ALBERT

Description: In recent decades, food safety has become a major concern due to frequent food safety incidents in many countries. This may lead to increased health risks associated with low quality food consumption, thereby reducing consumer trust in food safety. A better understanding of consumer perceptions of food safety can improve indicators that do not meet consumer expectations. We propose a food safety gap model with four gap-construct based on consumer expectations and perceptions. The model was empirically tested through a survey of 25 items, and then assessed for gaps through the importance–performance analysis (IPA). From a sample of 697 Taiwanese consumers, we found a huge gap between consumer expectations and perceptions related to food safety. More importantly, the results of the IPA indicate that most items must be immediately improved, which is vital in order to mitigate the risk of food safety.

Description: Autism spectrum disorders (ASD) are among the most common childhood neurodevelopmental disorders. Identification of risk and protective factors are necessary to improve the guidance of prevention and intervention strategies. Our study aims to determine the potential risk and protective factors in ASD in the Lebanese population. Our case-control study included 100 ASD patients and 100 healthy matched controls recruited from all the Lebanese districts. The data collected from the questionnaires was analyzed using SPSS 23.0. Independent Student T-test and Chi-Square test were carried out for the bivariate analysis of the data. In addition, the variables revealing a p-value 〈 0.05 were used for the multivariate logistic regression analysis. Multivitamins intake, especially omega 3 and vitamin B (Odds Ratio (OR) = 0.257; 95% Confidence Interval (CI) [0.115–0.579]), rich cereal diet (OR = 0.212; 95% CI [0.089–0.510]), and supplementation in iron during pregnancy (OR = 0.229; 95% CI [0.083–0.627]) were identified as protective factors against ASD. On the other hand, stress during pregnancy (OR = 6.339; 95% CI [2.845–14.125]), the presence of ASD patients in the family (OR = 7.878; 95% CI [1.877–33.065]) and the presence of attention deficit hyperactivity disorder (ADHD) patients in the family (OR = 6.981; 95% CI [1.362–35.789]) were associated with ASD. This study shed light on risk and protective factors associated with ASD in the Lebanese population. Further rigorous research, taking into consideration these factors, is needed to assist in early detection, prevention and subsequent intervention targeting ASD and its associated comorbidities, given that our study is not experimental and does not prove causality.

Description: Emotional intelligence is an important skill for nurses and midwives and leads them to cleverly work in various fields and contexts, successfully handling colleagues, patients and their families. The aim of this cross-sectional study is to evaluate the relationship between emotional intelligence, sociodemographic and academic variables in current and former master’s degree students in nursing and midwifery, through the administration of a questionnaire to 71 subjects. Emotional intelligence is significantly related to gender. Females showed higher scores (0.2 points higher than men) for emotional intelligence factors, highlighting an excellent ability to “evaluate and express emotions in relation to others”. Moreover, significant differences in academic performances are shown: both females and midwives demonstrated higher academic performance (a mean degree mark 3.8 points higher than men and a mean degree mark 2.6 point than nurses, respectively). High levels of emotional intelligence in individuals who carried out training activities in the organization area are also evident: These subjects have an ability regarding the “regulation of emotion in the others”, which is significantly higher (p = 0.01) than those interested in other master’s degree areas. Emotional intelligence (EI) is strongly linked to the individual’s characteristics and their personalities and differs from technical and professional skills. EI is also an excellent predictor of professional success.

Description: Background: In response to population aging, there is a need for health systems to focus on care for chronic disease, specifically palliative care, while focusing on people-centered care. The objective of this study is to explore the healthcare system enablers and barriers to the provision of quality palliative and end-of-life care from the perspective of healthcare professionals. Materials and Methods: Using purposive sampling, fifteen focus group interviews and nine individual interviews involving 72 healthcare providers were conducted. Primary qualitative data were collected between May 2016 and July 2017. All recorded discussions were transcribed verbatim and analyzed. A thematic framework was developed. Results: The provision of quality palliative and end-of-life care is influenced by the interaction and integration of nine sub-themes under four identified themes: (1) political context; (2) organization setting; (3) support to patients, caregivers, and family members, and (4) healthcare workers and the public. Conclusions: Integration of palliative and end-of-life care is an important pillar of healthcare service to improve quality of life by addressing patients’ values, wishes and preference, and assist their family to handle challenges at the end stage of life. Further improvements to the service framework would be required, specifically in the political framework, multidisciplinary approach, and readiness and competence in healthcare workers and community. These were highlighted in our study as key components in service provision to ensure that patients can receive continuous and integrated care between hospitals and the community as well as dignified care at the end stage of life.

Description: The aim of this study was to explore knowledge, practice of risk and guidelines of the novel corona virus disease (COVID-19) infection among the eye care practitioners and the potential associated factors. A cross-sectional self-administered online survey was distributed via emails and social media networks between 2nd and 18th May 2020 corresponding to the week of the lockdown in Nigeria to eye care practitioners (ECPs). Data for 823 respondents were analyzed. Knowledge and risk practice were categorized as binary outcome and univariate and multivariate linear regression were used to examine the associated factors. The mean score for COVID-19-related knowledge of public health guidelines was high and varied across the ECPs. Ophthalmic Nurses, Ophthalmologists and Optometrists showed higher COVID-19-related knowledge than other ECPs (p 〈 0.001), particularly those working in the private sector. More than 50% of ECPs stated they provided essential services during the COVID-19 lockdown via physical consultation, particularly the Ophthalmologists. Most respondents reported that the guidelines provided by their Association were useful but expressed their lack of confidence in attending to patients during and after the COVID-19 lockdown. Compared to other ECPs in Nigeria, more Ophthalmic Nurses received training in the use of Personal Protective Equipment (PPE). This survey is the first to assess knowledge, attitudes and practice in response to the COVID-19 pandemic in Nigeria. ECPs in Nigeria displayed good knowledge about COVID-19 and provided eye care services during the COVID-19 lockdown in Nigeria, despite the majority not receiving any training on the use of PPEs with concerns over attending to patients. There is need for the government to strengthen health systems by improving and extending training on standard infection prevention and control measures to ECPs for effective control of the pandemic and in the future as essential health workers.

Description: This article proposes the quality of life (QOL) construct as a framework from which to develop useful indicators to operationalize, measure, and implement the Articles of the Convention on the Rights of Persons with Disabilities (CRPD). A systematic review of the scientific literature on people with intellectual and developmental disabilities (IDD) was carried out, with the aim of identifying personal outcomes that can be translated into specific and measurable items for each of the CRPD Articles aligned to the eight QOL domains. Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, the systematic review was conducted across the Web of Science Core Collection, Current Contents Connect (CCC), MEDLINE, KCI-Korean Journal Database, Russian Science Citation Index and SciELO Citation Index, for articles published between 2008 and 2020. A total of 65 articles focusing on people with IDD were selected. The results were grouped into four broad categories: conceptual frameworks used to monitor the CRPD; instruments used to assess the rights set out in the CRPD; recommendations on the use of inclusive research; and indicators or personal outcomes associated with specific rights contained in the CRPD.

Description: Due to the occurrence among musicians of musculoskeletal problems associated with playing a musical instrument, it is necessary to use prophylaxis. The aim of the study was to compare the effectiveness of two physioprophylaxis methods: chair massage and an original set of exercises. The study lasted four weeks and consisted of eight 15-min meetings (chair massage/exercises). The study was conducted on 44 music students assigned to three groups (chair massage/exercise program/control group). The algometric measurements and questionnaire were conducted. Health problems associated with playing an instrument was reported by 86.4% of the participants. The largest changes in pain threshold concerned the trigger points of the muscles with the highest pain sensitivity, i.e., upper part of trapezius ones, and reached 25–34% in relation to the initial values. For the trigger points of the levator scapulae and lower part of trapezius, the increase in the pain threshold was between 20 and 28%. Raising the pain threshold was observed both after each session and meeting by meeting, and these differences were most visible in the massage group. This effect was particularly visible from the fourth treatment. Chair massage and exercise should be used regularly, and significant results can be obtained after two weeks.

Description: Electronic nicotine delivery systems (ENDS) use, including e-cigarettes, has surpassed the use of conventional tobacco products. Emerging research suggests that susceptibility to e-cigarette use is associated with actual use among adolescents. However, few studies exist involving adolescents in high-risk, rural, socioeconomically distressed environments. This study examines susceptibility to and subsequent usage in school-going adolescents in a rural distressed county in Appalachian Tennessee using data from an online survey (N = 399). Relying on bivariate analyses and logistic regression, this study finds that while 30.6% of adolescents are ever e-cigarette users, 15.5% are current users. Approximately one in three adolescents are susceptible to e-cigarettes use, and susceptibility is associated with lower odds of being a current e-cigarette user (OR = 0.03; CI: 0.01–0.12; p 〈 0.00). The age of tobacco use initiation was significantly associated with decreased current use of e-cigarettes (OR = 0.89; CI: 0.83–0.0.97; p 〈 0.01). Overall, the results of this exploratory study suggest the need for larger studies to identify unique and generalizable factors that predispose adolescents in this high-risk rural, socioeconomically disadvantaged region to ENDS use. Nevertheless, this study offers insight into e-cigarette usage among U.S adolescents in rural, socioeconomically disadvantaged environments and provides a foundation for a closer examination of this vulnerable population.

Description: (1) Background: People with HIV (PWH) may perform more than one type of exercise cumulatively. The objective of this study is to investigate recreational exercise and its association with health-related quality of life (HRQOL) and comorbidities in relation to potential covariates. (2) Methods: The HIBES study (HIV-Begleiterkrankungen-Sport) is a cross-sectional study for people with HIV. The differences between non-exercisers versus exercisers (cumulated vs. single type of exercises) were investigated using regression models based on 454 participants. (3) Results: Exercisers showed a higher HRQOL score compared to non-exercisers (Wilcox r = 0.2 to 0.239). Psychological disorders were identified as the main covariate. Participants performing exercise cumulatively showed higher scores in duration, frequency, and intensity when compared to participants performing only one type of exercise. The mental health summary score was higher for the cumulated and single type of exercise if a psychological disorder existed. Duration and intensity were associated with an increase of HRQOL, whilst a stronger association between psychological disorders and exercise variables were evident. Exercise duration (minutes) showed a significant effect on QOL (standardized beta = 0.1) and for participants with psychological disorders (standardized beta = 0.3), respectively. (4) Conclusions: Psychological disorders and other covariates have a prominent effect on HRQOL and its association with exercise. For PWH with a psychological disorder, a stronger relationship between HRQOL with exercise duration and intensity emerged. However, differentiation of high-HRQOL individuals warrants further investigation by considering additional factors.

Description: Despite optimal control of serum phosphate level being imperative to avoid undesirable health outcomes, hyperphosphataemia is a highly prevalent mineral abnormality among the dialysis population. This study aimed to determine factors associated with hyperphosphatemia among hemodialysis patients in Malaysia. Multiple linear regression analysis was used to ascertain the possible factors that influence serum phosphate levels. A total of 217 hemodialysis patients were recruited. Hyperphosphatemia was prevalent. Only approximately 25% of the patients were aware that optimal control of hyperphosphatemia requires the combined effort of phosphate binder medication therapy, dietary restriction, and dialysis prescription. The presence of diabetes mellitus may affect serum phosphate levels, complicating dietary phosphorus management. Patients who were less depressive portrayed higher serum phosphate levels, implying intentional non-compliance. Better compliance on phosphate binder, longer sleep duration, and higher social support was associated with a lower level of serum phosphate. Despite sleep disturbance being one of the most prevalent and intense symptom burdens identified by hemodialysis patients, relatively few studies have addressed this issue. It is time to formulate sleep therapeutic interventions besides the encouragement of strong social support, hoping which many clinical outcomes including hyperphosphatemia can be better controlled among hemodialysis patients.

Description: A cross-sectional, self-administered survey was used to gather information about dental outcomes, sugar-containing food behaviors and intake, and sociodemographic characteristics of adults of Mexican and Central-American (Guatemala, El Salvador, Honduras) origin (n = 517). Bivariate and multiple-variable logistic regressions were used to examine the associations of behaviors related to added sugar-containing foods/beverages (overall intake and consumption before bed) with dental outcomes. Outcome measures involved dental outcomes, dental self-care practices, and added sugar intake. Estimated daily added sugar intake among all participants was 98 (SD = 99) g, with no difference in consumption among participants from different countries. The majority of added sugar (63 (SD = 74) g) was provided by sugar-sweetened beverages. Participants who reported consuming sugar-containing foods or beverages within an hour before bed were more likely to report having a fair/poor/very poor condition of teeth and gums and having felt dental pain (p 〈 0.05 for all). The amount of sugar intake was associated with being prescribed medication for oral or dental problems (p = 0.008) and dental pain (p = 0.003). Findings support the association between sugar containing food–related behaviors and dental problems among Hispanic immigrants to the U.S. Health promotion and preventive interventions for this population should consider these behaviors as modifiable contributors to adverse dental outcomes.

Description: The present research had two complementary aims: (a) to examine the associations between cooperative learning (CL) and emotional intelligence (EI) in physical education (PE) and (b) to explore and compare the use of CL in PE in primary education (PED), secondary education (SED) and baccalaureate (BA). A total of 1332 students (682 males, 650 females) took part in the study. All participants were aged between 10 and 20 years old (M = 13.09; SD = 2.47) and belonged to 13 different schools in Southwest Spain. They completed the cooperative learning questionnaire (CLQ), referring to the PE classes, in addition to the emotional intelligence questionnaire in physical education (EIQPE). Positive and significant associations were found between CL and EI in all school stages. In addition, moderately strong associations were uncovered between CL and the different dimensions of EI: emotional recognition, emotional control and regulation and emotional empathy. Participants belonging to classrooms with larger cooperation indices presented higher levels of EI. Results also highlighted a greater use of CL in PE classes during the PED stage in comparison to the SED and BA stages. These outcomes are discussed in light of the existing literature and methodological implications are derived for teaching PE. The use of CL in PE is recommended because of its positive contribution to the affective domain through IE. This will be especially important during the SED and BA stages, where lower rates of CL were observed.

