bluuebunny/crossref_metadata_2025 huggingface dataset:
Effect of C242T Polymorphism in the Gene Encoding the NAD(P)H Oxidase p22phox Subunit and Aerobic Fitness Levels on Redox State Biomarkers and DNA Damage Responses to Exhaustive Exercise: A Randomized Trial
Authors: Cho Su-Youn , So Wi-Young , Roh Hee-Tae
Published: June 2020

NAD(P)H oxidases (NOXs) constitute a principal source of cellular reactive oxygen species (ROS) and contribute to exercise-induced ROS production in the skeletal muscle. Here, we aimed to investigate the effect of single-bout exhaustive exercise on redox state biomarkers and oxidative DNA damage based on the C242T polymorphism in the gene encoding NOXs subunit p22phox (CYBA) and aerobic fitness levels. We enrolled 220 healthy adults in their 20s (men, n = 110; women, n = 110), who were divided into CC genotype and T allele groups through the analysis of the CYBA C242T polymorphism. Furthermore, maximum oxygen uptake (VO2max) was evaluated to divide subjects into high fitness (HF; 70th percentile for aerobic fitness) and mid-range fitness (MF; 40–60th percentile for aerobic fitness) groups, with a total of 32 subjects assigned to four groups (eight subjects per group): CC genotype and HF group (CC + HF), CC genotype and MF group (CC + MF), T allele and HF group (T + HF), and T allele and MF group (T + MF). All subjects performed treadmill running exercise at 85% of VO2max until exhaustion. Plasma lactate, malondialdehyde (MDA), superoxide dismutase (SOD), and lymphocyte DNA damage (tail DNA percentage [TD], tail length [TL], and the tail moment [TM]) were measured in the blood samples obtained immediately before (IBE), immediately after (IAE), and 30 min after exercise (30 MAE). Plasma lactate levels, SOD activities, and lymphocyte DNA damage markers (TD, TL, and TM) were significantly increased at IAE than that at IBE and significantly decreased at 30 MAE (p < 0.05). All groups displayed increased plasma MDA levels at IAE rather than at IBE, with CC + MF being significantly higher than T + HF (p < 0.05); only the CC + HF and T + HF groups exhibited a significant reduction at 30 MAE (p < 0.05). Moreover, TL at IAE was significantly higher in the CC + MF group than in the T + HF group (p < 0.05), and significantly higher in the CC + MF and CC + HF groups than in the T + HF group at 30 MAE (p < 0.05). TM was significantly higher in the T + MF than in the T + HF group at IAE (p < 0.05) and that of CC + MF was significantly higher than CC + HF and T + HF values at IAE and 30 MAE (p < 0.05). These results suggest that single-bout exhaustive exercise could induce peripheral fatigue and the accumulation of temporary redox imbalance and oxidative DNA damage. Moreover, high aerobic fitness levels combined with the T allele may protect against exercise-induced redox imbalance and DNA damage.
A Serosurvey Identifying Vulnerability to Measles in Health Care Workers. A Hospital-Based Prospective Seroprevalence Study
Authors: Malinová Jana , Petráš Marek , Čelko Alexander M.
Published: June 2020

The aim of this serological survey was to assess the persistence of measles antibodies among health care workers (HCWs) at risk of incidental measles. A prospective study of measles-specific antibodies in serum samples obtained from a total of 2782 participants aged 19–89 years was conducted between May 2018 and December 2019. The seropositivity rate of 93.7% (95% CI: 92.4–94.9%) in fully vaccinated participants aged 19–48 years was significantly lower than that of 98.0% (95% CI: 96.5–99.0%) in participants naturally immunised before 54 years. A cohort of those born in 1971–1975, vaccinated predominantly with one dose, showed lower seropositivity persistence (86.6%) than those fully vaccinated with two doses or naturally immunised. Otherwise, seropositivity was not markedly influenced by sex, age, smoking status, overweight, obesity or concomitant disease. The presence of sufficient antibody levels in a high proportion of HCWs irrespective of the way they acquired immunity is a favourable finding for managing incidental measles; hence, in the presence of a risk of a measles outbreak, it would be possible to perform targeted vaccination of only at-risk HCWs with a history of incomplete vaccination or missing information about the way in which immunity is acquired.
China’s Pathway towards Solar Energy Utilization: Transition to a Low-Carbon Economy
Authors: Gulzar Muhammad Awais , Asghar Haroon , Hwang Jinsoo , Hassan Waseem
Published: June 2020

Rapid economic growth has caused many environmental problems in China, resulting in international pressure on China to fight against climate change and to shift to a more environmentally friendly economy. Therefore, over the past decades, China has been working on transforming its economy to counter the concerns of different environmental hazards caused by the burning fossil fuels and rising oil imports to support the energy sector. This study explores the shift in the Chinese government’s policies towards a low-carbon economy by adopting more environmentally friendly solar energy. A cost–benefit analysis of the solar water heater industry in China indicates that it not only brings economic benefits to society but also environmental benefits to the earth. Furthermore, this paper focuses on the use of solar energy as a kind of renewable energy, as solar energy is plentiful, which is beneficial from both an environmental and economic perspective.
Sleep Quality and Psychological Status in a Group of Italian Prisoners
Authors: D’Aurizio Giulia , Caldarola Angelica , Ninniri Marianna , Avvantaggiato Marialucia , Curcio Giuseppe
Published: June 2020

