bluuebunny/crossref_metadata_2025 huggingface dataset:
Interactions between Environmental Factors and Glutathione S-Transferase (GST) Genes with Respect to Detectable Blood Aluminum Concentrations in Jamaican Children
Authors: Rahbar Mohammad H. , Samms-Vaughan Maureen , Zhao Yuansong , Saroukhani Sepideh , Bressler Jan , Hessabi Manouchehr , Grove Megan L. , Shakespeare-Pellington Sydonnie , Loveland Katherine A.
Published: October 2022

Aluminum (Al) is a metallic toxicant at high concentrations following natural or unnatural exposures. Dietary intake is considered as the main source of aluminum exposure in children. We used data from 366 typically developing (TD) children (ages 2–8 years) who participated as controls in an age- and sex-matched case–control study in Jamaica. We investigated additive and interactive associations among environmental factors and children’s genotypes for glutathione S-transferase (GST) genes (GSTT1, GSTM1, GSTP1), in relation to having a detectable blood aluminum concentration (BAlC) of >5.0 μg/L, using multivariable logistic regression models. Findings from interactive models revealed that the odds of having a detectable BAlC was significantly higher among children who ate string beans (p ≤ 0.01), whereas about 40% lower odds of having a detectable BAlC was observed in children with higher parental education level, (p = 0.02). A significant interaction between consumption of saltwater fish and GSTP1 in relation to having a detectable BAlC using either co-dominant or dominant genetic models (overall interaction p = 0.02 for both models) indicated that consumption of saltwater fish was associated with higher odds of having a detectable BAlC only among children with the GSTP1 Ile105Val Ile/Ile genotype using either co-dominant or dominant models [OR (95% CI) = 2.73 (1.07, 6.96), p = 0.04; and OR (95% CI) = 2.74 (1.08, 6.99), p = 0.03]. Since this is the first study from Jamaica that reports such findings, replication in other populations is warranted.
Multilocus Phylogeography and Population Genetic Analyses of Opsariichthys hainanensis Reveal Pleistocene Isolation Followed by High Gene Flow around the Gulf of Tonkin
Authors: Wang Junjie , Zhang Wenjun , Wu Jinxian , Li Chao , Ju Yu-Min , Lin Hung-Du , Zhao Jun
Published: October 2022

The ichthyofauna of continental islands is characterized by immigration through a land bridge due to fluctuating sea levels. Hainan Island is adjacent to the southern margin of mainland China and provides opportunities for understanding the origin and diversification of freshwater fishes. The aim of our study was to evaluate the level of genetic variation and phylogeographic structure of Opsariichthys hainanensis on Hainan Island and mainland China, using mtDNA cyt b gene (1140 bp) and D-loop (926 bp), nuclear RAG1 gene (1506 bp), and 12 microsatellite loci. Mitochondrial phylogenetic analysis identified five major lineages according to the geographical distribution from different populations. We suggested that two dispersal events occurred: the population in the Changhua River migrated to the Red River (Lineage B), and the populations in the South Hainan region moved northwards to the North Hainan region. However, populations in Northwest Hainan Island dispersed to the populations around the Gulf of Tonkin (Lineage A1) and populations in Northeast Hainan Island dispersed to the populations in mainland China (Lineage A2). Our results indicated that the populations of O. hainanensis suffered a bottleneck event followed by a recent population expansion supported by the ABC analysis. We suggest that O. hainanensis populations were found mostly in the lowlands and a lack of suitable freshwater habitat in southern mainland China and Hainan during the Last Interglacial period, and then expansion occurred during the Last Glacial Maximum.
Integrated Metabolite and Transcriptome Profiling-Mediated Gene Mining of Sida cordifolia Reveals Medicinally Important Genes
Authors: Padmanabhan Deepthi , Natarajan Purushothaman , Palanisamy Senthilkumar
Published: October 2022

Sida cordifolia is a medicinal shrub that is conventionally used in the Indian system of medicine;however, the genes contributing to its medicinal properties have been minimally explored, thus limiting its application. High-throughputsequencing and Liquid Chromatography with tandem mass spectrometry(LC-MS/MS) technologies were applied to unravel the medicinally important bioactive compounds. As a result, transcriptomic sequencing generated more than 12 GB of clean data, and 187,215 transcripts were obtained by de novoassembly. These transcripts were broadly classified into 20 classes, based on the gene ontology classification, and 6551 unigenes were annotated using Kyoto Encyclopedia of Genes and Genomes (KEGG) database with more than 142 unigenes involved in the biosynthesis of secondary metabolites. LC-MS/MS analysis of three tissues of Sida cordifolia revealed that acacetin and procyanidin are some important metabolites identified thatcontribute to its medicinal value. Several key enzymes witha crucial role in phenylpropanoid and flavonoid biosynthetic pathways were identified, especially phenylalanine ammonia lyase, which might be an important rate-limiting enzyme. Real-Time Quantitative Reverse Transcription Polymerase chain reaction (qRT-PCR) analysis revealed enzymes, such as Phenylalanine ammonia lyase (PAL), Cinnamyl alcohol dehydrogenase 1 (CAD), Cinnamoyl-CoA reductase 1 (CF1) and Trans cinnamate 4-monooxygenase(TCM), which were predominantly expressed in root compared to leaf and stem tissue. The study provides a speculative insight for the screening of active metabolites and metabolic engineering in Sida cordifolia.
Selection Signature and CRISPR/Cas9-Mediated Gene Knockout Analyses Reveal ZC3H10 Involved in Cold Adaptation in Chinese Native Cattle
Authors: Wang Luyu , Gao Yaping , Wang Jinpeng , Huang Ning , Jiang Qiang , Ju Zhihua , Yang Chunhong , Wei Xiaochao , Xiao Yao , Zhang Yaran , Yang Ling , Huang Jinming
Published: October 2022

