bluuebunny/crossref_metadata_2025 huggingface dataset:
Physicochemical and Microbiological Properties of Synbiotic Yogurt Made with Probiotic Yeast Saccharomyces boulardii in Combination with Inulin
Authors: Sarwar Abid , Aziz Tariq , Al-Dalali Sam , Zhao Xiao , Zhang Jian , ud Din Jalal , Chen Chao , Cao Yongqiang , Yang Zhennai
Published: October 2019

Saccharomyces boulardii is a unique species of yeast previously characterized as a probiotic strain (CNCM I-745) among a few probiotic yeasts reported to date. Inulin is one of the most common prebiotics that exhibit twisted hydrocolloidal properties in dairy products. The present study was designed to develop a synbiotic yogurt by incorporation of S. boulardii and inulin at 1%, 1.5%, and 2% (w/v), comparing with the probiotic and control plain yogurts. Microrheological, microstructural, microbiological, sensory properties, and volatile compounds of the yogurt samples were evaluated. Microrheological analysis showed that addition of inulin to yogurt slightly reduced the values of G′ and G″, while solid–liquid balance (SLB) values confirmed more solid properties of the synbiotic yogurt (0.582~0.595) than the plain yogurt (0.503~0.518). A total of 18 volatile compounds were identified in the synbiotic yogurt, while only five and six compounds were identified in plain and probiotic yogurts, respectively. Physiochemical parameters such as pH, acidity, and protein content were in the normal range (as with the control), while fat content in the synbiotic yogurt decreased significantly. Addition of 1% inulin not only reduced syneresis but also maintained viability of S. boulardii after 28 days of storage. Microstructural and microrheological studies confirmed the dense, compressed, homogeneous structure of the synbiotic yogurt. Thus, addition of inulin improved the textural and sensory properties of the synbiotic yogurt, as well as survival of S. boulardii with viable count above 6.0 log CFU/g in yogurt, as generally required for probiotics. Therefore, novel synbiotic yogurt with desirable quality was developed as an effective carrier for delivery of the probiotic yeast exerting its beneficial health effects.
Dietary Supplementation of Tannin-Extracts to Lambs: Effects on Meat Fatty Acids Composition and Stability and on Microbial Characteristics
Authors: Biondi Luisa , Randazzo Cinzia L. , Russo Nunziatina , Pino Alessandra , Natalello Antonio , Van Hoorde Koenraad , Caggia Cinzia
Published: October 2019

Two extracts derived from plant material rich in hydrolysable (Tara, T; Caesalpinia spinosa) or condensed (Mimosa, M; Acacia mearnsii) tannins were added to lamb’s diet and their effects on meat quality and on microbial population were evaluated; a diet without tannins represented the Control (C). Meat pH, vitamin E, intramuscular fat content and muscle fatty acid composition were determined. Oxidative stability and microbiological analyses were performed on meat samples after 0, 4 and 7 days of refrigerated storage. Psychrotrophic bacteria were identified through MALDI-TOF MS analysis. Regarding meat fatty acids, Tara treatment decreased the percentage of monounsaturated fatty acids. The counts of all microbial groups were similar among dietary treatments at day 0, while a significant reduction of microbial loads was observed in T-group at day 7. Pseudomonas fluorescens group count was significantly affected by T extract supplementation. The MALDI-TOF MS identification revealed the dominance of Pseudomonas fragi species in all samples while Pseudomonas lundensis, Brochothrix thermosphacta and Candida famata were revealed only in control ones. In conclusions, the tannin extract supplementation is a promising dietary strategy to preserve lamb meat quality.
Effects of High-Pressure Homogenization on the Structural, Physical, and Rheological Properties of Lily Pulp
Authors: Liu Jie , Wang Rongrong , Wang Xinyu , Yang Lvzhu , Shan Yang , Zhang Qun , Ding Shenghua
Published: October 2019

The effects of high-pressure homogenization (HPH) on the structural, physical, and rheological properties of lily pulp (15%, w/w) were investigated. Different pressures ranging from 0 MPa to 100 MPa were used. The focus was on evaluating the changes in the particle size distribution (PSD), structure, pulp sedimentation behavior, serum cloudiness (SC), total soluble solids (TSS), color, and rheological behavior of the pulps. PSD analysis showed that the diameter of suspended lily particles significantly decreased with an increasing homogenization pressure. The suspended particles observed through optical microscopy became small after homogenization, highlighting the effect of HPH on disrupting the suspended particles. Compared with the untreated pulp, the SC and sedimentation velocity of the homogenized pulps decreased due to the disruption of the suspended particles. The effects of HPH on the sedimentation index and SC exhibited an asymptotic behavior similar to that of the changes in the particle size of lily pulp. Moreover, HPH processing reduced the viscosity of lily pulp and increased the TSS and lightness of the homogenized pulps. HPH significantly modified the structural, physical, and rheological properties of lily pulp. The pulp homogenized above 60 MPa had good suspension stability. This finding indicates that HPH technology can be used to improve the stability of lily pulp.
Ultrasound-Assisted Marination: Role of Frequencies and Treatment Time on the Quality of Sodium-Reduced Poultry Meat
Authors: Inguglia Elena S. , Burgess Catherine M. , Kerry Joseph P. , Tiwari Brijesh K.
Published: October 2019

