bluuebunny/crossref_metadata_2025 huggingface dataset:
Relationships between Physical Activity, Work Ability, Absenteeism and Presenteeism in Australian and New Zealand Adults during COVID-19
Authors: Hunter Jayden R. , Meiring Rebecca M. , Cripps Ashley , Suppiah Haresh T. , Vicendese Don , Kingsley Michael I. , Gordon Brett A.
Published: November 2021

Public health movement and social restrictions imposed by the Australian and New Zealand governments in response to the COVID-19 pandemic influenced the working environment and may have affected health behaviours, work ability, and job performance. The aim of this study was to determine the associations between health behaviours and work ability and performance during COVID-19 restrictions and if health behaviours were related to demographic or population factors. A cross-sectional survey was used to gather responses from 433 adult employees in Australia and New Zealand between June and August 2020. The survey requested demographic information and used the International Physical Activity Questionnaire, Work Ability Index, and the World Health Organisation’s Health and Work Performance Questionnaire. Multivariate regression models were used to explore relationships between the identified variables while controlling for several possible confounders. Being sufficiently physically active was associated with higher reported physical (aOR = 2.1; p = 0.001) and mental work abilities (aOR = 1.8; p = 0.007) and self-reported job performance (i.e., lower presenteeism) (median +7.42%; p = 0.03). Part-time employees were 56% less likely (p = 0.002) to report a good or very good mental work ability. Those with existing medical conditions were 14% less likely (p = 0.008) to be sufficiently active and 80% less likely (p = 0.002) to report rather good or very good physical work ability. Being sufficiently active was associated with higher physical and mental work abilities and better job performance during the COVID-19 pandemic. Employers should support opportunities for regular physical activity and provide specific support to individuals with medical conditions or in part-time employment.
Perceived Health, Psychological Distress, and Subjective Well-Being among Older Adults with Parkinson’s Disease: A Cross-Lagged Analysis
Authors: Lee Sunwoo
Published: November 2021

A growing aging population leads to a gradual increase in the number of patients with Parkinson’s disease (PD). This study examines how perceived health, psychological distress, and subjective well-being evolve in older adults with PD. A cross-lagged study design was employed using data from Waves 4 and 6 of the Survey of Health, Aging and Retirement in Europe (SHARE). In total, 421 older adults diagnosed with PD at baseline (46% women; mean age 74.98  ±  9.05 years) were included in the study and were followed up after a four-year lag. Auto-regressive and cross-lagged associations between the measured variables were examined in reciprocal models. Individual differences in perceived health, psychological distress, and subjective well-being were relatively stable over the 4-year lag. A final reciprocal model with significant cross-lagged effects explained the underlying structure of the sample data well: χ2 (49) = 101.876, p < 0.001, CFI =  0.953, NFI = 0.935, RMSEA =  0.050, and AIC = 241.876. Increased difficulties in fulfilling instrumental activities and a lowered level of subjective well-being were particularly noticeable in older adults with PD during the four-year follow-up. Additional attention should be paid to helping older patients with PD cope better with their functional limitations and improve their sense of well-being.
Long-Term Water Quality Patterns in an Estuarine Reservoir and the Functional Changes in Relations of Trophic State Variables Depending on the Construction of Serial Weirs in Upstream Reaches
Authors: Jargal Namsrai , Lee Ho-Seong , An Kwang-Guk
Published: November 2021

Water quality degradation is one of the major problems with artificial lakes in estuaries. Long-term spatiotemporal patterns of water quality in a South Korean estuarine reservoir were analyzed using seasonal datasets from 2002 to 2020, and some functional changes in relations of trophic state variables due to the construction of serial weirs in the upper river were also investigated. A total of 19 water quality parameters were used for the study, including indicators of organic matter, nutrients, suspended solids, water clarity, and fecal pollution. In addition, chlorophyll-a (CHL-a) was used to assess algal biomass. An empirical regression model, trophic state index deviation (TSID), and principal component analysis (PCA) were applied. Longitudinal fluctuations in nutrients, organic matter, sestonic CHL-a, and suspended solids were found along the axis of the riverine (Rz), transition (Tz), and lacustrine zones (Lz). The degradation of water quality was seasonally caused by resuspension of sediments, monsoon input due to rainfall inflow, and intensity of Asian monsoon, and was also related to intensive anthropic activities within the catchment. The empirical model and PCA showed that light availability was directly controlled by non-algal turbidity, which was a more important regulator of CHL-a than total nitrogen (TN) and total phosphorus (TP). The TSID supported our hypothesis on the non-algal turbidity. We also found that the construction of serial upper weirs influenced nutrient regime, TSS, CHL-a level, and trophic state in the estuarine reservoir, resulting in lower TP and TN but high CHL-a and high TN/TP ratios. The proportions of both dissolved color clay particles and blue-green algae in the TSID additionally increased. Overall, the long-term patterns of nutrients, suspended solids, and algal biomass changed due to seasonal runoff, turnover time, and reservoir zones along with anthropic impacts of the upper weir constructions, resulting in changes in trophic state variables and their mutual relations in the estuarine reservoir.
Evaluation of an Access-Risk-Knowledge (ARK) Platform for Governance of Risk and Change in Complex Socio-Technical Systems
Authors: McDonald Nick , McKenna Lucy , Vining Rebecca , Doyle Brian , Liang Junli , Ward Marie E. , Ulfvengren Pernilla , Geary Una , Guilfoyle John , Shuhaiber Arwa , Hernandez Julio , Fogarty Mary , Healy Una , Tallon Christopher , Brennan Rob
Published: November 2021