Cold stress is an important factor affecting cattle health, production performance, and reproductive efficiency. Understanding of the potential mechanism underlying genetic adaptation to local environments, particularly extreme cold environment, is limited. Here, by using FLK and hapFLK methods, we found that the Zinc finger CCCH-type containing 10 (ZC3H10) gene underwent positive selection in the Menggu, Fuzhou, Anxi, and Shigatse humped cattle breeds that are distributed in the cold areas of China. Furthermore, ZC3H10 expression significantly increased in bovine fetal fibroblast (BFF) cells at 28 °C for 4 h. ZC3H10 knockout BFFs were generated using CRISPR/Cas9. Wild and ZC3H10-deleted BFFs were treated at two temperatures and were divided into four groups (WT, wild and cultured at 38 °C; KO, ZC3H10−/− and 38 °C; WT_LT, wild, and 28 °C for 4 h; and KO_LT, ZC3H10−/− and 28 °C for 4 h. A total of 466, 598, 519, and 650 differently expressed genes (two-fold or more than two-fold changes) were identified by determining transcriptomic difference (KO_LT vs. KO, WT_LT vs. WT, KO vs. WT, and KO_LT vs. WT_LT, respectively). Loss of ZC3H10 dysregulated pathways involved in thermogenesis and immunity, and ZC3H10 participated in immunity-related pathways induced by cold stress and regulated genes involved in glucose and lipid metabolism and lipid transport (PLTP and APOA1), thereby facilitating adaptability to cold stress. Our findings provide a foundation for further studies on the function of ZC3H10 in cold stress and development of bovine breeding strategies for combatting the influences of cold climate.
Evaluation of Mean Percentage of Full-Length SMN Transcripts as a Molecular Biomarker of Spinal Muscular Atrophy
Authors: Maretina Marianna , Egorova Anna , Lanko Kristina , Baranov Vladislav , Kiselev Anton
Published: October 2022

The elevation of SMN transcript and protein level remains the principal aim of SMA therapy. Still, there is no standard molecular biomarker for the assessment of its efficacy. In the current study, we tested three methods of SMN transcript level measurement using real-time RT-PCR, quantitative fluorescent RT-PCR, and a semiquantitative RT-PCR gel densitometric assay. We examined several potential mRNA-based biomarkers and examined their sensitivity and reliability by comparing the obtained values in peripheral blood mononuclear cells of SMA patients, SMA carriers, and healthy individuals. We found that the mean percentage of full-length (FL-SMN) transcripts relative to the total sum of FL-SMN and exon 7-deleted (Δ7 SMN) transcripts detected by semiquantitative and quantitative fluorescence RT-PCR differed significantly between the three analyzed groups. The relevance of this biomarker was proven in an SMN2-targeting therapeutic experiment. We showed that the values of the biomarker changed significantly in SMA fibroblast cell cultures after treatment with therapeutic antisense oligonucleotides targeting the ISS-N1 site in intron 7 of the SMN2 gene. The obtained results indicate the convenience of using the mean percentage of FL-SMN transcripts determined by semiquantitative and quantitative fluorescence RT-PCR as a putative biomarker for the assessment of SMA therapy efficacy in vitro.
Climate Pessimism and Human Nature
Authors: Higgins David
Published: October 2022

This article builds on scholarship that understands climate change not only as a geophysical phenomenon, but also as a complex idea. It argues for a historicised analysis of what it terms “climate pessimism”: the belief that catastrophic global heating cannot be prevented. Focusing especially on nonfictional texts by Jonathan Franzen and Roy Scranton, it suggests that climate pessimism draws on a Western intellectual tradition that takes a sceptical view of human capacities and the possibility of progress. At the same time, climate pessimism tends to evoke an idea of atomised human nature associated with capitalistic modernity. Franzen draws on ideas from evolutionary psychology in a rather simplistic way. Scranton, a more complex thinker, engages not only with Buddhist thought but also with the philosophies of Benedict Spinoza and Arthur Schopenhauer. Although often criticised as a “doomer”, he sometimes moves towards an epistemological pluralism and sense of human potentiality. The concluding section brings in the concept of the pluriverse as both a corrective to climate pessimism’s tendency to Westerncentrism, and a point of connection to Scranton’s work.
Mutual Role Expectations by Patients and General Practitioners—A Mixed Methods Study on Complementarity
Authors: Plagg Barbara , Engl Adolf , Piccoliori Giuliano , Atz Hermann , Becker Ulrich , Kiem Johann , Barbieri Verena , Eisendle Klaus , Wiedermann Christian Josef , Elsen Susanne Ursula , Lorenz Walter August
Published: October 2022