Prison could be considered a prolonged stressful situation that can trigger not only a dysregulation of sleep patterns but can also bring out psychiatric illness, such as anxiety and depression symptoms. Our study is aimed at exploring sleep quality and sleep habits in an Italian prison ward with three different security levels, and to attempt to clarify how anxiety state and the total time spent in prison can moderate insomnia complaints. There were 129 participants divided into three groups who enrolled in this study: 50 were in the medium-security prison ward (Group 1), 58 were in the high-security prison ward (Group 2) and 21 were in the medium-security following a protocol of detention with reduced custodial measures (Group 3). All participants filled in a set of questionnaires that included the Beck Depression Inventory (BDI-2), the State-Trait Anxiety Inventory (STAI), the Pittsburgh Sleep Quality Index (PSQI), and the Insomnia Severity Index (ISI). Based on their responses, we observed that all participants showed poor sleep quality and insomnia, mild to moderate depressive symptoms that tended to a higher severity in Groups 1 and 3, and the presence of clinically significant anxiety symptoms, mainly in Groups 1 and 3. Our study shows that increased anxiety state-level and the presence of mood alteration corresponds to an increase in both poor sleep quality and, more specifically, insomnia complaints. Finally, we propose that TiP (total time in prison) could have an interesting and stabilizing paradox-function on anxiety state and insomnia.
Assessment of Patient Safety and Cultural Competencies among Senior Baccalaureate Nursing Students
Authors: Lee Seung Eun , Lee Meen Hye , Peters Anya Bostian , Gwon Seok Hyun
Published: June 2020

This descriptive, correlational, cross-sectional study examined nursing students’ educational experiences on self-reported perceptions of patient safety and cultural competence in terms of curriculum content and learning venues. We performed descriptive analyses and a one-way analysis of variance with a sample of senior-year nursing students (N = 249) attending three state universities in the United States. We used the Nurse of the Future Nursing Core Competency Model, the Patient Safety Competency Self-Evaluation Tool for Nursing Students, and The Cultural Competence Assessment Instrument. Overall, participants reported that patient safety and cultural competencies were addressed in their curricula primarily through classroom activities as opposed to laboratory/simulation or clinical settings. Among the required patient safety knowledge topics, elements of highly reliable organizations were covered the least. For patient safety competency, participants reported higher scores for attitude and lower scores for skill and knowledge. For cultural competency, participants scored much higher for cultural awareness and sensitivity than behavior. There was no statistically significant difference between scores for patient safety and cultural competencies by nursing school. The results support the need for curriculum development to include all important aspects of patient safety and cultural competencies in various teaching/learning venues.
Awareness and Knowledge Regarding the Consumption of Dietary Fiber and Its Relation to Self-Reported Health Status in an Adult Arab Population: A Cross-Sectional Study
Authors: Alfawaz Hanan , Khan Nasiruddin , Alhuthayli Haya , Wani Kaiser , Aljumah Muneerah A. , Khattak Malak Nawaz Khan , Alghanim Saad A. , Al-Daghri Nasser M.
Published: June 2020

The objective of this study was to examine the awareness, knowledge, and habits regarding dietary fiber intake and to analyze its relationship with self-reported health status among Saudi adults. A survey-based study using face-to-face interview was designed, and 1363 apparently healthy adult Saudi males and females participated. Most participants were females (81.2%), aged 25 and above (87.2%), and were educated at least up to the secondary level of education (80.8%). The majority of the participants were aware of the role of fiber-rich foods in health conditions such as obesity (70.5%), cardiovascular diseases (68.9%), and regulation of blood sugar (68.9%), with females significantly having higher nutrition knowledge than males. A disconnect in translating this nutrition knowledge was observed particularly in food choices when eating out, where preferences for white bread (84.4%), fried potatoes (69.9%) and peeled fruits (60.6%) were significantly higher than preferences for cooked vegetables (29.6%) and brown bread (18.1%). The most common reason for this disconnect was due to perception that foods rich in dietary fibers were expensive (72.1%), have less health benefits (56.5%), were not readily available (51.6%), and participants’ disliking of the taste (52.8%). Participants in the highest quartile (Q4) for dietary fiber consumption reported a lower prevalence of constipation (odds ratio, 95% confidence interval of 0.40, 0.28–0.57, p < 0.01), high cholesterol (0.43, 0.27–0.68, p < 0.01) and obesity (0.67, 0.44–0.98, p = 0.03) than participants in the lowest quartile (Q1). Dietary fiber intake appears to be protective against constipation, high cholesterol and obesity in Saudi adults. However, a disparity observed between knowledge and attitude towards intake of dietary fibers could limit its health benefits. Further studies including adolescents should be conducted to impart knowledge on the emotional, cognitive and sensory factors related to food choices in order to minimize the gap between nutrition knowledge and the consumption of healthy high-fiber diets.
“You Need ID to Get ID”: A Scoping Review of Personal Identification as a Barrier to and Facilitator of the Social Determinants of Health in North America
Authors: Sanders Chris , Burnett Kristin , Lam Steven , Hassan Mehdia , Skinner Kelly
Published: June 2020

