted HR (aHR) = 1.23, 95% CI = 1.06–1.43) and with a comorbidity (aHR = 2.06, 95% CI = 1.7–2.5). Compared with the non-leptospirosis cohort without these comorbidities, the leptospirosis cohort with ≥2 comorbidities exhibited a significantly increased risk of dementia (aHR = 6.11, 95% CI = 3.15–11.9), followed by those with any one comorbidity (adjusted HR = 3.62, 95% CI = 1.76–7.46). Conclusions: Patients with leptospirosis were at a 1.89-fold greater risk of subsequent dementia, but potential genetic susceptibility bias in the study group is a major confound.

Description: Introduction: Accurate estimates of e-cigarette use are needed to gauge its impact on public health. We compared the results of online and traditional, large scale surveys and provide additional estimates from the Population Assessment of Tobacco and Health (PATH) survey, with the aim of assessing the extent of variation in prevalence estimates. Materials and Methods: We searched the peer-reviewed literature for nationally representative estimates of U.S. adult e-cigarette prevalence, and developed our own estimates from waves one, two, and three of the PATH survey. We compared estimates by age, gender, cigarette smoking status, and e-cigarette use intensity both between online and traditional surveys and among the traditional surveys. Results: For specific years, online surveys generally yielded higher adult use rates than most traditional surveys, but considerable variation was found among traditional surveys. E-cigarette prevalence was greater for less intensive than for more intensive use. Levels of use were higher among current and recent former cigarette smokers than among former smokers of longer quit duration and never smokers, and by those of younger ages. Conclusions: Considerable variation in e-cigarette use estimates was observed even for a specific year. Further study is needed to uncover the source of variation in e-cigarette prevalence measures, with a view towards developing measures that best explain regular use and transitions between the use of e-cigarettes and other tobacco products.

Description: Schools are salient locations for children with disabilities to accrue physical activity (PA) and to diminish sedentary time (ST). We examined seasonal variation in accelerometer-assessed PA and ST among children with disabilities during the school day in three school settings (physical education (PE) lessons, recess and lunchtime). Children (n = 270) from 13 special schools for those with five disability types (visual impairments, hearing impairments, physical disabilities, intellectual disabilities (ID), and social development problems) participated. Their PA and ST were assessed during three winter and three summer school days using accelerometry. Linear mixed models were performed to determine seasonal variation in the proportion of time they spent in moderate-to-vigorous physical activity (MVPA) and ST in the three settings. On average, the children spent 4.5% (18.6 min) and 4.0% (15.6 min) in MVPA at school during winter and summer days, respectively. They were more physically active during winter (especially during recess and lunchtime), but there were no seasonal differences for ST. Thus, children’s year-round engagement in PA needs to be promoted, especially during summer.

Description: What physical qualities can predict the quality of life (QoL) in women with fibromyalgia (FM)? QoL is a very complex outcome affected by multiple comorbidities in people with fibromyalgia. This study aims to determine which physical qualities can predict the quality of life in women with FM. Also, a comparison between the physical qualities of women with FM and healthy counterparts was conducted. In total, 223 women participated in this cross-sectional study, 123 with FM, with ages ranging between 45 and 70 years. The study was conducted at several fibromyalgia associations and specialized medical units. QoL was measured as the main outcome. In addition, functional capacity, muscular strength, maintenance of thoracic posture, postural control, flexibility, pain threshold, and anxiety were measured. Prediction of the QoL was conducted with multiple linear regression analysis and comparison between groups, using the Mann–Whitney U test. There were significant differences between groups in all the variables measured (p 〈 0.01). The multiple linear regression model showed that factors influencing QoL in women with FM for all the variables measured were functional capacity, handgrip strength and bicep strength, maintenance of thoracic posture, pain threshold, and anxiety (R2 = 0.53, p 〈 0.05). To conclude, women with FM show a significantly lower QoL than their healthy counterparts, and the factors that predict their perceived QoL are functional capacity, muscular strength, postural maintenance, pain threshold, and anxiety.

Description: This cross-sectional study analyses the usage patterns of the new communication and information technologies (ICTs) and their relationship with visual discomfort and musculoskeletal diseases in an intentional sample of 1259 workers of Spanish organizations. The usage pattern with the greatest incidence of visual and muscular-skeletal disorders, especially in the wrist and neck, combines the use of laptops and desktops during long working hours. However, the group of workers primarily using mobile devices and working mostly at mobile posts does not appear to be particularly vulnerable to the musculoskeletal diseases and visual fatigue. The ratio of taking a short pause per hour and the implantation of certain technical and preventive measures is related to lower incidence of disorders in the workers as a whole. Current usage of ICTs is very complex and should be addressed using empirical analysis of the different forms of usage and their impacts on health.

Description: Climate variability is highly impacting on mosquito-borne diseases causing malaria and dengue fever across the globe. Seasonal variability change in temperature and rainfall patterns are impacting on human health. Mosquitoes cause diseases like dengue fever, yellow fever, malaria, Chikungunya, West Nile and Japanese encephalitis. According to estimations by health organizations, annually one million human deaths are caused by vector-borne diseases, and dengue fever has increased about 30-fold over the past 50 years. Similarly, over 200 million cases of malaria are being reported annually. Mosquito-borne diseases are sensitive to temperature, humidity and seasonal variability. Both conventional (environmental, chemical, mechanical, biological etc.) and nanotechnology-based (Liposomes, nano-suspensions and polymer-based nanoparticles) approaches are used for the eradication of Malaria and dengue fever. Now green approaches are used to eradicate mosquitoes to save human health without harming the environment. In this review, the impact of climatic conditions on mosquito-borne diseases along with conventional and nanotechnology-based approaches used for controlling malaria and dengue fever have been discussed. Important recommendations have been made for people to stay healthy.

Description: Although online health communities (OHCs) are increasingly popular in public health promotion, few studies have explored the factors influencing patient e-health literacy in OHCs. This paper aims to address the above gap. Based on social cognitive theory, we identified one behavioral factor (i.e., health knowledge seeking) and one social environmental factor (i.e., social interaction ties) and proposed that both health knowledge seeking and social interaction ties directly influence patient e-health literacy; in addition, social interaction ties positively moderate the effect of health knowledge seeking on patient e-health literacy. We collected 333 valid data points and verified our three hypotheses. The empirical results provide two crucial findings. First, both health knowledge seeking and social interaction ties positively influence patient e-health literacy in OHCs. Second, social interaction ties positively moderate the effect of health knowledge seeking on patient e-health literacy. These findings firstly contribute to public health literature by exploring the mechanism of how different factors influence patient e-health literacy in OHCs and further contribute to e-health literacy literature by verifying the impact of social environmental factors.