Background: Changes in public attitudes toward “authorities” in general, as well as shifts in medical practice toward participative models of diagnosis and treatment, imply fundamental transformations in the patient–doctor relationship. However, consistency in reciprocal role expectations cannot be assumed, and this study reveals significant discrepancies in attitudes and behaviors in primary health consultations. Methods: We conducted a study in the tri-lingual northeastern Italian region of South Tyrol to determine whether perceptions of the patient’s role were congruent or differed. In a mixed method approach, the quantitative research part consisted of a survey with 34 identical questions for general practitioners (n = 109) and adult primary care patients (n = 506) on verbal communication, self-initiative and health literacy, interpersonal and social qualities of the patient–physician relationship, and formal aspects of the consultation. Patients were interviewed via telephone, and general practitioners responded online. In the qualitative part, 26 semi-structured in-depth interviews were conducted with the patients and analyzed. Results: General practitioners considered patients’ communicative efforts (p < 0.001), self-initiative (p < 0.001), compliance (p = 0.0026), and openness regarding psychosocial issues (p < 0.001) to be significantly more important, whereas patients showed a tendency to give increased importance to formal aspects such as politeness and hygiene (p < 0.001). Perception of the patient’s role differed significantly between the Italian and German linguistic groups. Conclusions: Patients and general practitioners differ in their understanding of patients’ roles. These data suggest that a considerable proportion of the population lacks a clear and tangible idea of the active role they could play in consultations. Targeted information on the identified aspects of patient–provider communication may facilitate participatory behavior and positively impact the longitudinal quality of the patient–general practitioner relationship.
Unmanned Aerial Vehicle in the Logistics of Pandemic Vaccination: An Exact Analytical Approach for Any Number of Vaccination Centres
Authors: Benayad Adnan , Malasse Olaf , Belhadaoui Hicham , Benayad Noureddine
Published: October 2022

While the development and manufacture of pandemic vaccines is a daunting task, the greatest challenge lies in how to deliver these vaccines to billions of people around the world. This requires an efficient strategy of deliveries, at constrained costs and deadlines. This paper proposes an exact analytical approach and operational strategy to the logistics of any pandemic vaccination efforts, applicable both to sparsely populated areas or deficient infrastructure, and to very dense urban fabrics where mobility is highly constrained. Our strategy consists in dividing the territory concerned into zones and districts in a concentric way. We opt for the use of unmanned aerial vehicles to free ourselves from land constraints. This involves serving, from a logistics centre (central depot), any number n of vaccination centres, while optimizing costs and deadlines. We have determined all equivalent and optimal flight path plans for a fixed and optimal number of drones, which depend on domain D(d); d being the demand of vaccination centers. The analysis of the results led us to define what we will call the “degeneracy of domain D”. All our results are expressed as a function of the parameter n.
In Vitro Floral Emergence and Improved Formation of Saffron Daughter Corms
Authors: Dewir Yaser Hassan , Alsadon Abdulla , Al-Aizari Ahmed Ali , Al-Mohidib Mohaidib
Published: October 2022

In vitro cormogenesis is a potential tool for improving saffron production under controlled conditions. In this study, the effects of explant type, culture type, and medium supplements on saffron daughter corm formation in vitro were assessed. Saffron flowers emerged 30 days after culture, and the sizes of in-vitro- and ex-vitro-produced flowers and stigmas were similar. In vitro daughter corm formation and the saffron life cycle was completed after 10 and 14 weeks of culture, respectively. Using in vitro intact corms was more effective for corm production than using apical buds. Compared with apical bud explants, mother corm explants produced more corms with a higher fresh weight and diameter. Compared with solid culture, liquid cultures using bioreactors provided corms with a higher fresh weight and diameter, regardless of explant type. An ebb and flow system provided the highest cormlet fresh weight and diameter but the fewest cormlets, whereas an immersion system provided more cormlets with a smaller size. Saffron apical buds cultured with salicylic acid at 75 mg L−1 or glutamine at 600 mg L−1 exhibited the highest cormlet diameter and fresh weight. These findings will improve the process of in vitro cormogenesis and the production of saffron under controlled conditions.
Antecedents of Self-Efficacy to Achieve Smoking-Behavior-Change Goals among Low-Income Parents Enrolled in an Evidence-Based Tobacco Intervention
Authors: Baishya Mona L. , Collins Bradley N. , Lepore Stephen J.
Published: October 2022