The objective of this study was to evaluate the influence of high-power ultrasound (US) to accelerate marination of chicken breast; the effect of ultrasonic frequencies and marination times were investigated on samples containing full sodium levels (FS) or 25% sodium reduction, either by reducing NaCl (R50) or by its partial substitution with KCl (SR). Chicken breasts were marinated in plastic bags immersed in an ultrasonic bath operating with a frequency of 25, 45 or 130 kHz for 1, 3 or 6 h at a temperature of 2.5 ± 0.5 °C. Chicken marinated using US had a significantly higher uptake (p < 0.05) of sodium compared to control samples (no US) marinated for the same amount of time. No significant changes were observed in the quality parameters of sonicated chicken samples compared to controls. However, significant decreases (p < 0.05) in lipid oxidation were observed in SR samples when treated by US. These results suggest the use of ultrasound in the meat processing industry as a novel technology for enhancing marination processes and formulation of reduced sodium meat products.
Oxidation and Polymerization of Triacylglycerols: In-Depth Investigations towards the Impact of Heating Profiles
Authors: Khor Yih Phing , Hew Khai Shin , Abas Faridah , Lai Oi Ming , Cheong Ling Zhi , Nehdi Imededdine Arbi , Sbihi Hassen Mohamed , Gewik Mohamed Mossad , Tan Chin Ping
Published: October 2019

The stability of refined, bleached, and deodorized palm olein (RBDPO) was studied under controlled heating conditions. RBDPO was heated continuously for 24 h at 160, 170, and 180 °C, with oil sampled at four hour intervals. Thermo-oxidative alterations were measured through various parameters, such as monomeric oxidized triacylglycerols (oxTAG), total polar compounds (TPC), polymerized triacylglycerols (PTG), oxidative stability, and fatty acid composition. After 24 h of heating, the TPC and triacylglycerol oligomers showed a linear increase with heating time at all heating temperatures. At the end of the heating study, more epoxy acids were formed than keto and hydroxy acids. Moreover, caprylic acid, which was not present in fresh oil, was formed in significant amounts. The increase in oxTAG was strongly correlated with the increase in the p-anisidine value and total oxidation value. The decreases in diacylglycerol and free fatty acids were strongly correlated with an increase in PTG.
Application of Microfluidics in the Production and Analysis of Food Foams
Authors: Deng Boxin , de Ruiter Jolet , Schroën Karin
Published: October 2019

Emulsifiers play a key role in the stabilization of foam bubbles. In food foams, biopolymers such as proteins are contributing to long-term stability through several effects such as increasing bulk viscosity and the formation of viscoelastic interfaces. Recent studies have identified promising new stabilizers for (food) foams and emulsions, for instance biological particles derived from water-soluble or water-insoluble proteins, (modified) starch as well as chitin. Microfluidic platforms could provide a valuable tool to study foam formation on the single-bubble level, yielding mechanistic insights into the formation and stabilization (as well as destabilization) of foams stabilized by these new stabilizers. Yet, the recent developments in microfluidic technology have mainly focused on emulsions rather than foams. Microfluidic devices have been up-scaled (to some extent) for large-scale emulsion production, and also designed as investigative tools to monitor interfaces at the (sub)millisecond time scale. In this review, we summarize the current state of the art in droplet microfluidics (and, where available, bubble microfluidics), and provide a perspective on the applications for (food) foams. Microfluidic investigations into foam formation and stability are expected to aid in optimization of stabilizer selection and production conditions for food foams, as well as provide a platform for (large-scale) production of monodisperse foams.
Food-Grade Gelatin Nanoparticles: Preparation, Characterization, and Preliminary Application for Stabilizing Pickering Emulsions
Authors: Feng Xin , Dai Hongjie , Ma Liang , Yu Yong , Tang Mi , Li Yuan , Hu Weijie , Liu Tingwei , Zhang Yuhao
Published: October 2019

In this paper, the food-grade gelatin nanoparticles (GNPs) were prepared by a two-step desolvation method and using genipin as a cross-linker. The GNPs with narrow size distribution and good dispersion could be obtained only at pH 12. The effect of the genipin dosage (8–12 wt%) on the GNPs was systematically investigated. The results showed that the cross-linking degree of the GNPs increased with the increasing dosage of genipin, thus leading to a more obvious cross-linking morphology observed from scanning electron microscope (SEM). The obtained GNPs showed a good dispersibility with a size range of 386–438 nm. However, the GNPs cross-linked by 8 wt% genipin dosage revealed a relatively higher size because of the aggregation induced by hydrogen bond. The 10 wt% group had good thermal stability and storage stability. The optical microscopy results showed that the Pickering emulsions (30–50 vol% internal phase) stabilized by the GNPs had good uniformity and stability, even after 30 days of storage time, suggesting that the stable GNPs had great potential in food-grade Pickering emulsions.
miR2Diabetes: A Literature-Curated Database of microRNA Expression Patterns, in Diabetic Microvascular Complications
Authors: Park Sungjin , Moon SeongRyeol , Lee Kiyoung , Park Ie Byung , Lee Dae Ho , Nam Seungyoon
Published: October 2019