Description: Anaerobic fermentation is a cost-effective biowaste disposal approach. During fermentation, microorganisms require a trace amount of metals for optimal growth and performance. This study investigated the effects of metal mixtures on biogas properties, process stability, substrate degradation, enzyme activity, and microbial communities during anaerobic fermentation. The addition of iron (Fe), nickel (Ni), and zinc (Zn) into a copper (Cu)-stressed fermentation system resulted in higher cumulative biogas yields, ammonia nitrogen (NH4+-N) concentrations and coenzyme F420 activities. Ni and Zn addition enhanced process stability and acetate utilization. The addition of these metals also improved and brought forward the peak daily biogas yields as well as increased CH4 content to 88.94 and 86.58%, respectively. Adding Zn into the Cu-stressed system improved the abundance of Defluviitoga, Fibrobacter and Methanothermobacter, the degradation of cellulose, and the transformation of CO2 to CH4. The bacterial and archaeal communities were responsible for the degradation of lignocelluloses and CH4 production during the fermentation process. This study supports the reutilization of heavy metal-contaminated biowaste and provides references for further research on heavy metals impacted anaerobic fermentation.

Description: Electro-oxidation is an effective approach for the removal of 2-chlorophenol from wastewater. The modeling of the electrochemical process plays an important role in improving the efficiency of electrochemical treatment and increasing our understanding of electrochemical treatment without increasing the cost. The backpropagation artificial neural network (BP–ANN) model was applied to predict chemical oxygen demand (COD) removal efficiency and total energy consumption (TEC). Current density, pH, supporting electrolyte concentration, and oxidation–reduction potential (ORP) were used as input parameters in the 2-chlorophenol synthetic wastewater model. Prediction accuracy was increased by using particle swarm optimization coupled with BP–ANN to optimize weight and threshold values. The particle swarm optimization BP–ANN (PSO–BP–ANN) for the efficient prediction of COD removal efficiency and TEC for testing data showed high correlation coefficient of 0.99 and 0.9944 and a mean square error of 0.0015526 and 0.0023456. The weight matrix analysis indicated that the correlation of the five input parameters was a current density of 18.85%, an initial pH 21.11%, an electrolyte concentration 19.69%, an oxidation time of 21.30%, and an ORP of 19.05%. The analysis of removal kinetics indicated that oxidation–reduction potential (ORP) is closely correlated with the chemical oxygen demand (COD) and total energy consumption (TEC) of the electro-oxidation degradation of 2-chlorophenol in wastewater.

Description: Prompt investigation of food poisoning outbreak are essential, as it usually involves a short incubation period. Utilizing the advancement in mobile technology, a mobile application named MyMAFI (My Mobile Apps for Field Investigation) was developed with the aim to be an alternative and better tool for current practices of field investigation of food poisoning outbreak. A randomized cross-over trial with two arms and two treatment periods was conducted to assess the effectiveness of the newly developed mobile application as compared to the standard paper-based format approach. Thirty-six public health inspectors from all districts in Kelantan participated in this study and they were randomized into two equal sized groups. Group A started the trial as control group using the paper-format investigation form via simulated outbreaks and group B used the mobile application. After a one-month ‘washout period’, the group was crossed over. The primary outcome measured was the time taken to complete the outbreak investigation. The treatment effects, the period effects and the period-by-treatment interaction were analyzed using Pkcross command in Stata software. There was a significant treatment effect with mean square 21840.5 and its corresponding F statistic 4.47 (p-value = 0.038), which indicated that the mobile application had significantly improve the reporting timeliness. The results also showed that there was a significant period effect (p-value = 0.025); however, the treatment by period interaction was not significant (p-value = 0.830). The newly developed mobile application—MyMAFI—can improve the timeliness in reporting for investigation of food poisoning outbreak.

Description: Globalization and urbanization in Nepal have driven a nutritional transition from an agricultural-based diet to an ultra-processed, sugary diet. This study assessed the nutrition and oral health of 836 children age 6 months to 6 years and their families in rural and urban Nepal. Mothers were interviewed about maternal–child oral health and nutrition, and children received dental exams and height and weight measurements. Analyses utilized SPSS statistical software. Most families lived within a 5-minute walk to a store selling ultra-processed snacks and sugary drinks. While most mothers knew sweets caused tooth decay, half of the children were given sweets daily, and 58.2% of children had dental caries. Caries began in the first 2 years and increased in prevalence and severity to age 6, when 74.3% had caries and 20% experienced mouth pain. Despite greater health knowledge and resources among urban mothers, urban children’s increased access to junk food and frequency of consumption was associated with higher prevalence and severity of caries compared to rural children. Severe caries was associated with malnutrition, especially in rural children. Preventive strategies are needed in early childhood to incorporate nutrition and oral health education and dental care into maternal–child health services, and develop policies to prohibit the sale of junk food around schools.

Description: Increasing pressure on limited healthcare resources has necessitated the development of measures promoting early discharge and avoiding inappropriate hospital (re)admission. This systematic review examines the evidence for interventions in acute hospitals including (i) hospital-patient discharge to home, community services or other settings, (ii) hospital discharge to another care setting, and (iii) reduction or prevention of inappropriate hospital (re)admissions. Academic electronic databases were searched from 2005 to 2018. In total, ninety-four eligible papers were included. Interventions were categorized into: (1) pre-discharge exclusively delivered in the acute care hospital, (2) pre- and post-discharge delivered by acute care hospital, (3) post-discharge delivered at home and (4) delivered only in a post-acute facility. Mixed results were found regarding the effectiveness of many types of interventions. Interventions exclusively delivered in the acute hospital pre-discharge and those involving education were most common but their effectiveness was limited in avoiding (re)admission. Successful pre- and post-discharge interventions focused on multidisciplinary approaches. Post-discharge interventions exclusively delivered at home reduced hospital stay and contributed to patient satisfaction. Existing systematic reviews on tele-health and long-term care interventions suggest insufficient evidence for admission avoidance. The most effective interventions to avoid inappropriate re-admission to hospital and promote early discharge included integrated systems between hospital and the community care, multidisciplinary service provision, individualization of services, discharge planning initiated in hospital and specialist follow-up.

Description: Recent studies of unconventional resource development (URD) and adverse health effects have been limited by distance-based exposure surrogates. Our study compared exposure classifications between air pollutant concentrations and “well activity” (WA) metrics, which are distance-based exposure proxies used in Marcellus-area studies to reflect variation in time and space of residential URD activity. We compiled Pennsylvania air monitoring data for benzene, carbon monoxide, nitrogen dioxide, ozone, fine particulates and sulfur dioxide, and combined this with data on nearly 9000 Pennsylvania wells. We replicated WA calculations using geo-coordinates of monitors to represent residences and compared exposure categories from air measurements and WA at the site of each monitor. There was little agreement between the two methods for the pollutants included in the analysis, with most weighted kappa coefficients between −0.1 and 0.1. The exposure categories agreed for about 25% of the observations and assigned inverse categories 16%–29% of the time, depending on the pollutant. Our results indicate that WA measures did not adequately distinguish categories of air pollutant exposures and employing them in epidemiology studies can result in misclassification of exposure. This underscores the need for more robust exposure assessment in future analyses and cautious interpretation of these existing studies.