Description: Thailand hosts many workers who have migrated from neighboring countries and is facing a large burden of non-communicable diseases (NCDs). Health screening for migrant workers routinely emphasizes infectious diseases but overlooks NCDs. We surveyed prevalent health behaviors for NCDs and their influencing factors, particularly cultural adaptation patterns among Myanmar migrant workers in Chiang Mai, Northern Thailand. A total of 414 migrant workers consented to participate in the study. Lack of exercise (75.8%), current alcohol consumption (40.8%), current smoking (26.9%), and central obesity (24.3%) were major lifestyle problems. Being female and uneducated was associated with a lack of exercise. Current alcohol consumption was significantly associated with being male and being of Myanmar ethnicity, with an integrative strategy for acculturation, and with a higher income. Male participants and participants with a lower mean score of marginalization were more likely to smoke. Central obesity was associated with being older than 40 years, being female, engaging in an assimilation strategy, and being uneducated. These findings highlight the need for gender inclusive health promotion, the screening of NCD risk behaviors, and timely health education for migrant workers. It may assist authorities to devise strategies to extend health promotion and universal health coverage to the migrant population.

Description: The state of Qatar suffers from diabetes epidemic due to obesity-associated metabolic syndrome. However, the prevalence of insulin resistance prior to obesity, which could play an important role in the high prevalence of diabetes, has not yet been described. This study aims to compare the prevalence of insulin resistance in apparently healthy non-obese and obese participants from Qatar and identify the predictors of insulin resistance in different body mass index (BMI)-groups. In this cross-sectional study, 150 young healthy females from Qatar were dichotomized into four groups (underweight, normal weight, overweight and obese) based on their BMI. Anthropometric measures as well as fasting plasma levels of lipids, adipokines, blood glucose and insulin were recorded. The prevalence of insulin resistance as per homeostatic model assessment of insulin resistance (HOMA-IR) was estimated and differences between insulin sensitive and insulin resistant were compared. Linear models were used to identify predictors of insulin resistance in every BMI group. Prevalence of insulin resistance in non-obese healthy females from Qatar ranges between 7% and 37% and increases with BMI. Overall, predictors of insulin resistance in the Qatari population are triglycerides/high-density lipoprotein (HDL) ratio and free fat mass but vary according to the BMI group. The main predictors were triglycerides in normal weight, triglycerides/HDL in overweight and triglycerides/HDL and interleukin-6 (IL-6) in obese individuals. The high prevalence of insulin resistance in non-obese Qataris may partially explain diabetes epidemic. Larger studies are warranted to confirm these findings and identify underlying causes for insulin resistance in non-obese individuals in Qatar, aiming at targeted intervention before diabetes onset.

Description: The incidence of depression among adolescents has gradually increased, leading to adult psychological outcomes and suicide. Although the rate of secondhand smoke exposure (SHSE) has recently decreased, SHSE remains high in children. We aimed to determine the association between depressive symptoms in adolescents and the locations of SHSE using an extensive population survey. Using data from the 14th Korea Youth Risk Behavior Web-based Survey, we assessed self-reported data of depressive symptoms and SHSE among non-smokers. SHSE locations were classified into four groups: only at school, only at home, at both school and home, and other places. Multiple logistic regression analysis was performed to identify the associations between SHSE locations and depressive symptoms. The relationship between SHSE and depressive symptoms was the highest in the “SHSE at home and school” group (boys: odds ratio [OR] = 1.61, 95% confidence interval [CI] = 1.44–1.80; girls: OR = 1.72, 95% CI = 1.54–1.91), followed by the “school” (boys: OR = 1.53, 95% CI = 1.39–1.67; girls: OR = 1.36, 95% CI = 1.25–1.48) and “home” groups (boys: OR = 1.23, 95% CI = 1.12–1.35; girls: OR = 1.30, 95% CI = 1.20–1.40). These results emphasize the importance of stricter smoking regulations not only in public places, but also in households. Adolescents and their families should be educated on the dangers of smoking and the effects of SHSE on mental health.

Description: In response to the COVID-19 pandemic, health care modalities such as video consultations have been rapidly developed to provide safe health care and to minimize the risk of spread. The purpose of our study is to explore Spanish healthcare professionals’ perceptions about the implementation of video consultations. Based on the testimonies of 53 professionals, different categories emerged related to the four identified themes: benefits of video consultations (for professionals, patients, and the health system, and compared to phone calls), negative aspects (inherent to new technologies and the risk of a perceived distancing from the professional), difficulties associated with the implementation of video consultations (technological difficulties, lack of technical skills and refusal to use video consultation among professionals and patients), and the need for training (technological, nontechnical, and social-emotional skills, and adaptation of technical skills). Additionally, the interviewees indicated that this new modality of health care may be extended to a broader variety of patients and clinical settings. Therefore, since video consultations are becoming more widespread, it would be advisable for health policies and systems to support this modality of health care, promoting their implementation and guaranteeing their operability, equal access and quality.

Description: Italy presented the first largest COVID-19 outbreak outside of China. Veneto currently ranks fourth among the Italian regions for COVID-19 confirmed cases (~19,000). This study presents health surveillance data for SARS-CoV-2 in 6100 health workers (HW) employed in a large public hospital. Workers underwent oropharyngeal and nasopharyngeal swabs, with a total of 5942 participants (97.5% of the population). A total of 11,890 specimens were tested for SARS-CoV-2 infection using PCR, identifying the viral genes E, RdRP, and N. Positive tests were returned for 238 workers (cumulative incidence of 4.0%, similar in both COVID and nonCOVID units). SARS-CoV-2 risk was not affected by gender, age, or job type, whereas work setting and occupation were both predictors of infection. The risk was higher in medical wards (OR 2.7, 95% CI 1.9–3.9) and health services (OR 4.3, 95% CI 2.4–7.6), and lower in surgical wards and administration areas. To our knowledge, this study represents the largest available HW case list swab-tested for SARS-CoV-2, covering almost the total workforce. Mass screening enabled the isolation of HW, improved risk assessment, allowed for close contacts of and infected HW to return to work, provided evidence of SARS-CoV-2 diffusion, and presented solid ground to prevent nosocomial SARS-CoV-2 infections. The ongoing concurrent sero-epidemiological study aims to enable the improvement of health surveillance to maintain the safety of HWs and the communities they serve.

Description: This prospective cohort study aimed to identify the incidence and characteristics of Taekwondo-related injuries according to age, sex, and event type (i.e., practice or competition) based on a web-based injury surveillance system (ISS) with a follow-up period of 12 months. A total of 285 members of the Korea Taekwondo Association who competed in the 2016 season participated. Injury incidence rates (IRs) were calculated per 1000 athlete-exposures (AEs). Injury rate ratios (RRs) with 95% confidence intervals were calculated and compared regarding age, sex, and event type. During the season, 336 injuries were reported, resulting in a rate of 6.31/1000 AEs. The most common location, type, and mechanism of injury in Taekwondo athletes were the foot/ankle, ligament sprain, and contact with another player, respectively. The overall injury IRs associated with Taekwondo practicing and competition were 4.79/1000 AEs and 24.86/1000 AEs, respectively. The overall injury RR related to both practice and competition was higher in youth athletes than in adult athletes. However, adult athletes were more likely to sustain more severe injuries. Korean elite Taekwondo athletes were commonly exposed to injury, especially youth and female athletes. Therefore, continuation of the ISS suggests the development of interventions for preventing injuries sustained by Taekwondo athletes.

Description: Statistical methods such as multiple linear regression (MLR) and classification and regression tree (CART) analysis were used to build prediction models for the levels of pollutant concentrations in Macao using meteorological and air quality historical data to three periods: (i) from 2013 to 2016, (ii) from 2015 to 2018, and (iii) from 2013 to 2018. The variables retained by the models were identical for nitrogen dioxide (NO2), particulate matter (PM10), PM2.5, but not for ozone (O3) Air pollution data from 2019 was used for validation purposes. The model for the 2013 to 2018 period was the one that performed best in prediction of the next-day concentrations levels in 2019, with high coefficient of determination (R2), between predicted and observed daily average concentrations (between 0.78 and 0.89 for all pollutants), and low root mean square error (RMSE), mean absolute error (MAE), and biases (BIAS). To understand if the prediction model was robust to extreme variations in pollutants concentration, a test was performed under the circumstances of a high pollution episode for PM2.5 and O3 during 2019, and the low pollution episode during the period of implementation of the preventive measures for COVID-19 pandemic. Regarding the high pollution episode, the period of the Chinese National Holiday of 2019 was selected, in which high concentration levels were identified for PM2.5 and O3, with peaks of daily concentration exceeding 55 μg/m3 and 400 μg/m3, respectively. The 2013 to 2018 model successfully predicted this high pollution episode with high coefficients of determination (of 0.92 for PM2.5 and 0.82 for O3). The low pollution episode for PM2.5 and O3 was identified during the 2020 COVID-19 pandemic period, with a low record of daily concentration for PM2.5 levels at 2 μg/m3 and O3 levels at 50 μg/m3, respectively. The 2013 to 2018 model successfully predicted the low pollution episode for PM2.5 and O3 with a high coefficient of determination (0.86 and 0.84, respectively). Overall, the results demonstrate that the statistical forecast model is robust and able to correctly reproduce extreme air pollution events of both high and low concentration levels.

Description: Background: The Spanish population presents higher levels of loneliness than citizens of countries in Northern Europe. Numerous studies have linked loneliness to increased morbidity and mortality, but very few studies have associated loneliness with healthy lifestyles. The objectives of this research are to identify the feeling of unwanted loneliness in various age and gender groups in the city of Alcalá de Henares (Madrid, Spain), to determine lifestyle habits in the areas of diet and physical exercise, and to examine the association between lifestyle habits and perceived loneliness. Methods: A cross-sectional, observational and analytical study on the perception of loneliness among men (59.06%) and women (60.06%) in a sample (n = 611) of the general population (N = 198,945), by means of random assignment of a health survey, was conducted. The data were collected using an ad hoc questionnaire. The data were stratified and analyzed with the IBM SSPS® v.25 software package. Results: The frequency of loneliness is stratified by sex and age, and healthy lifestyle habits in terms of diet and physical exercise are analyzed. Conclusions: People with perceived loneliness do not have worse lifestyle habits. However, women living with other people have a higher perception of loneliness than those living alone. Specifically, the perception of loneliness in young adult women could suggest a low level of moderate physical exercise.

Description: As air pollution becomes highly focused in China, the accurate identification of its influencing factors is critical for achieving effective control and targeted environmental governance. Land-use distribution is one of the key factors affecting air quality, and research on the impact of land-use distribution on air pollution has drawn wide attention. However, considerable studies have mostly used linear regression models, which fail to capture the nonlinear effects of land-use distribution on PM2.5 (fine particulate matter with a diameter less than or equal to 2.5 microns) and to show how impacts on PM2.5 vary with land-use magnitudes. In addition, related studies have generally focused on annual analyses, ignoring the seasonal variability of the impact of land-use distribution on PM2.5, thus leading to possible estimation biases for PM2.5. This study was designed to address these issues and assess the impacts of land-use distribution on PM2.5 in Weifang, China. A machine learning statistical model, the boosted regression tree (BRT), was applied to measure nonlinear effects of land-use distribution on PM2.5, capture how land-use magnitude impacts PM2.5 across different seasons, and explore the policy implications for urban planning. The main conclusions are that the air quality will significantly improve with an increase in grassland and forest area, especially below 8% and 20%, respectively. When the distribution of construction land is greater than around 10%, the PM2.5 pollution can be seriously substantially increased with the increment of their areas. The impact of gardens and farmland presents seasonal characteristics. It is noted that as the weather becomes colder, the inhibitory effect of vegetation distribution on the PM2.5 concentration gradually decreases, while the positive impacts of artificial surface distributions, such as construction land and roads, are aggravated because leaves drop off in autumn (September–November) and winter (December–February). According to the findings of this study, it is recommended that Weifang should strengthen pollution control in winter, for instance, expand the coverage areas of evergreen vegetation like Pinus bungeana Zucc. and Euonymus japonicus Thunb, and increase the width and numbers of branches connecting different main roads. The findings also provide quantitative and optimal land-use planning and strategies to minimize PM2.5 pollution, referring to the status of regional urbanization and greening construction.

Description: The market for mass sports events geared towards adults is already saturated, while more new initiatives are exclusively targeting children and adolescents. Mass sports events for amateur athletes can be a great way to encourage young people to exercise regularly, such as in cases where physical education classes do not fully play this role. A lot of research has already been conducted on the subject of adult motivation for participating in amateur sports events, i.e., marathons, ultramarathons, duathlons or triathlons. However, the research niche is children and adolescents’ motivation. The aim of this study is to recognize motivation among children aged 12 for participating in children’s running events in Poland. The study was conducted via a diagnostic survey using the Motives for Physical Activity Measure–Revised (MPAM-R) scale to determine what motivation is most important for young athletes and whether there are any differences in terms of gender. The highest values were obtained by motivation related to fun and enjoyment during sporting events, while the lowest values were obtained by motivation related to social affiliation. Aspects associated with good fun should be promoted during activities related to the marketing of sporting events for young people. This article contains the results obtained from the Poznan Half Marathon pilot study and recommendations for future lines of research. Such results will allow us to understand the motivation behind modern young amateur athletes and to better manage mass sports events that target children and adolescents.

Description: A large portion of previous sport talent development research has been conducted using Western countries study subjects such as Canadian, Swedish, Spanish, British, or American athletes. However, the factors that affect oriental culture athletes remain an unexplored field. The aims of this investigation were to consolidate the exploration of the pilot study that studied the key factors for Chinese elite basketball players’ careers and understand what facts have helped them to achieve the highest sportive level through qualitative research. The pathway to excellence of 11 Chinese elite basketball players were analyzed through a semi-structured interview with different categories such as social context, sport context, tactical factors, or anthropometric factors. Results showed that cultural factors, family tradition, academic studies, coaches, mental strength, training structuration, and international competitions had a great effect and influence in the talent development of Chinese basketball players.

Description: Due to the rapid increase in the number of elderly people in Chinese cities, the development and planning of aged care facilities, and particularly community care facilities, which will gradually become the mainstream choice for the elderly in China, is becoming an important topic for urban sustainability. Previous studies have shown that the number and scale of aged care facilities in many cities are far from meeting the needs of the elderly and the overall occupation rate is low. Some of these cities are still expanding and some are undergoing urban renovation. In this process, the scientific planning of community care facilities to promote efficient use of facility resources has become an urgent problem that needs to be solved. In this study, the two-step floating catchment area (2SFCA) method and a potential model based on the Geographic Information System (GIS) were used to carry out a scientific evaluation of the spatial accessibility of community care facilities in the Beilin district of Xi’an. The aims were to explore the best quantitative research methods for assessing the distribution of Xi’an community care facilities’ spatial accessibility, provide ideas for similar studies in the future, and further the understanding of spatial allocation of urban community care facilities resources.

