bluuebunny/crossref_metadata_2025 huggingface dataset:
The Presence of Meaning in Parenthood, Perceived Social Support, and Happiness of Mothers Living in Hong Kong: A Comparative Study on Younger and Older Mothers
Authors: To Siu-Ming , Yang Lei , Yan Ming-Wai
Published: February 2022

This study investigates whether and how mothers’ meaning of parenthood and their perceived social support interact and are associated with their happiness. Similarities and differences in these areas between younger and older mothers are also explored. A total of 1292 Chinese mothers were recruited from different Hong Kong communities; 361 were 24 years of age and younger and were categorized as younger mothers, and 931 were older than 24 years of age and were categorized as older mothers. Multiple regression analyses were performed to discern direct and interaction effects. The results show that older mothers were happier than younger mothers and indicate that parental meaning and perceived social support had a positive effect on the happiness of both younger and older mothers. Notably, while the results reveal significant interaction effects between the meaning of parenthood and perceived social support from significant others and friends on the happiness of older mothers, these effects are not found among younger mothers. This study suggests that the social support young mothers receive from their significant others and friends does not amplify the association between their meaning of parenthood and happiness. These findings provide insights into the importance of synergizing social support and meaning-making among younger mothers.
The Hierarchy of Controls as an Approach to Visualize the Impact of Occupational Safety and Health Coordination
Authors: Ajslev Jeppe Z. N. , Møller Jeppe L. , Andersen Malene F. , Pirzadeh Payam , Lingard Helen
Published: February 2022

Occupational safety and health (OSH) in construction work continues to be a problematic issue, and OSH coordinators are a pivotal initiative for improving this in the EU. However, no studies on the impact of (OSH) coordinators in construction exists. This study conceptualizes the hierarchy of controls (HOC) as a means for visualizing and evaluating the impact of OSH coordinators’ work. The study engages with a large observational material based on fieldwork notes from 107 days of observations with 12 successful OSH coordinators. The analysis shows that during the 107 observation days, the coordinators implemented 280 OSH measures and were prevented 71 times from implementing measures. Most of the implemented measures were in the administrative (53.6%) and engineering (35%) controls. This may provide part of the explanation of why an increasing focus on OSH coordination has not translated into improved OSH outcomes in construction. The study contributes with insights for OSH coordinators and professionals seeking to improve the visibility and legitimacy of their work. In addition, it may be beneficial to organizations interested in ensuring the effectiveness of their organizational OSH practices. The study also creates foundations for more research-based practices, education, and professionalization of OSH coordinators as a profession.
Changes in Ammonia-Oxidizing Archaea and Bacterial Communities and Soil Nitrogen Dynamics in Response to Long-Term Nitrogen Fertilization
Authors: Xu Aixia , Li Lingling , Xie Junhong , Gopalakrishnan Subramaniam , Zhang Renzhi , Luo Zhuzhu , Cai Liqun , Liu Chang , Wang Linlin , Anwar Sumera , Jiang Yuji
Published: February 2022

Ammonia oxidizing archaea (AOA) and bacteria (AOB) mediate a crucial step in nitrogen (N) metabolism. The effect of N fertilizer rates on AOA and AOB communities is less studied in the wheat-fallow system from semi-arid areas. Based on a 17-year wheat field experiment, we explored the effect of five N fertilizer rates (0, 52.5, 105, 157.5, and 210 kg ha−1 yr−1) on the AOA and AOB community composition. This study showed that the grain yield of wheat reached the maximum at 105 kg N ha−1 (49% higher than control), and no further significant increase was observed at higher N rates. With the increase of N, AOA abundance decreased in a regular trend from 4.88 × 107 to 1.05 × 107 copies g−1 dry soil, while AOB abundance increased from 3.63 × 107 up to a maximum of 8.24 × 107 copies g−1 dry soil with the N105 treatment (105 kg N ha−1 yr−1). Application rates of N fertilizer had a more significant impact on the AOB diversity than on AOA diversity, and the highest AOB diversity was found under the N105 treatment in this weak alkaline soil. The predominant phyla of AOA and AOB were Thaumarchaeota and Proteobacteria, respectively, and higher N treatment (N210) resulted in a significant decrease in the relative abundance of genus Nitrosospira. In addition, AOA and AOB communities were significantly associated with grain yield of wheat, soil potential nitrification activity (PNA), and some soil physicochemical parameters such as pH, NH4-N, and NO3-N. Among them, soil moisture was the most influential edaphic factor for structuring the AOA community and NH4-N for the AOB community. Overall, 105 kg N ha−1 yr−1 was optimum for the AOB community and wheat yield in the semi-arid area.
Latent Heterogeneity in the Impact of Financial Coaching on Delay Discounting among Low-Income Smokers: A Secondary Analysis of a Randomized Controlled Trial
Authors: Rogers Erin S. , Vargas Elizabeth , Wysota Christina N. , Sherman Scott E.
Published: February 2022