microRNAs (miRNAs) have been established as critical regulators of the pathogenesis of diabetes mellitus (DM), and diabetes microvascular complications (DMCs). However, manually curated databases for miRNAs, and DM (including DMCs) association studies, have yet to be established. Here, we constructed a user-friendly database, “miR2Diabetes,” equipped with a graphical web interface for simple browsing or searching manually curated annotations. The annotations in our database cover 14 DM and DMC phenotypes, involving 156 miRNAs, by browsing diverse sample origins (e.g., blood, kidney, liver, and other tissues). Additionally, we provide miRNA annotations for disease-model organisms (including rats and mice), of DM and DMCs, for the purpose of improving knowledge of the biological complexity of these pathologies. We assert that our database will be a comprehensive resource for miRNA biomarker studies, as well as for prioritizing miRNAs for functional validation, in DM and DMCs, with likely extension to other diseases.
The G119S Acetylcholinesterase (Ace-1) Target Site Mutation Confers Carbamate Resistance in the Major Malaria Vector Anopheles gambiae from Cameroon: A Challenge for the Coming IRS Implementation
Authors: Elanga-Ndille Emmanuel , Nouage Lynda , Ndo Cyrille , Binyang Achille , Assatse Tatiane , Nguiffo-Nguete Daniel , Djonabaye Doumani , Irving Helen , Tene-Fossog Billy , Wondji Charles S.
Published: October 2019

Growing resistance is reported to carbamate insecticides in malaria vectors in Cameroon. However, the contribution of acetylcholinesterase (Ace-1) to this resistance remains uncharacterised. Here, we established that the G119S mutation is driving resistance to carbamates in Anopheles gambiae populations from Cameroon. Insecticide bioassay on field-collected mosquitoes from Bankeng, a locality in southern Cameroon, showed high resistance to the carbamates bendiocarb (64.8% ± 3.5% mortality) and propoxur (55.71% ± 2.9%) but a full susceptibility to the organophosphate fenitrothion. The TaqMan genotyping of the G119S mutation in field-collected adults revealed the presence of this resistance allele (39%). A significant correlation was observed between the Ace-1R and carbamate resistance at allelic ((bendiocarb; odds ratio (OR) = 75.9; p < 0.0001) and (propoxur; OR = 1514; p < 0.0001)) and genotypic (homozygote resistant vs. homozygote susceptible (bendiocarb; OR = 120.8; p < 0.0001) and (propoxur; OR = 3277; p < 0.0001)) levels. Furthermore, the presence of the mutation was confirmed by sequencing an Ace-1 portion flanking codon 119. The cloning of this fragment revealed a likely duplication of Ace-1 in Cameroon as mosquitoes exhibited at least three distinct haplotypes. Phylogenetic analyses showed that the predominant Ace-1R allele is identical to that from West Africa suggesting a recent introduction of this allele in Central Africa from the West. The spread of this Ace-1R represents a serious challenge to future implementation of indoor residual spraying (IRS)-based interventions using carbamates or organophosphates in Cameroon.
Basic Protocol for On-Site Testing Consolidant Nanoparticles on Stone Cultural Heritage
Authors: Becerra Javier , Zaderenko Ana Paula , Ortiz Pilar
Published: October 2019

Currently the application of consolidants based on nanoparticles is common practice among restorers. Consolidants should not modify the properties of original materials according to international recommendation, which requires previous studies to decide the optimal option. The selection must be based on empirical results, and not only in the expertise of the restorer, because the consolidant’s effectiveness is influenced by its own properties and other factors such as the characteristics of the artwork (elemental composition, porosity, texture, etc.) and its context (temperature, relative humidity, etc.). Moreover, new protocols must be sustainable and compatible with on-site restoration. A new protocol to test consolidant nanoparticles has been designed and assessed. This is based on easy trials and low-cost techniques—digital microscope, colorimeter, peeling test and ultrasound—that could be employed by restorers in situ. In this paper, different consolidant nanoparticles were tested on stones from two historical quarries. The first treatment was SiO2 nanoparticles, and the second, a new nanocomposite of Ca(OH)2 and ZnO quantum dots that allows us to measure penetration depth easily and discern the treated areas under UV lights. This second treatment was the best option for the studied stones, validating the protocol designed for the choice of consolidants.
The Importance of Self-Monitoring for Behavior Change in Youth: Findings from the SWITCH® School Wellness Feasibility Study
Authors: McLoughlin Gabriella M. , Rosenkranz Richard R. , Lee Joey A. , Wolff Maren M. , Chen Senlin , Dzewaltowski David A. , Vazou Spyridoula , Lanningham-Foster Lorraine , Gentile Douglas A. , Rosen Marisa S. , Welk Gregory J.
Published: October 2019