Personal identification (PID) is an important, if often overlooked, barrier to accessing the social determinants of health for many marginalized people in society. A scoping review was undertaken to explore the range of research addressing the role of PID in the social determinants of health in North America, barriers to acquiring and maintaining PID, and to identify gaps in the existing research. A systematic search of academic and gray literature was performed, and a thematic analysis of the included studies (n = 31) was conducted. The themes identified were: (1) gaining and retaining identification, (2) access to health and social services, and (3) facilitating identification programs. The findings suggest a paucity of research on PID services and the role of PID in the social determinants of health. We contend that research is urgently required to build a more robust understanding of existing PID service models, particularly in rural contexts, as well as on barriers to accessing and maintaining PID, especially among the most marginalized groups in society.
Simulation of Land Use Change and Ecosystem Service Value Dynamics under Ecological Constraints in Anhui Province, China
Authors: Hu Sai , Chen Longqian , Li Long , Zhang Ting , Yuan Lina , Cheng Liang , Wang Jia , Wen Mingxin
Published: June 2020

Land use change has a significant impact on the structure and function of ecosystems, and the transformation of ecosystems affects the mode and efficiency of land use, which reflects a mutual interaction relationship. The prediction and simulation of future land use change can enhance the foresight of land use planning, which is of great significance to regional sustainable development. In this study, future land use changes are characterized under an ecological optimization scenario based on the grey prediction (1,1) model (GM) and a future land use simulation (FLUS) model. In addition, the ecosystem service value (ESV) of Anhui Province from 1995 to 2030 were estimated based on the revised estimation model. The results indicate the following details: (1) the FLUS model was used to simulate the land use layout of Anhui Province in 2018, where the overall accuracy of the simulation results is high, indicating that the FLUS model is applicable for simulating future land use change; (2) the spatial layout of land use types in Anhui Province is stable and the cultivated land has the highest proportion. The most significant characteristic of future land use change is that the area of cultivated land continues to decrease while the area of built-up land continues to expand; and (3) the ESV of Anhui Province is predicted to increase in the future. The regulating service is the largest ESV contributor, and water area is the land use type with the highest proportion of ESV. These findings provide reference for the formulation of sustainable development policies of the regional ecological environment.
Maternal but Not Paternal High-Fat Diet (HFD) Exposure at Conception Predisposes for ‘Diabesity’ in Offspring Generations
Authors: Schellong Karen , Melchior Kerstin , Ziska Thomas , Rancourt Rebecca C. , Henrich Wolfgang , Plagemann Andreas
Published: June 2020

While environmental epigenetics mainly focuses on xenobiotic endocrine disruptors, dietary composition might be one of the most important environmental exposures for epigenetic modifications, perhaps even for offspring generations. We performed a large-scale rat study on key phenotypic consequences from parental (F0) high-caloric, high-fat diet (HFD) food intake, precisely and specifically at mating/conception, focusing on ‘diabesity’ risk in first- (F1) and second- (F2) generation offspring of both sexes. F0 rats (maternal or paternal, respectively) received HFD overfeeding, starting six weeks prior to mating with normally fed control rats. The maternal side F1 offspring of both sexes developed a ‘diabesity’ predisposition throughout life (obesity, hyperleptinemia, hyperglycemia, insulin resistance), while no respective alterations occurred in the paternal side F1 offspring, neither in males nor in females. Mating the maternal side F1 females with control males under standard feeding conditions led, again, to a ‘diabesity’ predisposition in the F2 generation, which, however, was less pronounced than in the F1 generation. Our observations speak in favor of the critical impact of maternal but not paternal metabolism around the time frame of reproduction for offspring metabolic health over generations. Such fundamental phenotypic observations should be carefully considered in front of detailed molecular epigenetic approaches on eventual mechanisms.
The Impact of an Individual Educational Program on the Quality of Life and Severity of Symptoms of Patients with Irritable Bowel Syndrome
Authors: Sierżantowicz Regina , Lewko Jolanta , Jurkowska Grażyna
Published: June 2020

Background: Irritable bowel syndrome (IBS) is one of the most common functional diseases of the gastrointestinal tract. A typical symptom is changed bowel patterns: diarrhea, constipation, or alternation of the two. Abdominal pains vary in intensity and location, with periods of exacerbation and remission, causing disorganization in everyday life and work. Educational intervention could be one strategy to improve the well-being of IBS patients. Only a few trials have examined this hypothesis. The aim of this study was to examine the effect of an educational program combined with elements of behavioral therapy, individualized for each patient, on quality of life (QOL) and severity of pain of patients with IBS. Methods: In total, 150 IBS patients and 100 healthy persons in the control group were included. QOL (36-Item Short Form Health Survey, SF-36) and pain severity (Visual Analogue Scale) were measured at baseline and six months after education of IBS patients. Results: At baseline, patients with IBS showed highly significantly worse QOL. In the IBS group, significantly higher physical component summary (PCS) and mental component summary (MCS) scores were noted for 35- to 50-year-old patients compared to other patients. Six months after education and behavioral therapy, significant improvement in QOL and a significant decrease in the subjective perception of pain severity were noted compared to values before therapeutic education. Conclusion: An educational program combined with elements of behavioral therapy, individualized for patients with IBS, is an important part of therapy for these patients.
Validation of the Lasher and Faulkender Anxiety about Aging Scale (AAS) for the Spanish Context
Authors: Fernández-Jiménez Carolina , Álvarez-Hernández Joaquín F. , Salguero-García Darío , Aguilar-Parra José M. , Trigueros Rubén
Published: June 2020