Low-income adults are significantly more likely to smoke, and face more difficulty in quitting, than people with high income. High rates of delay discounting (DD) may be an important factor contributing to the high rates of tobacco use among low-income adults. Future-oriented financial coaching may offer a novel approach in the treatment of smoking cessation among low-income adults. This secondary analysis (N = 251) of data from a randomized controlled trial examined the integration of future-oriented financial coaching into smoking cessation treatment for low-income smokers. Linear regression and finite mixture models (FMM) estimated the overall and the latent heterogeneity of the impact of the intervention versus usual care control on DD rates 6 months after randomization. Though standard linear regression found no overall difference in DD between intervention and control (β = −0.23, p = 0.338), the FMM identified two latent subgroups with different responses to the intervention. Subgroup 1 (79% of the sample) showed no difference in DD between intervention and control (β = 0.25, p = 0.08). Subgroup 2 (21% of the sample) showed significantly lower DD (β = −2.06, p = 0.003) among intervention group participants versus control at 6 months. Participants were more likely to be a member of subgroup 2 if they had lower baseline DD rates, were living at or below 100% of federal poverty, or were married/living with a partner. This study identified a group of low-income adults seeking to quit smoking who responded to financial coaching with decreased DD rates. These results can be used to inform future targeting of the intervention to individuals who may benefit most, as well as inform future treatment adaptations to support the subgroup of low-income smokers, who did not benefit.
Forecasting Frequent Alcohol Use among Adolescents in HBSC Countries: A Bayesian Framework for Making Predictions
Authors: Charrier Lorena , Bersia Michela , Vieno Alessio , Comoretto Rosanna , Štelemėkas Mindaugas , Nardone Paola , Baška Tibor , Dalmasso Paola , Berchialla Paola
Published: February 2022

(1) Aim: To summarize alcohol trends in the last 30 years (1985/6–2017/8) among 15-year-olds in Health Behaviour in School-aged Children (HBSC) countries (overall sample size: 413,399 adolescents; 51.55% girls) and to forecast the potential evolution in the upcoming 2021/22 HBSC survey. (2) Methods: Using 1986–2018 prevalence data on weekly alcohol consumption among 15-year-olds related to 40 HBSC countries/regions, a Bayesian semi-parametric hierarchical model was adopted to estimate trends making a clusterization of the countries, and to give estimates for the 2022 HBSC survey. (3) Results: An overall declining trend in alcohol consumption was observed over time in almost all the countries. However, compared to 2014, some countries showed a new increase in 2018 and 2021/22 estimates forecast a slight increase in the majority of countries, pointing out a potential bounce after a decreasing period in frequent drinking habits. (4) Conclusions: The clusterization suggested a homogenization of consumption habits among HBSC countries. The comparison between 2022 observed and expected data could be helpful to investigate the effect of risk behaviour determinants, including the pandemic impact, occurring between the last two waves of the survey.
Biological, Psychological, and Physical Performance Variations in Football Players during the COVID-19 Lockdown: A Prospective Cohort Study
Authors: My Giulia , Marsigliante Santo , Bianco Antonino , Zangla Daniele , Silva Carlos Marques da , Muscella Antonella
Published: February 2022

This prospective cohort study aimed to evaluate whether COVID-19 lockdown caused biological, psychological, and/or physical performance variations in footballers. We compared the 2018/2019 and 2019/2020 seasons evaluating the plasma volume, hematological parameters, iron/ferritin, creatine kinase, vitamin D, cortisol, testosterone, and physiological state of players of the Italian football major league (Serie A). Measurements were performed before the preparatory period (T0), at the beginning (T1) and in the middle (T2) of the championship, and in March (T3) and at the end of season (T4). The results showed that in the 2019/2020 season affected by the lockdown, the weight, BMI, and fat mass percentage were higher than in the previous season. Hematocrit, hemoglobin, red blood cells, and ferritin decreased during both seasons, more significantly than in the regular season. During both seasons, creatine kinase increased from T2 whilst iron concentrations decreased in T3. Testosterone increased in both seasons from T0 to T3 and returned to initial levels at T4; cortisol increased in T2 and T3 during the 2018/2019 season but not during the COVID-19 season. Physical performance tests revealed differences associated with lockdown. Thus, although from a medical point of view, none of the evaluated changes between the two seasons were clinically relevant, training at home during lockdown did not allow the players to maintain the jumping power levels typical of a competitive period.
The Protective Role of Self-Compassion in the Relationship between Perfectionism and Burnout in Portuguese Medicine and Dentistry Students
Authors: Pereira Ana Telma , Brito Maria João , Cabaços Carolina , Carneiro Mário , Carvalho Frederica , Manão Andreia , Araújo Ana , Pereira Daniela , Macedo António
Published: February 2022