Description: Background: Emerging evidence suggests that exposure to secondhand and thirdhand aerosol from electronic cigarettes may have serious health risks including respiratory and cardiovascular diseases. Social media data can help identify common locations referenced in vaping-related discussions and offer clues about where individuals vape. These insights can strengthen current tobacco regulations and prioritize new policies to improve public health. This study identified commonly referenced locations in vaping-related discussions on Twitter in 2018. Methods: Vaping-related posts to Twitter were obtained from 1 January 2018 to 31 December 2018. Rule-based classifiers categorized each Twitter post into 11 location-related categories (social venues, living spaces, stores, modes of transportation, schools, workplaces, healthcare offices, eateries, correctional facilities, religious institutions, and miscellaneous) using a data dictionary of location-related keywords (n = 290,816). Results: The most prevalent category was social venues (17.9%), followed by living spaces (16.7%), stores (15.9%), modes of transportation (15.5%), schools (14.9%), and workplaces (11.9%). Other categories pertained to: healthcare offices (2.0%), eateries (1.2%), correctional facilities (0.7%), and religious institutions (0.4%). Conclusion: This study suggests that locations related to socialization venues may be priority areas for future surveillance and enforcement of smoke-free air policies. Similarly, development and enforcement of similar policies at workplaces, schools and multi-unit housing may curb exposure to secondhand and thirdhand aerosol among the public.

Description: Although patients under supportive periodontal therapy (SPT) have a stable periodontal condition, the acute symptom of chronic periodontal disease occasionally occurs without a clear reason. Therefore, in the present study, to obtain a better understanding of this relationship in patients undergoing SPT, we hypothesized that the acute symptom of chronic periodontal disease might be affected by climate factors. We conducted a questionnaire study and carried out oral examinations on patients undergoing SPT who had been diagnosed as having the acute symptom of chronic periodontal disease. We collected climate data from the local climate office in Okayama city, Japan. We predicted parameters that affect the acute symptom of chronic periodontal disease with unidentified cause and divided patients into high and low groups in terms of climate predictors. Then we defined the cut-off values of parameters showing significant differences in the incidence of the acute symptom of chronic periodontal disease. The incidence of the acute symptom of chronic periodontal disease with unidentified cause was significantly different when the cases were classified according to the maximum hourly decrease in barometric pressure (1.5 and 1.9 hPa) (p = 0.04 and p = 0.03, respectively). This suggests that climate variables could be predictors of the acute symptom of chronic periodontal disease. Therefore, gaining a better understanding of these factors could help periodontal patients undergoing SPT prepare to avoid the acute symptom of chronic periodontal disease.

Description: In 2017, more than half of the global burden of incident tuberculosis (TB) came from the Western Pacific region. In Lao People’s Democratic Republic (PDR), the high rates of tobacco use and use of polluting biomass fuels for cooking (e.g., wood, charcoal, crop waste, dung) represent significant risk factors for TB. The purpose of this study was to determine the association between self-reported (1) smoking and TB; and (2) exposure to air pollution (from both cooking fires and environmental tobacco smoke) and TB among adults in Lao PDR. We analyzed data from the 2012 National Adult Tobacco Survey (NATSL) of Lao PDR—a multi-stage stratified cluster sample of 9706 subjects from 2822 households located in all 17 provinces. Utilizing a nationally representative sample and inferential, multivariable methods, we observed a significant increase in odds of self-reported TB among those who smoked tobacco (OR = 1.73, 95% CI = (1.00 to 2.98)). Larger multivariable models identified independent contributions from exposure to tobacco pipes (OR = 21.51, 95% CI = (6.34 to 72.89)) and communal outdoor fires (OR = 2.27, 95% CI = (1.15 to 4.49)). An index measuring combined exposure to smoked tobacco, environmental tobacco smoke in enclosed workspace, indoor cooking fire, trash fires, and other outdoor communal fires also showed a positive association (OR per added exposure = 1.47, 95% CI = (1.14 to 1.89)). The findings of this study underscore the need for multi-sectoral collaboration between tobacco control, environmental health, TB prevention and treatment programs, national authorities, policy makers, civil groups, and the private sector to address the convergence of potential risk factors impacting respiratory health in Lao PDR.

Description: The main activity of the accountant is the preparation and audit of the financial information of a company. The subjective well-being of the accountant is important to ensure a balanced professional judgment and to offer a positive image of the profession in the face of the incorporation and retention of talent. However, accountants are subjected to intense pressures that affect their well-being in the performance of their tasks. In this paper, the job demands–resources theoretical framework is adopted to analyze the relationships between job demands, job resources, and the subjective well-being of a large sample of 739 accounting experts at the European level. Applying a structural equations model, the results confirm, on the one hand, the direct effects provided in the theoretical framework and, on the other, a new mediating role of job demands–subjective well-being relationship resources.

Description: People with obesity in Romania are often under medical supervision, which is aimed to decrease body weight and treat accompanying metabolic disorders and cardiovascular implications. However, there is limited information regarding the implementation of dietary recommendations in adults with obesity. We aimed to evaluate the prevalence of reaching the recommended intakes of macro- and micro-nutrients in adults with obesity under medical supervision. Individuals with obesity, recruited in the context of a study with a larger scope (NutriGen ClinicalTrials.gov NCT02837367), who were under medical supervision underwent four 24 h recalls in order to assess daily food intakes. Macro- and micro-nutrient intakes were computed, and the prevalence of reaching recommended dietary allowances (RDAs) for each nutrient was calculated. The majority of subjects did not meet the recommended intakes for most nutrients. Energy from fat exceeded the threshold of 35% recommended intake, even in the lowest quartile of energy intake. The micronutrients with less than 5% of individuals reaching the RDAs were vitamin D, vitamin E, fluoride, and omega-3 fatty acids for both males and females, and choline, magnesium, and potassium in females. The burden of inadequate nutrition in individuals with obesity should be acknowledged and properly addressed within efforts to reduce obesity rates and associated disorders.

Description: Aims: The present study aimed to examine and compare the socioecological correlates of park-based physical activity (PA) among Hong Kong and Leipzig older adults in terms of types of activity areas, perceived park environment, psychosocial factors, and the interactions between the perceived park environmental and psychosocial factors. Methods: Based on the SOPARC, systematic observations were conducted in six randomly selected urban parks in each city. A total of 317 Hong Kong (Mage = 69.96; SD = 6.81) and 311 Leipzig (Mage = 72.06; SD = 6.78) older adults from these six parks completed an interviewer-delivered survey measuring their perceived park environment, psychosocial variables, and park-based PA. Results: In both cities, the types of activity areas were positively associated with the number of older adults observed being active in parks. Psychosocial factors, especially self-efficacy and perceived barriers, had larger associations with park-based PA compared with the perceived park environment. The interaction between perceived park features and self-efficacy in the association with park-based PA was found in Leipzig, but not in Hong Kong. Conclusion: Findings of the current study contribute to the cross-cultural understanding of the socioecological correlates of park-based PA among older adults.