Previous studies have shown that greater self-efficacy (SE) to modify smoking behaviors during treatment improves long-term post-treatment outcomes. Little is known about factors that might enhance SE for smoking abstinence and for reducing children’s tobacco smoke exposure (TSE). The present study investigated hypothesized predictors of end-of-treatment SE to abstain from smoking and to protect children from TSE by conducting secondary multiple regression analyses of data (N = 327) from the Kids Safe and Smokefree (KiSS) behavioral intervention trial. KiSS aimed to reduce parental smoking and child TSE in urban, low-income, and minority communities. The results showed that partner support and initiating a planned quit attempt during treatment were positively related to SE to abstain from smoking and to reduce children’s TSE (all p’s < 0.001) at the end of treatment (EOT). Further, lower baseline nicotine dependence and the use of nicotine replacement were related to higher SE to abstain from smoking at EOT (p < 0.01), whereas more restrictive residential smoking rules and lower children’s TSE at baseline was associated with higher SE to reduce children’s TSE at EOT (all p’s < 0.05). These findings inform theory and future intervention design, identifying individual and social-environmental factors that might enhance smoking-behavior-change SE.
Krill Oil Supplementation Does Not Change Waist Circumference and Sagittal Abdominal Diameter in Overweight Women: A Pilot Balanced, Double-Blind, and Placebo-Controlled Clinical Trial
Authors: Lobo Patrícia C. B. , Roriz Letícia N. , Siqueira Jéssika M. , Giglio Bruna M. , Marini Ana C. B. , Corgosinho Flávia C. , Schincaglia Raquel M. , Pimentel Gustavo D.
Published: October 2022

An excess of body fat is one of the biggest public health concerns in the world, due to its relationship with the emergence of other health problems. Evidence suggests that supplementation with long-chain polyunsaturated fatty acids (omega-3) promotes increased lipolysis and the reduction of body mass. Likewise, this clinical trial aimed to evaluate the effects of supplementation with krill oil on waist circumference and sagittal abdominal diameter in overweight women. This pilot, balanced, double-blind, and placebo-controlled study was carried out with 26 women between 20 and 59 years old, with a body mass index >25 kg/m2. The participants were divided into the control (CG) (n = 15, 3 g/daily of mineral oil) and krill oil (GK) (n = 16, 3 g/daily of krill oil) groups, and received the supplementation for eight weeks. Food intake variables were obtained using a 24 h food recall. Anthropometric measurements (body mass, body mass index, waist circumference, and sagittal abdominal diameter) and handgrip strength were obtained. After the intervention, no changes were found for the anthropometric and handgrip strength variables (p > 0.05). Regarding food intake, differences were found for carbohydrate (p = 0.040) and polyunsaturated (p = 0.006) fatty acids, with a reduction in the control group and an increase in krill oil. In conclusion, supplementation with krill oil did not reduce the waist circumference and sagittal abdominal diameter. Therefore, more long-term studies with a larger sample size are necessary to evaluate the possible benefits of krill oil supplementation in overweight women.
The Causes and Role of Antinatalism in Poland in the Context of Climate Change, Obstetric Care, and Mental Health
Authors: Karuga Filip Franciszek , Szmyd Bartosz , Petroniec Karolina , Walter Aleksandra , Pawełczyk Agnieszka , Sochal Marcin , Białasiewicz Piotr , Strzelecki Dominik , Respondek-Liberska Maria , Tadros-Zins Monika , Gabryelska Agata
Published: October 2022

Antinatalism is an umbrella term for numerous moral dilemmas associated with procreation. In the past few years, the deterioration of environmental conditions, social difficulties, global worsening of people’s mental health, and pandemics have induced discussion about antinatalism. Therefore, we aimed to characterize antinatalists in the Polish population in terms of the frequency and description of the main reasons behind this phenomenon. The cross-sectional study was performed in the Polish population. An online, four-part survey was performed between 19 and 25 January 2022. The study group comprised 1240 respondents. Antinatalists (n = 472, 38%) were defined as people who do not have children and want to be childless in the future, whereas pronatalists (n = 768, 62%) consisted of people who want to have offspring in the future and/or already have children. The opinion that climate change is a significant reason not to have a child appeared twice as often among antinatalists. Additionally, the performed binary logistic regression model highlighted the importance of the fear of climate change as an independent factor facilitating an antinatalistic attitude. Regarding females, the following factors discouraging them from having a child were observed: fear of child’s congenital diseases, pregnancy complications, dissatisfaction with medical services, and fear of exacerbation of maternal chronic diseases. Anxiety, depression, and stress were not found to be statistically different between pro- and antinatalist groups. However, further analysis revealed that female antinatalists were significantly more depressive and anxious. Our study helps us to understand why, as mentioned beforehand, around 38% of respondents prefer to stay childless. In conclusion, antinatalism views have become relatively prevalent in society, and its reasons include environmental antinatalism and medical factors, including depression and anxiety. However, better access to medical services and changes in climate politics were not found to be significant factors in encouraging society to decide to have offspring.
Changes in Alcohol Consumption among Different Population Groups during the SARS-CoV-2 Pandemic: Outcomes of the Slovenian Cross-Sectional National Survey (SI-PANDA)
Authors: Radoš Krnel Sandra , Roškar Maja , Hovnik Keršmanc Marjetka , Rehberger Maruša , Levičnik Gorazd , Hočevar Grom Ada
Published: October 2022