School Wellness Integration Targeting Child Health (SWITCH®) is a school wellness implementation initiative focused on building capacity for schools to plan and coordinate wellness programming. Grounded in Social Cognitive Theory (SCT), the purpose of this study was to evaluate the utility of the web-based, self-regulation system on physical activity (PA) behavior outcomes. At pre-test and post-test, students in SWITCH® schools (n = 8) completed the online Youth Activity Profile (YAP) to assess PA and sedentary behavior (SB). Students (n = 513) were categorized into high or low self-monitoring groups (using a median split) based on their use of the web-based self-regulation platform. Linear mixed models were used to assess differences in moderate-to-vigorous PA (MVPA) and sedentary behavior, with school, classroom, student, time-by-school, and time-by-classroom random effects and main and interaction fixed effects for student self-monitoring, gender, and time. Significant self-monitoring-by-time interactions were observed for estimates of PA F(1, 477) = 5.55, p = 0.02 and SB F(1, 477) = 4.90, p = 0.03. Students in the high self-monitoring group had larger gains in PA per day and larger declines in hours per day of sedentary screen time behavior compared to students in the low self-monitoring group. These findings support the utility of web-based self-regulation for facilitating PA change in youth.
Effects of Soil Aggregate Stability on Soil Organic Carbon and Nitrogen under Land Use Change in an Erodible Region in Southwest China
Authors: Liu Man , Han Guilin , Zhang Qian
Published: October 2019

Soil aggregate stability can indicate soil quality, and affects soil organic carbon (SOC) and soil organic nitrogen (SON) sequestration. However, for erodible soils, the effects of soil aggregate stability on SOC and SON under land use change are not well known. In this study, soil aggregate distribution, SOC and SON content, soil aggregate stability, and soil erodibility were determined in the soils at different depths along the stages following agricultural abandonment, including cropland, abandoned cropland, and native vegetation land in an erodible region of Southwest China. Soil aggregation, soil aggregate stability, and SOC and SON content in the 0–20 cm depth soils increased after agricultural abandonment, but soil texture and soil erodibility were not affected by land use change. Soil erodibility remained in a low level when SOC contents were over 20 g·kg−1, and it significantly increased with the loss of soil organic matter (SOM). The SOC and SON contents increased with soil aggregate stability. This study suggests that rapidly recovered soil aggregate stability after agricultural abandonment promotes SOM sequestration, whereas sufficient SOM can effectively maintain soil quality in karst ecological restoration.
Feasibility and Preliminary Efficacy of an m-Health Intervention Targeting Physical Activity, Diet, and Sleep Quality in Shift-Workers
Authors: Oftedal Stina , Burrows Tracy , Fenton Sasha , Murawski Beatrice , Rayward Anna B. , Duncan Mitch J.
Published: October 2019

Poor health behaviors are prevalent in shift-workers, but few multiple health-behavior interventions consider their unique needs. This study aimed to (1) evaluate the feasibility and acceptability of an existing app-based intervention to improve physical activity, diet, and sleep quality in a shift-worker population, (2) estimate intervention effect in a four-week pilot randomized controlled trial (RCT) (ACTRN12618001785291). Shift-workers (18–65 years old) were randomized to intervention (n = 20) or wait-list (n = 20) groups. Outcomes included recruitment, engagement, attrition, usefulness ratings, System Usability Scale (SUS), qualitative interviews, and estimation of treatment effect (minutes of physical activity, diet quality, and sleep quality) using mixed model analysis. Recruitment took one week. App-use at week four was 55% (11/20), 85% (34/40) completed the four-week follow-up questionnaire, and 20% (4/20) of the intervention group completed the qualitative interview. The intervention was rated as slightly to moderately useful by 76.9% (10/13) of participants on a five-point scale. The SUS score was 62.7 (12.7) out of 100. Diet quality improved for the intervention (4.5 points; 95% confidence interval (CI) = 0.1, 8.9; p = 0.047) vs. the wait-list group, but not physical activity or sleep quality. Qualitative interviews found that a more tailored intervention, more accessible information, and interactive features were desired. The intervention was feasible in terms of recruitment, but modifications to increase engagement are needed.
Total-Factor Eco-Efficiency and Its Influencing Factors in the Yangtze River Delta Urban Agglomeration, China
Authors: Cheng Yongyi , Shao Tianyuan , Lai Huilin , Shen Manhong , Li Yi
Published: October 2019

Urban agglomerations are not only the core areas leading economic growth but also the fronts facing severe resource and environmental challenges. This paper aimed to increase our understanding of urban eco-efficiency and its influencing factors and thus provide the scientific basis for green development. We developed a model that incorporates super-efficiency, slacks-based-measure, and global-frontier technology to calculate the total-factor eco-efficiency (TFEE) and used a spatial panel Tobit model to take into account spatial spillover effects. An empirical study was conducted utilizing a prefecture-level dataset in the Yangtze River Delta Urban Agglomeration (YRDUA) from 2003 to 2016. The main findings reveal that significant spatial differences exist in TFEE in the YRDUA: high-TFEE cities were majorly located in the coastal areas, while low-TFEE cities were mostly situated inland. Overall, TFEE shows a trend of “decline first and then rise with fluctuation”; the disparity between inland and coastal regions has expanded. Further regression analysis suggests that industrial structure, environmental regulation, and innovation were positively related to TFEE, while foreign direct investment was not conducive to the growth in TFEE. The relationship between population intensity and urban eco-efficiency is an inverted U-shaped curve. Finally, several specific policy implications were raised based on the results.
Recipients of Suicide-Related Disclosure: The Link between Disclosure and Posttraumatic Growth for Suicide Attempt Survivors
Authors: Frey Laura M. , Drapeau Christopher W. , Fulginiti Anthony , Oexle Nathalie , Stage Dese’Rae L. , Sheehan Lindsay , Cerel Julie , Moore Melinda
Published: October 2019