Description: Illicit drug/s use (IDU) among university students is a public health concern. We assessed the associations between socio-demographic, academic, and health and lifestyle characteristics (independent variables) and regular, occasional or never IDU (dependent variables). Data were collected across seven faculties (1177 students) at the University of Turku (Finland) via an online questionnaire. About 1.5% of the sample had regular IDU, 19% occasional IDU, and 79% never IDU. Independent predictors of ever (lifetime) IDU included males [adjusted odds ratio (AOR) 1.82, P = 0.001], not living with parents (AOR 2.59, P 〈 0.001), singles (AOR 0.51, P 〈 0.001), lower religiosity (AOR 1.49, P = 0.022), better self-rated general health (AOR 0.41, P = 0.003), higher health awareness (AOR 1.93, P = 0.014), more depressive symptoms (AOR 1.82, P = 0.004), daily smokers (AOR 3.69, P 〈 0.001), heavy episodic drinking (AOR 2.38, P 〈 0.001) and possible alcohol dependency (AOR 2.55, P 〈 0.001). We observed no independent associations between ever IDU with age, study discipline, perceived stress or academic performance. The 20.5% ever IDU is concerning. The compelling independent predictors of ever IDU included not living with parents, lower religiosity, daily smokers, heavy episodic drinking and possible alcohol dependency (AOR range 2.38–3.69). Education and prevention need to emphasize the negative consequences to reinforce abstinence from IDU. Health promotion could focus on beliefs and expectations about IDU and target students at risk for successful efforts.

Description: Background: In Israeli colleges and universities, many Arab students experience acculturative stress. Such stress arises from the need to learn new cultural rules, manage the overarching conflict inherent in maintaining elements of their culture of origin (i.e., Arab culture) while incorporating elements of the host culture (i.e., Jewish academic culture), and deal with experiences of prejudice and discrimination present in the host culture. Methods: This study investigated the association between acculturative stress and depressive symptoms among 170 Arab undergraduates from northern and central Israel. It also explored the roles of sense of coherence and coping strategies in the relationship between acculturative stress and depressive symptoms. Participants completed questionnaires on acculturative stress, depressive symptoms, sense of coherence, coping strategies, and demographics. Results: The findings reveal gender differences in the use of different coping strategies and in levels of depressive symptoms. However, academic-year differences were found only in levels of sense of coherence and depressive symptoms. Specifically, female students expressed higher levels of both active and avoidant coping. Moreover, female students and those in their first and second years of university studies reported higher levels of depressive symptoms. Among the male students, acculturative stress was related to depressive symptoms indirectly via sense of coherence and active coping. In contrast, among the female students, acculturative stress was related to depressive symptoms both directly and indirectly via sense of coherence and avoidant coping. Among first- and second-year students, acculturative stress was related to depressive symptoms indirectly via sense of coherence and avoidant coping. However, among third- and fourth-year students, acculturative stress was related to depressive symptoms both directly and indirectly via sense of coherence. Conclusions: This article underscores the significance of gender and academic-year differences in pathways involving acculturative stress.

Description: Prenatal smoking exposure and early-life respiratory infections are major determinants of asthma during childhood. We investigate the factors influencing allergic sensitization (AS), asthma, and lung function in children and the balance between individual and environmental characteristics at different life stages. 1714 children aged 7–16 years and living in southern Italy were investigated using a parental questionnaire, skin prick tests, and spirometry. We found 41.0% AS prevalence: among children without parental history of asthma, male sex, maternal smoking during pregnancy (MatSmoke), and acute respiratory diseases in the first two years of life (ARD2Y) were significant risk factors for AS. MatSmoke was associated (OR = 1.79) with ARD2Y, and this association was influenced by sex. ARD2Y was, in turn, a significant risk factor (OR = 8.53) for childhood current asthma, along with AS (OR up to 3.03) and rhinoconjuctivitis (OR = 3.59). Forced mid-expiratory flow (FEF25–75%) was negatively affected by ARD2Y, with a sex-related effect. Thus, males exposed to MatSmoke had significantly lower FEF25–75% than unexposed males. Despite the difficulty of discriminating among the complex interactions underlying the development of allergic respiratory diseases, ARD2Y appears to strongly influence both asthma and lung function during childhood. In turn, ARD2Y is influenced by prenatal exposure to tobacco smoke with a sex-dependent effect.

Description: (1) Objective: To understand the perception of Brazilian children about the Quality of Life (QoL) considering their living environment. (2) Methods: This is a qualitative study conducted with children aged 6–10 years, from a medium-sized Brazilian municipality, recruited from public and private schools. An adaptation of the “draw, write, and say” method was used to collect data. At first, all children (n = 252) drew a “neighborhood with QoL”. On the same day, the researcher analyzed the graphic elements of the representations and intentionally selected the two best-detailed drawings from each class (n = 49) and the children were invited to narrate them. The narratives were analyzed through content analysis. (3) Results: Two major themes emerged from the content analysis, namely, the physical environment and social environment. The first included the needs to live in a community, such as housing, places of leisure, essential services, and natural elements. The second was relationships with family and friends. (4) Conclusion: The children presented the meaning of an environment with QoL, pointing out essential items to have this ideal environment. The social environment and the physical environment were perceived interdependently; that is, any change in one of these aspects may affect children’s QoL.

Description: Dibothriocephalus latus (Linnaeus, 1758) (Cestoda: Diphyllobothriidea; syn. Diphyllobothrium latum), is a fish-borne zoonotic parasite responsible for diphyllobothriasis in humans. Although D. latus has long been studied, many aspects of its epidemiology and distribution remain unknown. The aim of this study was to investigate the prevalence, mean intensity of infestation, and mean abundance of plerocercoid larvae of D. latus in European perch (Perca fluviatilis) and its spatial distribution in three commercial fishing areas in Lake Iseo (Northern Italy). A total of 598 specimens of P. fluviatilis were caught in 2019. The total prevalence of D. latus was 6.5%. However, there were significant differences between areas (10.2% North; 7.3% Center; 1.5% South) (Chi-square test, p = 0.0018). The mean intensity of infestation ranged from 1 larva in southern area to 1.2 larvae in both the central and northern (Pisogne) areas. In addition, the mean abundance ranged from 0.02 in the southern area to 0.26 in the northern area (Pisogne). The total number of larvae (anterior dorsal—AD = 21; anterior ventral—AV = 1; posterior dorsal—PD = 15; posterior ventral—PV = 5) differed significantly between the four anatomical quadrants (Kruskal–Wallis test; p = 0.0001). The prevalence of D. latus plerocercoid larvae in European perch from Lake Iseo has long been investigated, but without an appropriate sampling design. With the present study, a broader analysis in spatial distribution has been added to the existing literature, revealing new information about D. latus distribution and occurrence in Lake Iseo, with new data that will be useful for health authorities and future studies.

Description: Digitalization of knowledge work is essential for today’s organizations, responding to diversified employee needs. Many organizations are already implementing some form of flexibility to help workers perform work and non-work duties, while maintaining high productivity. While these changes in workplaces, “New Ways of Working (NWW)”, have been discussed in the literature, a systematic appraisal of evidence of NWW has not been conducted. Relating to poor work-related mental health worldwide, this systematic review analyzed the psychological impacts of NWW, and the quality and quantity of NWW research. Following the preferred reporting items for systematic reviews and meta-analysis (PRISMA) guidelines, NWW studies targeting psychological outcomes were evaluated. Initial literature search on ProQuest, PsycINFO, Science Direct, and Google Scholar retrieved 308 titles, from which seven articles fulfilled all inclusion criteria. Our appraisal revealed that NWW research evaluated diverse psychological outcomes. While NWW can help workers’ engagement, work-related flow, and connectivity among staff, NWW can also increase blurred work-home boundary, fatigue, and mental demands. The quality of NWW research was overall medium, needing more rigorous studies. Our findings can inform decision-makers in the workplace to effectively implement NWW, and researchers to improve the quality and the usefulness of future NWW studies.

Description: The digital revolution has changed many aspects of the medical profession. Medical doctors and doctors in the dental sciences have been pushed to modify their workflow using new instruments such as decisional software, intraoral and extraoral scanners, and CAD-CAM technologies, which have improved diagnostics and the clinical/surgical phase of treatment and follow-up, and nowadays it is clear that medical professional life will continue in the era of digital medicine.

Description: Fine particulate matter with an aerodynamic diameter of less than 2.5 µm (PM2.5) is highly variable in space and time. In this study, the dynamics of PM2.5 concentrations were mapped at high spatio-temporal resolutions using bicycle-based, mobile measures on a university campus. Significant diurnal and daily variations were revealed over the two-week survey, with the PM2.5 concentration peaking during the evening rush hours. A range of predictor variables that have been proven useful in estimating the pollution level was derived from Geographic Information System, high-resolution airborne images, and Light Detection and Ranging (LiDAR) datasets. Considering the complex interplay among landscape, wind, and air pollution, variables influencing the PM2.5 dynamics were quantified under a new wind wedge-based system that incorporates wind effects. Panel data analysis models identified eight natural and built environment variables as the most significant determinants of local-scale air quality (including four meteorological factors, distance to major roads, vegetation footprint, and building and vegetation height). The higher significance level of variables calculated using the wind wedge system as compared to the conventional circular buffer highlights the importance of incorporating the relative position of emission sources and receptors in modeling.

Description: Objectives. Training for sport is associated with the development of bone minerals, and the need for reference data based on athletes is often indicated. The purpose of this study was to develop a reference for bone mineral density (BMD) and content (BMC) specific for youth athletes of both sexes participating in several sports. Methods DEXA (dual energy X-ray absorptiometry) was used for total body measurements of bone minerals in 1385 athletes 11 to 20 years, 1019 males and 366 females. The athletes were training in several sports at Hungarian academies. Reference values for total bone mineral density and bone mineral content, and also BMD excluding the head (total body less head, TBLH) were developed using the LMS chartmaker pro version 2.3. Results. The centile distributions for BMD and BMC of the athletes differed significantly from those of the age- and sex-specific references for the general population. The youth athletes had higher BMD and BMC than those of the reference for the general population. Conclusion. The potential utility of the DEXA reference for male and female youth athletes may assist in monitoring changes in the BMC and BMD associated with normal growth and maturation, and perhaps more importantly, may be useful in monitoring changes specific to different phases of sport-specific training protocols.

Description: Research in preschool children that investigates the impact of different exercise interventions on physical fitness is limited. This pre–post study was aimed at determining if participation in a nine-month structured multisport program (MSG; n = 38) could enhance physical fitness components compared to a formal exercise program (control group (CG); n = 36) among preschool children. Physical fitness was assessed using standardized tests (the standing long jump, sit and reach, 20 m sprint, sit-ups for 30 s, bent-arm hang, medicine ball throw (MBT), grip strength, 4 × 10 m shuttle run, and 20 m shuttle run tests). The structured multisport program involved fundamental/gross and fine motor skills and ball game-based exercises twice a week. The control group was free of any programmed exercise except for the obligatory program in kindergartens. A mixed ANOVA demonstrated significant group-by-time interaction effects for the 4 × 10 m shuttle run, standing long jump, sit-ups, bent-arm hang, grip strength, and sit and reach tests (p 〈 0.05). There was no significant group-by-time interaction effect for the 20 m sprint test (p = 0.794) or for the 20 m shuttle run test (p = 0.549). Moreover, the MSG and CG performance in the MBT and 20 m shuttle run tests improved to a similar extent from pre- to post-test. Our results indicate that compared to the formal plan, the structured multisport program led to a sustained improvement in physical fitness in healthy 5-to-6-year old children.

Description: Against a rapidly aging population, projections are done to size up the demand for long-term care (LTC) services for long-range policy planning. These projections are typically focused on functional factors such as disability. Recent studies indicate the importance of social factors, for example, socially isolated seniors living alone are more likely to be institutionalized, resulting in higher demand for LTC services. This is one the first known studies to complete a 40-year projection of LTC demand based on disability and social isolation. The primary micro dataset was the Retirement and Health Survey, Singapore’s first nationally representative longitudinal study of noninstitutionalized older adults aged 45 to 85 with over 15,000 respondents. Disability prevalence across the mild to severe spectrum is projected to increase five-fold over the next 40 years, and the number of socially isolated elders living alone is projected to grow four-fold. Regression models of living arrangements revealed interesting ethnic differences: Malay elders are 2.6 times less likely to live alone than their Chinese counterparts, controlling for marital status, age, and housing type. These projections provide a glimpse of the growing demand for LTC services for a rapidly aging Singapore and underscore the need to shore up community-based resources to enable seniors to age-in-place.

Description: This study was to investigate the association of built environment (BE) with physical activity (PA) and physical fitness of residents inside the city wall of Xi’an, one of the most historic cities in China. The cross-sectional study was conducted among 728 adults in this area. BE and PA were measured by Neighborhood Environment Walkability Scale and International Physical Activity Questionnaire, respectively. Body mass index (BMI), body fat percentage, blood pressure (BP), lung capacity, curl up, sit and reach, reaction time, balance, and grip strength were also measured. The results showed, for men, aesthetics was positively associated with total and leisure-time PA, and curl-up tests, respectively. Walking/cycling facilities were positively associated with leisure-time PA. Street connectivity was negatively associated with leisure-time PA and BMI. Residential density was positively correlated with BMI. Access to service was positively associated with lung capacity. Crime safety was negatively correlated with reaction time. For women, residential density was negatively associated with transportation PA and BP. Street connectivity was positively associated with curl-up test. The results suggest some BE attributes are positively related to PA and physical fitness in this population. Creating more PA-supportive BEs is recommended in this historic area along with urban conservation.