Three key challenges to a whole-system approach to process improvement in health systems are the complexity of socio-technical activity, the capacity to change purposefully, and the consequent capacity to proactively manage and govern the system. The literature on healthcare improvement demonstrates the persistence of these problems. In this project, the Access-Risk-Knowledge (ARK) Platform, which supports the implementation of improvement projects, was deployed across three healthcare organisations to address risk management for the prevention and control of healthcare-associated infections (HCAIs). In each organisation, quality and safety experts initiated an ARK project and participated in a follow-up survey and focus group. The platform was then evaluated against a set of fifteen needs related to complex system transformation. While the results highlighted concerns about the platform’s usability, feedback was generally positive regarding its effectiveness and potential value in supporting HCAI risk management. The ARK Platform addresses the majority of identified needs for system transformation; other needs were validated in the trial or are undergoing development. This trial provided a starting point for a knowledge-based solution to enhance organisational governance and develop shared knowledge through a Community of Practice that will contribute to sustaining and generalising that change.
Scaling Digital Health Innovation: Developing a New ‘Service Readiness Level’ Framework of Evidence
Authors: Hughes Janette , Lennon Marilyn , Rogerson Robert J. , Crooks George
Published: November 2021

Digital innovation has scaled exponentially in many sectors including tourism, banking, and retail. It is well cited that the health sector is slower to embrace digital health innovations (DHI) beyond the pilot stage and consequently, many successful DHI pilot projects have failed to scale up. Such failure arises in part from a knowledge gap around what type and level of evidence are needed to convince implementers and decision makers to fund, endorse, or adopt new innovations into care delivery systems and sustainable practice. Much is known about the range of DHI evaluation methods used; however, less is published on the evidence that decision makers need to move innovations to scale. This paper draws on interviews (N = 18) with decision makers/project leads engaged in DHI in Scotland to identify what evidence matters when making DHI adoption/scale decisions. The results are used to present a heuristic service readiness level (SRL) framework that captures the changing nature of the evidence base required over a project lifecycle for progression to scale. We utilise this framework to discuss ‘what evidence’ is required and ‘how data accumulate’ over time to assist project teams to build a ‘DHI case for scale’.
The Influence of Socio-Demographic Factors on the Forms of Leisure for the Students at the Faculty of Physical Education and Sports
Authors: Mocanu George Danut , Murariu Gabriel , Munteanu Dan
Published: November 2021

The study investigates the influences of gender, area of origin and age stage variables and also of the interaction between them, on the free time behavior of the students at the Faculty of Physical Education and Sports from Galati. The questionnaire applied in the academic year 2019–2020 had 85 items and was structured on 4 factors: leisure budget, leisure limiting factors, preferred leisure activities, and leisure sports activities. The multivariate/MANOVA analysis showed statistically significant data for some of the analyzed items, with values of F associated with thresholds p < 0.05. The results support longer screen time for urban areas and for those <25 years and time limitation for the favorite activities of students >25 years, while reading had higher stress scores for men and students <25 years. Men tended to limit their free time working overtime and women limited their free time due to housework. Students from rural areas and men >25 years were more stressed by socializing on the internet and shopping. Financial limitations for preferred activities were higher for women and students <25 years—women read more and visited their friends more often while men had higher scores in relation to involvement in physical activities throughout the week, an aspect also reported for those <25 years. Students >25 years spent more time with their family, while those <25 years socialized more on the internet and had better scores when going out with friends. Those in urban areas did more jogging, men had better scores in relation to playing sports games, higher indicators for the satisfaction generated by sports activity, and women preferred jogging and cycling/rollerblading. Sports games and different types of fitness were the most common variants practiced at the level of the studied group. Conclusion: There was no dominant orientation of the investigated group towards forms of passive leisure and there were no cases of sedentariness, even if the use of technologies (video games, socializing on the Internet and TV) were forms of leisure often used by students.
The Influence of an Alpha Band Neurofeedback Training in Heart Rate Variability in Athletes
Authors: Domingos Christophe , Silva Carlos Marques da , Antunes André , Prazeres Pedro , Esteves Inês , Rosa Agostinho C.
Published: November 2021