It is important to explore factors that could help or hinder one’s wellbeing following a suicide attempt, which could yield not only negative consequences but also posttraumatic growth (PTG; positive changes following a traumatic event). The present study used a multivariate analysis of covariance (MANCOVA) to test the relationship between disclosure, PTG, and posttraumatic depreciation among suicide attempt survivors when controlling for time since attempt and to test whether these effects remained after controlling for quality of support from family and friends. Suicide attempt survivors (n = 159) completed an online survey about their experiences. Increases in disclosure to family and friends but not to healthcare providers predicted changes in PTG. The effects of family disclosure remained even after controlling for quality of support. Disclosure to healthcare providers demonstrated some statistical effects on PTG, yet in the opposite direction and only after controlling for quality of support. The control variables—time since attempt and quality of support—were the only variables that predicted a change in posttraumatic depreciation. These findings suggest there is value in disclosing one’s personal story to family regardless of whether one receives supportive responses and that social support can impact one’s PTG.
Executive Function and Attention Performance in Children with ADHD: Effects of Medication and Comparison with Typically Developing Children
Authors: Miklós Martina , Futó Judit , Komáromy Dániel , Balázs Judit
Published: October 2019

The emerging literature reports that children with Attention-Deficit/Hyperactivity Disorder (ADHD) show deficits in executive functioning. To date, the combination of drug therapy with certain evidence-based non-medication interventions has been proven to be the most effective treatment for ADHD. There is a gap in the literature regarding comparing the executive functions (EF) of treatment naïve and medicated children with ADHD with both each other and typically developing children. Altogether, 50 treatment naïve and 50 medicated children with ADHD and 50 typically developing children between the ages of six and 12 were enrolled. The Mini International Neuropsychiatric Interview for Children and Adolescents (Mini Kid) and the Test of Attentional Performance for Children (KiTAP) measures were employed. Treatment naïve children with ADHD showed weaker performance on most executive function measures (12 out of 15) than either the medicated ADHD group or the controls. There were no significant differences between the medicated ADHD children and typically developing children in most KiTAP parameters (10 out of 15). Executive function impairments were observable in treatment naïve ADHD children, which draws attention to the importance of treating ADHD. Future studies should focus on the specific effects of stimulant medication on executive functions.
Mothers’ Subjective Well-Being after Having a Second Child in Current China: A Case Study of Xi’an City
Authors: Liu Jianghua , Zhou Zhongliang
Published: October 2019

The introduction of the two-child family planning policy in China calls for a study of the response of mothers’ subjective well-being after the birth of a second child. Generally focusing on Western countries, previous studies suggested that a series of factors could influence the response, but insufficient attention has been paid to the relative importance of these factors so far. Based on survey data from mothers of two children in the Xi’an metropolitan area, Shaanxi Province, China, our study indicates that the important factors associated with mothers’ life satisfaction after having a second child were, in general, common to Western countries and China. There were also two factors somewhat unique to China: positive adjustment (i.e., becoming happier) by firstborn children (average age, 6 years old) following a sibling’s birth, predicted enhanced life satisfaction for mothers; additionally, mothers who had both a son and a daughter reported the highest increase in life satisfaction, while mothers who had two sons reported the lowest increase. Socioenvironmental constraints (i.e., parenting pressure and work–family conflict) had a larger association with mothers’ life satisfaction than individual ideational factors (e.g., family orientation and fertility desire). These findings suggest that fertility-friendly policies and convenient family intervention institutions are needed to alleviate potential undesirable consequences and improve maternal life quality following a second childbirth so that the two-child policy can be a success.
Changes in Perceived Accessibility to Healthcare from the Elderly between 2005 and 2014 in China: An Oaxaca–Blinder Decomposition Analysis
Authors: Zhang Tao , Liu Jing , Liu Chaojie
Published: October 2019

Elderly people are characterized with high needs for healthcare, accompanied by high barriers in access to healthcare. This study aimed to identify temporal changes in access to healthcare and determinants of such changes from the elderly in China, over the period between 2005 and 2014. Two waves (2005 and 2014) of data were extracted from the Chinese Longitudinal Healthy Longevity Survey (CLHLS), measuring changes in perceived accessibility to healthcare when needed by the elderly (≥65 years). The effects of the explanatory variables (need, predisposing and enabling factors) on the changes were divided into two components using the Oaxaca–Blinder decomposition method: (1) the endowment portion as a result of distribution differences of the explanatory variables and (2) the coefficient portion as a result of differential responses of the dependent variable to the explanatory variables. Perceived accessibility to healthcare from the elderly increased from 89.6% in 2005 to 96.7% in 2014. The coefficient portion (82%) contributed more to the change than the endowment portion (63%) after adjustments for a negative interaction effect (−45%) between the two. Lower perceived accessibility was associated with older age, lower income, lower affordability of daily expenses and lower insurance coverage. But the coefficient effects suggested that their impacts on perceived accessibility to healthcare declined over time. By contrast, the impacts of gender and out-of-pocket payment ratio for medical care on perceived accessibility to healthcare increased over time. Perceived accessibility to healthcare from the elderly improved between 2005 and 2014. Gender gaps are closing. But the increased effect of out-of-pocket medical payments on perceived accessibility to healthcare deserves further investigation and policy interventions.
Evaluation of Long-Term Care Insurance Policy in Chinese Pilot Cities
Authors: Zhang Yanzhe , Yu Xiao
Published: October 2019