Increased longevity has led to concerns and fears among the population about the inexorable process of ageing. This process causes individuals to become more anxious about the physical and psychosocial changes caused by the passage of time. However, there are currently no scales in the Spanish context that analyse ageing. Therefore, the aim of the present study is to validate the Anxiety about Aging scale to the Spanish context. In the present study, 594 subjects between 25 and 64 years old participated. Both exploratory and confirmatory factor analyses were used. The results revealed that the factor structure of the questionnaire shows adequate psychometric properties, showing a four-factor factor structure.
The Association between Noise Exposure and Metabolic Syndrome: A Longitudinal Cohort Study in Taiwan
Authors: Huang Tao , Chan Ta-Chien , Huang Ying-Jhen , Pan Wen-Chi
Published: June 2020

Metabolic syndrome is becoming more common worldwide. Studies suggest environmental pollution, including traffic noise, might be linked with metabolic syndrome. This study sought to evaluate how noise exposure is linked to the development of metabolic syndrome and its components in Taiwan. Using data from a cohort of 42,509 participants and Cox proportional hazards regression models, the effects of noise exposure on metabolic syndrome and its components were quantified. After adjustment for covariates (age, gender, body mass index, and physical activity), the hazard ratio for metabolic syndrome was 1.13 (95% CI: 1.04–1.22) for medium noise exposure and 1.24 (95% CI: 1.13–1.36) for high noise exposure. Noise exposure was also positively associated with all of metabolic syndrome’s components. This finding suggests noise exposure might contribute to metabolic syndrome and its components. Policies aiming to reduce noise pollution might reduce the risks of metabolic syndrome and its components.
Do Rescuers’ Physiological Responses and Anxiety Influence Quality Resuscitation under Extreme Temperatures?
Authors: Martin-Conty José Luis , Martin-Rodríguez Francisco , Criado-Álvarez Juan José , Romo Barrientos Carmen , Maestre-Miquel Clara , Viñuela Antonio , Polonio-López Begoña , Durantez-Fernández Carlos , Marcos-Tejedor Félix , Mohedano-Moriano Alicia
Published: June 2020

Teaching and training cardiopulmonary resuscitation (CPR) through simulation is a priority in Health Sciences degrees. Although CPR is taught as a simulation, it can still be stressful for the trainees since it resembles a real-life circumstance. The aim of this study was to assess the physiological effects and anxiety levels of health sciences undergraduates when faced with CPR process in different temperatures (room temperature, extremely cold, or extremely warm). This was a descriptive cross-sectional before–after study conducted during the 2018/2019 academic year with 59 students registered in the Faculty of Health Sciences of the Castilla-La Mancha University (UCLM). State Trait Anxiety Inventory (STAI) questionnaires were distributed among the students before and after the CPR simulation. We found greater level of situational anxiety in undergraduates faced with extreme adverse temperature scenarios (extreme heat and cold), especially in conditions of extreme heat compared to controlled environment (at room temperature). We discovered differences regarding sex, in which men scored 6.4 ± 5.55 points (STAI after CPR score) and women scored 10.4 ± 7.89 points (STAI after CPR score). Furthermore, there was less lactate in blood, before and during the event in individuals with anxiety. In addition, beginning in Minute 7, we observed a remarkable decrease (but not significant) in the performance of rescuers with anxiety. Programs targeted at promoting coping mechanisms to reduce anxiety before a critical clinic situation should be implemented in academic training.
Multimorbidity Patterns in the General Population: Results from the EpiChron Cohort Study
Authors: Ioakeim-Skoufa Ignatios , Poblador-Plou Beatriz , Carmona-Pírez Jonás , Díez-Manglano Jesús , Navickas Rokas , Gimeno-Feliu Luis Andrés , González-Rubio Francisca , Jureviciene Elena , Dambrauskas Laimis , Prados-Torres Alexandra , Gimeno-Miguel Antonio
Published: June 2020