Neurofeedback training is a technique which has seen a widespread use in clinical applications, but has only given its first steps in the sport environment. Therefore, there is still little information about the effects that this technique might have on parameters, which are relevant for athletes’ health and performance, such as heart rate variability, which has been linked to physiological recovery. In the sport domain, no studies have tried to understand the effects of neurofeedback training on heart rate variability, even though some studies have compared the effects of doing neurofeedback or heart rate biofeedback training on performance. The main goal of the present study was to understand if alpha-band neurofeedback training could lead to increases in heart rate variability. 30 male student-athletes, divided into two groups, (21.2 ± 2.62 year 2/week protocol and 22.6 ± 1.1 year 3/week protocol) participated in the study, of which three subjects were excluded. Both groups performed a pre-test, a trial session and 12 neurofeedback sessions, which consisted of 25 trials of 60 s of a neurofeedback task, with 5 s rest in-between trials. The total neurofeedback session time for each subject was 300 min in both groups. Throughout the experiment, electroencephalography and heart rate variability signals were recorded. Only the three sessions/week group revealed significant improvements in mean heart rate variability at the end of the 12 neurofeedback sessions (p = 0.05); however, significant interaction was not found when compared with both groups. It is possible to conclude that neurofeedback training of individual alpha band may induce changes in heart rate variability in physically active athletes.
Orthodontic Forced Eruption of Permanent Anterior Teeth with Subgingival Fractures: A Systematic Review
Authors: Reichardt Elisabeth , Krug Ralf , Bornstein Michael M. , Tomasch Jürgen , Verna Carlalberta , Krastl Gabriel
Published: November 2021

(1) Background: To assess orthodontic forced eruption (OFE) as a pre-restorative procedure for non-restorable permanent teeth with subgingival dental hard tissue defects after dental trauma. (2) Methods: A systematic electronic search of three databases, namely, MEDLINE, Cochrane Library, and EMBASE, revealed a total of 2757 eligible publications. Randomized controlled clinical trials (RCT), retro- and prospective clinical studies, or case series (with a minimum of three patients) were reviewed. (3) Results: Thirteen full-text papers were included: one RCT, one prospective clinical trial, two retrospective cohort studies, and nine case series. Within case series, statistical significance between age and cause of fracture (p < 0.03) was determined. The mean extrusion rate of OFE was 1.5 mm a week within a four to six weeks treatment period followed by retention. Three OFE protocols for maxillary single teeth are available: 1. OFE without migration of gingiva and alveolar bone, 2. OFE with gingival migration and slight alveolar bone migration, and 3. OFE with migration of both gingiva and alveolar bone. (4) Conclusions: The current state of the evidence suggests that OFE is a feasible pre-treatment option for non-restorable permanent teeth. OFE can promote the migration of tooth surrounding hard and soft tissues in the esthetic zone. Root resorption does not seem to be a relevant side effect of OFE.
Tobacco Smoke Exposure and Urinary Cadmium in Women from Northern Mexico
Authors: Mérida-Ortega Ángel , López-Carrillo Lizbeth , Rangel-Moreno Karla , Ramirez Natalia , Rothenberg Stephen J.
Published: November 2021

Cadmium (Cd), a carcinogenic metal also related to reproductive and cardiovascular diseases, is contained in tobacco and elevated concentrations of it in humans have been consistently associated with first-hand tobacco smoke; however, there is scarce and inconclusive evidence of the relationship between Cd and secondhand smoke (SHS) exposure. Our aim was to evaluate the association between exposure to tobacco, both active and SHS, with urinary Cd concentrations in Mexican women. In a cross-sectional analysis that included 998 women living in northern Mexico, we measured the concentration of creatinine-adjusted urinary Cd (µg-cadmium/g-creatinine) using inductively coupled plasma triple quadrupole (ICP-QQQ) in tandem mass spectrometry mode (MS/MS). We gathered tobacco smoking information through an in-person interview and formed seven groups: non-smokers without SHS exposure; non-smokers with SHS exposure; ex-smokers without SHS exposure <1 year of quitting; ex-smokers without SHS exposure ≥1 year of quitting, ex-smokers with SHS exposure <1 year of quitting; ex-smokers with SHS exposure ≥1 year of quitting and current smokers. The interview also yielded sociodemographic characteristics. We used linear multivariable regression models to estimate the association between Cd concentrations and tobacco smoke exposure. Compared to non-smokers without SHS exposure, we found higher Cd concentrations in ex-smokers with SHS exposure <1 year of quitting and current smokers (adjusted geometric means 0.51 vs. 1.01 and 0.69 µg-cadmium/g-creatinine, respectively). Our results do not support a conclusion that SHS exposure is a source of Cd body burden.
Online Training in Accessibility and Design for All: A Tool to Train Post-COVID Inclusive Graduates
Authors: Moreno-Rodriguez Ricardo , Diaz-Vega Miriam , Lopez-Bastias Jose Luis , Espada-Chavarria Rosa
Published: November 2021