Since 2016, 15 pilot cities in China have implemented a long-term care insurance (LTCI) policy. The aim of this research was to explore the outcomes and evaluate the performance of the LTCI policy in the Chinese pilot cities and estimate the willingness of Chinese citizens to expand the formal implementation of LTCI policy in China. We gathered data from 1500 elderly people aged over 60 years in 15 pilot cities (100 surveys for each city) and the effective response rate was 77.8% (1167/1500). We relied on statistical analysis to elicit the outcomes and performance of LTCI implementation and an ordinal logit regression to analyze the factors associated with the extension of the LTCI policy. We examined factors associated with the perception according to sex, age, degree of disability, choices of care, living location, number of children, and monthly income. Among these factors, the relationship between living location and number of children of the family and the outcomes and performance of the LTCI policy in the pilot cities was significant. The rest of the factors showed no significance with the implementation of the LTCI in Chinese pilot cities. This study is among the first to explore the attitudes of Chinese citizens among those who have benefited from the LTCI policy in the pilot cities and contributes to identifying the outcomes of the LTCI in pilot cities to assist policymakers in their further implementation in China.
Assessment of Respiratory Health Symptoms and Asthma in Children near a Drying Saline Lake
Authors: Farzan Shohreh F. , Razafy Mitiasoa , Eckel Sandrah P. , Olmedo Luis , Bejarano Esther , Johnston Jill E.
Published: October 2019

Residents of the Imperial Valley, a rural, agricultural border region in California, have raised concerns over high rates of pediatric asthma symptoms. There is an urgent need to understand the influences and predictors of children’s respiratory health in Imperial Valley. We assessed the impacts of sociodemographic, lifestyle, and household factors on children’s respiratory health and asthma prevalence by administering a survey to parents of elementary school children (n = 357) in northern Imperial Valley. We observed an overall asthma prevalence of 22.4% and respiratory symptoms and allergies were widely reported, including wheezing (35.3%), allergies (36.1%), bronchitic symptoms (28.6%), and dry cough (33.3%). Asthmatics were significantly more likely to report respiratory symptoms, but high rates of wheezing, allergies, and dry cough were observed among nonasthmatics, suggesting the possibility for underdiagnosis of respiratory impairment in our school-age population. Having an asthmatic mother and exposure to environmental tobacco smoke were also associated with greater odds of asthma. Our findings provide evidence to support community concerns about children’s respiratory health, while also suggesting that household and demographic characteristics have limited explanatory power for assessing asthma in this population. This work provides critical baseline data with which to evaluate local environmental factors and their influence on asthma and respiratory symptoms.
“Youth Are More Aware and Intelligent than Imagined”: The Mountain Air Youth Photovoice Project
Authors: Cardarelli Kathryn M. , Paul Marcy , May Beverly , Dunfee Madeline , Browning Steven , Schoenberg Nancy
Published: October 2019

Appalachian Kentucky reports some of the highest rates of respiratory illness in the United States, including chronic obstructive pulmonary disease and asthma. While smoking rates are high in the region, unexplained variation remains, and community-engaged research approaches are warranted to identify contributing factors. The Mountain Air Project’s community advisory board recommended that investigators invite youth to provide their perspectives on possible contributing factors to respiratory illness, and we undertook an exploratory study to determine the utility of photovoice to elicit such perspectives with this population. While photovoice has been employed for other youth-focused health studies in Appalachia, to our knowledge, this work represents the region’s first environmental study using photovoice among youth. Over eight weeks, ten participants (age 12–18) represented their perspectives through photographs and accompanying narratives. A brief thematic content analysis of the youth narratives that accompanied the photos revealed three primary themes of environmental determinants of respiratory illness. These themes included compromises community members make regarding respiratory health in order to secure a livelihood; tension between cultural legacies and respiratory health; and consequences of geographic forces. This study demonstrates the value of incorporating youth perspectives in environmental health research, and that photovoice was a valuable approach to elicit such perspectives.
Scenario Modeling of Urbanization Development and Water Scarcity Based on System Dynamics: A Case Study of Beijing–Tianjin–Hebei Urban Agglomeration, China
Authors: Bao Chao , He Dongmei
Published: October 2019