Recent studies have documented the high prevalence of burnout among medicine and dentistry students, with potentially catastrophic consequences for both students and patients. Both environmental and personality factors play a part in burnout; perfectionism, a common trait in medicine students’ personalities, has been linked to psychological distress and increasing students’ vulnerability to burnout. Self-compassion, i.e., treating oneself kindly through hardship, has recently emerged as a buffer between perfectionism and psychological distress. While using a novel three-factor conceptualization of perfectionism (BIG3), this study aims to analyze if self-compassion has a protective role in the relationship between perfectionism and burnout, in a sample of medicine and dentistry students, through mediation analysis. We found that self-compassion significantly mediated the relationship between all three forms of perfectionism and burnout: as a partial mediator in self-critical and rigid perfectionism, as well as a full mediator in narcissistic perfectionism. Our findings underline self-compassion’s relevance in burnout prevention and management, supporting its use as an intervention target in burnout reduction programs and strategies.
Midlife Urinary Phthalate Metabolite Concentrations and Prior Uterine Fibroid Diagnosis
Authors: Pacyga Diana C. , Ryva Brad A. , Nowak Romana A. , Bulun Serdar E. , Yin Ping , Li Zhong , Flaws Jodi A. , Strakovsky Rita S.
Published: February 2022

Fibroid etiology is poorly understood but is likely hormonally mediated. Therefore, we evaluated associations between midlife phthalates (hormone-altering chemicals) and prior fibroid diagnosis, and considered differences by weight gain status. Women (ages: 45–54; n = 754) self-reported past fibroid diagnosis. We pooled 1–4 urines collected after fibroid diagnosis over the consecutive weeks to analyze nine phthalate metabolites and calculate relevant molar sums (e.g., di(2-ethylhexyl) phthalate, ΣDEHP; anti-androgenic phthalates, ΣAA; all metabolites, ΣPhthalates). Using Poisson regression, we evaluated associations between phthalate biomarkers and the risk of having fibroid diagnosis. We explored if associations differed by weight gain from age 18 to 45–54 or in women diagnosed with fibroids within 5 years of phthalate assessment. Our major finding was that women had a 13% (RR: 1.13; 95%CI: 1.02, 1.26) and 16% (RR: 1.16; 95% CI: 1.03, 1.31) greater risk of prior fibroid diagnosis for each two-fold increase in ΣDEHP or ΣAA, respectively. These associations were strongest in women who became overweight/obese from age 18 to 45–54 and in those diagnosed <5 years before phthalate assessment. Based on these results, prospective studies should corroborate our findings related to associations between phthalates and fibroids, and may consider evaluating the role that weight gain may play in these associations.
Public Water Policy Knowledge and Policy Preferences in the American West
Authors: Wolters Erika Allen , Steel Brent S. , Siddiqi Muhammed Usman Amin , Symmes Melissa
Published: February 2022

The Western United States has made significant contributions to agricultural products both domestically and internationally. As the Western U.S. continues to grapple with water scarcity and extended periods of drought, evidence of misalignment between crop production and the volume of water necessary to maintain abundant food yields is becoming more pronounced. There are several policy nudges and mitigation strategies that can be employed to bring water availability and crop selection into alignment. Whether there is public support for these policies, or knowledge of how policies could impact water use in agriculture, it is important to understand what those preferences are and how people weigh tradeoffs between developing agricultural and water use. Using random household surveys of residents in the western U.S. states of Washington, Oregon, Idaho, and California, this study explores public water knowledge, the correlates of public water knowledge, and the impact knowledge has on preferred water policies while controlling for demographic characteristics, environmental efficacy, climate change belief, and political ideology. Findings show that knowledge does have an independent impact on preferred approaches to water policies while controlling for demographic characteristics, environmental efficacy, belief in climate change, and political ideology. Respondents who are knowledgeable about water recycling for food and water use for agriculture were significantly more supportive of water conservation policy approaches and less supportive of water supply-side approaches.
Underestimated Risk Perception Characteristics of Drivers Based on Extended Theory of Planned Behavior
Authors: Chen Yunteng , Liu Xianyong , Xu Jinliang , Liu Huan
Published: February 2022

Aggressive driving behaviors due to drivers’ underestimation of risks are one of the major causes of traffic accidents. Due to the complexity of factors influencing risk perception, the mechanism of risk underestimation remains unclear. In this study, the theory of planned behavior (TPB) was extended by adding a new variable, namely drivers’ normlessness, forming an extended TPB (ETPB) framework to analyze the factors influencing risk underestimation and the extent of their influence. A total of 376 drivers’ perceived characteristics of risk underestimation were collected through an online survey, and a structural equation model was applied to investigate the effects of normlessness, behavioral attitudes, subjective norm, and perceived behavioral control on the tendency to underestimate the risk. The results showed that the ETPB model can explain the variance in the underestimation risk behavior by 69%; perceptual behavior control, attitude, and subjective norm (in descending order) had significant positive effects on driver’s tendency to underestimate risk; the normlessness variable can directly promote attitude and underestimated risk behavior; drivers with low annual mileage, complete insurance coverage, and no prior accident experience were more likely to underestimate driving risk. The study contributes to understanding of risk perception characteristics and provide theoretical basis for reducing underestimated risk behavior.
What Is the Role of Night-Time Noise Exposure in Childhood Allergic Disease?
Authors: Kim A-Ram , Bang Jin-Hee , Lee Sung-Hee , Lee Jiho
Published: February 2022