Agenda 2030 expresses, through the Sustainable Development Goals (SDG), and in particular through No. 4, the need to ensure an inclusive and equitable education, which promotes learning opportunities for all. At the university level, all students are urged to acquire the necessary theoretical and practical knowledge to promote sustainable development, so that they become graduates capable of facing the challenges of the future and the real demands of a society marked by heterogeneity, including the needs of people with some kind of disability. In this sense, the present work analyzed the impact of a transversal training program in Design for All on university degree students. For this purpose, a descriptive and comparative ex post facto study was developed in which the impact of an online training program was quantified by establishing comparative pre- and post-training. The results indicate that the approach, through the delivery of a training xplain eon Design for All, contributed to a change in the perceptions of students regarding disability, its role in the university and in the future workplace. Furthermore, it increased the knowledge of institutional action undertaken in terms of awareness and approach to human disability.
Cooperative Evolution of China’s Excellent Innovative Research Groups from the Perspective of Innovation Ecosystem: Taking an “Environmental Biogeochemistry” Research Innovation Group as a Case Study
Authors: Gao Jie , Liu Shu , Li Zhijian
Published: November 2021

Research, understanding, and prediction of complex systems is an important starting point for human beings to tackle major problems and emergencies such as global warming and COVID-19. Research on innovation ecosystem is an important part of research on complex systems. With the rapid development of sophisticated industries, the rise of innovative countries, and the newly developed innovation theory, innovation ecosystem has become a new explanation and new paradigm for adapting to today’s global innovation cooperation network and the scientific development of complex systems, which is also in line with China’s concept of building an innovative country and promoting comprehensive innovation and international cooperation with scientific and technological innovation as the core. The Innovative Research Group at Peking University is the most representative scientific and technological innovation team in the frontier field of basic research in China. The characteristics of its organization mechanism and dynamic evolution connotation are consistent with the characteristics and evolution of innovation ecosystem. An excellent innovative research group is regarded as a small innovation ecosystem. We selected the “Environmental Biogeochemistry” Innovation Research Group at Peking University as a typical case in order to understand and analyze the evolution of cooperation among scientific and technological innovation teams, improve the healthy development as well as internal and external governance of this special small innovation ecosystem, promote the expansion of an innovation team cooperation network and the improvement of cooperation quality, promote the linkage supports of funding and management departments, and improve their scientific and technological governance abilities. Through scientometrics, visual analysis of knowledge maps, and an exploratory case study, we study the evolution process and development law of team cooperation. It is found that the main node authors of the cooperation network maintain strong cooperation frequency and centrality, and gradually strengthen with the expansion of the cooperation network and the evolution of time. Driven by the internal cooperative governance of the team and the external governance of the funding and management departments, this group has gradually formed a healthy, orderly, open, and cooperative special innovation ecosystem, which is conducive to the stability and sustainable development of the national innovation ecosystem and the global innovation ecosystem.
Development of Nonlaboratory-Based Risk Prediction Models for Cardiovascular Diseases Using Conventional and Machine Learning Approaches
Authors: Sajid Mirza Rizwan , Almehmadi Bader A. , Sami Waqas , Alzahrani Mansour K. , Muhammad Noryanti , Chesneau Christophe , Hanif Asif , Khan Arshad Ali , Shahbaz Ahmad
Published: November 2021

Criticism of the implementation of existing risk prediction models (RPMs) for cardiovascular diseases (CVDs) in new populations motivates researchers to develop regional models. The predominant usage of laboratory features in these RPMs is also causing reproducibility issues in low–middle-income countries (LMICs). Further, conventional logistic regression analysis (LRA) does not consider non-linear associations and interaction terms in developing these RPMs, which might oversimplify the phenomenon. This study aims to develop alternative machine learning (ML)-based RPMs that may perform better at predicting CVD status using nonlaboratory features in comparison to conventional RPMs. The data was based on a case–control study conducted at the Punjab Institute of Cardiology, Pakistan. Data from 460 subjects, aged between 30 and 76 years, with (1:1) gender-based matching, was collected. We tested various ML models to identify the best model/models considering LRA as a baseline RPM. An artificial neural network and a linear support vector machine outperformed the conventional RPM in the majority of performance matrices. The predictive accuracies of the best performed ML-based RPMs were between 80.86 and 81.09% and were found to be higher than 79.56% for the baseline RPM. The discriminating capabilities of the ML-based RPMs were also comparable to baseline RPMs. Further, ML-based RPMs identified substantially different orders of features as compared to baseline RPM. This study concludes that nonlaboratory feature-based RPMs can be a good choice for early risk assessment of CVDs in LMICs. ML-based RPMs can identify better order of features as compared to the conventional approach, which subsequently provided models with improved prognostic capabilities.
When Your Child Has Cancer: A Path-Analysis Model to Show the Relationships between Flourishing and Health in Parents of Children with Cancer
Authors: Pozo Muñoz Carmen , Bretones Nieto Blanca , Vázquez López María Ángeles
Published: November 2021