Due to the accelerated process of urbanization in China, urban agglomerations have become the core areas for human settlement and economic development. High population and economic density has brought great pressure on water supply. Water scarcity is increasingly becoming one of the most important issues for the sustainable and healthy development of China’s urban agglomerations. In this paper, a system dynamics model was constructed to simulate the current conditions and future scenarios of urbanization development and water scarcity in the Beijing–Tianjin–Hebei (BTH) urban agglomeration in 2000–2030, by examining the interaction and feedback between the six major subsystems: water supply, water demand, water pollution, population urbanization, economic urbanization, and land urbanization. It is found that the South-to-North Water Diversion Project and the improved Reclaimed Water Reuse System may greatly increase the water supply. However, the speed of population urbanization and economic growth, the spatial structure of urban agglomeration and the water consumption pattern may determine the water demand. Although all scenarios may risk water scarcity in the future at some point, we could detect a comprehensive and relatively rational scenario to balance water scarcity, regional equity, and efficiency. It might help to synthetically understand the coordinated development mode between urbanization and water resources in Beijing–Tianjin–Hebei (BTH) urban agglomeration, and provide a useful analytical and decision support tool for scientists and policy-makers to achieve the sustainable urbanization development and water resource management.
Water Source Preferences and Water Quality Perceptions among Women in the Eastern Region, Ghana: A Grounded Theory Study
Authors: Chew Jhanel F. , Corlin Laura , Ona Fernando , Pinto Sarah , Fenyi-Baah Esther , Osei Bernard G. , Gute David M.
Published: October 2019

Residents in the Eastern Region, Ghana with access to improved water sources (e.g., boreholes and covered wells) often choose to collect water from unimproved sources (e.g., rivers and uncovered wells). To assess why, we conducted two field studies to coincide with Ghana’s rainy and dry seasons. During the rainy season, we conducted semi-structured in-depth interviews among a convenience sample of 26 women in four rural communities (including one woman in the dry season). We asked each participant about their attitudes and perceptions of water sources. During the dry season, we observed four women for ≤4 days each to provide context for water collection and water source choice. We used a grounded theory approach considering the multiple household water sources and uses approach to identify three themes informing water source choice: collection of and access to water, water quality perception, and the dynamic interaction of these. Women selected water sources based on multiple factors, including season, accessibility, religious/spiritual messaging, community messaging (e.g., health risks), and ease-of-use (e.g., physical burden). Gender and power dynamics created structural barriers that affected the use of unimproved water sources. A larger role for women in water management and supply decision-making could advance population health goals.
Who and How: Exploring the Preferred Senders and Channels of Mental Health Information for Wisconsin Farmers
Authors: Rudolphi Josie M. , Berg Richard , Marlenga Barbara
Published: October 2019

Unfavorable economic and environmental conditions have fueled the development of mental health resources and services for farmers. However, it is unclear who farmers want mental health information from (senders) and how they want mental health information delivered (channels). A self-administered questionnaire was used to determine the preferred senders of mental health information and the preferred channels of mental health information. Farmers were most receptive to receiving mental health information from medical providers, spouses/family members, and friends. Among the channels of information, respondents were interested in receiving mental health information from farm newspapers/magazines and one-on-one in person. Our findings have pragmatic implications for agricultural safety and health and public health organizations working to disseminate mental health information to farmers. Receptiveness to specific senders and channels of information among farmers should inform resource dispersion and future intervention.
Randomized Controlled Trial on Effects of a Brief Clinical-Based Intervention Involving Planning Strategy on Self-Care Behaviors in Periodontal Patients in Dental Practice
Authors: Lin Jo-Hsin , Huang Yuan-Kai , Lin Kun-Der , Hsu Yuan-Jung , Huang Wei-Fu , Huang Hsiao-Ling
Published: October 2019

Background: Strengthening adherence to self-care behaviors in patients with periodontal disease (PD) and reducing the plaque index is crucial for improving PD treatment. We evaluated the effectiveness of a theory of planned behavior (TPB)-based health education intervention involving a planning strategy on self-care behaviors in patients with PD. Methods: A randomized controlled trial was conducted; 158 and 139 patients comprised the experimental group (EG) and control group (CG), respectively. Both groups received a leaflet, and the EG also received a planning intervention, which was a brief one-on-one counseling session with a planning sheet. Data were collected using a self-administered questionnaire. Results: Between-group comparisons of TPB measures revealed significant differences in all domains when controlling for baseline covariates. The EG exhibited significantly higher levels of action and coping planning than the CG at two-week follow-up (effect size (ES) = 5.54 and 5.57, respectively) and six-week follow-up (ES = 5.66 and 5.66, respectively). Between-group differences in changes of brushing behaviors increased significantly. More frequent use of dental floss was observed in the EG than in the CG at two-week and six-week follow-ups (24.7% and 22.8%, respectively). Conclusions: The intervention involving planning strategy effectively promoted adherence to self-care behaviors in patients with PD.
Health Care Financing Systems and Their Effectiveness: An Empirical Study of OECD Countries
Authors: Ivanková Viera , Kotulič Rastislav , Gonos Jaroslav , Rigelský Martin
Published: October 2019