The correct management of patients with multimorbidity remains one of the main challenges for healthcare systems worldwide. In this study, we analyze the existence of multimorbidity patterns in the general population based on gender and age. We conducted a cross-sectional study of individuals of all ages from the EpiChron Cohort, Spain (1,253,292 subjects), and analyzed the presence of systematic associations among chronic disease diagnoses using exploratory factor analysis. We identified and clinically described a total of 14 different multimorbidity patterns (12 in women and 12 in men), with some relevant differences in the functions of age and gender. The number and complexity of the patterns was shown to increase with age in both genders. We identified associations of circulatory diseases with respiratory disorders, chronic musculoskeletal diseases with depression and anxiety, and a very consistent pattern of conditions whose co-occurrence is known as metabolic syndrome (hypertension, diabetes, obesity, and dyslipidaemia), among others. Our results demonstrate the potential of using real-world data to conduct large-scale epidemiological studies to assess the complex interactions among chronic conditions. This could be useful in designing clinical interventions for patients with multimorbidity, as well as recommendations for healthcare professionals on how to handle these types of patients in clinical practice.
When Is the Negative Effect of Abusive Supervision on Task Performance Mitigated? An Empirical Study of Public Service Officers in Korea
Authors: Park Heetae , Choi Wonseok , Kang Seung-Wan
Published: June 2020

Supervisory leadership has occupied an important place in management literature in identifying the supervisory behaviors that are associated with positive outcomes. However, researchers also have turned their attention to the dark side of supervisory behavior, such as abusive supervision. This study investigates the role of coworker support and self-efficacy in the relationship between abusive supervision and the subordinate’s task performance. Data are collected from 192 supervisor–subordinate pairs in the South Korean Army. As hypothesized, when subordinates receive higher levels of coworker support or have higher self-efficacy, abusive supervision is less negatively related to task performance. The implications of the study and directions for future research are discussed.
Three-Year Longitudinal Association Between Built Environmental Factors and Decline in Older Adults’ Step Count: Gaining insights for Age-Friendly Urban Planning and Design
Authors: Hino Kimihiro , Usui Hiroyuki , Hanazato Masamichi
Published: June 2020

This study examined the longitudinal association between the change in the step count of older adults and the neighborhood-built environment (BE) in Yokohama, Japan. We analyzed pedometer data in March 2016 and March 2019 that were acquired from 21,557 older adults aged 65–79 years at baseline, who lived in 758 neighborhoods in Yokohama City and participated in the Yokohama Walking Point Program (YWPP). Six BE variables were computed, for each of which neighborhoods were classified into quartiles. Using multilevel regression analysis, we examined the association between the BE variables, baseline step count, and change in step count. Higher population density, lower intersection density, and the second shortest quartile of the average distance to the nearest railway station were associated with a higher baseline step count. A lower intersection density and shorter average distance to the nearest railway station were associated with a smaller decline. The lowest quartile of population density was inversely associated with step-count decline. In conclusion, the neighborhood BEs were not only associated with their step count at baseline, but also widened the disparity of the step count over the three years. These findings would contribute to creating age-friendly cities where older adults can maintain and promote their health.
Relationship between Alcohol Consumption and Drinking Refusal Self-Efficacy among University Students: The Roles of Sports Type and Gender
Authors: Kim Youngho , Kuan Garry
Published: June 2020

The present study examines the relationship between drinking behaviour and drinking refusal self-efficacy among university students, with a focus on the influential roles of sports type and gender. A total of 354 students from Seoul National University of Science and Technology volunteered and participated in this study. The Korean Alcohol Use Disorders Identification Test (AUDIT-K), the Korean Drinking Refusal Self-Efficacy (DRSE) Questionnaire-Revised, and a questionnaire measuring participation in sports activities were administered to measure students’ alcohol drinking behaviours, refusal self-efficacy and sport-related activities, respectively. The data were analysed using descriptive statistics, two-way ANOVAs, correlation analysis, and regression analysis. The subdomains of DRSE had significant influences on binge drinking. Specifically, low DRSE in situations involving social pressure played a key role in predicting increased binge drinking. There was also a significant relationship between sports type and drinking behaviour, but only for male students. Those who participated in individual sports binge drank less than those who participated in team sports. Finally, gender differences were also revealed in drinking behaviour. Male students were more likely to binge drink compared to their female counterparts. This study offers a foundation for practical interventions to help control problematic drinking behaviour among university students.
Risk of Prevalent Asthma among Children Affected by Inflammatory Bowel Disease: A Population-Based Birth Cohort Study
Authors: Barbiellini Amidei Claudio , Zingone Fabiana , Zanier Loris , Canova Cristina
Published: June 2020

Literature on the risk of asthma among children with inflammatory bowel disease (IBD) is limited and has reported discording results. To the best of our knowledge, no previous study has evaluated the association between asthma and childhood onset IBD, focusing on pediatric IBD with onset between 10 and 17 years, early-onset IBD (EO-IBD) between 0 and 9 years, and very early-onset IBD (VEO-IBD) between 0 and 5 years, all conditions characterized by different clinical progressions. A nested matched case-control design on a longitudinal cohort of 213,515 newborns was adopted. Conditional binomial regression models were used to estimate odds ratios (OR) and 95% confidence intervals (CI) of asthma among children with IBD compared with controls. We found 162 children with IBD and 1620 controls. Overall, childhood onset IBD was associated with increased risks of being affected by asthma (OR: 1.49 95% CI 1.05–2.12), although a significant risk was only present among males (OR: 1.60 95% CI 1.02–2.51). Children with Crohn’s disease and ulcerative colitis had similarly increased risks, although they failed to attain statistical significance. Risks of asthma based on age at IBD onset were inversely related to age, with the lowest non-significant risks for pediatric IBD and EO-IBD, while children affected by VEO-IBD had the highest risk of asthma (OR: 2.75 95% CI 1.26–6.02). Our study suggests the presence of a higher prevalence of asthma among both male children with IBD and children with VEO-IBD. It could be advisable to pay greater attention to possible respiratory symptoms among these categories at higher risk.
Outpatient Visits among Older Adults Living Alone in China: Does Health Insurance and City of Residence Matter?
Authors: Wang Jianyun , Pei Yaolin , Zhong Renyao , Wu Bei
Published: June 2020