Background: Childhood cancer is a disease with a psychosocial impact on parents who experience health problems and distress. Their reactions depend on the relationship of multiple factors. The objective of this paper is to evaluate the interrelationships between flourishing and the variables linked to the health and wellbeing of parents of children with cancer. Methods: Mothers/fathers of children with cancer participated in an exploratory study in response to a series of questionnaires. Likert-type scales were used to measure perceived health, wellbeing, flourishing, stress, coping, and social support. Results: Out of a total of 94 children, 138 parents (60 men/78 women) are represented. Participants show physical symptoms and an unstable coping pattern. A path analysis model is presented. As to the goodness of adjustment of the statistics used, good results were obtained. Flourishing tends to coexist with wellbeing, while flourishing coexists negatively with symptoms. There is an indirect relationship between flourishing and poor health. There is a positive relationship between flourishing and coping, as well as between flourishing and satisfaction with the support received (especially from sons/daughters). This support was negatively related to the subjective health report. Conclusions: Flourishing is shown as a healthy coping strategy. The results can enrich the development of psychosocial interventions aimed at promoting adequate adaptation.
Perceiving the Role of Communication Skills as a Bridge between the Perception of Spiritual Care and Acceptance of Evidence-Based Nursing Practice—Empirical Model
Authors: Panczyk Mariusz , Iwanow Lucyna , Musik Szymon , Wawrzuta Dominik , Gotlib Joanna , Jaworski Mariusz
Published: November 2021

Decision making using evidence-based practice (EBP) is generally universally accepted by nurses. Such acceptance may affect the personnel’s behaviour towards patients, which is also demonstrated by taking into consideration the patient’s preferences, including the patient’s spiritual needs, in the care plan. The provision of such care requires the development of an attitude of approval and an adequate level of communicative competence, which will enable the actual implementation of the EBP. The purpose of our study was to assess the perception of spirituality and the nurse’s role in providing spiritual care, as well as the perception of the significance of communication skills in the approval of EBP in professional practice. A multi-centre cross-section study was conducted on a population of 1176 participants (459 undergraduate (bachelor’s programme, BP) and 717 postgraduate students (master’s programme, MP)) from 10 medical universities in Poland. Three tools were used in the study to evaluate the participants’ approach: Evidence-Based Practice Competence Questionnaire (EBP-COQ), The Spirituality and Spiritual Care Rating Scale (SSCRS), and Communication Skills Attitude Scale (CSAS). Structural equation modelling was used for the analysis. An analysis of structural equations revealed the presence of positive relationships of the attitude to spiritual care and the role of communicative competences with the approach to EBP regardless of the cohort. A significant difference was found related to the influence of age on the attitude towards learning communicative competences. The approval in this respect was observed to decrease with age in the MP group. Increasing approval of EBP requires strengthening the approach to activity-centred spiritual care, with the simultaneous development of a positive attitude towards learning communicative competences. The model reveals the need to integrate a humanistic approach with EBP, which can be achieved by planning different interventions in different groups of recipients: nurses, academic teachers and students.
Local Characteristics Related to SARS-CoV-2 Transmissions in the Seoul Metropolitan Area, South Korea
Authors: Im Changmin , Kim Youngho
Published: November 2021

The Seoul metropolitan area is one of the most populated metropolitan areas in the world; hence, Seoul’s COVID-19 cases are highly concentrated. This study identified local demographic and socio-economic characteristics that affected SARS-CoV-2 transmission to provide locally targeted intervention policies. For the effective control of outbreaks, locally targeted intervention policies are required since the SARS-CoV-2 transmission process is heterogeneous over space. To identify the local COVID-19 characteristics, this study applied the geographically weighted lasso (GWL). GWL provides local regression coefficients, which were used to account for the spatial heterogeneity of SARS-CoV-2 outbreaks. In particular, the GWL pinpoints statistically significant regions with specific local characteristics. The applied explanatory variables involving demographic and socio-economic characteristics that were associated with higher SARS-CoV-2 transmission in the Seoul metropolitan area were as follows: young adults (19~34 years), older population, Christian population, foreign-born population, low-income households, and subway commuters. The COVID-19 case data were classified into three periods: the first period (from January 2020 to July 2021), the second period (from August to November 2020), and the third period (from December 2020 to February 2021), and the GWL was fitted for the entire period (from January 2020 to February 2021). The result showed that young adults, the Christian population, and subway commuters were the most significant local characteristics that influenced SARS-CoV-2 transmissions in the Seoul metropolitan area.
Decreased Physical Activity during Pregnancy Is Associated with Excessive Gestational Weight Gain
Authors: Sun Jia-Jing , Chien Li-Yin
Published: November 2021