Description: This retrospective cohort study examined the effects of care continuity on the utilization of follow-up services and outcome of breast cancer patients (stages I–III) in the post-treatment phase of care. Propensity score matching and generalized estimation equations were used in the analysis of data obtained from national longitudinal databases. The continuity of care index (COCI) was calculated separately for primary care physicians (PCP) and oncologists. Our results revealed that breast cancer survivors with a higher oncology COCI were more likely than those with a lower oncology COCI to use mammography or breast ultrasound during the follow-up period (OR = 1.26, 95% CI: 1.19–1.32; OR = 1.12, 95% CI: 1.06–1.18; respectively). In terms of health outcomes, a higher oncology COCI was associated with a lower likelihood of hospitalization (OR = 0.78, 95% CI: 0.71–0.85) and emergency department use (OR = 0.88, 95% CI: 0.82–0.95). A higher PCP COCI was also associated with a lower likelihood of hospitalization (OR = 0.77, 95% CI: 0.70–0.85) and emergency department use (OR = 0.75, 95% CI: 0.68–0.82). Overall, this study determined that ambulatory care continuity is positively associated with the likelihood of using recommended follow-up care services and negatively associated with adverse health events among breast cancer survivors.

Description: Objectives: “Karoshi” (death due to overwork) of doctors occurred frequently and attracted increasing attention in recent years in China. This study aimed to determine the prevalence of work-related accumulated fatigue of doctors and its associated factors in tertiary hospitals of China. Methods: A cross-sectional questionnaire survey was conducted on 1729 full-time doctors employed by 24 tertiary hospitals across eastern developed, central developing, and western underdeveloped regions of China. Accumulated fatigue was categorized into four levels using the “Self-diagnosis Checklist for Assessment of Workers’ Accumulated Fatigue” rated on a scale matrix considering both overwork and fatigue symptoms. Ordinal logistic regression analyses were performed to identify factors associated with work-related accumulated fatigue. Results: About 78.8% of respondents reported a “high level” of work-related accumulated fatigue, including 42.0% at a “very high” level. Male doctors and those aged between 30 and 45 years and who had a professional title were found to have higher levels of accumulative fatigue than others. Low salary and poor working conditions (in the western region) were also significantly associated with high levels of work-related accumulated fatigue (p 〈 0.05). Conclusion: High levels of work-related accumulated fatigue are prevalent in doctors working in tertiary hospitals in China. Male doctors establishing their early- and mid-careers are the high-risk group. Poor working conditions are associated with work-related accumulated fatigue.

Description: This study examined the differences in health spending within the World Health Organization (WHO) Europe region by comparing the EU15, the EU post-2004, CIS, EU Candidate and CARINFONET countries. The WHO European Region (53 countries) has been divided into the following sub-groups: EU15, EU post-2004, CIS, EU Candidate countries and CARINFONET countries. The study period, based on the availability of WHO Global Health expenditure data, was 1995 to 2014. EU15 countries have exhibited the strongest growth in total health spending both in nominal and purchasing power parity terms. The dynamics of CIS members’ private sector expenditure growth as a percentage of GDP change has exceeded that of other groups. Private sector expenditure on health as a percentage of total government expenditure, has steadily the highest percentage point share among CARINFONET countries. Furthermore, private households’ out-of-pocket payments on health as a percentage of total health expenditure, has been dominated by Central Asian republics for most of the period, although, for the period 2010 to 2014, the latter have tended to converge with those of CIS countries. Western EU15 nations have shown a serious growth of health expenditure far exceeding their pace of real economic growth in the long run. There is concerning growth of private health spending among the CIS and CARINFONET nations. It reflects growing citizen vulnerability in terms of questionable affordability of healthcare. Health care investment capability has grown most substantially in the Russian Federation, Turkey and Poland being the classical examples of emerging markets.

Description: Background: While measuring and monitoring disease morbidity, it is essential to focus on regions experiencing inequitable health outcomes, especially coastal populations. However, no research investigating population health outcomes in coastal areas has been conducted. Therefore, we aimed to investigate the burden of disease morbidity in coastal areas of South Korea. Methods: Using an administrative division map and the ArcGIS, we identified and included 496 coastal districts. In this observational study, years lived with disability (YLDs) were estimated using incidence-based approaches to calculate the burden of disease in 2015. Incidence and prevalence cases were collected using National Health Insurance Service (NHIS) medical claim data using a specialized algorithm. Results: Age-standardized years lived with disability (ASYLDs) in the coastal areas were 24,398 per 100,000 population, which is greater than the 22,613 YLDs observed nationwide. In coastal areas, the burden of disease morbidity was higher in females than in males. Diabetes mellitus was the leading specific disease of total YLDs per 100,000 population, followed by low back pain, chronic obstructive pulmonary disease, osteoarthritis, and ischemic stroke. Conclusion: In this study, the coastal areas of South Korea carry a higher burden than the national population. Additionally, chronic diseases compose the majority of the health burden in coastal areas. Despite the limitation of data, YLD was the best tool available for evaluating the health outcomes in specific areas, and has the advantage of simplicity and timely analysis.

Description: Consequent upon rapid development in Abu Dhabi, there has been a rise in chronic disease, the susceptibilities to which are influenced by events occurring in early life. Hence, maternal and infant health are key areas in public health policy. Following a study of maternal and infant health in a cohort of mothers in Abu Dhabi between 2002 and 2004, seven key informant interviews were undertaken to elucidate the study findings through the impressions of Emirati women in positions within the healthcare area—including ministries, hospitals, and universities in Abu Dhabi. Semi-structured interviews were based on five key questions that covered the cultural responsiveness of the maternal health services—breastfeeding, health education, and physical and recreational activity. The responses were analysed using a thematic content technique and indicated that the status of women, cultural beliefs and practices, limited health knowledge, and language differences between the local population, healthcare providers, and health promoting materials were important themes. The study highlighted areas for future research and policy, including the communication gaps between healthcare professionals and women, the influences of advertising and the media on health issues, heath education, and ways to increase women’s participation in physical exercise. It is vital to consider non-medical determinants of health alongside biomedical determinants, to help develop culturally appropriate health strategies for this population.

Description: Children’s favourite food and beverage brands use various tactics to foster positive associations and loyalty. This brand-consumer dynamic is frequently influenced by the use of implicit techniques and emotional appeals. Few studies have used physiological methods to examine the connections that brands build with children and the influence this has on their automatic responses. These techniques are potentially less prone to bias than behavioural or cognitive methods. This is the first study to explore the implicit response that children have to images of their favourite food and beverage brands using skin conductance responses as a marker of arousal. Australian children aged 8–11 years (n = 48) were recruited. Images of the participants’ favourite branded food and beverage products, alongside images of the same products unpackaged, their family and friends, and neutral objects were presented in a randomised order with a standard timed interval between images. Children were significantly more aroused by branded images of their favourite food and beverage products than by their unpackaged counterparts (p 〈 0.042, d = 0.4). The physiological response to the branded products was similar to the response to the children’s family and friends (p = 0.900, d = −0.02). These findings suggest that children may have an implicit connection to their favourite branded products.