Background: The primary aim of the research in the present study was to determine the effectiveness of health care in classifying health care financing systems from a sample of OECD (Organisation for Economic Co-operation and Development) countries (2012–2017). This objective was achieved through several stages of analysis, which aimed to assess the relations between and relation diversity in selected variables, determining the effectiveness of health care and the health expenditure of health care financing systems. The greatest emphasis was placed on the differences between health care financing systems that were due to the impact of health expenditure on selected health outputs, such as life expectancy at birth, perceived health status, the health care index, deaths from acute myocardial infarction and diabetes mellitus. Methods: Methods such as descriptive analysis, effect analysis (η2), binomial logistic regression analysis, linear regression analysis, continuity analysis (ρ) and correspondence analysis, were used to meet the above objectives. Results: Based on several stages of statistical processing, it was found that there are deviations in several of the relations between different health care funding systems in terms of their predisposition to certain areas of health outcomes. Thus, where one system proves ineffective (or its effectiveness is questionable), another system (or systems) appears to be effective. From a correspondence analysis that compared the funding system and other outputs (converted to quartiles), it was found that a national health system, covering the country as a whole, and multiple insurance funds or companies would be more effective systems. Conclusions: Based on the findings, it was concluded that, in analyzing issues related to health care and its effectiveness, it is appropriate to take into account the funding system (at least to verify the significance of how research premises affect the systems); otherwise, the results may be distorted.
Understanding the Hierarchical Relationships in Female Sex Workers’ Social Networks Based on Knowledge, Attitude, and Practice
Authors: Dong Xianlei , Sun Mengge , Wang Jingguo , Yang Zhihan , Hu Beibei
Published: October 2019

Female sex workers (FSWs) represent a high-risk population for HIV infection and transmission. In general, their fellow FSWs (peers) also play a role in their level of susceptibility to HIV/AIDS. This paper draws from interview data of 93 FSWs to construct a multi-layer FSW social network model based on their knowledge, attitude, and practice (KAP). Statistical analyses of the correlation among the three dimensions of KAP as well as their social interactions indicated that FSWs had basic knowledge of HIV/AIDS prevention but demonstrated little enthusiasm in acquiring relevant information. Their knowledge, attitude, and practice were highly positively correlated. Their attitude was more likely to be negatively influenced by their companions, while their practice was more likely to be positively affected. Besides, FSWs exhibited high homophily in KAP with their neighbors. Thus, during HIV/AIDS interventions, FSWs should receive individualized education based on their specific KAP. Considering the high level of homophily among FSWs, their propensity to be positive or negative in their KAP are significantly influenced by their companions. Making full use of peer education and social interaction-based interventions may help prevent and control the spread of HIV/AIDS.
Is a History of Falling Related to Oral Function? A Cross-Sectional Survey of Elderly Subjects in Rural Japan
Authors: Hasegawa Yoko , Horii Nobuhide , Sakuramoto-Sadakane Ayumi , Nagai Koutatsu , Ono Takahiro , Sawada Takashi , Shinmura Ken , Kishimoto Hiromitsu
Published: October 2019

Background: Deteriorated physical function makes older adults prone to fall, and it is therefore known to prompt elders to require long-term care. In this regard, oral function can be related to the loss of motor function. This cross-sectional study assessed the oral factors that increase the risk of falling among older adults. Methods: We surveyed 672 self-reliant elderly individuals aged ≥65 years who were dwelling in a rural area. We assessed each subject’s risk of falling and any related anxiety. Oral-related conditions (number of teeth, occlusal support, masticatory performance, occlusal force, and tongue pressure) and physical motor functions (gait speed, knee extension force, and one-legged standing) were also assessed. Statistical analyses were performed using Mann-Whitney’s U-test, the χ2 test, and a logistic regression model. Results: In all subjects, 23% had a history of falling, while 40% had anxiety over falling. Both factors were significantly higher among female subjects, who also had slower gait speeds, and greater lateral differences in occlusion. The subjects with histories of falling were older, had impaired physical motor function, and exhibited a decrease in occlusal force and left/right occlusal imbalances. We recognized similar trends for anxiety about falling. Conclusions: These results revealed that the risk of falling might be lessened by maintaining healthy teeth occlusion and promoting healthy oral function.
Mental Disabilities Increase the Risk of Respiratory Infection-Related Healthcare Utilization
Authors: Chiang Chen-Hung , Tsai Ming-Che , Ng Yee-Yung , Wu Shiao-Chi
Published: October 2019

Patients with chronic mental illness are highly vulnerable to chronic respiratory problems. We examined the influence of mental disability on respiratory infection-related utilization risk in individuals with and without mental disabilities (MDs). A population-based, retrospective cohort design and two-part model were used to analyze respiratory infection-related utilization in individuals with MDs (MD group) and a matched reference group. The respiratory infection-related utilization rate in one year was lower in the MD group (53.8%) than in the reference group (56.6%). The odds ratios (ORs) were significantly higher among individuals with profound MDs (aOR = 1.10; 95% CI: 1.07–1.14) and those with a history of dental cavities (aOR = 1.16; 95% CI: 1.13–1.19) or periodontal disease (aOR = 1.22; 95% CI: 1.19–1.26) after controlling for covariables. The average number of visits was higher in the MD group (5.3) than in the reference group (4.0). The respiratory infection-related utilization rate and average number of visits were significantly higher in the mild, moderate and severe disabled groups with a history of periodontal disease, respectively, than that of the reference group. In conclusion, healthcare authorities must develop an incentive program to prevent respiratory infections among individuals with MDs.