The majority of pregnant women in Taiwan are not considered physically active. During pregnancy, many women decrease their physical activity levels when compared to pre-pregnancy. The purpose of this study was to examine the association between decreased physical activity from pre-pregnancy to pregnancy and excessive gestational weight gain (GWG). This study applied a prospective panel design. Recruitment was conducted at six medical facilities in Taiwan and lasted from August 2016 to April 2017. Physical activity levels were determined both before and during pregnancy using the International Physical Activity Questionnaire—Short Form, with data subsequently being transformed into METs-min/week. Excessive GWG was determined based on the body mass index (BMI) specific GWG range. We recruited 747 pregnant women in their second trimester and followed them through to one-month postpartum. About 40% of participants (41.2%) exhibited excessive GWG. Physical activity decreased from an average of 2261 (SD = 3999) to 1252 (SD = 2258) METs-min/week from pre-pregnancy to pregnancy (p < 0.0001). Controlling for age and pre-pregnancy BMI, a logistic regression model revealed that a decline in physical activity of > 4000 METs-min/week from pre-pregnancy to pregnancy was associated with an increased risk for excessive GWG (OR = 2.83, 95% CI: 1.27–4.43). A substantial decrease in physical activity from pre-pregnancy to pregnancy was a risk factor for excessive GWG. Although most women decreased their physical activity during pregnancy, only those pregnant women who were physically active pre-pregnancy could show the kind of large decrease that resulted in excessive GWG. Health professionals should continue to develop strategies for counteracting the problematic trend of decreasing PA during pregnancy among low-risk pregnant women.
Ethnic Inequalities in Healthcare Use and Care Quality among People with Multiple Long-Term Health Conditions Living in the United Kingdom: A Systematic Review and Narrative Synthesis
Authors: Hayanga Brenda , Stafford Mai , Bécares Laia
Published: November 2021

Indicative evidence suggests that the prevalence of multiple long-term conditions (i.e., conditions that cannot be cured but can be managed with medication and other treatments) may be higher in people from minoritised ethnic groups when compared to people from the White majority population. Some studies also suggest that there are ethnic inequalities in healthcare use and care quality among people with multiple long-term conditions (MLTCs). The aims of this review are to (1) identify and describe the literature that reports on ethnicity and healthcare use and care quality among people with MLTCs in the UK and (2) examine how healthcare use and/or care quality for people with MLTCs compares across ethnic groups. We registered the protocol on PROSPERO (CRD42020220702). We searched the following databases up to December 2020: ASSIA, Cochrane Library, EMBASE, MEDLINE, PsycINFO, PubMed, ScienceDirect, Scopus, and Web of Science core collection. Reference lists of key articles were also hand-searched for relevant studies. The outcomes of interest were patterns of healthcare use and care quality among people with MLTCs for at least one minoritised ethnic group, compared to the White majority population in the UK. Two reviewers, L.B. and B.H., screened and extracted data from a random sample of studies (10%). B.H. independently screened and extracted data from the remaining studies. Of the 718 studies identified, 14 were eligible for inclusion. There was evidence indicating ethnic inequalities in disease management and emergency admissions among people with MLTCs in the five studies that counted more than two long-term conditions. Compared to their White counterparts, Black and Asian children and young people had higher rates of emergency admissions. Black and South Asian people were found to have suboptimal disease management compared to other ethnic groups. The findings suggest that for some minoritised ethnic group people with MLTCs there may be inadequate initiatives for managing health conditions and/or a need for enhanced strategies to reduce ethnic inequalities in healthcare. However, the few studies identified focused on a variety of conditions across different domains of healthcare use, and many of these studies used broad ethnic group categories. As such, further research focusing on MLTCs and using expanded ethnic categories in data collection is needed.
Study on the Roof Solar Heating Storage System of Traditional Residences in Southern Shaanxi, China
Authors: Chen Shuo , Dewancker Bart J. , Yang Simin , Mao Jing , Chen Jie
Published: November 2021

Solar energy is a renewable, green, clean, and universal resource that has great potential in rural areas. Combining solar heating technology with building design to increase indoor thermal comfort in winter is an effective energy-saving and environmentally friendly approach. The factors affecting solar building heating mainly include two aspects; one is the lighting area of the building, and the other is the storage of building materials. By increasing the lighting area and using materials with good heat preservation and storage performance, the indoor temperature in winter can be effectively increased, and the heating time can be prolonged, thus decreasing the energy requirements of the building. In this paper, traditional houses in cold winter areas are selected as the research object, and a roof solar heating storage system is proposed. The method is to transform the opaque roof of the traditional houses into a transparent glass roof, and the thermal insulation and heat storage material HDPE is installed in the attic floorboards. The working principle of this system is to increase the amount of indoor solar radiation to raise the indoor temperature and make use of the thermal insulation performance of heat storage materials to prolong the indoor heating time. Through ANSYS software simulation, the heat transfer process, heat transfer mode, and temperature change of the system are analyzed, and the energy saving of the system is analyzed. The system can effectively raise the indoor temperature and has good energy-saving performance. The indoor temperature is raised by 5.8 °C, and the annual heat load of the building is reduced by 1361.92 kW·h, with a reduction rate of 25.02%.
Connectedness to Family, School, and Neighborhood and Adolescents’ Internalizing Symptoms
Authors: Eugene Danielle R.
Published: November 2021