This study aimed to examine the association between health insurance, city of residence, and outpatient visits among older adults living alone in China. A sample of 3173 individuals was derived from “Survey on Older Adults Aged 70 and Above Living Alone in Urban China” in five different cities. Logistic regression models indicated that older adults living alone who had urban employee basic medical insurance, urban resident basic medical insurance, and public medical insurance were more likely to have outpatient visits than those without any health insurance. After controlling the number of chronic diseases, only those with public medical insurance were more likely to have outpatient visits than uninsured older adults. Additionally, older adults who resided in Shanghai and Guangzhou were more likely to have outpatient visits than those in Chengdu, whereas older adults who were in Dalian and Hohhot were less likely to have outpatient visits. To improve the equity of outpatient visits among older adults living alone in China, policy efforts should be made to reduce fragmentation of different health insurance plans, expand the health insurance coverage for older adults, provide programs that consider the needs of this special group of older adults, and reduce the inequality in health resources and health insurance policies across cities.
A Review of Players’ Characterization and Game Performance on Male Rink-Hockey
Authors: Ferraz António , Valente-Dos-Santos João , Sarmento Hugo , Duarte-Mendes Pedro , Travassos Bruno
Published: June 2020

The aim of this study was to review the evolutionary tendencies of research regarding to the study of male Rink-Hockey players´ and game performance. A systematic search was conducted in PubMed, Web of Knowledge and Scopus databases according to PRISMA method. The initial search identified 815 titles, resulting in 19 articles being included within the review. Original papers (English language) contained relevant data regarding rink hockey players’ performance or morphological/physiological demands, anthropometry/body composition characteristics were eligible. Studies were classified into categories: (1) Physiological Demands, (2) Anthropometry and Body Composition, (3) Game Characterization/Patterns, (4) Injuries. Results indicated that Rink hockey requires high intensity effort which demands both short and long duration efforts requirements from players. Body composition analysis shows to be an important monitoring tool which complements the understanding of the athlete’s cardiac adaptation. Game patterns shows a combination of specific game momentums with different outcomes according to the game zone. The intense short-term movements, collision and contact between players, in addition to the weight and speed of the hard ball and the stick, can considerably increase the risk of moderate and severe injuries. Lack of literature in Rink-Hockey is remarkable, and research is mainly focused on children and adolescents’ players. Furthermore, the existing research with adult elite athletes was assessed with a small sample size.
The Political Economy of Tobacco in Mozambique and Zimbabwe: A Triangulation Mixed Methods Protocol
Authors: Lencucha Raphael , Drope Jeffrey , Labonte Ronald , Cunguara Benedito , Ruckert Arne , Mlambo Zvikie , Kadungure Artwell , Bialous Stella , Nhamo Nhamo
Published: June 2020

Changing global markets have generated a dramatic shift in tobacco consumption from high-income countries (HICs) to low- and middle-income countries (LMICs); by 2030, more than 80% of the disease burden from tobacco use will fall on LMICs. Propelling this shift, opponents of tobacco control have successfully asserted that tobacco is essential to the economic livelihoods of smallholder tobacco farmers and the economy of tobacco-growing countries. This nexus of economic, agricultural and public health policymaking is one of the greatest challenges facing tobacco control efforts, especially in LMICs. To date, there is a lack of comparative, individual level evidence about the actual livelihoods of tobacco-growing farmers and the political economic context driving tobacco production. This comparative evidence is critically important to identify similarities and differences across contexts and to provide local evidence to inform policies and institutional engagement. Our proposed four-year project will examine the economic situation of smallholder farmers in two major tobacco-growing LMICs—Mozambique and Zimbabwe—and the political economy shaping farmers’ livelihoods and tobacco control efforts. We will collect and analyze the existing data and policy literature on the political economy of tobacco in these two countries. We will also implement household-level economic surveys of nationally representative samples of farmers. The surveys will be complimented with focus group discussions with farmers across the major tobacco-growing regions. Finally, we will interview key informants in these countries in order to illuminate the policy context in which tobacco production is perpetuated. The team will develop country-level reports and policy briefs that will inform two sets of dissemination workshops in each country with relevant stakeholders. We will also conduct workshops to present our findings to the survey and focus group participants, and other members of these tobacco-growing communities, so they can directly benefit from the research to which they are contributing.
Eat to Live, Don’t Live to Eat: Black Men, Masculinity, Faith and Food
Authors: Brown Letisha Engracia Cardoso
Published: June 2020