Background: Slovenia ranks amongst the countries with the highest recorded alcohol consumption. The mortality rate attributed to alcohol-related causes of death in Slovenia also exceeds the EU average. The aim of our research was to confirm the changes in alcohol consumption in Slovenia during the SARS-CoV-2 virus pandemic on a representative sample and to identify vulnerable groups at higher risk of increasing alcohol consumption. Methods: Two consecutive data collections of the National Survey on the Impact of the Pandemic on Life, each in different epidemiological situations, were conducted. A structured questionnaire was used to monitor the number of alcoholic beverages consumed during the pandemic, compared to the time before the pandemic. Results: The majority of the population did not change the number of alcoholic beverages consumed, and among those with changes, there were significantly more of those who drank less than those who drank more. Among respondents who drank a greater number of alcoholic beverages, statistically significantly higher proportions were found in younger age groups, people with post-secondary vocational education or higher, and people with a higher probability of mental health problems. Conclusions: During the pandemic crisis, we need to pay special attention to vulnerable groups that are at higher risk of increasing alcohol use.
Quantitative Measurement of the Pressure and Shear Stress Acting on the Body of a Wheelchair User Using a Wearable Sheet-Type Sensor: A Preliminary Study
Authors: Shirogane Satoshi , Toyama Shigeru , Hoshino Motonori , Takashima Atsushi , Tanaka Toshiaki
Published: October 2022

To provide a safer sitting environment for wheelchair users, it is important to quantitatively measure the forces acting on the contact surface between the seat and the person in the wheelchair. In addition to the pressure acting on the buttocks, shear forces have received particular attention in recent years; however, measuring shear force is more difficult than measuring pressure. To obtain this measurement, a thin and flexible sensor that can be used in a natural state on a wheelchair is needed. Therefore, we constructed a measurement system using our previously developed wearable sheet-type sensor (0.9 mm thick). In this study, preliminary tests were conducted using human dummies before testing on humans. Sensors were placed in four locations on the humanoid dummy’s back and buttocks, and the electric wheelchair was tilted and reclined five times each. The results showed that the sensor output pattern was reproducible and valid enough to proceed to the next step. However, the shear force in the internal and external directions was greater than expected, which indicates that the equipment and testing methods must be reviewed. On the basis of the results obtained in this preliminary study, preparations will be made for testing on human subjects.
Latin American Youths’ Migration Journeys and Settlement in the Tarapacá Region in Chile: Implications for Sexual and Reproductive Health
Authors: Obach Alexandra , Carreño Alejandra , Sadler Michelle
Published: October 2022

The sexual and reproductive health of young migrants has not been sufficiently addressed in mobility studies. In this article, we dwell on some aspects of this issue in the migration process of Latin American youth. We conducted a qualitative study in the region of Tarapacá, Chile, carrying out in-depth interviews with key informants, health staff and young migrants between 18 and 25 years old. The results show some motivations to migrate related to sexual and reproductive health: young pregnant women, LGBTQI+ and HIV-positive people seeking access to health care and social contexts of reduced gender discrimination. During the migration process, young people are exposed to various kinds of sexual violence, and in their settlement in Chile, to situations of racism, stigma and discrimination in society as a whole and in access to and during sexual and reproductive health care. Health care for young migrants is mainly focused on maternal care and reproductive issues, while sexual health as a whole is disregarded. We argue that sexual health must be addressed as a central dimension of the lived experiences of young migrants, and that the social, cultural and structural factors that undermine their sexual and reproductive health must be addressed in order to provide culturally competent health services.
Review of Use Prevalence, Susceptibility, Advertisement Exposure, and Access to Electronic Nicotine Delivery Systems among Minorities and Low-Income Populations in the United States
Authors: Addo Ntim Susana , Martin Bria , Termeh-Zonoozi Yasmin
Published: October 2022

Increased use of electronic nicotine delivery systems (ENDS) and improper disposal after use pose a public health and an environmental justice (EJ) concern if use prevalence is disproportionately high among minorities and people of low socioeconomic status (SES) (broadly termed “EJ populations” for the purposes of this review). This review synthesizes literature on demographic patterns of use prevalence, susceptibility, advertisement exposure, and access to ENDS, and extrapolates environmental tobacco exposure (ETE) from ENDS among EJ populations. Seven electronic databases were searched using ENDS-related terms. We included studies published between 2017 and May 2020 that described ENDS use prevalence, susceptibility to ENDS use, advertisement exposure, and access to ENDS by race, ethnicity, or SES. Data synthesis was based on the assumptions that ETE increases with high use prevalence, susceptibility may influence future use, and advertisement exposure and access may impact demographic differences in use. We identified 32 studies describing use prevalence, susceptibility, advertisement exposure, or access to vape shops and other tobacco retail outlets by race/ethnicity or SES. We found higher prevalence of ENDS use among non-Hispanic Whites and inconclusive use patterns by SES. Patterns of susceptibility to use, advertisement exposure, and access were also mixed, with slightly higher outcomes observed among low SES youth. However, the evidence base on advertisement exposure was limited, with limited generalizability. Our findings indicate low prevalence of ENDS use among EJ populations. While this suggests low potential ETE among these groups, mixed outcomes on susceptibility, advertisement exposure, and access to ENDS among low SES groups may affect future ENDS use and ETE. Educational campaigns that discourage ENDS uptake should target EJ youth. Initiatives aimed at managing vape shop presence in EJ communities and monitoring targeted advertisement are also needed.
Nurses’ Perception of, and Barriers to, Delivering Cardiopulmonary Rehabilitation for Heart Failure Patients: A National Survey in Saudi Arabia
Authors: Aldhahir Abdulelah M.
Published: October 2022