Description: Cigarette smoking represents a major public health problem in Lao People’s Democratic Republic (Lao PDR). This study aims to examine factors associated with cigarette smoking cessation attempts and intention to quit. Data were from the Lao National Adult Tobacco Survey that consisted of 7562 participants ≥15 years old. Multivariable logistic regression models were used to evaluate the associations, adjusted for sex, age groups, education level, income per day, and smoking frequency. Results show that past quit attempts were associated with visiting a healthcare provider in the past year (adjusted odds ratio [AOR]: 1.74, 95% confidence intervals [CI]: 1.28–2.35), home smoking bans (AOR: 5.52, 95% CI: 2.13–14.33), noticing media-based messages informing the dangers of smoking or encouraging quitting (AOR: 3.25, 95% CI: 2.28–4.63), noticing health warnings on cigarette packages in the past 30 days (AOR: 3.33, 95% CI: 2.21–5.03), and believing that smoking is seriously harmful to their health (AOR: 3.45, 95% CI: 1.24–9.57). The Lao PDR government should continue implementing tobacco control policies that demonstrated associations with cessation attempts or intention to quit, such as smoke-free environments and required health warnings on cigarette packages. Tobacco cessation treatment programs are pressingly needed in Lao PDR.

Description: Background: Impairment in speech perception is a common feature of older adults. This study aimed at evaluating the acute and sub-acute (after three months) effects of auditory training on central auditory processing in older people with hearing loss. Methods: A nonrandomized study was conducted enrolling 15 older adults with hearing loss and an average age of 78.6 ± 10.9 years. All participants underwent a baseline otoscopy, tympanogram, audiogram and speech-in-noise test with a signal-noise ratio (SNR) of 10 and 15 dB. Afterwards, auditory training intervention was implemented consisting of 10 training sessions over 5 weeks. Participants were divided into two groups: group 1 (G1) underwent auditory training based on a speech-in-noise test; group 2 (G2) underwent a filtered-speech test. Auditory processing was evaluated at baseline (T0) immediately after the intervention (T1) and 3 months after the intervention (T2). Results: Group 1 were quite efficient regardless of the SNR in the right ear with statistically significant differences from T0 to T1 (p = 0.003 and p = 0.006 for 10 dB and 15 dB, respectively) and T0 to T2 (p = 0.011 and 0.015 for 10 dB and 15 dB, respectively). As for the left ear, the increase of success was statistically significant for the SNR of 10 dB and 15 dB from T0 to T1 (p = 0.001 and p = 0.014, respectively) and from T0 to T2 (p = 0.016 and p = 0.003). In G2, there was a significant variation only from T0 for T1 in the left ear for an SNR of 10 dB (p = 0.001). Conclusion: Speech perception in noise significantly improved after auditory training in old adults.

Description: Evidence for recommendations concerning the resumption of activities of daily life, including work and sport, after knee arthroplasty is lacking. Therefore, recommendations vary considerably between hospitals and healthcare professionals. We aimed to obtain multidisciplinary consensus for such recommendations. Using a Delphi procedure, we strived to reach consensus among a multidisciplinary expert panel of six orthopaedic surgeons, three physical therapists, five occupational physicians and one physician assistant on recommendations regarding the resumption of 27 activities of daily life. The Delphi procedure involved three online questionnaire rounds and one face-to-face consensus meeting. In each of these four rounds, experts independently decided at what time daily life activities could feasibly and safely be resumed after knee arthroplasty. We distinguished patients with a fast, average and slow recovery. After four Delphi rounds, the expert panel reached consensus for all 27 activities. For example, experts agreed that total knee arthroplasty patients with a fast recovery could resume cycling six weeks after the surgery, while those with an average and slow recovery could resume this activity after nine and twelve weeks, respectively. The consensus recommendations will subsequently be integrated into an algorithm of a personalized m/eHealth portal to enhance recovery among knee arthroplasty patients.

Description: Background: Due to the importance of energy efficiency and economy in endurance performance, it is important to know the influence of different paddling cadences on these variables in the stand-up paddleboarding (SUP). The purpose of this study was to determine the effect of paddling at different cadences on the energy efficiency, economy, and physiological variables of international SUP race competitors. Methods: Ten male paddlers (age 28.8 ± 11.0 years; height 175.4 ± 5.1 m; body mass 74.2 ± 9.4 kg) participating in international tests carried out two test sessions. In the first one, an incremental exercise test was conducted to assess maximal oxygen uptake and peak power output (PPO). On the second day, they underwent 3 trials of 8 min each at 75% of PPO reached in the first test session. Three cadences were carried out in different trials randomly assigned between 45–55 and 65 strokes-min−1 (spm). Heart rate (HR), blood lactate, perceived sense of exertion (RPE), gross efficiency, economy, and oxygen uptake (VO2) were measured in the middle (4-min) and the end (8-min) of each trial. Results: Economy (45.3 ± 5.7 KJ·l−1 at 45 spm vs. 38.1 ± 5.3 KJ·l−1 at 65 spm; p = 0.010) and gross efficiency (13.4 ± 2.3% at 45 spm vs. 11.0 ± 1.6% at 65 spm; p = 0.012) was higher during de 45 spm condition than 65 spm in the 8-min. Respiratory exchange ratio (RER) presented a lower value at 4-min than at 8-min in 55 spm (4-min, 0.950 ± 0.065 vs. 8-min, 0.964 ± 0.053) and 65 spm cadences (4-min, 0.951 ± 0.030 vs. 8-min, 0.992 ± 0.047; p 〈 0.05). VO2, HR, lactate, and RPE were lower (p 〈 0.05) at 45 spm (VO2, 34.4 ± 6.0 mL·kg−1·min−1; HR, 161.2 ± 16.4 beats·min−1; lactate, 3.5 ± 1.0 mmol·l−1; RPE, 6.0 ± 2.1) than at 55 spm (VO2, 38.6 ± 5.2 mL·kg−1·min−1; HR, 168.1 ± 15.1 beats·min−1; lactate, 4.2 ± 1.2 mmol·l−1; RPE, 6.9 ± 1.4) and 65 spm (VO2, 38.7 ± 5.9 mL·kg−1·min−1; HR, 170.7 ± 13.0 beats·min−1; 5.3 ± 1.8 mmol·l−1; RPE, 7.6 ± 1.4) at 8-min. Moreover, lactate and RPE at 65 spm was greater than 55 spm (p 〈 0.05) at 8-min. Conclusion: International male SUP paddlers were most efficient and economical when paddling at 45 spm vs. 55 or 65 spm, confirmed by lower RPE values, which may likely translate to faster paddling speed and greater endurance.

Description: Promotion of healthy active behaviors should start from early ages, as behaviors learned in youth are more likely to endure. A fundamental body of research in this field focuses on the implementation of programs within physical education (PE), thanks to its favorable characteristics. However, traditional PE based on exercise training and controlling styles seems to have weaker association with students’ health benefits. For this reason, the aim of this study was to assess the effects of a game-based PE program on physical fitness and psychological health in schoolchildren aged 10 to 12 years old. A total of 252 students were distributed in experimental (EG, games-centered activities) and control (CG, traditional exercise training activities) groups. The program lasted 6 months. Health-related physical fitness components, psychological wellbeing, self-esteem, stress, and anxiety were assessed before and after the treatment. Both groups increased physical fitness at post-test; however, cardiorespiratory fitness did not improve. No differences were found between the groups at post-test. Our results show that games may be as effective as traditional training methods; yet, they suggest that PE alone may be insufficient for obtaining substantive benefits in cardiorespiratory fitness, regardless of the type of task presented.

Description: The sorting of domestic waste is the most effective way to alleviate the problem of mass garbage accumulation around the villages of rural China. Farmers are the creators of rural domestic waste as well as the direct beneficiaries of effective waste management. However, few studies have been conducted on the psychological determinants of farmers’ intentions to sort domestic waste. This paper applies planned behavior theory (TPB) and normative activation theory (NAM), to analyze the domestic waste sorting intentions of rural residents in Guanzhong, China. Based on the micro-data of 327 rural households in Guanzhong, structural equation models of the factors influencing farmers’ domestic waste sorting intentions were estimated. The results demonstrate the following. (1) Farmers’ attitudes, perceived behavioral control, and personal norms have significant positive direct impacts on their domestic waste sorting intentions, with personal norms having the greatest direct impact. (2) Subjective norms have no direct impact on farmers’ domestic waste sorting intentions but do have an indirect impact on them through personal norms, behavioral attitudes, and perceived behavior control. This article increases scholarly understanding of the psychosocial determinants of the environmentally friendly behavioral intention to sort domestic waste. The study also provides academic and theoretical support to policy makers in implementing relevant policy recommendations.

Description: This study aimed to investigate the influence of a structured movement activity program on the motor development of children aged three to five years attending preschool. Participants were 136 preschool students with normative development at three to four years old who lived in the Region of Murcia (Spain). The McCarthy Children’s Psychomotricity and Aptitude Scales (MSCA) battery of psychomotor tests was used to evaluate the motor development profiles of preschoolers before and after the intervention. The sample was divided into two groups: an intervention group (28 students) and a comparison group (108 students). A structured 24 week physical education program was used in the intervention group. An experiential program based on free play was used in the comparison group during the same period. Preschoolers in both groups got a significant improvement in the contrast of pre-intervention with post-intervention in limb coordination. Statistically significant differences in the post-intervention measurements between the comparison group and the intervention group on arm and leg coordination were observed, whereby the intervention group presented higher arm coordination values (F1,134 = 14,389, p = 0.000, η2 = 0.097) and higher leg coordination values (F1,134 = 19,281, p = 0.000, η2 = 0.126) than the comparison group. It was pointed out that structured physical activity education is better educational methodology than free play to achieve adequate motor development in preschool children.

Description: This paper describes the design of the LIKE programme, which aims to tackle the complex problem of childhood overweight and obesity in 10–14-year-old adolescents using a systems dynamics and participatory approach. The LIKE programme focuses on the transition period from 10-years-old to teenager and was implemented in collaboration with the Amsterdam Healthy Weight Programme (AHWP) in Amsterdam-East, the Netherlands. The aim is to develop, implement and evaluate an integrated action programme at the levels of family, school, neighbourhood, health care and city. Following the principles of Participatory Action Research (PAR), we worked with our population and societal stakeholders as co-creators. Applying a system lens, we first obtained a dynamic picture of the pre-existing systems that shape adolescents’ behaviour relating to diet, physical activity, sleep and screen use. The subsequent action programme development was dynamic and adaptive, including quick actions focusing on system elements (quick evaluating, adapting and possibly catalysing further action) and more long-term actions focusing on system goals and/or paradigm change. The programme is supported by a developmental systems evaluation and the Intervention Level Framework, supplemented with routinely collected data on weight status and health behaviour change over a period of five years. In the coming years, we will report how this approach has worked to provide a robust understanding of the programme’s effectiveness within a complex dynamic system. In the meantime, we hope our study design serves as a source of inspiration for other public health intervention studies in complex systems.

Description: Purpose: Several studies showed that the sintering temperature of 1250 °C could affect the formation of α-Ca3(PO4)2, which is responsible for the reduction of the hardness value of biphasic calcium phosphate biocomposites, but they did not evaluate the inference of the sintering time at peak temperature on transition of β-Ca3(PO4)2 to α-Ca3(PO4)2. This analysis explored, in an innovative way, inferences and correlations between volumetric microstructure, mechanical properties, sintering temperature, and time at peak temperature in order to find the best sintering conditions for biphasic calcium phosphate composites grafted in severe alveolar bone defects. Methods: Sintered biphasic calcium phosphates (30%-hydroxyapatite/70%-tricalcium phosphate) were tested by microCT imaging for the 3D morphometric analysis, by compressive loading to find their mechanical parameters, and by X-ray diffraction to quantify the phases via Rietveld refinement for different sintering temperatures and times at the peak temperature. Data were analysed in terms of statistical inference using Pearson’s correlation coefficients. Results: All the studied scaffolds closely mimicked the alveolar organization of the jawbone, independently on the sintering temperatures and times; however, mechanical testing revealed that the group with peak temperature, which lasted for 2 hours at 1250 °C, showed the highest strength both at the ultimate point and at fracture point. Conclusion: The good mechanical performances of the group with peak temperature, which lasted for 2 hours at 1250 °C, is most likely due to the absence of the α-Ca3(PO4)2 phase, as revealed by X-ray diffraction. However, we detected its presence after sintering at the same peak temperature for longer times, showing the time-dependence, combined with the temperature-dependence, of the β-Ca3(PO4)2 to α-Ca3(PO4)2 transition.

Description: The mental health of nurses working in long-term healthcare centers is affected by the care they provide to older people with major chronic diseases and comorbidity and this in turn affects the quality of that care. The aim of the study was to investigate dispositional optimism, burnout and self-reported health among nurses working in long-term healthcare centers. A descriptive, cross-sectional survey design was used. Survey questionnaires were distributed in 11 long-term health care centers (n = 156) in Catalonia (Spain). The instruments used were LOT-R (dispositional optimism), MBI (burnout) and EuroQol EQ-5D (self-reported health). Bivariate analyses and multivariate linear regression models were used. Self-reported health correlated directly with dispositional optimism and inversely with emotional exhaustion and cynicism. Better perceived health was independently associated with greater dispositional optimism and social support, lower levels of emotional exhaustion level and the absence of burnout. Dispositional optimism in nurses is associated with a greater perception of health and low levels of emotional exhaustion.

Description: Perfectionism is considered to be an important personality factor within the dance context given the high number of dancers whose psychological health is influenced by its consequences. The relationship between perfectionism and dancers’ well- and ill-being can be mediated by a range of variables. The present study explores the role of forms of motivation (i.e., autonomous motivation, controlled motivation and amotivation) as mediators in the relationship between perfectionism (i.e., self-oriented and socially prescribed) and an indicator of well-being (i.e., subjective vitality) and ill-being (i.e., burnout). Participants of the study were 146 male and female Spanish vocational dancers aged between 12 and 26 years old (Mean age = 15.40 ± 2.96) who completed questionnaires measuring the variables of interest. Results of multiple mediator regression analyses showed that amotivation mediated the relationships between self-oriented and socially prescribed perfectionism with burnout and subjective vitality. Self-oriented perfectionism was negatively correlated, and socially prescribed perfectionism positively associated with amotivation. Amotivation of dancers was a positive predictor of burnout and a negative predictor of subjective vitality. Overall, the findings corroborate the importance of amotivation in the relationship between perfectionism dimensions and well-being and ill-being in dancers.

Description: South Korea’s suicide rate has remained among the highest in the world for some years, and there is also a gap in suicide rates among regions within the country. This study investigates the differences in years of life lost (YLLs) due to suicide in 250 districts and the factors associated with regional YLLs in South Korea in 2016. The relationships between YLLs due to suicide by region and factors such as population characteristics, health behaviors, socioeconomic factors, and mental health resources in the community were examined through multiple linear regression analysis. The gap between districts with the highest and lowest YLL due to suicide per 100,000 people was more than a 7-times difference. Factors related to YLLs due to suicide by region were physical activity rates and community mental healthcare centers, and there were differences in these factors according to gender. In conclusion, to prevent suicide at the community level, it is necessary to consider gender in establishing intervention strategies. The community needs to play an active role in promoting mental health and reducing suicide among local residents and to continue to invest in the support and management of those at high risk of suicide.