The cause of the allergic disease is known to be multifactorial, and there is growing evidence of environmental factors triggering the disease. Indeed, it is essential to find modifiable environmental factors related to allergic disease. Noise is an environmental pollutant causing various health problems, especially when exposed during the night-time. This study assessed the impact of night-time noise exposure in allergic disease. Subjects were selected from a panel data survey containing questions on allergic disease and related factors. Incidence of allergic disease, covariates, and addresses was derived from survey questionnaires. By applying the Land Use Regression modeling method, each subject’s night-time noise estimates were elicited based on the night-time noise level collected from the noise monitoring site. Association between night-time noise difference rate and incidence of asthma were analyzed by Cox proportional hazard regression. Incidence of allergic disease increased when night-time noise difference was positive compared to the negative difference. Additionally, the incidence of allergic disease increased by per interquartile range of night-time noise difference rate. The result showed that exposure to night-time noise tends to increase the risk of allergic disease. With further studies, the result of our study may serve as supplementary data when determining noise limits.
Stand Together by Staying Apart: Extreme Online Service-Learning during the Pandemic
Authors: Compare Christian , Albanesi Cinzia
Published: February 2022

Service-Learning (SL) is an experience that allows students to (a) participate in activities co-designed in partnership by universities and local organizations and (b) reflect on the service activity in such a way as to gain an enhanced sense of responsibility. These experiences represent significant ways to meet and experience real-world contexts for students. The COVID-19 pandemic required Higher Education Institutions to rethink and shift in-presence courses to online platforms. This transition included SL courses as well. This study aimed to explore the responsibility and democratic dimensions elicited by an extreme online Service-Learning (XE-SL) experience and the perceptions of engaging in exclusive online service activities with local communities during the COVID-19 Italian national quarantine. A qualitative driven mixed-method longitudinal approach was chosen to triangulate qualitative (reflexive journal) and quantitative (pre-post questionnaire) data from 20 university students. The findings shed a positive light on the capability of XE-SL to promote a sense of responsibility, civic engagement, and the acquirement of democratic and transferrable competencies, such as perspective-taking, adaptability, cultural background respect, global mindedness, teamwork, leadership, communication, creativity, and organizational competencies. Reflection, connection, and being agents of change for the community were perceived as the major assets of the XE-SL experience, while adapting face-to-face SL experiences to exclusively online activities evoked ambivalent feelings in students. The study suggests a rethinking of the design XE-SL and other forms of eSL with the inclusion of more structured interactive activities within community contexts to favor students’ sense of connection to the community organizations or NGOs.
Effect of Wastewater Treatment on Bacterial Community, Antibiotic-Resistant Bacteria and Endoparasites
Authors: Papajová Ingrid , Šmigová Júlia , Gregová Gabriela , Šoltys Jindřich , Venglovský Ján , Papaj Ján , Szabóová Tatiana , Dančová Nikola , Ihnacik Lukáš , Schusterová Ingrid , Sušinková Jana , Raková Jana , Regecová Ivana
Published: February 2022

Wastewater and wastewater treatment plants serve as urban reservoirs of pathogenic microorganisms. Wastewaters frequently contain bacteria, antibiotic-resistant bacteria, and developmental stages of parasites with significant zoonotic potential. Five wastewater treatment plants in the central part of Slovakia were investigated to determine the effect of treatment on bacterial community, antibiotic-resistant bacteria, and the occurrence of helminth eggs. Although all monitored chemical factors (chemical oxygen demand, biochemical oxygen demand, N-NH4, total nitrogen, and total phosphorus) in the effluent were in line with the legislative standards for discharge into public waterways, the results of minimal inhibitory concentrations show that reclaimed water harbors E. coli resistant to several commonly used antibiotics (ampicillin, piperacillin, and tazobactam, combine ampicillin and sulbactam, cefotaxime, tetracycline). The presence of endoparasite developmental stages in wastewater and sludge (Ascaris spp., Hymenolepis nana, eggs from the Ancylostomatidae family, Giardia duodenalis) indicates potential health risks for humans and workers at these sites. Treatment such as composting before applying sludge to land is necessary to reduce human pathogens.
The Ecological Dynamics Framework: An Innovative Approach to Performance in Extreme Environments: A Narrative Review
Authors: Seifert Ludovic , Hacques Guillaume , Komar John
Published: February 2022

(1) Background: Uncertainty in extreme sports performance environments, such as climbing, provides considerable psycho-emotional and physiological demands, notably due to the many different environments in which climbing can be performed. This variety of environments, conditions of practice and engagement would challenge the acquisition of perceptual-motor skills; (2) Methods: To better understand how perceptual-motor skills are controlled and acquired in climbing, we proposed a narrative review anchored in the ecological dynamics theoretical framework and showed how this theoretical framework would support a nonlinear pedagogy to skill acquisition and to design safe learning and training situations that are representative of extreme performance contexts; (3) Results: We explained three theoretical pillars and we provide examples for design intervention following nonlinear pedagogy, notably (i) to set a constraint-led approach (in particular task constraint), (ii) to implement conditions of practice (constant vs. variable, imposed vs. self-controlled), (iii) to promote adaptive and creative behavioral variability during practice; (4) Conclusions: The challenge for the extreme sport practitioner is how to set up conditions of practice for efficient exploration in a manner that manages the dangers of performing in uncertain environments. Representing uncertainty within the relative safety of indoor settings may be one approach for preparing climbers for performance in extreme environments.
Using a Combined Lean and Person-Centred Approach to Support the Resumption of Routine Hospital Activity following the First Wave of COVID-19
Authors: Daly Ailish , Teeling Sean Paul , Garvey Suzanne , Ward Marie , McNamara Martin
Published: February 2022