Description: Background: Migrant workers (MWs) generally perform dangerous jobs and have reduced access to occupational health (OH) care, therefore being prone to developing occupational diseases (OD). The aim of the work is to describe a case series of MWs and report on related outcomes for OH professionals. Methods: A case series of 724 MWs, sent from January 2001 to June 2013 to a public OH unit for OD or fitness-for-work (FFW) evaluation, was entered in a dedicated database and elaborated for descriptive statistics with Microsoft Excel. Results: MWs were mostly (75%) men, with a mean age of 40. They came mainly from Morocco, Senegal, Albania, Romania, and Pakistan. Main sectors of employment were manufacturing, metal industry, services, construction. OD were found in 210 cases, main diagnoses being: Lumbar disc and upper limb musculoskeletal disorders (51%), contact dermatitis (15%), allergic asthma (8%), noise-induced hearing loss (7%), tumors (3%), psychiatric disorders (2%). Moreover, 136 FFW judgements were formulated, with some limitations/restrictions expressed. Finally, a relevant prevalence of some chronic non-occupational diseases was found. Conclusions: MWs in Italy may suffer from OH inequalities. Qualified public OH professionals and occupational physicians in workplaces should have a proactive role to concretely meet MWs’ health needs.

Description: Observational studies and randomised controlled studies suggest that vitamin D plays a role in the prevention of acute respiratory tract infection (ARTI); however, findings are inconsistent and the optimal serum 25-hydroxyvitamin D (25(OH)D) concentration remains unclear. To review the link between 25(OH)D concentration and ARTI, we searched PubMed and EMBASE databases to identify observational studies reporting the association between 25(OH)D concentration and risk or severity of ARTI. We used random-effects meta-analysis to pool findings across studies. Twenty-four studies were included in the review, 14 were included in the meta-analysis of ARTI risk and five in the meta-analysis of severity. Serum 25(OH)D concentration was inversely associated with risk and severity of ARTI; pooled odds ratios (95% confidence interval) were 1.83 (1.42–2.37) and 2.46 (1.65–3.66), respectively, comparing the lowest with the highest 25(OH)D category. For each 10 nmol/L decrease in 25(OH)D concentration, the odds of ARTI increased by 1.02 (0.97–1.07). This was a non-linear trend, with the sharpest increase in risk of ARTI occurring at 25(OH)D concentration 〈 37.5 nmol/L. In conclusion, there is an inverse non-linear association between 25(OH)D concentration and ARTI.

Description: Research in work and organizational psychology has paid little attention to religious workers, something certainly surprising as faith-based organizations play a key role in the welfare state of many countries. This research shows that religious workers in a Catholic order present a high degree of subjective wellbeing, both in terms of flourishing and satisfaction with life in general, and a positive balance of positive and negative feelings. More specifically, this study examines the relationship between authenticity and wellbeing amongst religious workers. Survey responses from 142 religious workers in Spain were analyzed using partial least squares path modelling. The results reveal that subjective wellbeing at work is positively related to authenticity. In addition, this relationship is mediated by their level of work engagement.

Description: A standardized residency training program (SRT) was launched in Shanghai in 2010, for both Western Medicine (WM) and Traditional Chinese Medicine (TCM). This study aimed to assess whether the program impacted trainees’ willingness to become a doctor and whether the program had different effects among WM and TCM trainees. A structured questionnaire was distributed to 2114 trainees to assess their perceptions and satisfaction with the program and their willingness to become a doctor after the exposure to the program. The trainees’ characteristics were compared between WM and TCM specialties using X2 tests. The potential factors associated with trainees’ perception of the program and willingness to become a doctor after the exposure to the SRT program were assessed by multiple linear and logistic regression models. Compared to WM trainees (n = 1853), TCM trainees (n = 261) would be more likely to become doctors if there were no SRT program (p = 0.003). Both individual and program-wide (different specialties) factors contributed to trainees’ perception, overall satisfaction, and willingness. Only specialty played an independent role in the associations with all three outcome variables. Inequality of characteristics between TCM and WM trainees reduced TCM trainees’ willingness to become a doctor after the exposure to the SRT program.

Description: The urban environment is a complex ecosystem influenced by strong human disturbances in multi-environmental media, so it is necessary to analyze urban environmental pollutants through the comprehensive analysis of different media. Soil, road dust, foliar dust, and camphor leaves from 32 sample sites in Shanghai were collected for the analysis of mercury contamination in soil–road dust–leaves–foliar dust systems. Mercury concentrations in surface soils in Shanghai were the highest, followed by road dust, foliar dust, and leaves, successively. The spatial distribution of mercury in the four environmental media presented different distribution patterns. Except for the significant correlation between mercury concentrations in road dust and mercury concentrations in leaves (r = 0.56, p 〈 0.001), there was no significant correlation between the other groups in the four media. Besides this, there was no significant correlation between mercury concentrations and land types. The LUR (Land use regression) model was used to assess the impact of urbanization factors on mercury distribution in the environment. The results showed that soil mercury was affected by factories and residential areas. Foliar dust mercury was affected by road density and power plants. Leaf mercury was affected by power plants and road dust mercury was affected by public service areas. The highest average HI (Hazard index) value of mercury in Shanghai was found in road dust, followed by surface soil and foliar dust. The HI values for children were much higher than those for adults. However, the HI values of mercury exposure in all sampling sites were less than one, suggesting a lower health risk level. The microscopic mechanism of mercury in different environmental media was suggested to be studied further in order to learn the quantitative effects of urbanization factors on mercury concentrations.

Description: Objective: To study the trajectories of work ability and investigate the impact of multisite pain and working conditions on pathways of work ability over a six-year period. Methods: The longitudinal study was conducted with Finnish food industry workers (n = 866) with data collected every 2 years from 2003–2009. Questions covered musculoskeletal pain, physical and psychosocial working conditions (physical strain, repetitive movements, awkward postures; mental strain, team support, leadership, possibility to influence) and work ability. Latent class growth analysis and logistic regression were used to analyse the impact of multisite pain and working conditions on work ability trajectories (pathways). Results: Three trajectories of work ability emerged: decreasing (5%), increasing (5%), and good (90%). In the former two trajectories, the mean score of work ability changed from good to poor and poor to good during follow-up, while in the latter, individuals maintained good work ability during the follow-up. In the multivariable adjusted model, number of pain sites was significantly associated with higher odds of belonging to the trajectory of poor work ability (Odds ratio (OR) 4 pain sites 2.96, 1.25–7.03). Conclusions: A substantial number of employees maintained good work ability across the follow up. However, for employees with poor work ability, multisite musculoskeletal pain has an important influence, with effective prevention strategies required to reduce its prevalence.