Description: Family socioeconomic status (SES) differences in early childhood development (ECD) are well documented, as are the neighborhood effects in early development outcomes. However, little is known about whether the SES gradient in ECD outcomes varies across geographic contexts by county-level variables in contemporary China. This study examines the effects of county-level socioeconomic background on inequalities in the developmental outcomes of young Chinese children. Individual-level child development data based on four early development milestones—taking a first step, first sentences, counting 10 objects, fully independent toileting—were combined with family- and county-level socioeconomic data from the China Family Panel Studies (CFPS). Using a hierarchical linear model (HLM) to examine how the broader socioeconomic context plays a role in the attainment of developmental milestones at expected times as young children grow and develop, we have found significant cross-level interaction effects between family SES and county-level variables in relation to developmental milestone attainment. The family SES gradient in the achievement of children’s developmental milestones is steeper for those in the under-developed regions than their counterparts in the more developed regions. Our findings suggest that low-SES children who are living in socioeconomically deprived regions suffer from a double disadvantage in terms of early development outcomes. Further research would be needed to contextualize the observed interactions and better explain the underlying mechanisms.

Description: For the sake of solving the optimization problem of urban waste collection and transportation in China, a priority considered green vehicle routing problem (PCGVRP) model in a waste management system is constructed in this paper, and specific algorithms are designed to solve the model. We pay particular concern to the possibility of immediate waste collection services for high-priority waste bins, e.g., those containing hospital or medical waste, because the harmful waste needs to be collected immediately. Otherwise, these may cause dangerous or negative effects. From the perspective of environmental protection, the proposed PCGVRP model considers both greenhouse gas (GHG) emission costs and conventional waste management costs. Waste filling level (WFL) is considered with the deployment of sensors on waste bins to realize dynamic routes instead of fixed routes, so that the economy and efficiency of waste collection and transportation can be improved. The optimal solution is obtained by a local search hybrid algorithm (LSHA), that is, the initial optimal solution is obtained by particle swarm optimization (PSO) and then a local search is performed on the initial optimal solution, which will be optimized by a simulated annealing (SA) algorithm by virtue of the global search capability. Several instances are selected from the database of capacitated vehicle routing problem (CVRP) so as to test and verify the effectiveness of the proposed LSHA algorithm. In addition, to obtain credible results and conclusions, a case using data about waste collection and transportation is employed to verify the PCGVRP model, and the effectiveness and practicability of the model was tested by setting a series of values of bins’ number with high priority and WFLs. The results show that (1) the proposed model can achieve a 42.3% reduction of negative effect compared with the traditional one; (2) a certain value of WFL between 60% and 80% can realize high efficiency of the waste collection and transportation; and (3) the best specific value of WFL is determined by the number of waste bins with high priority. Finally, some constructive propositions are put forward for the Environmental Protection Administration and waste management institutions based on these conclusions.

Description: The black triangle resulting from interdental papilla (IDP) loss is associated with poor aesthetics and difficulty in pronunciation and food impaction. There is limited knowledge of gingival tissue inflammatory response to hyaluronic acid (HA) filler injection, a minimally invasive IDP reconstruction method. This study aimed to examine the morphological and histological changes in IDP and the inflammatory cytokine localization to the IDP post-HA filler injection using an open gingival embrasure (OGE) mouse model. Mice from the control, sham, and OGE groups were attached with reference, inactive, and activated wires for 5 days, respectively. The degree of IDP loss was determined based on the spring-papilla distance (SPD). Morphological and histological changes in the OGE group injected with phosphate-buffered saline (PBS) or HA fillers were examined on days 2 and 7 post-injection. Immunohistochemical analysis was performed to determine the localization patterns of tumor necrosis factor (TNF)-α, interleukin (IL)-1β, IL-6, myeloperoxidase (MPO), and Ki67. Five days post-wire attachment, the control and OGE groups exhibited a significantly higher SPD than the sham group (p 〈 0.0167). The SPD of the HA filler injection group was significantly lower than that of the PBS injection group on days 2, 4, and 7 post-injection (p 〈 0.05). The IDP of the OGE group was wide and flat. HA filler was stable in the connective tissue underlying the epithelial tissue even on day 7 post-injection. TNF-α, IL-1β, IL-6, MPO, and Ki67 were highly localized to the connective tissue surrounding the filler on day 2, which decreased on day 7 post-injection. Thus, HA filler can safely and successfully reconstruct the IDP in cases of OGE.

Description: We conducted a multilevel analysis to identify factors affecting adolescents’ preventive dental treatment experience in South Korea. We sampled 72,435 students who participated in the 9th Korea Youth Risk Behavior Web-based Survey. The individual-level variables were divided into demographic factors, socioeconomic factors, oral health behavioral factors, and oral symptom experience factors. The regional-level variables included oral health resources, rate of students receiving oral health education at school by region, social deprivation index, and the number of private educational institutions. A higher rate of receiving oral health education in school by region was associated with increased fluoride application (1.04 times, p = 0.003). However, the number of private educational institutes per 1000 people was negatively associated with fluoride application experienced by students (0.64 times, p = 0.039). Students underwent more scaling when there were more dentists per 10,000 individuals (1.14 times, p = 0.008) and less scaling in areas with a higher social deprivation index (0.88 times, p = 0.024). To increase the access to preventive care for oral diseases among adolescents, a preventive system should be established in schools, and a primary dental care system should be established through the cooperation of the government, private dental clinics, and schools.

Description: Indoor air quality has been a matter of concern for the international scientific community. Public health experts, environmental governances, and industry experts are working to improve the overall health, comfort, and well-being of building occupants. Repeated exposure to pollutants in indoor environments is reported as one of the potential causes of several chronic health problems such as lung cancer, cardiovascular disease, and respiratory infections. Moreover, smart cities projects are promoting the use of real-time monitoring systems to detect unfavorable scenarios for enhanced living environments. The main objective of this work is to present a systematic review of the current state of the art on indoor air quality monitoring systems based on the Internet of Things. The document highlights design aspects for monitoring systems, including sensor types, microcontrollers, architecture, and connectivity along with implementation issues of the studies published in the previous five years (2015–2020). The main contribution of this paper is to present the synthesis of existing research, knowledge gaps, associated challenges, and future recommendations. The results show that 70%, 65%, and 27.5% of studies focused on monitoring thermal comfort parameters, CO2, and PM levels, respectively. Additionally, there are 37.5% and 35% of systems based on Arduino and Raspberry Pi controllers. Only 22.5% of studies followed the calibration approach before system implementation, and 72.5% of systems claim energy efficiency.

Description: A positive future orientation (FO) is associated with a range of positive outcomes. It is a crucial resilience factor that assists individuals to navigate developmental difficulties during the transition to young adulthood and during periods of social adversity. Exposure to negative social context threatens young people’s FO. The social demonstrations and the outbreak of coronavirus disease in Hong Kong over the past year have caused considerable hardship to the local society. Under such circumstance, young people in Hong Kong may develop a negative FO. Scant research has directly examined the relationship between perceived social hardship and FO as well as the underlying mechanism among Hong Kong young people. In this study, we tested the idea that young people’s perceived social hardship would be negatively related to FO via belief in a just world, a well-known foundation for individuals to think, feel, and plan their future. Participants were 554 students recruited from eight universities in Hong Kong. They filled in self-report questionnaires online. Results of structural equation modeling supported our hypothesis. These findings shed light on how to nurture Hong Kong young people to develop a positive mindset during periods of social hardship.

Description: The current systematic review aimed to investigate the incidence, prevalence, and risk factors causing hemiplegic shoulder pain (HSP) after stroke. Two independent authors screened titles and abstracts for the eligibility of the included studies in the electronic databases PubMed and Web of Science. Studies which reported the incidence, prevalence, and risk factors of HSP following stroke were included. The included studies were assessed using the Newcastle–Ottawa Scale for evaluating the quality of nonrandomized studies in meta-analyses. Eighteen studies were included in the final synthesis. In all studies, the number of patients ranged between 58 and 608, with the mean age ranging from 58.7 to 76 years. Seven included studies were rated as “good “quality, while one study rated “fair” and 10 studies rated “poor” quality. Eight studies reported incidence rate while 11 studies reported the prevalence of HSP following a stroke. The incidence of HSP was ranging from 10 to 22% in the metanalysis of the included studies. The prevalence of HSP was ranging from 22 to 47% in the metanalysis of the included studies. The most significant predictors of HSP were age, female gender, increased tone, sensory impairment, left-sided hemiparesis, hemorrhagic stroke, hemispatial neglect, positive past medical history, and poor National Institutes of Health Stroke Scale score. The incidence and prevalence of HSP after stroke vary considerably due to various factors. Knowledge of predictors is important to minimize the risk of developing HSP following a stroke.

Description: Increasing global urbanization limits interaction between people and natural environments, which may negatively impact population health and wellbeing. Urban residents who live near parks report better mental health. Physical activity (PA) reduces depression and improves quality of life. Despite PA’s protective effects on mental health, the added benefit of urban park use for PA is unclear. Thus, we examined whether park-based PA mediated associations between park proximity and mental distress among 3652 New York City residents (61.4% 45 + years, 58.9% female, 56.3% non-white) who completed the 2010–2011 Physical Activity and Transit (PAT) random-digit-dial survey. Measures included number of poor mental health days in the previous month (outcome), self-reported time to walk to the nearest park from home (exposure), and frequency of park use for sports, exercise or PA (mediator). We used multiple regression with bootstrap-generated 95% bias-corrected confidence intervals (BC CIs) to test for mediation by park-based PA and moderation by gender, dog ownership, PA with others, and perceived park crime. Park proximity was indirectly associated with fewer days of poor mental health via park-based PA, but only among those not concerned about park crime (index of moderated mediation = 0.04; SE = 0.02; 95% BC CI = 0.01, 0.10). Investment in park safety and park-based PA promotion in urban neighborhoods may help to maximize the mental health benefits of nearby parks.

Description: Breast cancer is the most frequently diagnosed malignant neoplasm among females. The proportion of women diagnosed in the premenopausal period is relatively small. Nevertheless, this is the most commonly diagnosed cancer among young women. The aim of the study was to analyze the incidence rate of breast cancer in a group of young women based on data obtained in the Lower Silesian Voivodeship between 1984 and 2016. A total of 34,251 women with a diagnosis of invasive breast cancer were analyzed. The median age of diagnosis exhibited an upward trend from 57 to 63. The youngest age of breast cancer diagnosis did not decrease. Women up to the age of 24 were sporadically diagnosed. Given the total number of cases, the proportion of women under the age of 39 was approximately 5%, and it did not increase throughout the entire examination period. The major increase in the growth trend during the analyzed period was observed in a group of women aged of 50–69 (regression coefficient: +24.9) and above 70 (regression coefficient +21.2). In a group of women under 40 the regression coefficient was only +4. It seems that breast cancer does not increasingly affect younger women since the risk in this age group remains low. However, an increasing incidence rate of breast cancer is more commonly observed in premenopausal women.

Description: Purpose: Periodontal disease causes tooth loss if not treated early, and advanced periodontitis can cause a decline in various oral functions. These results diminish the health-related quality of life (QOL) for various populations. Thus, early detection and management of the disease, as well as a systematic strategy for the prevention of periodontal disease, are necessary. Methods: Adults, 19 years of age or older and diagnosed with chronic gingivitis or chronic periodontitis under the ICD-10 codes, were selected to participate in the study. A total of 20 participants were informed of the purpose of the study and gave consent to participate in in-depth interviews. Results: The treatment of periodontal disease improved health-related QOL and enabled the participants to have positive dental care health behaviors. Furthermore, the participants recognized the severity of periodontal disease and the importance of dental examinations. It enabled them to be aware of the societal need for dental care awareness. Conclusions: This study was an in-depth examination of the health-related QOL of periodontal patients through a qualitative research methodology. We expect that this study will expand research on health-related QOL due to periodontal disease and revitalize the dental health system and practices.

Description: Background: We monitored exposure to fine particulates (PM2.5), ozone, nitrogen dioxide (NO2), and ambient temperature for pregnant women with and without asthma. Methods: Women (n = 40) from the Breathe—Well-Being, Environment, Lifestyle, and Lung Function Study (2015–2018) were enrolled during pregnancy and monitored for 2–4 days. Daily pollutants were measured using personal air monitors, indoor air monitors, and nearest Environmental Protection Agency’s stationary monitors based on GPS tracking and home address. Results: Personal-monitor measurements of PM2.5, ozone, and NO2 did not vary by asthma status but exposure profiles significantly differed by assessment methods. EPA stationary monitor-based methods appeared to underestimate PM2.5 and temperature exposure and overestimate ozone and NO2 exposure. Higher indoor-monitored PM2.5 exposures were associated with smoking and the use of gas appliances. The proportion of waking-time during which personal monitors were worn was ~56%. Lower compliance was associated with exercise, smoking, being around a smoker, and the use of a prescription drug. Conclusions: Exposure did not vary by asthma status but was influenced by daily activities and assessment methods. Personal monitors may better capture exposures but non-compliance merits attention. Meanwhile, larger monitoring studies are warranted to further understand exposure profiles and the health effects of air pollution during pregnancy.

Description: Deciding between palliative and overly aggressive therapies for advanced cancer patients who present to the emergency department (ED) with acute issues requires a prediction of their short-term survival. Various scoring systems have previously been studied in hospices or intensive care units, though they are unsuitable for use in the ED. We aim to examine the use of a shock index (SI) in predicting the 60-day survival of advanced cancer patients presenting to the ED. Identified high-risk patients and their families can then be counseled accordingly. Three hundred and five advanced cancer patients who presented to the EDs of three tertiary hospitals were recruited, and their data retrospectively analyzed. Relevant data regarding medical history and clinical presentation were extracted, and respective shock indices calculated. Multivariate logistic regression analyses were performed. Receiver operating characteristic (ROC) curves were plotted to evaluate the predictive performance of the SI. Nonsurvivors within 60 days had significantly lower body temperatures and blood pressure, as well as higher pulse rates, respiratory rates, and SI. Each 0.1 SI increment had an odds ratio of 1.39 with respect to 60-day mortality. The area under the ROC curve was 0.7511. At the optimal cut-off point of 0.94, the SI had 81.38% sensitivity and 73.11% accuracy. This makes the SI an ideal evaluation tool for rapidly predicting the 60-day mortality risk of advanced cancer patients presenting to the ED. Identified patients can be counseled accordingly, and they can be assisted in making informed decisions on the appropriate treatment goals reflective of their prognoses.