Men often have poorer health outcomes than women. In the United States, Black men in particular tend to have worse health than not only Black women but other racial/ethnic groups of men. One factor that contributes to health is the role of masculinity. Previous research notes that men who cling to hegemonic notions of masculine identity tend to engage in negative health behaviors. However, hegemonic masculinity is not the realm in which Black men exist. Criminalized, surveilled, and subject to structural racism and racial discrimination, Black masculinities exist on their own spectrum separate from that of White men. One characteristic associated with Black masculinity is that of faith, and faith is a growing field of study with respect to health. This paper examines the relationship between Black masculinity as framed by faith in shaping the food and eating habits of Black men. Food and eating are central to health and well-being yet remain understudied with respect to Black masculinity through the lens of faith. This study offers a qualitative account of Black men’s experiences through the use of in-depth interview data. The key finding of this study is that fasting operates as a mechanism of health promotion for Black men. This paper utilizes the term Black men as an all-encompassing term of members of the African diaspora as opposed to African American in order to recognize the diversity of the participants in this study.
Association of Stress-Induced Hyperglycemia and Diabetic Hyperglycemia with Mortality in Patients with Traumatic Brain Injury: Analysis of a Propensity Score-Matched Population
Authors: Tsai Yu-Chin , Wu Shao-Chun , Hsieh Ting-Min , Liu Hang-Tsung , Huang Chun-Ying , Chou Sheng-En , Su Wei-Ti , Hsu Shiun-Yuan , Hsieh Ching-Hua
Published: June 2020

Background: Hyperglycemia at the time of hospital admission is associated with higher morbidity and mortality rates in patients with traumatic brain injury (TBI). Using data from the Chang Gung Research Database (CGRD), this study aimed to compare mortality outcomes between patients with stress-induced hyperglycemia (SIH), diabetic hyperglycemia (DH), and nondiabetic normoglycemia (NDN). The study occurred at Keelung, Linkou, Chiayi, and Kaohsiung Chang Gung Memorial Hospitals (CGMHs). Methods: A total of 1166, 6318, 3622, and 5599 health records from Keelung, Linkou, Chiayi, and Kaohsiung CGMHs, respectively, were retrieved from the CGRD for hospitalized patients with TBI between January 2001 and December 2015. After propensity score matching for sex, age, and Glasgow Coma Scale (GCS) score, the matched cohorts were compared to evaluate differences in the primary outcome between patients with SIH, DH, and NDN. In-hospital mortality was the primary outcome. Results: The analysis of matched patient populations revealed that at the Kaohsiung CGMH, patients with SIH had 1.63-fold (95% CI: 1.09–2.44; p = 0.017) and 1.91-fold (95% CI: 1.12–3.23; p = 0.017) higher odds of mortality than patients with NDN and DH, respectively. Similar patterns were found at the Linkou CGMH; patients with SIH had higher odds of mortality than patients with NDN and DH. In contrast, at the Keelung CGMH, patients with SIH had significantly higher odds of mortality than those with NDN (OR: 3.25; 95% CI: 1.06–9.97; p = 0.039). At the Chiayi CGMH, there were no significant differences in mortality rates among all groups. Conclusions: This study’s results suggest that SIH and DH differ in their effect on the outcomes of patients with TBI. The results were similar between medical centers but not nonmedical centers; in the medical centers, patients with SIH had significantly higher odds of mortality than patients with either NDN or DH.
Preserving Organizational Resilience, Patient Safety, and Staff Retention during COVID-19 Requires a Holistic Consideration of the Psychological Safety of Healthcare Workers
Authors: Rangachari Pavani , L. Woods Jacquelynn
Published: June 2020

During the COVID-19 pandemic, healthcare workers are fighting a lethal virus with acute shortages of Personal Protective Equipment (PPE). These unprecedented circumstances have amplified the sources of emotional distress and worker burnout. However, many healthcare organizations (HCOs) in the United States, have opted for a “stoic approach” to healthcare worker support, i.e., no additional support beyond federal and state policy protections for the licensing and liability of healthcare workers. In this scenario, a key public health concern is sustaining an adequate healthcare workforce, both by way of quantity (adequate numbers) and quality (maximizing clinician resilience to provide safe care to large volumes of patients under challenging conditions). Therefore, it is imperative for HCO leaders to recognize that a limited view of worker psychological safety, without due consideration for the broader emotional distress created by the pandemic, could have the effect of restricting organizational resilience and adversely impacting patient safety and staff retention during and beyond the pandemic. This paper uses the organizational resilience framework to discuss the potential impact of a stoic approach to healthcare worker support on patient safety and staff retention in a hospital intensive care unit (ICU) during COVID-19. The discussion in turn, helps to develop recommendations for HCOs to overcome these challenges.
Association of Nap Duration after Lunch with Prevalence of Metabolic Syndrome in a Chinese Government Employee Population
Authors: He Jun , Ouyang Feiyun , Qiu Dan , Duan Yanying , Luo Dan , Xiao Shuiyuan
Published: June 2020