The unexpected advent of the COVID-19 pandemic led to a sudden disruption of routine medical care, with a subsequent reorganization of hospital structures and of care. Case studies are becoming available in the literature referring to the logistical difficulties involved in a hospital resuming normal activity following the first COVID-19 lockdown period. This paper details the experience of a study site, a private hospital in Dublin, Ireland, in the redesign of service delivery in compliance with new COVID-19 prevention regulations to facilitate the resumption of routine hospital activity following the first wave of COVID-19. The aim was to resume routine activity and optimize patient activity, whilst remaining compliant with COVID-19 guidelines. We employed a pre-/post-intervention design using Lean methodology and utilised a rapid improvement event (RIE) approach underpinned by person-centred principles. This was a system-wide improvement including all hospital staff, facilitated by a specific project team including the chief operation officer, allied therapy manager (encompassing health and social care professionals), infection prevention and control team, head of surgical services, clinical nurse managers, patient services manager and the head of procurement. Following our intervention, hospital services resumed successfully, with the initial service resumption meeting the organizational target of a 75% bed occupancy rate, while the number of resumed surgeries exceeded the target by 13%. Our outpatient visits recovered to exceed the attendance numbers pre-COVID-19 in 2019 by 10%. In addition, patient satisfaction improved from 93% to 95%, and importantly, we had no in-hospital patient COVID-19 transmission in the study period of July to December 2020.
Metabolic Treatment of Wolfram Syndrome
Authors: Iafusco Dario , Zanfardino Angela , Piscopo Alessia , Curto Stefano , Troncone Alda , Chianese Antonietta , Rollato Assunta Serena , Testa Veronica , Iafusco Fernanda , Maione Giovanna , Pennarella Alessandro , Boccabella Lucia , Ozen Gulsum , Palma Pier Luigi , Mazzaccara Cristina , Tinto Nadia , Miraglia del Giudice Emanuele
Published: February 2022

Wolfram Syndrome (WS) is a very rare genetic disorder characterized by several symptoms that occur from childhood to adulthood. Usually, the first clinical sign is non-autoimmune diabetes even if other clinical features (optic subatrophy, neurosensorial deafness, diabetes insipidus) may be present in an early state and may be diagnosed after diabetes’ onset. Prognosis is poor, and the death occurs at the median age of 39 years as a consequence of progressive respiratory impairment, secondary to brain atrophy and neurological failure. The aim of this paper is the description of the metabolic treatment of the WS. We reported the experience of long treatment in patients with this syndrome diagnosed in pediatric age and followed also in adult age. It is known that there is a correlation between metabolic control of diabetes, the onset of other associated symptoms, and the progression of the neurodegenerative alterations. Therefore, a multidisciplinary approach is necessary in order to prevent, treat and carefully monitor all the comorbidities that may occur. An extensive understanding of WS from pathophysiology to novel possible therapy is fundamental and further studies are needed to better manage this devastating disease and to guarantee to patients a better quality of life and a longer life expectancy.
Identifying Factors That Predict Behavioral Intention to Stay under Lockdown during the SARS-CoV-2 Pandemic Using a Structural Equation Model
Authors: Padilla-Bautista Joaquin Alberto , Galindo-Aldana Gilberto Manuel
Published: February 2022

Lockdown is considered to be a successful strategy for preventing the spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). To predict the behavioral intention to stay under lockdown (BIKL), components of the theory of planned behavior (TPB) and the behavioral indicators of infection were applied. Sampling was conducted between 11 April and 30 May 2020. The objective of the study was to identify factors predictive of BIKL by means of a structural equation model. Method: A correlational and comparative repeated measures study was conducted with a sample of 315 participants from different cities in Mexico. Results: Model indices were χ2 = 505.1, SD = 228, p < 0.001, χ2/SD = 2.2, CFI = 0.91, RMSEA = 0.06, and SRMR = 0.06; 47% of BIKL was explained by the variables attitude (β = 0.71, p < 0.001), subjective norm (β = 0.14, p = 0.042), and behavioral control (β = 0.24, p < 0.001). Conclusions: Personal and family work conviction and persuasion are favorable for the maintenance of lockdown, including concepts of civic responsibility, a positive attitude, and a family that supports compliance with lockdown. From a governmental point of view, there is a context that promotes control over the situation and exerts a positive impact on the behavioral intention to stay under lockdown.
Nurses’ Knowledge about Delirium in the Group of Intensive Care Units Patients
Authors: Krupa Sabina , Friganović Adriano , Oomen Ber , Benko Snježana , Mędrzycka-Dąbrowska Wioletta
Published: February 2022