In the U.S., there is a strong national interest in social connectedness as a key determinant in promoting positive well-being in adolescents through building strong bonds and creating protective relationships that support adolescent mental health. To this end, this study examined whether, and to what extent, specific types of connectedness to family, school, and neighborhood were associated with internalizing symptoms (i.e., depression and anxiety) among a diverse sample of adolescents from disadvantaged backgrounds. The sample (n = 2590) was majority male (51%), with an average age of 15.6 years, and identified as Black (49%) and Hispanic/Latino (26%). The results revealed that adolescents who reported strong connections to their parent (β = −0.128, p < 0.001), school (β = −0.222, p < 0.001), and neighborhood (β = −0.116, p = 0.003) were more likely to report lower levels of depressive symptomology, with school connectedness exerting a greater influence. In addition, parent connectedness (β = −0.157, p < 0.001) and school connectedness (β = −0.166, p < 0.001) were significantly related to teen anxiety; however, neighborhood connectedness was not (β = −0.123, p = 0.087). The findings have important implications, which are discussed.
Normalization of the Mini-MAC (Mental Adjustment to Cancer) Questionnaire among Cancer Patients
Authors: Czerw Aleksandra , Religioni Urszula , Szymański Filip , Nieradko-Heluszko Agnieszka , Mękal Dominika , Hering Dagmara , Kowalczuk Anna , Merks Piotr , Borowska Mariola , Bogdan Magdalena , Pajewska Monika
Published: November 2021

Cancer is associated with discomfort and many changes in patients’ lives to which they must adapt. The main objective of the study was to assess the use of the mini-MAC questionnaire scale among persons diagnosed with malignant cancer and to develop standards allowing differentiation of patients with diagnosed cancer in terms of their style of adjustment to the disease. The mini-MAC questionnaire is a widely used tool in assessing coping strategies among cancer patients. Sten standards have been developed to determine the level of results on the questionnaire scales in the low–average–high categories. The study included 1187 patients diagnosed with malignant cancer who are covered by outpatient care at the Maria Sklodowska-Curie Institute—Oncology Center in Warsaw. The questionnaire concerning mental adjustment to cancer was used (mini-MAC). Patients with cancer most often adopt strategies of fighting spirit and positive reevaluation. The variables that differentiate the results most significantly include gender, presence of metastasis, and the state of undergoing chemotherapy. The mini-MAC questionnaire should be a tool for psycho-oncological diagnosis of patients’ attitudes towards cancer. The obtained results indicate that cancer patients are characterized by their constructive style of adjustment to the disease.
Reaction Times among Batik Workers: The Influence of Gender and Occupational Lead Exposure
Authors: Agustiningsih Denny , Sofyana Meida , Budiharjo Santosa , Febriana Sri Awalia , Nurokhmanti Hikmawati , Suhartini Suhartini , Priyambodo Dewanto Yusuf , Nugrahaningsih Dwi Aris Agung , Roto Roto , Wibowo Rakhmat Ari
Published: November 2021

(1) Background: Neglected occupational health and safety aspects in batik industries cause their workers to have an increased risk of lead exposure. The effect of occupational lead exposure on neurocognitive performance is inconclusive. Therefore, we conducted an observational study to examine the difference in simple reaction time between lead-exposed batik workers and non-exposed referents. (2) Methods: This cross-sectional study was conducted in seven batik enterprises in Lendah District, Indonesia, excluding workers with medical conditions impairing reaction time. Simple reaction time tests were conducted using an online tool. Two-way model ANCOVAs examined interactions between gender and job types on the mean differences in reaction time. (3) Results: After controlling for age and body mass index, we observed longer reaction times among lead-exposed batik workers than non-exposed referents with an adjusted mean difference of 0.19 (95% CI: 0.016–0.368) seconds. A more prominent detrimental effect of lead exposure on reaction time among female workers than among male workers was observed. (4) Conclusions: Our results suggest that occupational lead exposure could contribute to longer reaction time, notably among female workers. Thus, occupational health and safety precautions are vital to protect batik workers and preserve their important contributions to cultural heritage.
Age, Sex, and Race/Ethnicity Associations between Fat Mass and Lean Mass with Bone Mineral Density: NHANES Data
Authors: Garvey Meghan E. , Shi Ling , Gona Philimon N. , Troped Philip J. , Camhi Sarah M.
Published: November 2021