Description: Sexual minority women are disproportionately impacted by obesity yet are underrepresented in weight stigma research. This Ecological Momentary Assessment (EMA) study is a secondary analysis that aimed to elucidate the frequency and contextual characteristics of perceived experiences of lifetime and momentary weight stigma among sexual minority women with overweight/obesity. Participants were 55 sexual minority women ages 18–60 with a body mass index ≥25 kg/m2. Perceived lifetime weight stigma events were assessed at baseline. For the subsequent five days, participants used a smartphone to complete five daily, random EMA prompts assessing the frequency/characteristics of perceived weight stigma events in daily life. All participants reported at least one lifetime weight stigma event. During the EMA period, participants reported 44 momentary weight stigma events (M = 0.80), with 24% of participants reporting at least one event. During most instances of weight stigma, women perceived the stigma’s cause to be their weight and another minority identity (e.g., sexual orientation). Findings showing high rates of perceived lifetime weight stigma in this sample and frequent co-occurrence of perceived weight stigma with stigma due to other marginalized identities in daily life underscore the need for future, larger studies investigating weight stigma through an intersectional lens in sexual minority women with overweight/obesity.

Description: This study aimed to analyze the food safety conditions in home kitchens from the Brazilian Federal District. A previously validated instrument composed of 77 items (in four blocks) was used to evaluate the safety conditions in home kitchens. A survey was carried out with on-site application with 226 home kitchens’ food handlers in the Federal District, Brazil to evaluate Brazilian home kitchens’ good practices. Of the home kitchen food handlers, most of them were female (64.6%), had completed undergraduate education (29.2%), and were 45–59 years old (23.5%). The visited households had an average of 3.38 ± 1.48 residents that ate some of their meals at home, and 40% declared the monthly family income to be between 5 and 15 Brazilian minimum wages (MW). Regarding the reliability of the instrument, from the KR-20 test, it was verified that the instrument presents good internal consistency (α = 0.758). According to the instrument classification, the home kitchens’ sample was considered as at a medium risk of food contamination (46.5% of them presented from 51 to 75% of conformities to the instrument). There was a statistical difference between house-kitchens with a family income from zero to one minimum wage (MW) and those receiving from 5 to 15 MW (p = 0.017), as well as between those from zero to one MW and who earn above 15 MW (p = 0.009). The result of the on-site evaluation shows that the instrument was able to measure food safety conditions in Brazilian Federal District domestic kitchens. Such findings can contribute positively to the development of actions in health education that help in the adoption of good practices of food manipulation and, consequently, in the reduction in foodborne disease outbreaks in residences.

Description: Increasing evidence suggests adults living in greener areas tend to have more favourable sleep-related outcomes, but children and adolescents are under-researched. We hypothesised that children and adolescents living in greener areas would have better quality and more sufficient levels of sleep on average, especially within the context of high traffic noise exposure. These hypotheses were tested using multilevel logistic regressions fitted on samples from the nationally representative Longitudinal Study of Australian Children (10–11 years old, n = 3469, and 14–15 years old, n = 2814) and the GINIplus and LISA cohorts (10 years old, n = 1461, and 15 years old, n = 4172) from the Munich, Wesel, and Leipzig areas of Germany. Questionnaire-based binary indicators of sleep sufficiency and sleep quality in each cohort were assessed with respect to objectively measured green space exposures adjusting for age, sex, and maternal education. Models were augmented with proxy measures of traffic noise and two-way interaction terms to test for effect modification. Cross-tabulations illustrated little convincing evidence of association between green space and insufficient sleep or poor sleep quality in either sample, except for insufficient sleep among 10 year old participants in Germany. These null findings were replicated in adjusted models. The proxy for traffic noise was associated with poor quality sleep in 15 year old participants in Germany, but no convincing evidence of modified association with green space was observed.

Description: Background: Despite the advances in End-of-life (EOL) cancer care, disparities remain in the accessibility and utilisation of EOL cancer care resources. Often explained by socio-demographic factors, geographic variation exists in the availability and provision of EOL cancer care services among EOL cancer decedents across urban versus rural settings. This systematic review aims to synthesise mortality follow-back studies on the patterns of EOL cancer care resource use for adults (〉18 years) during end-of-life cancer care. Methods: Five databases were searched and data analysed using Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Inclusion criteria involved; a) original research; b) quantitative studies; c) English language; d) palliative care related service use in adults (〉18 years) with any malignancy excluding non-melanoma skin cancers; e) exclusive end of life focus; f) urban-rural focus. Narrative reviews and discussions were excluded. Results: 24 studies met the inclusion criteria. End-of-life cancer care service utilisation patterns varied by rurality and treatment intent. Rurality was strongly associated with higher rates of Emergency Department (ED) visits and hospitalisations and lower rates of hospice care. The largest inequities between urban and rural health service utilisation patterns were explained by individual level factors including age, gender, proximity to service and survival time from cancer diagnosis. Conclusions: Rurality is an important predictor for poorer outcomes in end-of-life cancer care. Findings suggest that addressing the disparities in the urban-rural continuum is critical for efficient and equitable palliative cancer care. Further research is needed to understand barriers to service access and usage to achieve optimal EOL care for all cancer patient populations.

Description: Violence against women in heterosexual intimate relationships is a major social problem with serious physical and psychological consequences for the victims. There is a line of research that seeks to analyze how ideological variables and contextual variables influence the way in which this type of violence is perceived. This study analyzed the relationship between hostile sexism, benevolent sexism and social dominance in the acceptance of the myths about violence against women in intimate relationships. A total of 215 Spanish university students (125 women and 90 men) participated in the research. The results indicate that hostile sexism and social dominance orientation act as factors that influence the acceptance of such myths in men. Benevolent sexism did not act in this way. The data reconfirm the importance of hostile sexism and social dominance orientation in the perception of violence against women, in this case, that which is committed by their partners (or ex-partners) in the area of intimate relationships.

Description: Occupational therapists (OTs) are exposed to physical factors at work, which can lead to an increased risk of musculoskeletal disorders. Most studies examining musculoskeletal complaints in OT report that the neck, shoulders, and lower back are most often afflicted. The aim of the present study was to examine the impact of work as an OT (focusing on specific work tasks) on specific musculoskeletal complaints compared to the general working population. A cross-sectional study involving a self-administered standardized questionnaire was conducted from January until October 2015 in Germany. In OT and the comparison group, the highest 12-month prevalence of musculoskeletal disorders were observed for the lower back, the neck, and the shoulders. In contrast, elevated prevalence ratios (PR) were found for OT in the thumbs (PR = 2.7; 95% CI = 1.9–3.8), the wrists (PR = 1.4; 95% CI = 1.1–1.8), and the elbows (PR = 1.5; 95% CI = 1.0–2.2). OTs were particularly exposed to high exertion hand activity and several stressful postures at work. In conclusion, OTs seem to be at risk of developing work-related musculoskeletal complaints in the thumbs, wrists, and elbows. Preventive measures should help to reduce the exposures caused by highly repetitive and forceful hand activities.

Description: During the large-scale outbreak of COVID-19 in China, the Chinese government adopted multiple measures to prevent the epidemic. The consequence was that a sudden variation in residents’ travel behavior took place. In order to better evaluate the temporal distribution of air pollution, and to effectively explore the influence of human activities on air quality, especially under the special situation, this study was conducted based on the real data from a case city in China from this new perspective. Two case scenarios were constructed, in which the research before the changes of residents’ travel behavior was taken as case one, and the research after the changes in residents’ travel behavior as case two. The hourly real-time concentrations of PM2.5, PM10, SO2, NO2, CO and O3 that have passed the augmented Dickey–Fuller (ADF) test were employed as a data source. A series of detailed studies have been carried out using the correlation method, entropy weight method and the Air Quality Index (AQI) calculation method. Additionally, the research found that the decrease rate of NO2 concentration is 61.05%, and the decrease rate of PM10 concentration is 53.68%. On the contrary, the average concentration of O3 has increased significantly, and its growth rate has reached to 9.82%. Although the air quality in the first week with fewer travels was in the excellent category, and chief pollutant (CP), as well as excessive pollutant (EP), were not found, as traffic volume increased, it became worse in the second and third weeks. In addition to that, special attention should still be paid to the development trend of O3, as its average hourly concentration has increased. The findings of this study will have some guiding significance for the study of air pollution prevention, cleaner production, and indoor environmental safety issues, especially for the study of abnormal traffic environments where residents’ travel behaviors have changed significantly.

Description: While earlier studies on men having sex with men (MSM) tended to examine infection-related cancers, an increasing number of studies have been focusing on effects of sexual orientation on other cancers and social and cultural causes for cancer disparities. As a type of tertiary research, this umbrella review (UR) aims to synthesize findings from existing review studies on the effects of sexual orientation on cancer. Relevant peer-reviewed systematic reviews (SRs) will be identified without date or language restrictions using MEDLINE, Cochrane Database of Systematic Reviews, and the International Prospective Register for Systematic Reviews, among others. The research team members will prepare the data extraction forms. Two reviewers will independently assess extracted SRs using the Assessment of Methodological Quality of Systematic Reviews. A third reviewer will weigh in to resolve discrepancies. The reviewers will be blinded to publisher, journal, and authors, making their judgements on the title, year, and abstract. The Preferred Reporting Items for Systematic Reviews and Meta-analysis checklist will guide data synthesis. By collating evidence from multiple reviews into one accessible and usable document, our first UR on global epidemiology of malignancies among MSM would serve as an evidence-based decision-making tool for the public health community.

Description: The aim of this study was to determine whether a rowing training program leads to improvements in physical fitness and body composition in women who have survived breast cancer (53.70 ± 7.88 years). The participants (n = 30) completed a twelve-week training program consisting of three sessions per week, with each session lasting from sixty to ninety minutes. An anthropometric and general physical fitness assessment was performed before and after the program. The results showed statistically significant improvements in all the physical fitness tests performed: sit and reach (2.82 cm); back scratch, dominant (3.29 cm); back scratch, non-dominant (4.59 cm); counter movement jump (1.91 cm); hand grip, dominant (2.54 kgf); hand grip, non-dominant (2.53 kgf); chair stand (2.56 rep); and six-minute walk (51.56 m). In addition, a significant improvement was observed in the efficiency of the cardiovascular system measured by heart rate, in beats per minute (bpm), both before (−12.63 bpm) and after the six-minute walk test (−11.46 bpm). The evaluated body composition parameters also improved, specifically total lean mass (2.18 kg) and the percentage of total body fat (−2.63%). We can therefore conclude that rowing training programs can be a strategy to be considered for improving physical fitness in this population given the improvement obtained in both anthropometric and physical fitness variables, thus leading to better health and quality of life.

Description: It is important that length of stay (LOS) management for alleviating health care financial burdens and improving patient outcomes. The aim of this study was to report the differences of LOS and the factors affecting LOS of hip fracture patients using big data. A total of 463,194 data were collected from 2016 to 2017 KNHDS. Of those, 2238 patients with the hip fracture primary diagnosis were included in the study population. As independent variables were used gender, age, type of insurance, admission route, result of treatment, number of hospital beds, the presence of surgery, and comorbidities. Statistical analysis performed using the IBM SPSS Statistics for Windows, version 25.0. A statistically significant difference was observed in the length of stay of hip fracture patients according to the healthcare insurance type. The difference in LOS associated with comorbidities was statistically significant for hypertension, peptic ulcer disease, coagulopathy, and alcohol abuse (p 〈 0.05). Independent variables that affected LOS of hip fracture patients with national health insurance were the treatment result, operation presence, comorbidity count, and hospital beds (p 〈 0.001). The factors associated with the length of stay for hip fracture patients were the difference according to the healthcare insurance type. The results of this study can be used as a basic data for the national health policy for the proper distribution and utilization of medical resources.

Description: The purpose of the present research was to analyze the mediating role of motivational regulation between the satisfaction of basic psychological needs and burnout and engagement in athletes. From different sports 1011 young Spanish athletes participated in the study. Participants completed several measurement instruments concerning: the Basic Needs Satisfaction in Sport Scale, Behavioral Regulation in Sport Questionnaire, Athlete Burnout Questionnaire and Athlete Engagement Questionnaire. The results of structural equation modeling showed that the satisfaction of basic psychological needs has direct effects on burnout and engagement: a negative effect on athlete burnout (–0.49, p 〈 0.001) and a positive effect on engagement (0.54, p 〈 0.001). In addition, the satisfaction of basic psychological needs has a partial indirect effect over these variables in the same direction mediated by the self-determined degree of motivation. Thus, low levels of self-regulated motivation are positively related to burnout, but high levels of self-determined motivation are not. The same was observed with engagement, but vice versa: high levels of self-determined motivation are positively related to athlete engagement, but low levels of self-determined motivation are not. The proposed model explained 37% of the variance of burnout and 51% of the variance of engagement.

Description: The presence of growing fungi in the indoor environment has been associated with the development of respiratory problems such as asthma or allergic rhinitis, as well as the worsening of respiratory pathologies. Their proliferation indoors could be a result of water leakage or inadequate ventilation. Although the factors promoting mould growth have been widely investigated in traditional dwellings, little work has been done in energy efficient dwellings. Here, the effectiveness of ventilation type, i.e., natural or mechanical, in influencing mould development was estimated in 44 recent and 105 retrofitted energy efficient dwellings. Fungi growing on surfaces were investigated in the dwellings situated in rural, peri-urban, and urban regions of Switzerland. The presence of these fungi was also investigated in bedroom settled dust. Information on building characteristics and owners’ lifestyle were collected. Significant associations were found with the level of urbanisation, the location of mouldy area in dwellings, and the diversity of fungal taxa. Dwellings in peri-urban zones showed the most frequent fungal contamination in the owners’ bedroom and the highest diversity of fungal genera among dwellings. While the urbanisation level or the ventilation type favoured no specific genus, we found marked disparities in the diversity of fungi growing on surfaces in naturally ventilated versus mechanically ventilated dwellings. Aspergillus, in particular, was a frequent surface contaminant in bedrooms with natural ventilation, but not in those mechanically ventilated. We observed a strong association between fungal growth on surfaces and the number of fungal particles counted in the settled dust of owners’ bedrooms. These results demonstrate the importance of ventilation systems in energy efficient dwellings in controlling fungal proliferation in living areas.