Background: Heart failure (HF) patients require a holistic management approach to improve their clinical outcomes. Cardiopulmonary rehabilitation (CR) is a core component of HF patients’ management and is supervised by a multidisciplinary team including nurses. Nursing attitudes regarding CR delivery for patients with HF and the possible barriers and factors that potentially affect referral have not been explored. Therefore, this study seeks to evaluate nurses’ attitudes towards the delivery of CR programs and the possible barriers and factors that potentially influence the decision for a referral. Methods: An online survey with eight multiple-choice items was disseminated to all nurses between February and July 2022 in Saudi Arabia. The characteristics of the respondents were described using descriptive statistics. Percentages and frequencies were used to report categorical variables. Results: Overall, 1056 nurses completed the online survey, of which 395 (37.40%) were male. Out of 1056 nurses, 414 (39.20%) strongly agreed that CR would improve patients’ physical fitness, and 392 (37.10%) strongly agreed that CR would reduce breathlessness in patients with HF. In total, 381 nurses strongly agreed (36.10%) that CR would improve HF patients’ palpitation and fatigue. Out of 1056 nurses, 396 (37.50%) strongly agreed that CR would improve HF patients’ ability to perform daily activities, and 326 (30.90%) strongly agreed that CPR would reduce the rate of hospital readmission. The at-home program was the preferred mode of delivering CR programs among 607 (57.50%) nurses. Apart from the exercise component, symptom management was perceived by 704 (66.70%) nurses as the fundamental component of CR programs. The most common patient-related factor that strongly affected the decisions regarding referral was “mobility affected by breathlessness” (57%). A lack of CR centers (46%) was the most common barrier. Conclusion: Nurses perceived CR as an effective management strategy for HF patients. Although a home-based program, with symptom management being an essential component, in addition to the exercise component, was perceived as the preferred mode of delivery, CR centers are lacking, which represented a significant barrier to CR referral from the nurses’ perspective.
Intra- and Interrater Reliability of Short-Term Measurement of Heart Rate Variability on Rest in Individuals Post-COVID-19
Authors: Almeida Lucivalda Viegas de , Santos-de-Araújo Aldair Darlan , Cutrim Rodrigo Costa , Tavarez Rudys Rodolfo de Jesus , Borghi-Silva Audrey , Pereira Fábio Henrique Ferreira , Pontes-Silva André , Rêgo Adriana Sousa , Rocha Daniel Santos , Marinho Renan Shida , Dibai-Filho Almir Vieira , Bassi-Dibai Daniela
Published: October 2022

Individuals affected by COVID-19 have an alteration in autonomic balance, associated with impaired cardiac parasympathetic modulation and, consequently, a decrease in heart rate variability (HRV). This study examines the inter- and intrarater reliability of HRV) parameters derived from short-term recordings in individuals post-COVID. Sixty-nine participants of both genders post-COVID were included. The RR interval, the time elapsed between two successive R-waves of the QRS signal on the electrocardiogram (RRi), were recorded during a 10 min period in a supine position using a portable heart rate monitor (Polar® V800 model). The data were transferred into Kubios® HRV standard analysis software and analyzed within the stable sessions containing 256 sequential RRi. The intraclass correlation coefficient (ICC) ranged from 0.920 to 1.000 according to the intrarater analysis by Researcher 01 and 0.959 to 0.999 according to the intrarater by Researcher 02. The interrater ICC ranged from 0.912 to 0.998. The coefficient of variation was up to 9.23 for Researcher 01 intrarater analysis, 6.96 for Researcher 02 intrarater analysis and 8.83 for interrater analysis. The measurement of HRV in post-COVID-19 individuals is reliable and presents a small amount of error inherent to the method, supporting its use in the clinical environment and in scientific research.
Implementation Outcomes of National Convergence Action Policy to Accelerate Stunting Prevention and Reduction at the Local Level in Indonesia: A Qualitative Study
Authors: Herawati Dewi Marhaeni Diah , Sunjaya Deni Kurniadi
Published: October 2022

The study aims to explore the implementation outcome variables of Indonesia’s national policy convergence action in the stunting reduction intervention at district, sub-district, and village levels. The study design was qualitative with an implementation research approach at District Cirebon, Indonesia. Data were collected through in-depth interviews, focus group discussions, study documents, and 6 months of participant observation. We recruited 172 respondents. The assessment instrument used was formed on was implementation outcomes variables. Data were analyzed through coding, categorizing and thematic content analysis based on a predetermined theme. Comparative cross district activity-site analysis was applied between sub-districts and villages. The implementation outcome variables for the convergence action policy were performed well at the district level, in line with the central government’s adequate regulation, control, and budget. Meanwhile, the sub-district and village levels only performed aspects of acceptability, appropriateness, and coverage for specific interventions. The acceptability level in the village was only partially running. The barriers at the sub-district and village levels were issues of commitment, staff capacity, and poor coordination. Superficial understanding and capacity weaknesses drove the convergence of the stunting reduction responsibility back into the burden of the health sector at the forefront. Local politics also colored the implementation in the village.
Enumeration of the Public Health Workforce in New York State: Workforce Changes in the Wake of COVID-19
Authors: Michaels Isaac , Pirani Sylvia , Fleming Molly , Arana Mayela M. , D’Angelo Emily , Dyer-Drobnack Cristina , DiManno Margaret , Ravenhall Sarah , Gloria Christian T.
Published: October 2022