Description: Background: Seasonal influenza causes significant morbidity worldwide and has a substantial economic impact on the healthcare system. Objective: To assess the cost–benefit relation of implementing a real-time influenza test in emergency rooms (ER) of German hospitals. Methods: A deterministic decision-analytic model was developed simulating the incremental costs of using the Solana® Influenza A+B test, compared to those of using conventional clinical judgement alone to confirm or exclude influenza in adult ILI (influenza-like illness) patients, in German ER, prior to hospitalization. Direct costs were evaluated from the hospital perspective, considering resource use directly related to influenza testing and treatment, as well as indirect costs incurred by nosocomial influenza transmission. Results: Through base-case analysis and assuming an influenza prevalence of 42.6%, real-time testing with Solana® reduced average costs of hospitalized ILI patients by €132.61, per tested patient. Moreover, the Solana® saved €6.9 per tested patient in favor of the hospital. In probabilistic sensitivity analysis, under all reasonable assumptions, implementing the Solana® saved on average €144.13 as compared to applying the clinical-judgement-only strategy, thus, it was found to be constantly less expensive. Conclusions: Using highly sensitive and specific real-time influenza tests in ILI patients at German ER might significantly reduce hospital expenditures

Description: Policemen and firefighters encounter numerous emergency events that frequently lead to high burnout and low job support, resulting in adverse health effects. A number of studies reported the correlation between job characteristics and the risk of peptic ulcer diseases (PUD) across various industries. However, there is very little research on evaluating the interaction effects of burnout and job support on the prevalence of PUD among firefighters and policemen. The objective of this study was to assess the interactional effects between burnout and job support on the prevalence of PUD among firefighters and policemen. This was a cross-sectional quantitative study. Registered, full-time police officers and firefighters in Taiwan were anonymously interviewed by a mail-delivered questionnaire. All female workers were excluded due to different job characteristics and a limited sample size. A total of 9328 firefighters and 42,798 policemen completed the questionnaire, with a response rate of 78.7%. Overall, prevalence rates of self-reported and self-reports of physician-diagnosed PUD were 8.3% and 6.5% for policemen and 7.1% and 5.5% for firefighters, respectively. There was a 22% reduced odds ratio of PUD as diagnosed by physicians for the group with low burnout and high job support, but an increased odds ratio of 53% for the group with high burnout and low job support, after adjusting for lifestyle and demographic variables. There must be an increase of job support and reduction of burnout through the modification of work structure and setting up of counseling services to reduce workplace stress and the prevalence of PUD among policemen and firefighters.

Description: The practice of creating and sharing sexual images via technological devices, known as sexting, has received crescent attention in the past years, especially due to the increase of adolescent engagement in this behavior. Although consensual sexting is not prima facie a crime, as some research has shown, it has the potential to be a risky behavior, and a threshold to get exposure to dangerous kinds of victimization as sextortion, online grooming or cyberbullying. In this context, teenagers represent a vulnerable group due to their limited ability of self-regulation, their high susceptibility to peer pressure, their technophilia, and their growing sexual curiosity. The present paper aims to review the scientific literature to analyze the relationship between mental health and sexting as a potentially risky behavior and its association with online victimization. The results and implications will be discussed.

Description: Background: From a causal point of view, there exists a set of socioeconomic indicators concerning life expectancy. The objective of this paper is to determine the indicators which exhibit a relation of causality with life expectancy at birth. Methods: Our analysis applies the Granger causality test, more specifically its version by Dumitrescu–Hurlin, starting from the information concerning life expectancy at birth and a set of socioeconomic variables corresponding to 17 Spanish regions, throughout the period 2006–2016. To do this, we used the panel data involving the information provided by the Spanish Ministry of Health, Consumer Affairs and Social Welfare (MHCSW) and the National Institute of Statistics (NIS). Results: Per capita income, and the rate of hospital beds, medical staff and nurses Granger-cause the variable “life expectancy at birth”, according to the Granger causality test applied to panel data (Dumitrescu–Hurlin’s version). Conclusions: Life expectancy at birth has become one of the main indicators able to measure the performance of a country’s health system. This analysis facilitates the identification of those factors which exhibit a unidirectional Granger-causality relationship with life expectancy at birth. Therefore, this paper provides useful information for the management of public health resources from the point of view of the maximization of social benefits.

Description: (1) Background: Collaboration between the health care sector and the sports sector to increase physical activity (PA) behaviour among inactive adults is still rare. The objective of the study was to evaluate the short- and long-term effectiveness of a mixed PA intervention on the PA behaviour in an adult population. (2) Methods: In a quasi-experimental study with two follow-up measurements (four and 12 months), adults were contacted by post before their stay in a health resort. During the health resort stay, the intervention group (IG) received PA counselling and a coupon for 12 standardised free-of-charge sessions in a sports club. The participants in the comparator group (CG) received PA counselling and written material. PA was measured with an accelerometer (GENEActive). Linear mixed-effects models were applied to examine the change in PA behaviour, both within and between groups in moderate- to vigorous-intensity PA over time. (3) Results: We obtained at least one follow-up measurement from 217 participants (IG = 167, CG = 50), who were 50% female, with an average age of 53 (±6) years. PA significantly increased from the baseline to the four-month measurement by 58 min./wk (95% CI 36, 80) and to the 12-month measurement by 24 min./wk (95% CI 2, 46) within the IG. No change in PA occurred in the CG. We also found a short-term between-group (IG vs. CG) difference in change over time, but not a long-term difference. (4) Conclusions: The study confirms that a collaboration between the health care sector and local sports clubs is a feasible method of recruiting people into a standardised PA programme and to increase their PA over the long term.

Description: Trauma informed care (TIC) is a whole system organisational change process which emerged from the seminal Adverse Childhood Experiences (ACE) study, establishing a strong graded relationship between the number of childhood adversities experienced and a range of negative outcomes across multiple domains over the life course. To date, there has been no systematic review of organisation-wide implementation initiatives in the child welfare system. As part of a wider cross-system rapid evidence review of the trauma-informed implementation literature using systematic search, screening and review procedures, twenty-one papers reporting on trauma-informed implementation in the child welfare system at state/regional and organisational/agency levels were identified. This paper presents a narrative synthesis of the various implementation strategies and components used across child welfare initiatives, with associated evidence of effectiveness. Training was the TIC implementation component most frequently evaluated with all studies reporting positive impact on staff knowledge, skills and/or confidence. The development of trauma-informed screening processes, and evidence-based treatments/trauma focused services, where evaluated, all produced positive results. Whilst weaknesses in study design often limited generalisability, there was preliminary evidence for the efficacy of trauma-informed approaches in improving the mental and emotional well-being of children served by community-based child welfare services, as well as their potential for reducing caregiver stress and improving placement stability.