Metabolic syndrome is an important risk factor for cardiovascular disease, type 2 diabetes mellitus, and all-cause mortality. However, the relationship between napping and metabolic syndrome remains contradictory. The aim of this study was to evaluate the association between nap duration after lunch and prevalence of metabolic syndrome, and subgroup differences in the associations among a government employee population. A total of 5129 participants (mean age 39.4 years) were included in this study. Nap duration after lunch was self-reported, and metabolic syndrome was defined according to the Joint Interim Statement in 2009. Multivariate logistic regression models and adjusted restricted cubic spline functions were used to examine the association and dose-response relationship between nap duration after lunch and prevalence of metabolic syndrome. Of the participants, 17.3% had metabolic syndrome and 81.4% were habitual nappers. Adjusted odds ratio (OR) (95% confidence interval (CI)) of metabolic syndrome for longer nap duration (>90 min) per day was 1.77 (95% CI 1.09 to 2.89), compared with reference (~30 min). Results of stratification analyses indicated the association was found only among females (OR 3.02, 95% CI 1.38 to 6.57), participants without mood symptoms (OR 1.97, 95% CI 1.19 to 3.25), and those having longer night sleep duration (≥8 h) (OR 2.34, 95% CI 1.20 to 4.56). Longer nap duration was also associated with components of metabolic syndrome, including elevated waist circumference, elevated fasting plasma glucose, and elevated triglycerides. In conclusion, longer nap duration after lunch was associated with a higher prevalence of metabolic syndrome in females, people without mood symptoms, and people having longer night sleep duration.
Loneliness, Depressive Mood and Cyberbullying Victimization in Adolescent Victims of Cyber Dating Violence
Authors: Cava María-Jesús , Tomás Inés , Buelga Sofía , Carrascosa Laura
Published: June 2020

Currently, cyber dating violence (CDV) is a serious health problem among adolescents due to their frequent use of communication technologies in their romantic relationships including the use of these technologies to perpetrate dating violence. However, research on this topic is recent and more studies about victims’ psychosocial adjustment are needed. The objectives of this study were to analyze the prevalence of CDV victimization according to frequency (occasional and frequent) and type (cyber control and cyber-aggression) and to explore their relations with loneliness, depressive mood and cyberbullying victimization. A total of 604 adolescents (M age = 14.32, SD = 1.67) who had a dating relationship at the time or in the past 12 months, participated in this study. The results showed a higher prevalence for cyber-control than cyber-aggression victimization, and positive correlations of CDV victimization with depressive mood and cyberbullying victimization in boys and girls. Positive correlations with loneliness were also observed for girls. The average effect size of the aforementioned correlations was large for girls and medium for boys. Both boys and girls who were frequent victims of CDV also suffered more cyberbullying by peers than those who were never, and occasionally, cyber victimized by their partners. Girls who were frequent victims of CDV also reported higher scores for loneliness and depressive mood, with a small average effect size. All these results highlight close relations between cyberbullying and CDV in adolescents, being necessary to pay greater attention to possible experiences of poly-victimization, and a worse psychosocial adjustment in frequently victimized girls than boys. These findings may be useful for developing more effective intervention programs.
Influence of the CAD-CAM Systems on the Marginal Accuracy and Mechanical Properties of Dental Restorations
Authors: Padrós Roberto , Giner Luís , Herrero-Climent Mariano , Falcao-Costa Carlos , Ríos-Santos José-Vicente , Gil Francisco Javier
Published: June 2020

The aim of this study was to compare the quality of different computer-assisted-design and computer assisted manufacturing systems (CAD-CAM) generated by only one scanner, focusing on vertical fit discrepancies and the mechanical properties. A master model was obtained from a real clinical situation: the replacement of an absent (pontic) tooth, with the construction of a fixed partial denture on natural abutments with three elements. Nine scans were performed by each tested and 36 copies were designed using a dental CAD-CAM software (Exocad). The frameworks were manufactured using three-axis and five-axis, with the same batch of the chrome-cobalt (CrCo) alloy. The frameworks were not cemented. A focus ion beam-high resolution scanning electron microscope (FIB-HRSEM) allowed us to obtain the vertical gap measurements in five points for each specimen. Roughness parameters were measured using white light interferometry (WLI). The samples were mechanically characterized by means of flexural tests. A servo-hydraulic testing machine was used with a cross-head rate of 1 mm/min. One-way ANOVA statistical analysis was performed to determine whether the vertical discrepancies and mechanical properties were significantly different between each group (significance level p < 0.05). The overall mean marginal gap values ranged: from 92.38 ± 19.24 µm to 19.46 ± 10.20 µm, for the samples produced by three-axis and five-axis machines, respectively. Roughness was lower in the five-axis machine than the three-axis one, and as a consequence, the surface quality was better when the five-axis machine was used. These results revealed a statistically significant difference (p < 0.005) in the mean marginal gap between the CAD-CAM systems studied. The flexural strength for these restorations range from 6500 to 7000 N, and does not present any statistical differences’ significance between two CAD-CAM systems studied. This contribution suggests that the number of axes improves vertical fit and surface quality due to the lower roughness. These claims show some discrepancies with other studies.