Rising rates of obesity and osteoporosis have public health implications; hence, understanding the relationships between body composition (fat mass (FM) and lean mass (LM)) and bone mineral density (BMD) is important. The purpose of this study is to investigate these associations in a large representative sample. A cross-sectional analysis was conducted using National Health and Nutrition Examination Survey participants (n = 1717, age 44.1 ± 14.2 years) who had complete dual energy x-ray absorptiometry (total BMD g/cm2, FM kg, and LM kg) and covariate data. Hierarchical linear regression models were fitted, controlling for demographic and behavioral covariates. Stratum-specific models were fitted by race, sex, and age group. Significant negative associations were found for FM and BMD (β = −0.003) and significant positive associations for LM and BMD (β = 0.007). Stratum-specific analyses by race were consistent between groups, while variations in negative association magnitudes were seen in FM for sex (males β = −0.005 vs. females β = −0.002) and age (under 45 years of age β = −0.005 vs. 45 years and older β = −0.002). Consistent positive linear associations in total and stratum-specified models between LM and BMD could suggest a potential mechanical influence on bone health. The biological mechanisms driving the magnitude variations between FM and BMD by sex and age require more investigation.
Accessibility of Online Resources for Associations Providing Services to People with Brain Injuries in Covid-19 Pandemic
Authors: Lapierre Nolwenn , Piquer Olivier , Celikovic Erik , Routhier François , Ruel Julie , Lamontagne Marie-Eve
Published: November 2021

Background. Since the Covid-19 pandemic, many community-based services for people with traumatic brain injury (TBI) have been moved online, which may have hindered their accessibility. The study aims to assess the accessibility of online information and resources dedicated to people with TBI. Methods. The websites of 14 organizations offering information and resources to people with TBI in Quebec were evaluated. Two co-authors independently evaluated one page of each website and compared their results. Descriptive statistical analyses were performed. Results. The average accessibility score of the 14 websites evaluated was 54% with a standard deviation of 16%. Website design and writing were the most accessible aspects (72.3%). Only two out of the 14 websites (14%) presented multimedia content. This category presented the most barriers to accessibility with a score of 42%. Regarding images, they reached an accessibility score of 46%. Their main shortcoming was the absence of a caption. Conclusion. This study highlights accessibility issues specific to people with TBI to access online resources and identifies specific areas of improvement. The results of this study provide community organizations with avenues of improvement to make their online resources more accessible to people with TBI and may therefore lead to improved community practices.
Comparison of Data from Rain Gauges and the IMERG Product to Analyse Precipitation in Mountain Areas of Central Italy
Authors: Gentilucci Matteo , Bufalini Margherita , D’Aprile Fabrizio , Materazzi Marco , Pambianchi Gilberto
Published: November 2021

In central Italy, particularly in the Umbria-Marche Apennines, there are some complete, high-altitude weather stations, which are very important for assessing the climate in these areas. The mountain weather stations considered in this study were Monte Bove Sud (1917 m.a.s.l.), Monte Prata (1816 m.a.s.l.) and Pintura di Bolognola (1360 m.a.s.l.). The aim of this research was to compare the differences between the precipitation measured by the rain gauges and the data obtained by satellite using the IMERG algorithm, at the same locations. The evaluation of possible errors in the estimation of precipitation using one method or the other is fundamental for obtaining a reliable estimate of precipitation in mountain environments. The results revealed a strong underestimation of precipitation for the rain gauges at higher altitudes (Monte Bove Sud and Monte Prata) compared to the same pixel sampled by satellite. On the other hand, at lower altitudes, there was a better correlation between the rain gauge value and the IMERG product value. This research, although localised in well-defined locations, could help to assess the problems in rain detection through mountain weather stations.
Resilience of Urban Network Structure in China: The Perspective of Disruption
Authors: Wei Shimei , Pan Jinghu
Published: November 2021

In light of the long-term pressure and short-term impact of economic and technological globalization, regional and urban resilience has become an important issue in research. As a new organizational form of regional urban systems, the resilience of urban networks generated by flow space has emerged as a popular subject of research. By gathering 2017 data from the Baidu search index, the Tencent location service, and social statistics, this study constructs information, transportation, and economic networks among 344 cities in China to analyze the spatial patterns of urban networks and explore their structural characteristics from the perspectives of hierarchy and assortativity. Transmissibility and diversity were used to represent the resilience of the network structure in interruption scenarios (node failure and maximum load attack). The results show the following: The information, transportation, and economic networks of cities at the prefecture level and higher in China exhibit a dense pattern of spatial distribution in the east and a sparse pattern in the west; however, there are significant differences in terms of hierarchy and assortativity. The order of resilience of network transmissibility and diversity from strong to weak was information, economic, transportation. Transmissibility and diversity had nearly identical scores in response to the interruption of urban nodes. Moreover, a highly heterogeneous network was more likely to cause shocks to the network structure, owing to its cross-regional urban links in case of disturbance. We identified 12 dominant nodes and 93 vulnerable nodes that can help accurately determine the impetus behind network structure resilience. The capacity of regions for resistance and recovery can be improved by strengthening the construction of emergency systems and risk prevention mechanisms.