Description: Children’s exposure to unhealthy food marketing is one factor contributing to childhood obesity. The impact of marketing on children’s weight likely occurs via a cascade pathway, through influences on children’s food brand awareness, emotional responses, purchasing and consumption. Thus, building emotional attachments to brands is a major marketing imperative. This study explored Australian children’s emotional attachments to food and drink brands and compared the strength of these attachments to their food marketing exposure, using television viewing as a proxy indicator. A cross-sectional face-to-face survey was conducted with 282 Australian children (8–12 years). Children were asked to indicate their agreement/disagreement with statements about their favourite food and drink brands, as an indicator of the strength and prominence of their brand attachments. Questions captured information about minutes/day of television viewing and the extent that they were exposed to advertising (watched live or did not skip through ads on recorded television). For those children who were exposed to advertisements, their age and commercial television viewing time had significant effects on food and drink brand attachments (p = 0.001). The development of brand attachments is an intermediary pathway through which marketing operates on behavioural and health outcomes. Reducing children’s exposure to unhealthy food marketing should be a policy priority for governments towards obesity and non-communicable disease prevention.

Description: Non-suicidal self-injury (NSSI) is prevalent among adolescents. Low health literacy (HL) and problematic mobile phone use (PMPU) are risk factors of NSSI. But so far, no study has examined the interactive role of HL and PMPU on NSSI. In this context, the present study aimed to examine the interactions of HL and PMPU and their impact on NSSI in a school-based sample of Chinese adolescents. A total of 22,628 junior and high school students (10,990 males and 11,638 females) were enrolled in this study. The outcomes were self-reported HL, PMPU and NSSI. Analyses were conducted with chi-square tests and logistic regression models. The prevalence of NSSI was 32.1%. Low HL and PMPU were significantly associated with NSSI independently (ORlow HL = 1.886, 95% CI = 1.723–2.065, ORPMPU = 2.062, 95% CI = 1.934–2.199). Interaction analysis indicated that low HL and PMPU were interactively associated with increased risks of NSSI (OR = 2.617, 95% CI = 2.375–2.884). In all, our findings indicate that HL and PMPU are associated with NSSI independently and interactively. The intervention programs of NSSI should consider the adolescents HL levels and PMPU.

Description: The aim of the study was to assess the feasibility and reliability of physical fitness field tests used in the “Fuprecol kids” study among Colombian preschool children aged 3–5 years. A total of 90 preschoolers aged 3–5 years participated in the study. Weight, height, waist circumference, cardiorespiratory fitness (CRF), musculoskeletal fitness (handgrip strength and standing broad jump), speed–agility (4 × 10 m shuttle run), and flexibility (sit and reach test) components were tested twice (two weeks apart). The feasibility of the tests (preschoolers able to complete the test) ranged from 96% in the CRF test to 100% in the musculoskeletal fitness, speed–agility, and flexibility tests. Overall, the %TEMs were 0.625% for the weight, 0.378% for the height, 1.035% for the body mass index, and 0.547% for the waist circumference. In addition, all tests were substantial reliable, for CRF (in stages and laps, concordance correlation coefficient = 0.944 and 0.941, respectively) in both sexes and flexibility (concordance correlation coefficient = 0.949) in girls. There were no significant differences in fitness test–retest mean differences in the boys (p 〉 0.05), except in CRF (laps p = 0.017). In girls, there were differences in CRF (stages (p = 0.017) and laps (p = 0.013)), and flexibility (p = 0.002) variables. The results from this study indicate that the “Fuprecol kids” battery of tests, administered by physical education teachers, was reliable and feasible for measuring components of physical fitness in preschoolers in a school setting in Colombia.

Description: This study reports on the assessment of the impact of antimony mine wastes from Xikuangshan (XKS) Antimony Mine in Lengshuijiang City, Hunan Province. We focus on the leaching of a number of potentially toxic elements (PTEs) from residues from the processing of antimony ore. The PTE content of ore processing waste and solutions generated by leaching experiments were determined for a suite of PTEs associated with the ore mineralization. These were Sb, As, Hg, Pb, Cd and Zn. As anticipated, high concentrations of the PTEs were identified in the waste materials, far exceeding the standard background values for soil in Hunan Province. For Sb and As, values reached 〉1800 mg·kg−1 and 〉1200 mg·kg−1, respectively (〉600 and 〉90 times higher than the soil background). The leaching of Sb, As, Hg, Pb, Cd and Zn decreased with an increase in grain size and leachable portions of metal ranged between 0.01% to 1.56% of total PTE content. Leaching tests identified the release of PTEs through three stages: a. alkaline mineral dissolution and H+ exchanging with base cation; b. oxidation and acid production from pyrite and other reducing minerals; and c. the adsorption and precipitation of PTEs.

Description: Disparities in healthy food access are well documented in cross-sectional studies in communities across the United States. However, longitudinal studies examining changes in food environments within various neighborhood contexts are scarce. In a sample of 142 census tracts in four low-income, high-minority cities in New Jersey, United States, we examined the availability of different types of food stores by census tract characteristics over time (2009–2017). Outlets were classified as supermarkets, small grocery stores, convenience stores, and pharmacies using multiple sources of data and a rigorous protocol. Census tracts were categorized by median household income and race/ethnicity of the population each year. Significant declines were observed in convenience store prevalence in lower- and medium-income and majority black tracts (p for trend: 0.004, 0.031, and 0.006 respectively), while a slight increase was observed in the prevalence of supermarkets in medium-income tracts (p for trend: 0.059). The decline in prevalence of convenience stores in lower-income and minority neighborhoods is likely attributable to declining incomes in these already poor communities. Compared to non-Hispanic neighborhoods, Hispanic communities had a higher prevalence of small groceries and convenience stores. This higher prevalence of smaller stores, coupled with shopping practices of Hispanic consumers, suggests that efforts to upgrade smaller stores in Hispanic communities may be more sustainable.

Description: In this special issue of IJERPH, we feature studies conducted by research translation and community engagement teams that are funded through the Superfund Research Program in the United States. These and other teams funded by this program demonstrate how environmental and health communication research can contribute to generalizable lessons about helping and empowering contaminated communities. These types of applied behavioral, social and communication projects are important because while much about our communities is unique and must be addressed on a case by case basis, other aspects of research translation and community engagement processes are potentially generalizable across sites and can thus be used to scale up solutions to toxic contamination to other communities and countries more rapidly than would otherwise occur.