Background: Intensive Care Unit (ICU) delirium is a nonspecific, potentially preventable, and often reversible disorder of impaired cognition, which results from various causes in ICU patients. For appropriate management of delirium, early identification and risk factor assessment are key factors. Multidisciplinary collaboration and standardized care can enhance the recognition of delirium. Design: In this study, authors used the exploratory and descriptive study method. Method: The study was conducted in a group of 45 nurses of the cardiac intensive care unit. The department has 16 intensive care stations and is intended for patients after cardiac surgery who require intensive care in the postoperative period. Results: During the analysis the interviews, five Collective Subject Discourses were distinguished: signs and symptoms, physical restraint, use of sedatives, environment, and lack of education. Conclusion: Nurses have no knowledge of the factors contributing to the development of delirium, are unable to communicate with such patients and, most of all, do not know the consequences of the actions taken.
Neurophysiologic Reactions during Heart Rate Variability Biofeedback Session in Adolescents with Different Risk of Internet Addiction
Authors: Demin Denis , Poskotinova Liliya
Published: February 2022

The aim of this study was to determine electroencephalogram (EEG) in a session of heart rate variability biofeedback (HRV BF) in adolescents with different Internet addiction (IA) risks. In total, 100 healthy adolescents aged 16–17 years with minimal risk of IA (Group I, 35%), pronounced risk of IA (Group II, 51%), and stable pattern of IA (Group III, 14%) using the Chen Internet Addiction Scale were examined. HRV and EEG parameters were determined at baseline (5 min), and then during the short-term HRV BF session (5 min), in order to increase the total power (TP, ms2) of the HRV spectrum. Against the background of an increase in the TP and a decrease in sympathetic activity, an increase in alpha EEG was revealed, especially in Groups I and II. The greatest increase in the power of beta1-activity of EEG in the frontal, central, and temporal brain regionswas found in Groups I and II. In adolescents with a pronounced risk of IA, HRV BF is accompanied by a severe activation of the brain systems, while in persons with a stable type of IA, the least brain reactivity is shown, especially in the beta1 EEG band.
Neural Mechanisms of Subliminal Mentor-Student Relationship Stimuli Processing: An ERP Study
Authors: Wu Yang , Luo Na , Zhang Yan
Published: February 2022

In educational contexts, mentorship roles often complicate the mentor-student relationship because mentors act not only as the closest academic ally of graduate students but also their program supervisors who can affect their timely graduation. This study examines how graduate students react to their mentors’ names when subliminally presented. A total of 63 graduate students (31 male; Mean Age = 23.450) were asked to perform an irrelevant color judgment task of valenced words (positive vs. negative relationship words) after a subliminal presentation of three different types of names (i.e., mentors, authorities, and friends). Results show that mentor and friend names elicit a greater P2 peak than authority names, whereas mentor names evoke a reduced N2 and P3 amplitude than friend and authority names. In addition, participants with a history of abusive supervision tend to have an overall decline in P2 amplitude. These event-related potential (ERP) findings suggest that mentors are perceived by students as familiar while attention-inducing figures.
A Successful Outcome of Veno-Venous Extracorporeal Membrane Oxygenation in Obese Patients with Respiratory Failure in the Course of COVID-19: A Report of Two Cases
Authors: Janc Jarosław , Łysenko Lidia , Lewandowska Olga , Chrzan Olimpia , Suchański Michał , Gemel Marek , Leśnik Patrycja
Published: February 2022

The use of extracorporeal membrane oxygenation (ECMO) in patients with respiratory failure in the course of COVID-19 indicates its limited efficacy and high mortality rates. It seems that one of the conditions for the success of veno-venous ECMO (VV ECMO) in obese patients with COVID-19 is the correct qualification and rapid implementation of this method. We present two cases of obese patients with acute respiratory distress syndrome (ARDS) as a result of SARS-CoV-2 infection with the successful use of ECMO. Two 41-year-old obese patients (Case 1: BMI 31.5 kg/m2 and Case 2: 44.5 kg/m2), with pneumonia and severe respiratory failure in the course of COVID-19, underwent ECMO therapy. The Extracorporeal Life Support Organization (ELSO) guidelines were used to qualify the patients. Due to the persistence of PaO2/FiO2 rate <80 for 6 h, a decision was made to implement VV ECMO. Both patients were discharged from the intensive care unit (Case 1: on day 35; Case 2: on day 22). Rapid implementation of VV ECMO in middle-aged, obese patients with ARDS in the course of COVID-19 showed a positive outcome.
Equity in Health-Seeking Behavior of Groups Using Different Transportations
Authors: Du Fangye , Wang Jiaoe , Liu Yu , Zhou Zihao , Jin Haitao
Published: February 2022