The governmental public health workforce in the United States has faced staffing shortages for over a decade that have been exacerbated by the COVID-19 pandemic. To assess this critical issue, the Region 2 Public Health Training Center collaborated with the New York State Association of County Health Officials to enumerate the city and county public health workforce in New York State. The organizations used an online survey to: (1) count employees and full-time equivalent (FTEs) staff in local health departments in 2021; (2) assess workforce trends since the COVID-19 pandemic; and, (3) identify challenges local health departments encounter in recruiting and retaining qualified public health workers. To assess trends, findings were compared with secondary data from 2019. Despite playing a central role in COVID-19 mitigation, local health departments experienced no overall increase in staffing in 2021 compared to 2019, with many health departments experiencing large increases in vacant positions. Recruitment challenges include noncompetitive salaries, difficulties finding qualified candidates, and lengthy hiring processes. This study complements accumulating evidence indicating that long-term investment in local public health infrastructure is needed to bolster the workforce and ensure that communities are protected from current and future health threats.
Herbal Decoctions for the Levels of Sulfur Dioxide, Benzopyrene, and Mycotoxin from Traditional Korean Medicine Clinics: A Preliminary Study
Authors: Jeong Hye In , Han Ji-Eun , Shin Byung-Cheul , Jang Soobin , Won Jae-Hee , Kim Kyeong Han , Sung Soo-Hyun
Published: October 2022

In this study, we investigated whether the levels of sulfur dioxide (SO2), benzopyrene, and mycotoxins in herbal decoctions in Korea in 2019 were within normal limits. In total, 30 decoctions composed of multi-ingredient traditional herbs were sampled from traditional Korean medicine (TKM) clinics, TKM hospitals, and external herbal dispensaries in 2019. The decoctions were analyzed for SO2, benzopyrene, and mycotoxins using 10 samples. SO2 and benzopyrene were not detected in any of the herbal decoctions. With regard to mycotoxins, aflatoxin B1 was not detected, but B2 was detected in 7 cases (0.00~0.04 ppb), G1 in 13 cases (0.03~0.29 ppb), and G2 in 9 cases (0.02~0.93 ppb). None of these values exceeded the restrictions in prior studies. Thus, we confirm that the amounts of SO2, benzopyrene, and mycotoxins in herbal decoctions are at safe levels and provides the basis of establishing safety management criteria for herbal decoctions.
Association between Physical Activity and 32 Chronic Conditions among Spanish Adults
Authors: López Sánchez Guillermo F. , Mendiola Olivares Jaime , Torres Cantero Alberto M.
Published: October 2022

The objective was to analyse the association between physical activity and the risk of suffering from 32 chronic conditions using a large representative sample of Spanish adults. We utilised the dataset of the last edition of the Spanish National Health Survey, which was conducted in the year 2017. This dataset included a total of 23,089 adults between the ages of 15 and 103 years. The average age was 53.4 years (standard deviation 18.9 years). Regarding sex distribution, 54.1% of the participants were females. The instrument used to measure physical activity was the short form of the international physical activity questionnaire. The question used to evaluate if the participants suffered from chronic conditions was “Have you ever been diagnosed with chronic condition?”. This question was asked for 32 different chronic conditions. The association between low levels of physical activity (exposure) and chronic conditions (outcome) was assessed with multivariable logistic regression analyses. The highest prevalence of chronic conditions was found in the group doing less than 600 MET (metabolic equivalent of task)-min/week of physical activity (in 28 of the 32 conditions analyzed). The lowest prevalence was in the group doing at least 1200 MET-min/week (in 30 of the 32). Adjusted multivariable logistic regression analyses showed that less than 600 MET-min/week of physical activity was significantly associated with a higher risk of 19 chronic conditions. All these significant associations, except for hypertension, were also maintained in those doing less than 1200 MET-min/week. In conclusion, higher physical activity is a protective factor against the risk of suffering from chronic conditions, with the lowest prevalence of chronic conditions in people doing more than 1200 MET-min/week. International physical activity guidelines should recommend at least 1200 MET-min/week to prevent the risk of chronic conditions.
The Roles and Challenges of Traditional Health Practitioners in Maternal Health Services in Rural Communities of Mthatha, South Africa
Authors: Thipanyane Mvulakazi Patricia , Nomatshila Sibusiso Cyprian , Musarurwa Hannibal Tafadzwa , Oladimeji Olanrewaju
Published: October 2022