Description: Background: Patient safety is a priority of any healthcare system, and one of the most effective measures is hand hygiene. For this, it is important that health staff have correct adherence and perform the technique properly. Otherwise, the incidence of nosocomial infections can increase, with consequent complications. The aim here was to analyze hand hygiene training and the effectiveness of different methods and educational strategies among nurses and whether they maintained correct adherence over time. Methods: A systematic review was conducted in the sources CINAHL (Cumulative Index to Nursing and Allied Health Literature), Dialnet, Lilacs (Latin American and Caribbean Health Sciences Literature), ProQuest (Proquest Health and Medical Complete), Medline, SciELO (Scientific Electronic Library Online), and Scopus. The search equation with Medical Subject Headings (MeSH) descriptors was “Nurs* AND (handwashing OR hand hygiene) AND clinical trial”. The review was performed following the recommendations of the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. Results: n = 17 clinical trials were included, with a total of 5747 nurses and nursing students. Strategies such as reminder sounds, practical simulations, videos, and audiovisual media improved handwashing compliance. Adherence overtime increased by up to 60%. The greatest effectiveness was related to the use of povidone–iodine, which reduced colony formation compared Hand hygiene teaching strategies among nursing staff: a systematic review to soap. Conclusions: The strategies that go beyond teaching techniques such as lectures may be more effective at increasing hand hygiene compliance. Combined approaches to learning/instruction improve user satisfaction by enabling self-management, flexibility, and repetition.

Description: The application of the compact disk (CD) method for radon measurements at mines, caves and other workplaces needs testing under highly variable exposure conditions. We present the results from a blind comparison of CDs exposed in the Laboratory of Natural Radiation (Saelices el Chico, Spain). During the exposure the temperature varied from 6.5 to 24.9 °C (average 12.6 °C) and the 222Rn activity concentrations varied from 〈10 Bq m−3 to 147 kBq m−3. Good correspondence was observed between the integrated 222Rn activity concentration determined by the reference instruments in the laboratory (122,500 ± 6100 kBq h m−3) and that assessed by analysis of the CDs at a depth 80 µm beneath the front surface (118,000 ± 12,000 kBq h m−3) and at a depth of 120 µm (106,000 ± 12,000 kBq h m−3). The theoretical modeling of the CD response under variable temperature and radon concentration suggested that the small bias is probably due to the time variation of the calibration factor because of the time variations of the temperature.

Description: Prior research explored reasons for tobacco use among pregnant Alaska Native (AN) women but did not address the postpartum period. This study followed up with AN women one to three years postpartum who had participated in a prenatal smoking cessation intervention study (Motivate Alaska Women (MAW) Phase 3) and had consented to be re-contacted for future studies. Of 47 eligible women, 32 (68%) participated. A semi-structured phone interview was conducted a mean of 2.0 years after delivery (range 1.6–2.8). Measures assessed self-reported tobacco use status in the 12 months after delivery, at 12 months postpartum, and at the time of the interview; reasons for maintaining abstinence, continued use, or relapse; and included the Perceived Stress Scale (PSS) and Negative Affect (NA) scale. Content analysis was used to generate themes from open-ended response items. Tobacco use was reported by 23 women (72%) at delivery, 30 (94%) within the 12 months after delivery, 27 (84%) at 12 months postpartum, and 29 (91%) at the time of the interview. Among nine women not using tobacco at delivery, seven (78%) relapsed during the 12 months after delivery. Of the 29 current tobacco users, 28 (97%) smoked cigarettes. Twenty-seven participants (84%) reported stress and 15 (52%) indicated addiction as reasons for continuing, starting, or resuming tobacco use. Types of stressors were related to parenting and traumatic experiences. Among current tobacco users, mean NA score (18.7) was significantly higher (p = 0.01) than the normative mean (14.8), but no differences were detected for PSS score. In this sample of AN women, postpartum tobacco use was highly prevalent, and stress was a primary reason that women endorsed for using tobacco. These preliminary results have several practice and research implications for exploring ways to support non-tobacco use among postpartum AN women.

Description: There is great potential for reducing greenhouse gas emissions (GHGE) from public-sector meals. This paper aimed to develop a strategy for reducing GHGE in the Swedish school food supply while ensuring nutritional adequacy, affordability, and cultural acceptability. Amounts, prices and GHGE-values for all foods and drinks supplied to three schools over one year were gathered. The amounts were optimized by linear programming. Four nutritionally adequate models were developed: Model 1 minimized GHGE while constraining the relative deviation (RD) from the observed food supply, Model 2 minimized total RD while imposing stepwise GHGE reductions, Model 3 additionally constrained RD for individual foods to an upper and lower limit, and Model 4 further controlled how pair-wise ratios of 15 food groups could deviate. Models 1 and 2 reduced GHGE by up to 95% but omitted entire food categories or increased the supply of some individual foods by more than 800% and were deemed unfeasible. Model 3 reduced GHGE by up to 60%, excluded no foods, avoided high RDs of individual foods, but resulted in large changes in food-group ratios. Model 4 limited the changes in food-group ratios but resulted in a higher number of foods deviating from the observed supply and limited the potential of reducing GHGE in one school to 20%. Cost was reduced in almost all solutions. An omnivorous, nutritionally adequate, and affordable school food supply with considerably lower GHGE is achievable with moderate changes to the observed food supply; i.e., with Models 3 and 4. Trade-offs will always have to be made between achieving GHGE reductions and preserving similarity to the current supply.

Description: (1) The present study aims to explore the impact of job demands and resources (JDR), personal resources, and the organizational culture on workers’ wellbeing and health. (2) A cross-sectional survey of Spanish workers in small and medium-sized enterprises (SMEs) was conducted with a sample of 1599 workers from 154 SMEs. A multivariate multilevel analysis was performed to analyze the different relationships. (3) In light of the results obtained, we observed that job demands were negatively associated with workers’ health, while job resources were positively correlated to workers’ health and wellbeing. Secondly, the different types of identification at work are positively related to job satisfaction and organizational citizenship behaviors (OCBs), but the intensity of this association differs with the form of identification. Finally, at the organization level, the dimensions of organizational culture are related differently to employees’ job satisfaction, OCBs, and health; (4) these results confirm the role of organizational culture and its association with desirable outcomes, allowing us to expand the JDR model.

Description: The objective of this research is to analyze the transfer of technology developed by the commercial and industrial compensation policy of the initiative of the Plan of Expansion of Radiotherapy of the Ministry of Health. The data of the organization subsidized by the Plan of Expansion of Radiotherapy were obtained through research documentary, interviews with professionals and participant observation. The methodological strategy consisted of a case study supported by a cross-sectional study, the internal environment was analyzed with variables found in the literature, allowing its comprehension in a certain hospital situation. The results revealed that the initiatives of introduction of radiotherapy equipment by the Expansion Plan suffered numerous confrontations within the contextual and organizational circumstances that affected its development and effectiveness. Given the struggles of the Expansion Plan at the tactical and operational levels of decision-making, there are challenges that require responses from organizations involved in the process to implement the trade agreement established by the compensation policy, with the initial stage being highlighted as a technology transfer process. Due to management skills and expertise, it gives you the paradigm status to be followed based on the relevant dimensions and indicators of the technology transfer analysis.