The equity of health-seeking behaviors of groups using different transportations is an important metric for health outcome disparities among them. Recently, smart card data and taxi trajectory data have been used extensively but separately to quantify the spatiotemporal patterns of health-seeking behavior and healthcare accessibility. However, the differences in health-seeking behavior among groups by different transportations have hitherto received scant attention from scholars. To fill the gap, this paper aimed to investigate the equity in health-seeking behavior of groups using different transportations. With sets of spatial and temporal constraints, we first extracted health-seeking behaviors by bus and taxi from smart card data and taxi trajectory data from Beijing during 13–17 April 2015. Then, health-seeking behaviors of groups by bus and taxi were compared regarding the coverage of hospital service areas, time efficiency to seek healthcare, and transportation access. The results indicated that there are inequities in groups using different travel modes to seek healthcare regarding the coverage of hospital service areas, time efficiency to seek healthcare, and transportation access. They provide some suggestions for mode-specific interventions to narrow health disparity, which might be more efficient than a one-size-fits-all intervention.
Trends in the Epidemiology and Outcomes of Pneumocystis Pneumonia among Human Immunodeficiency Virus (HIV) Hospitalizations
Authors: Elango Kalaimani , Mudgal Mayuri , Murthi Swetha , Yella Prashanth Reddy , Nagrecha Savan , Srinivasan Vedhapriya , Sekar Vijaykumar , Koshy Maria , Ramalingam Sathishkumar , Gunasekaran Kulothungan
Published: February 2022

Introduction: Pneumocystis Pneumonia (PCP) is a common opportunistic infection among people living with the human immunodeficiency virus (HIV). This study’s objective was to assess temporal trends in PCP epidemiology among hospitalized patients with HIV/AIDS in the US and to compare data for hospitalizations with HIV with PCP to those without PCP. Methods: The national inpatient sample (NIS) data were analyzed from 2002–2014. The discharge coding identified hospitalized patients with HIV or AIDS and with or without PCP. Results: We identified 3,011,725 hospitalizations with HIV/AIDS during the study period; PCP was present in 5% of the patients with a diagnosis of HIV. The rates of PCP progressively declined from 6.7% in 2002 to 3.5 % in 2014 (p < 0.001). Overall mortality in patients with HIV was 3.3% and was significantly higher in those with PCP than without PCP (9.9% vs. 2.9%; p < 0.001). After adjusting for demographics and other comorbidities, PCP had higher odds of hospital mortality 3.082 (OR 3.082; 95% CI, 3.007 to 3.159; p < 0.001). Conclusion: From 2002 to 2014, the rate of PCP in HIV patients has decreased significantly in the United States but is associated with substantially higher mortality.
Digitized Prenatal Newsletter: Impact on Obstetric Patient Satisfaction and Loyalty
Authors: Caballero-Galilea María , Martínez-Miguel Esther , Fernández Gonzalo Juan Carlos , Saiz de la Cuesta Abbad Ricardo , Rubio Alonso Margarita
Published: February 2022

The high demand for health information from pregnant women has encouraged the creation of an informative program through a weekly digital newsletter. The objective of this study is to evaluate its quality as a digital communication medium, in terms of satisfaction and loyalty to the pregnancy follow-up and delivery service. A cross-sectional, prospective study was carried out, surveying 179 patients by means of an online self-referral questionnaire including variables related to humanization, information needs, perceived accompaniment and satisfaction, as well as factors related to its influence on their decision to remain loyal to the center. A total of 81.2% of the participants showed high levels of satisfaction with the program. Satisfaction among nulliparous patients was significantly lower in several aspects. The resolution of doubts and the perception of peace of mind following the information received was positive for 54.8%. Of the patients in the program, 88.8% finally remained at the center, showing a strong influence of the program on their decision (mean value 75 on 1 to 100 scale). A weekly digital newsletter with specific information reduced the demand for information from pregnant women, generating high levels of satisfaction and positively influencing the decision to remain loyal to the Center.
The Study of Variation of Metabolites by Sleep Deficiency, and Intervention Possibility of Aerobic Exercise
Authors: Park Jong-Suk , Kim Young-Jun , Heo Wan , Kim Sangho
Published: February 2022

The purpose of this study is to determine the difference in sleep-related factors and metabolites between normal sleep (NS) and sleep deficiency (SD) and to analyze the variations in metabolites according to the intensity of aerobic exercise under SD conditions. This study was conducted on 32 healthy male university students. Participants experienced both NS (8 h of sleep per night for 3 consecutive days) and SD (4 h of sleep per night for 3 consecutive days). After the SD period, the participants underwent treatment for 30 min by the assigned group [sleep supplement after SD (SSD), low-intensity aerobic exercise after SD (LES), moderate-intensity aerobic exercise after SD (MES), high-intensity aerobic exercise after SD (HES)]. For analysis, sleep-related factors were measured, and metabolites were analyzed by untargeted metabolite analysis using gas chromatography-time-of-flight mass spectrometry. As a result, SD showed that total sleep time (TST), duration of rapid eye movement (REM), duration of light sleep, and duration of deep sleep were significantly decreased compared to NS, whereas the Pittsburgh sleep quality index (PSQI), Epworth sleepiness scale (ESS), and visual analogue scale (VAS) were significantly increased compared to NS. The difference in metabolites between NS and SD showed that there were significant changes in the seven metabolites. There were 18 metabolites that changed according to the treatment groups in SD conditions. In summary, SD can exacerbate sleep quality, induce daytime sleepiness, increase fatigue, and increase metabolites that cause insulin resistance. Aerobic exercise under SD conditions can reduce metabolites that induce insulin resistance and increase the metabolites that help relieve depression caused by SD. However, HES has a negative effect, which increases fatigue, whereas LES has no negative effect. Thus, this study suggests that LES is the most appropriate exercise method under SD conditions.
Healthcare Professional Students’ Perspectives on Substance Use Disorders and Stigma: A Qualitative Study
Authors: Cernasev Alina , Kline Kiki M. , Barenie Rachel Elizabeth , Hohmeier Kenneth C. , Stewart Steven , Forrest-Bank Shandra S.
Published: February 2022