Traditional health practitioners (THPs) are considered as the entry level of care in African societies and play an important role in the delivery of health services to the population. A phenomenological qualitative study was carried out among purposefully selected THPs in Mthatha to understand their roles and the challenges they face in providing maternal health services. The study included a focus group discussion with seven participants which yielded three themes and seven subthemes. The content analysis of descriptive data from the focus group discussion revealed threats posed by unregistered and counterfeit THPs to the lives of pregnant women in rural settings. The THPs’ wide range of services allowed pregnant women to receive prenatal, antenatal, and postnatal care in proximity. However, this community level of care was marked by high levels of secrecy and counterfeit practitioners who used human body parts, which compromised the practice and rendered it unpopular. The South African government recommended the establishment of a register for THPs in order to protect the public, including the clarification of functional referral pathways between THPs and conventional health services.
Positive Affect Moderates the Influence of Perceived Stress on the Mental Health of Healthcare Workers during the COVID-19 Pandemic
Authors: Wang Xu , Luo Rui , Guo Pengyue , Shang Menglin , Zheng Jing , Cai Yuqi , Mo Phoenix K. H. , Lau Joseph T. F. , Zhang Dexing , Li Jinghua , Gu Jing
Published: October 2022

The coronavirus disease 2019 (COVID-19) pandemic has posed a profound psychological impact on healthcare workers. However, the role of positive affect in moderating the effect of perceived stress on the psychological states of healthcare workers remains unknown. This study aimed to analyze the moderating effect of positive affect on the association between stress and the mental health of healthcare workers during the COVID-19 pandemic. This cross-sectional study evaluated the relationships between perceived stress (the Perceived Stress Scale), positive affect (the Positive and Negative Affect Schedule), depression (the Patient Health Questionnaire-9), and anxiety (the Generalized Anxiety Disorder 7-item Scale) during the COVID-19 pandemic in 644 Chinese healthcare workers who completed online self-reports. The results revealed a significant negative association between positive affect and psychological problems, including stress, depression, and anxiety. At the total group level, multiple regression analysis showed that positive affect alleviated the influence of perceived stress on depression, but no significant moderating effect was found for anxiety. In the subgroups divided by perceived stress, the moderating effect of positive affect on depression was only significant in healthcare workers with a high level of perceived stress. These results suggested that positive affect played a moderative role in alleviating the effect of stress on depression among healthcare workers, particularly those with a high level of stress, thus emphasizing the importance of positive affect as an intervention strategy for promoting the mental health of healthcare workers in the context of the ongoing COVID-19 pandemic.
Measuring Safety Culture Using an Integrative Approach: The Development of a Comprehensive Conceptual Framework and an Applied Safety Culture Assessment Instrument
Authors: van Nunen Karolien , Reniers Genserik , Ponnet Koen
Published: October 2022

An exponential amount of academic research has been dedicated to the safety culture concept, but still, no consensus has been reached on its definition and content. In general, safety culture research lacks an interdisciplinary approach. Furthermore, although the concept of safety culture is characterised by complexity and multifacetedness, the safety culture concept has been characterised by reductionism, where models and theories simplify the concept in order to better grasp it, leading to confined approaches. In this article, the multifacetedness of safety culture is acknowledged, and the topic is addressed from a safety science perspective, combining insights from multiple academic disciplines. An integrative and comprehensive conceptual framework to assess safety culture in organisations is developed, taking into account the limitations of existing models, as well as the needs of the work field. This conceptual framework is called the ‘Integrated Safety Culture Assessment’ (ISCA), where the ‘assessment’ refers to its practical usability. The practical rendition of ISCA can be used to map the safety culture of an organisation and to formulate recommendations in this regard, with the ultimate goal of bringing about a change towards a positive safety culture. The comprehensiveness of ISCA lies in the inclusion of technological factors, organisational or contextual factors and human factors interacting and interrelating with each other, and in considering both observable or objective safety-related aspects in an organisation, and non-observable or subjective safety-related aspects. When using ISCA, organisational safety culture is assessed in an integrative way by using a variety of research methods involving the entire organisation, and by taking into account the specific context of the organisation.
Prenatal Depressive Symptoms, Self-Rated Health, and Diabetes Self-Efficacy: A Moderated Mediation Analysis
Authors: Lara-Cinisomo Sandraluz , Loret de Mola Julio Ricardo , Flores-Carter Kendra , Tabb Karen M. , Roloff Kristina
Published: October 2022

Background: Diabetes leads to risk for pregnant persons and their fetuses and requires behavioral changes that can be compromised by poor mental health. Poor self-rated health (SRH), a reliable predictor of morbidity and mortality, has been associated with depressive symptoms and lower self-efficacy in patients with diabetes. However, it is unclear whether SRH mediates the association between depressive symptoms and self-efficacy in pregnant patients with diabetes and whether the healthcare site moderates the mediation. Thus, we sought to test these associations in a racially and ethnically diverse sample of pregnant individuals diagnosed with diabetes from two clinical settings. Materials and methods: This was an observational, cross-sectional study of 137 pregnant individuals diagnosed with diabetes at two clinical study sites. Participants self-administered a demographic questionnaire and measures designed to assess depressive symptoms, SRH in pregnancy, and diabetes self-efficacy. A moderated mediation model tested whether these indirect effects were moderated by the site. Results: The results show that SRH mediated the association between depressive symptoms and diabetes self-efficacy. The results also showed the site moderated the mediating effect of SRH on depressive symptoms and diabetes self-efficacy. Conclusions: Understanding the role of clinical care settings can help inform when and how SRH mediates that association between prenatal depressive symptoms and self-efficacy in diabetic patients.