Description: Depression and other mood and anxiety disorders are recognized as common complications following cardiac events. Some studies report poorer cardiac outcomes among patients in socioeconomically marginalized neighbourhoods. This study aimed to describe associations between socioeconomic and built environment characteristics of neighbourhood environments and mental health service contacts following an acute myocardial infarction (AMI or heart attack) among adults in the province of New Brunswick, Canada. This province is characterized largely by residents in small towns and rural areas. A cohort of all adults aged 45 and over surviving AMI and without a recent record of mental disorders was identified by linking provincial medical-administrative datasets. Residential histories were tracked over time to assign neighbourhood measures of marginalization, local climate zones, and physical activity friendliness (i.e., walkability). Cox models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for the risk of healthcare use for mood and anxiety disorders over the period 2003/04–2015/16 by neighbourhood characteristics. The baseline cohort included 13,330 post-AMI patients, among whom 32.5% were found to have used healthcare services for a diagnosed mood or anxiety disorder at least once during the period of observation. Among men, an increased risk of mental health service use was found among those living in areas characterized by high ethnic concentration (HR: 1.14 (95%CI: 1.03–1.25)). Among women, the risk was significantly higher among those in materially deprived neighbourhoods (HR: 1.16 (95%CI: 1.01–1.33)). We found no convincing evidence of associations between this outcome and the other neighbourhood characteristics considered here. These results suggest that selected features of neighbourhood environments may increase the burden on the healthcare system for mental health comorbidities among adults with cardiovascular disease. Further research is needed to understand the differing needs of socioeconomically marginalized populations to improve mental health outcomes following an acute cardiac event, specifically in the context of smaller and rural communities and of universal healthcare coverage.

Description: Hepatitis C (HCV) is a global pandemic. The World Health Organization has developed a strategic plan for HCV elimination that focuses on low- and middle-income countries (LMICs) and high-risk populations, including people who inject drugs (PWID). While direct-acting antiviral (DAA) therapies are highly effective at eliminating HCV infections and have few side effects, medical professionals and policymakers remain concerned about the risk of reinfection among PWID. This study is a systematic review of research measuring the rate of HCV reinfection among PWID in LMICs and identifies additional areas for further research. A systematic search strategy was used to identify studies documenting HCV reinfection after sustained virologic response in PWID in LMICs. We refined results to include studies where at least 50% of participants had DAA treatment for primary HCV infection. Pooled reinfection rate was calculated across all studies. Seven studies met eligibility criteria. Most studies were conducted in six upper middle-income countries (Mexico, Romania, Russia, Taiwan, Georgi, and Brazil) and one lower middle-income country (Bangladesh) with a total of 7665 participants. No study included information from PWID in low-income countries. Sample sizes ranged from 200 to 3004 individuals, with demographic data missing for most participants. Four studies used deep gene sequencing, and reflex genotyping procedures to differentiate reinfection (infection by a different HCV genotype/subtype) from virologic relapse (infection by the same strain). The follow-up time of people cured from primary chronic HCV infection ranged from 12 weeks to 6.6 years. The pooled reinfection rate of all seven studies was 2.8 (range: 0.02 to 10.5) cases per 100 person-years (PY). In the five studies that differentiated relapse from reinfection, the incidence of reinfection was 1.0 per 100 PY. To date, research on reinfection rates among PWID in LMICs remains limited. Research focused on PWID in low-income countries is particularly needed to inform clinical decision making and evidence-based programs. While rates of reinfection among PWID who complete DAA treatment in upper and lower middle-income countries were similar or lower than rates observed in PWID in high-income countries, the rates were highly variable and factors may influence the accuracy of these measurements. This systematic review identifies several areas for continued research. Policies concerning access to HCV testing and treatment should be comprehensive and not place restrictions on PWID in these settings.

Description: (1) Background: The present study aimed to examine physical, cognitive and emotional factors affecting falls in community-dwelling older adults with and without pain; (2) Methods: Data from 789 older adults who participated in a community-based health survey were analyzed. Participants completed questionnaires on the presence of pain and previous falls. Muscle weakness (handgrip strength 〈 26.0 kg for men and 〈 18.0 kg for women) and low skeletal muscle mass (appendicular skeletal muscle mass index 〈 7.0 kg/m2 for men and 〈 5.7 kg/m2 for women) were determined. Mild cognitive impairment (MCI) and depressive symptoms were assessed using the National Center for Geriatrics and Gerontology-Functional Assessment Tool and 15-item geriatric depression scale (GDS-15), respectively; (3) Results: In participants with pain, MCI and GDS-15 were associated with previous falls after adjusting for age, sex, education and medication use. In participants without pain, muscle weakness and low skeletal muscle mass were associated with previous falls when adjusting for the above covariates; (4) Conclusions: Falls in participants with pain were associated with cognitive and emotional factors, whereas falls in those without pain were associated with physical factors. Fall prevention interventions for older adults with pain may require tailored strategies to address cognitive and emotional factors.

Description: This study was intended to confirm the structural relationship between clinical nurse communication skills, problem-solving ability, understanding of patients’ conditions, and nurse’s perception of professionalism. Due to changes in the healthcare environment, it is becoming difficult to meet the needs of patients, and it is becoming very important to improve the ability to perform professional nursing jobs to meet expectations. In this study method, structural model analysis was applied to identify factors influencing the perception of professionalism in nurses. The subjects of this study were 171 nurses working at general hospitals in city of Se, Ga, and Geu. Data analysis included frequency analysis, identification factor analysis, reliability analysis, measurement model analysis, model fit, and intervention effects. In the results of the study, nurse’s perception of professionalism was influenced by factors of communication skills and understanding of the patient’s condition, but not by their ability to solve problems. Understanding of patient’s condition had a mediating effect on communication skills and nursing awareness. Communication skills and understanding of the patient’s condition greatly influenced the nurse’s perception of professionalism. To improve the professionalism of clinical nurses, nursing managers need to emphasize communication skills and understanding of the patient’s condition. The purpose of this study was to provide a rationale for developing a program to improve job skills by strengthening the awareness of professional positions of clinical nurses to develop nursing quality of community.

Description: Preventive strategies can be developed by gathering more information about oral and maxillofacial injuries and oral pathologies in immigrants from low- to middle-income countries (LMIC). Additional information on the quality of care can also improve the allocation of clinical resources for the management of these patients. We studied immigrants from LMIC who presented in the emergency department (ED) at Berne University Hospital with dental problems or oral or maxillofacial injuries. The patient data included age, gender, nationality, the etiology and type of trauma and infection in the oral-maxillofacial area, and overall costs. The greatest incidence of maxillofacial injuries was observed in the age group of 16–35 years (n = 128, 63.6%, p = 0.009), with males outnumbering females in all age groups. Trauma cases were most frequent in the late evening and were mostly associated with violence (n = 82, 55.4%, p = 0.001). The most common fracture was fracture of the nose (n = 31). The mean costs were approximately the same for men (mean = 2466.02 Swiss francs) and women (mean = 2117.95 Swiss francs) with maxillofacial injuries but were greater than for isolated dental problems. In conclusion, the etiology of dental and maxillofacial injuries in immigrants in Switzerland requires better support in the prevention of violence and continued promotion of oral health education.

Description: Exergames have been recommended as alternative ways to increase the health benefits of physical exercise. However, energy system contributions (phosphagen, glycolytic, and oxidative) of exergames in specific age groups remain unclear. The purpose of this study was to investigate the contributions of three energy systems and metabolic profiles in specific age groups during exergames. Seventy-four healthy males and females participated in this study (older adults, n = 26: Age of 75.4 ± 4.4 years, body mass of 59.4 ± 8.7 kg, height of 157.2 ± 8.6 cm; adults, n = 24: Age of 27.8 ± 3.3 years, body mass of 73.4 ± 17.8 kg, height of 170.9 ± 11.9 cm; and adolescents, n = 24: Age of 14 ± 0.8 years, body mass of 71.3 ± 11.5 kg, height of 173.3 ± 5.2 cm). To evaluate the demands of different energy systems, all participants engaged in exergames named Action-Racing. Exergames protocol comprised whole-body exercises such as standing, sitting, stopping, jumping, and arm swinging. During exergames, mean heart rate (HRmean), peak heart rate (HRpeak), mean oxygen uptake (VO2mean), peak oxygen uptake (VO2peak), peak lactate (Peak La−), difference in lactate (ΔLa−), phosphagen (WPCr), glycolytic (WLa−), oxidative (WAER), and total energy demands (WTotal) were analyzed. The contribution of the oxidative energy system was higher than that of the phosphagen or glycolytic energy system (65.9 ± 12% vs. 29.5 ± 11.1% or 4.6 ± 3.3%, both p 〈 0.001). The contributions of the total energy demands and oxidative system in older adults were significantly lower than those in adults and adolescents (72.1 ± 28 kJ, p = 0.028; 70.3 ± 24.1 kJ, p = 0.024, respectively). The oxidative energy system was predominantly used for exergames applied in the current study. In addition, total metabolic work in older adults was lower than that in adolescents and adults. This was due to a decrease in the oxidative energy system. For future studies, quantification of intensity and volume is needed to optimize exergames. Such an approach plays a crucial role in encouraging physical activity in limited spaces.

Description: This study is aimed at investigating the effects of synchronized neuromuscular electrical stimulation (NMES) and chewing exercises on bite force and the masseter muscle thickness in community-dwelling older adults. Material and methods: Forty older adults were enrolled in South Korea and randomly assigned to either an experimental or control group. The experimental group performed chewing exercises using the No-Sick Exerciser equipment synchronized with NMES applied to the bilateral masseter muscles, while the control group performed only chewing exercises. Both groups received interventions for 20 min/day, 5 days/week, for 6 weeks. Bite force was measured using the OCCLUZER device, and masseter muscle thickness was measured using a portable ultrasound. Results: Both groups showed a significant increase in bite force and masseter muscle thickness compared to baseline measurements (p 〈 0.05). The experimental group showed a significantly higher increase in bite force and masseter muscle thickness than the control group after combined intervention (p 〈 0.05). Conclusion: This study demonstrates that NMES synchronized with chewing exercises is more efficient in increasing bite force and masseter muscle thickness than chewing exercises alone in community-dwelling older adults.

Description: Objectives: Patients’ knowledge about oral squamous cell carcinoma (OSCC) plays an important role in primary prevention, early diagnosis, and prognosis and survival rate. The aim of this study was to assess OSCC awareness attitudes among general population in order to provide information for educational interventions. Methods: A survey delivered as a web-based questionnaire was submitted to 505 subjects (aged from 18 to 76 years) in Italy, and the answers collected were statistically analyzed. Information was collected about existence, incidence, features of lesions, risk factors of oral cancer, and self-inspection habits, together with details about professional reference figures and preventive behaviors. Results: Chi-square tests of independence with adjusted standardized residuals highlighted correlations between population features (age, gender, educational attainment, provenance, medical relationship, or previous diagnoses of oral cancer in family) and knowledge about oral cancer. Conclusions: Knowledge about OSCC among the Italian population is limited, and it might be advisable to implement nudging and sensitive customized campaigns in order to promote awareness and therefore improve the prognosis of this disease.

Description: The novel coronavirus disease, COVID-19, is a highly contagious infectious disease declared by the World Health Organization to be a pandemic and a global public health emergency. During outbreaks, health care workers are submitted to an enormous emotional burden as they must balance the fundamental “duty to treat” with their parallel duties to family and loved ones. The aims of our study were to evaluate disease perceptions, levels of stress, emotional distress, and coping strategies among medical staff (COVID-19 versus non-COVID-19 departments) in a tertiary pulmonology teaching hospital in the first month after the outbreak of COVID-19. One hundred and fifteen health care workers completed four validated questionnaires (the brief illness perception questionnaire, perceived stress scale, the profile of emotional distress emotional, and the cognitive coping evaluation questionnaire) that were afterwards interpreted by one psychologist. There was a high level of stress and psychological distress among health care workers in the first month after the pandemic outbreak. Interestingly, there were no differences between persons that worked in COVID-19 departments versus those working in non-COVID-19 departments. Disease perceptions and coping mechanisms were similar in the two groups. As coping mechanisms, refocusing on planning and positive reappraisal were used more than in the general population. There is no difference in disease perceptions, levels of stress, emotional distress, and coping strategies in medical staff handling COVID-19 patients versus those staff who were not handling COVID-19 patients in the first month after the pandemic outbreak.

Description: Myostatin A55T genotype is one of the candidates showing inter-individual variation in skeletal muscle phenotypes. The aim of this study was to investigate the effect of the myostatin A55T genotype on markers of muscle damage after eccentric exercise. Forty-eight young, healthy male college students (age = 24.8 ± 2.2 years, height = 176.7 ± 5.3 cm, weight = 73.7 ± 8.3 kg) were enrolled in this study, and muscle damage was induced through 50 reps of maximal eccentric muscle contraction. As markers of muscle damage, maximal isometric strength (MIS), muscle soreness, creatine kinase (CK), and aspartate transaminase (AST) were measured. Myostatin A55T genotypes were classified into homozygous myostatin A55T allele (AA, n = 34, 72%), heterozygous myostatin A55T allele (AT, n = 13, 26%), and homozygous mutant carriers (TT, n = 1, 2%). After eccentric exercise, the subjects with heterozygous for AT showed markedly quicker MIS recovery compared to the AA group (p = 0.042). However, there were no significant variations in muscle soreness (p = 0.379), CK (p = 0.955), and AST (p = 0.706) among the groups. These results suggest that AT in myostatin A55T genotype may be associated with quicker strength recovery following exercise-induced muscle damage.