Background: Access to and quality of care for Substance Use Disorders (SUDs) remain a major public health issue. Stigma associated with SUDs contributes to the gap between the number of patients who need treatment and the much smaller fraction that receive it. Healthcare professional students are future care providers; an opportunity exists to characterize their collective perspectives on patients with SUDs and how that informs the care they provide. Methods: Healthcare professional students participated in online, semi-structured focus group (FGs) between March and April 2021. The FGs were conducted until thematic saturation was achieved. All verbatim transcripts were analyzed applying Thematic Analysis using Dedoose® qualitative software. Inductive codes were grouped into categories based on similarities that facilitated the emergence of themes. Results: Thematic Analysis revealed one theme (1) Decreasing stigma among healthcare professionals by viewing substance use disorder as a disease; and two sub-themes: Subtheme 1a: Relating with the patients, “It could be me…”; Subtheme 1b: Interactions with patients, “We just don’t know exactly how to counsel these patients…” These themes describe how future healthcare professionals might perceive and approach patients with SUDs and highlight the importance of SUD training in the curriculum. Conclusion: Medical and pharmacy students are uniquely positioned to apply critical thinking from their didactic training to their real-world clinical experiences, and their collective perspectives inform gaps in training and opportunities to develop best practices for SUD care. An opportunity exists to leverage these findings in order to train future healthcare professionals to ensure access to and quality of SUD care.
Gastronomy Tourism and Well-Being: Evidence from Taiwan and Catalonia Michelin-Starred Restaurants
Authors: Lin Min-Pei , Marine-Roig Estela , Llonch-Molina Nayra
Published: February 2022

In the tourism and hospitality industry, ensuring the well-being of visitors is essential to achieving a competitive tourist destination. This objective is even more pressing in the gastronomy sector. Surprisingly, the scientific literature on this topic is scarce and relies on questionnaire surveys and interviews as a data source. After scrutinizing the 13 articles on gastronomy tourism and well-being indexed in the Web of Science or in Scopus, this study proposes two new lines of research interrelated by the concept of gastronomic image. These exploit the content shared online by consumers in order to assess subjective well-being derived from quality gastronomic experiences. The first is a framework for the customer-perceived image based on Grönroos’s service quality model, and the second is a conceptual model based on Morris’s semiotics to measure gastronomic image. Through mixed methodologies, i.e., qualitative in the first research line and quantitative in the second, the study applies the theoretical framework to Michelin-starred restaurants in two tourist regions with similar features but with different gastronomic cultures—Taiwan (Asia) and Catalonia (Europe)—using as a data source all the online travel reviews (OTRs) written in English about these restaurants shared on the TripAdvisor portal. Comparing the three categories of restaurants in both regions, the results show branding and marketing problems and significant differences in the popularity of restaurants and the satisfaction and well-being of diners. There is a positive relationship between the category of restaurants according to the number of Michelin stars and their popularity according to the number of OTRs, as well as with the satisfaction and well-being of diners, except for a 3-star restaurant that is the worst-rated. These outcomes from the demand side can be useful to stakeholders to design or improve gastronomic products and services.
Stress and Distress during the COVID-19 Pandemic: The Role of Neighborhood Context
Authors: Kondo Michelle C. , Felker-Kantor Erica , Wu Kimberly , Gustat Jeanette , Morrison Christopher N. , Richardson Lisa , Branas Charles C. , Theall Katherine P.
Published: February 2022

Neighborhoods play a central role in health and mental health, particularly during disasters and crises such as the COVID-19 pandemic. We examined changes in psychological distress following the pandemic, and the potential role of neighborhood conditions among 244 residents of New Orleans, Louisiana. Using modified linear regression models, we assessed associations between neighborhood characteristics and change in psychological distress from before to during the pandemic, testing effect modification by sex and social support. While higher density of offsite alcohol outlets (β = 0.89; 95% CI: 0.52, 1.23), assault rate (β = 0.14; 95% CI: 0.03, 0.24), and walkable streets (β = 0.05; 95% CI: 0.02, 0.07) in neighborhoods were associated with an increase in distress, access to neighborhood parks (β = −0.03; 95% CI: −0.05, −0.01), collective efficacy (β = −0.23; 95% CI: −0.35, −0.09), and homicide rate (β = −1.2; 95% CI: −1.8, −0.6) were associated with reduced distress related to the pandemic. These relationships were modified by sex and social support. Findings revealed the important but complicated relationship between psychological distress and neighborhood characteristics. While a deeper understanding of the neighborhoods’ role in distress is needed, interventions that target neighborhood environments to ameliorate or prevent the residents’ distress may be important not only during crisis situations.