Description: Osteoporosis is a global public health issue and its consequent effects are a growing concern worldwide. Caregivers generally experience occupational physical ailments and they have less of a tendency to engage in preventive health behaviors, leading them to be in a higher risk group for osteoporosis. This study aims to present a general profile of health literacy related to osteoporosis risks and identify its associated factors among disability institutional caregivers. A cross-sectional study with a structured questionnaire was used to collect information on 465 caregivers from seven disability care institutions regarding their awareness of the health literacy related to osteoporosis risks. The results indicate that the average literacy score related to osteoporosis risks among the respondents was 60 points (full score is 80 points), with 50–59 being the most common range (51.9%), followed by 60–69 points (43.5%), and 4.4% of cases had more than 70 points. A multivariate logistic regression model revealed that respondents’ age (40–49 vs. 18–29; odds ratio (OR) = 2.53, 95% confidence interval (CI) = 1.31–4.87), education level (senior high vs. primary and junior high, OR = 2.00, 95% CI = 1.03–3.89; college and above vs. primary and junior high, OR = 3.66, 95% CI = 1.84–7.31), experience in undergoing a bone density test (OR = 1.94, 95% CI = 1.28–2.93), and poor physical fitness status (OR = 0.64, 95% CI = 0.43–0.95) were the significant predictors of the osteoporosis health literacy level. The osteoporosis health literacy of institutional caregivers is moderate, and there are many items that are worthy of attention in future health promotion programs. This study highlights risk factors related to a lower level of osteoporosis healthy literacy such as older age, less education, no experience of bone density test, and poor physical fitness that highlight the need to raise further awareness in order to improve caregivers’ bone health.

Description: A global pandemic of a new highly contagious disease called COVID-19 resulting from coronavirus (severe acute respiratory syndrome (SARS)-Cov-2) infection was declared in February 2020. Though primarily transmitted through the respiratory system, other organ systems in the body can be affected. Twenty percent of those affected require hospitalization with mechanical ventilation in severe cases. About half of the disease survivors have residual functional deficits that require multidisciplinary specialist rehabilitation. The workforce to deliver the required rehabilitation input is beyond the capacity of existing community services. Strict medical follow-up guidelines to monitor these patients mandate scheduled reviews within 12 weeks post discharge. Due to the restricted timeframe for these events to occur, existing care pathway are unlikely to be able to meet the demand. An innovative integrated post-discharge care pathway to facilitate follow up by acute medical teams (respiratory and intensive care) and a specialist multidisciplinary rehabilitation team is hereby proposed. Such a pathway will enable the monitoring and provision of comprehensive medical assessments and multidisciplinary rehabilitation. This paper proposes that a model of tele-rehabilitation is integrated within the pathway by using digital communication technology to offer quick remote assessment and efficient therapy delivery to these patients. Tele-rehabilitation offers a quick and effective option to respond to the specialist rehabilitation needs of COVID-19 survivors following hospital discharge.

Description: The windy season brings numerous community complaints for gold mining companies situated in the Witwatersrand due to windblown dust from partially rehabilitated tailings storage facilities (TSFs). For communities encroaching onto TSFs, windblown dust is perceived as a health hazard and an environmental challenge. In a study conducted in 2017 by the Lawyers for Human Rights, the community of a gold mine village perceived tailings storage facility 6 (TSF6) and other surrounding tailings storage facilities which are partially rehabilitated to be a health and socio-economic threat. Since 2013, when a nearby gold mining company was liquidated, this community has been complaining about dust fallout. To validate the claims made by the community this paper reports on the dust deposition impacts, and respiratory illnesses risk posed by wind-blown generated dust. The study conducts an air quality assessment using dispersion modelling of windblown dust. Surface material from the TSFs was sampled, analysed for silica and heavy metal content using X-ray fluorescence (XRF) and inductively coupled plasma-mass spectrometry (ICP-MS) respectively. This study finds that PM10 dust fallout, high in silica and uranium content, could potentially pose health threats to the surrounding community. The study further shows that dust deposition is the highest in July–October, with TSF6 posing a nuisance while TSF1 represents a potential health threat owing to its particle size distribution for the surrounding gold mine village community. Potential receptors of the air pollution by dust in this study area include neighbouring property owners, business owners of the nearby shopping centre, the school and the clinic. This study further finds that sudden mine closure due to mine liquidation results in unrehabilitated tailings storage facilities which exacerbates dust deposition.

Description: Background: A series of reforms were implemented to improve the quality of primary care services in China. This study aims to assess patients’ perceived quality of primary healthcare between rural and urban community health centers in Guangdong. Methods: A cross-sectional survey was conducted from July to December 2015 in Guangdong. We surveyed 1010 respondents who visited either community health centers/stations (CHCs/CHSs) in urban areas or township health centers/rural health stations (THCs/RHSs) in rural areas. A validated Chinese version of the Primary Care Assessment Tool-Adult Short Version (PCAT-AS), representing ten primary care domains, was used to collect information on patients’ primary care experiences. A t-test was used for comparison on domain scores and total scores between patients from CHCs/CHSs and THCs/RHSs. An analysis of covariance was employed to compare the adjusted PCAT domain scores and total scores. Multilevel models were used to explore factors associated with PCAT total scores. Results: Overall, patients reported a lower level of experience of community orientation and family centeredness compared to other primary care domains. Patients from THCs/RHSs settings in the rural area reported better primary care experience in four domains, including first contact, accessibility, ongoing care, and community orientation. Higher education background and those with a chronic disease were associated with better primary care experience, after controlling for confounding factors. Patients who preferred primary care institutions when getting sick or used health services more frequently reported better primary care experiences. Conclusion: Continued efforts are needed to strengthen primary care performances, particularly in a community orientation and family centeredness. Primary care delivery in CHCs/CHSs settings should be improved in four domains, including first contact, accessibility, ongoing care, and community orientation.

Description: We used AdaBoost (AB), alternating decision tree (ADTree), and their combination as an ensemble model (AB-ADTree) to spatially predict landslides in the Cameron Highlands, Malaysia. The models were trained with a database of 152 landslides compiled using Synthetic Aperture Radar Interferometry, Google Earth images, and field surveys, and 17 conditioning factors (slope, aspect, elevation, distance to road, distance to river, proximity to fault, road density, river density, normalized difference vegetation index, rainfall, land cover, lithology, soil types, curvature, profile curvature, stream power index, and topographic wetness index). We carried out the validation process using the area under the receiver operating characteristic curve (AUC) and several parametric and non-parametric performance metrics, including positive predictive value, negative predictive value, sensitivity, specificity, accuracy, root mean square error, and the Friedman and Wilcoxon sign rank tests. The AB model (AUC = 0.96) performed better than the ensemble AB-ADTree model (AUC = 0.94) and successfully outperformed the ADTree model (AUC = 0.59) in predicting landslide susceptibility. Our findings provide insights into the development of more efficient and accurate landslide predictive models that can be used by decision makers and land-use managers to mitigate landslide hazards.

Description: Allergic disorders in the agriculture sector are very common among farm workers, causing many injuries and occupational diseases every year. Agricultural employees are exposed to multiple conditions and various allergenic substances, which could be related to onset of anaphylactic reactions. This systematic review highlights the main clinical manifestation, the allergens that are mostly involved and the main activities that are usually involved. This research includes articles published on the major databases (PubMed, Cochrane Library, Scopus), using a combination of keywords. The online search yielded 489 references; after selection, by the authors, 36 articles (nine reviews and 27 original articles) were analyzed. From this analysis, the main clinical problems that were diagnosed in this category were respiratory (ranging from rhinitis to asthma) and dermatological (eczema, dermatitis, hives) in nature, with a wide symptomatology (from a simple local reaction to anaphylaxis). The main activities associated with these allergic conditions are harvesting or cultivation of fruit and cereals, beekeepers and people working in greenhouses. Finally, in addition to the allergens already known, new ones have emerged, including triticale, wine, spider and biological dust. For these reasons, in the agricultural sector, research needs to be amplified, considering new sectors, new technologies and new products, and ensuring a system of prevention to reduce this risk.

Description: Post-traumatic growth (PTG) refers to personal growth that occurs after experiencing challenges. For many nursing students, PTG could occur during their clinical practice. Academic motivation and resilience could help students to overcome these traumatic clinical experiences and possibly achieve PTG. This study examined the relationships between nursing students’ academic motivation and resilience leading to post-traumatic growth. A total of 291 nursing students from three South Korean nursing colleges participated in this cross-sectional study. Self-report questionnaire data were analyzed using t-tests, ANOVA, correlations, and hierarchical multiple linear regressions. Intrinsically motivated students’ PTG scores were significantly higher compared to extrinsically motivated students (t = 4.62, p 〈 0.001). Resilience scores showed similar results (t = 3.81, p 〈 0.001). Significant total, direct, and indirect effects of academic motivation on resilience and PTG were found. In addition, resilience mediated 40.9% of the relationship between academic motivation and PTG. Nursing students with intrinsic academic motivation were more likely to achieve high PTG scores, and resilience mediated the relationship between academic motivation and PTG. It is suggested that the importance of academic motivation must be considered in the early stages of university-level nursing education to increase retention rates of nursing students.

Description: The world has been afflicted heavily by the burden of coronavirus disease 2019 (COVID-19) that overwhelmed health care systems and caused severe economic and educational deficits, in addition to anxiety among the public. The main aim of this study was to evaluate the mutual effects of belief that the pandemic was the result of a conspiracy on knowledge and anxiety levels among students at the University of Jordan (UJ). An electronic-based survey was conducted between 29 March, 2020 and 31 March, 2020. The targeted population involved all undergraduate and postgraduate students from the health, scientific and humanities schools at UJ. Survey sections included 26 items on: socio-demographic information, knowledge and sources of information about the disease, attitude towards the false notion that COVID-19 stemmed from a conspiracy and items to assess the anxiety level among students during the quarantine period. The total number of participants was 1540 students. The mean age of study participants was 22 years and females predominated the study population (n = 1145, 74.4%). The majority of participants perceived the disease as moderately dangerous (n = 1079, 70.1%). Males, Jordanians and participants with lower income were more inclined to feel that COVID-19 is very dangerous. A lower level of knowledge and a higher level of anxiety about COVID-19 were associated with the belief that the disease is part of a conspiracy. Females and participants with lower income were more likely to believe that the disease is related to conspiracy. Belief in conspiracy regarding the origin of COVID-19 was associated with misinformation about the availability of a vaccine and the therapeutic use of antibiotics for COVID-19 treatment. The Ministry of Health in Jordan was the most common source of information about COVID-19 reported by the participants (n = 1018). The false belief that COVID-19 was the result of a global conspiracy could be the consequence of a lower level of knowledge about the virus and could lead to a higher level of anxiety, which should be considered in the awareness tools of various media platforms about the current pandemic.

Description: The aim of this paper is to analyze the relationships between a controlling interpersonal style, psychological need thwarting and burnout in adolescent soccer players and to test a structural equation model to analyze whether (a) a controlling interpersonal style is a predictor of psychological need thwarting and whether (b) psychological need thwarting is a predictor of burnout. A total of 103 male soccer players between the ages of 12 and 17 participated in the research (M = 14.91; SD = 5.56). The Controlling Coach Behaviors Scale, the Psychological Need Thwarting Scale, and the Athlete Burnout Questionnaire were used to evaluate the variables under study. The analyses revealed significant relationships between a controlling interpersonal style, psychological need thwarting and burnout. Furthermore, the proposed structural equations model, using the partial least squares (PLS) method, showed that a controlling style is a positive predictor of basic psychological need thwarting and that the latter is a predictor of burnout, as well as revealing an indirect relationship between a controlling style and burnout. This indirect effect of the controlling style variable on burnout can be enhanced (or attenuated) by the basic psychological need thwarting variable, which acts as a modulator.

Description: Introduction: The ongoing severe acute respiratory syndrome (SARS)-CoV-2 pandemic has expanded globally. The aim of the current study is to investigate the knowledge, attitudes, and practices (KAP) of health care professionals in Greece towards SARS-CoV-2. Methods: From 10–25 February 2020, 500 health care workers were approached. Knowledge, attitudes, and practices towards SARS-CoV-2 were assessed via a personal interview questionnaire. For knowledge, each correct answer was given 1 point; attitudes, or concerns aimed at prevention of SARS-CoV-2 infection, and practices, or behaviors towards performing preventive practices, were assigned 1 point each. Points were summed and a score for each category was calculated. Results: A total of 461 health care workers returned the questionnaire and were included in the analysis (mean age ± SD: 44.2 ± 10.78 years, 74% females). The majority were nurses (47.5%), followed by physicians (30.5%) and paramedics (19%). The majority of subjects (88.28%) had a good level of knowledge (knowledge score equal to 4, or more). The majority of participants (71%) agreed with the temporary traveling restrictions ban. The uptake of a future vaccine against SARS-CoV-2 was estimated at 43%. Knowledge score was significantly associated with both attitudes score (p = 0.011) and practices score (p 〈 0.001), indicating that subjects with a high knowledge score demonstrated a more positive perception on preventive measures and would practice more preventive measures. Attitudes score was significantly associated with practices score (p = 0.009) indicating that subjects with a higher attitudes score are more likely to perform practices towards the prevention of SARS-CoV-2 transmission. Conclusion: There is a high level of knowledge concerning SARS-CoV-2 pandemic among Greek health care workers and this is significantly associated with positive attitudes and practices towards preventive health measures. The high level of knowledge of health professionals about SARS-CoV-2 may have contributed considerably to the successful management of the pandemic in Greece. Tailored educational campaigns aiming to increase the proportion of health care workers willing to accept a potential SARS-CoV-2 vaccine could be of paramount importance in future proactive vaccine educational campaigns.

Description: Common mental disorders are highly prevalent among pregnant women in low- and middle-income countries, yet prenatal anxiety remains poorly understood, particularly in the sociocultural context of South Asia. Our study explored sources, mitigators, and coping strategies for anxiety among symptomatic pregnant women in Pakistan, particularly in relation to autonomy in decision-making and social support. We interviewed 19 pregnant married women aged 18–37 years recruited from 2017–2018 at a public hospital in Rawalpindi who screened positive for anxiety. Thematic analysis was based on both inductive emergent codes and deductive a priori constructs of pregnancy-related empowerment. Gender norms emerged as an important dimension of Pakistani women’s social environment in both constraining pregnancy-related agency and contributing to prenatal anxiety. Women’s avenues of self-advocacy were largely limited to indirect means such as appeals to the husband for intercession or return to her natal home. The levels of autonomy during pregnancy depended on the area of decision-making, and peer/family support was a critical protective factor and enabling resource for maternal mental health. Women’s disempowerment is a key contextual factor in the sociocultural experience of prenatal maternal anxiety in South Asia, and further examination of the intersections between empowerment and perinatal mental illness might help inform the development of more context-specific preventive approaches.