bluuebunny/crossref_metadata_2025 huggingface dataset:
Patterns of Risky Sexual Behaviors and Associated Factors among Youths and Adolescents in Vietnam
Authors: Ngoc Do Ha , Ngoc Nguyen Diep , Quynh Thi Nguyen Hoa , Tuan Nguyen Anh , Duy Nguyen Hiep , Phuong Bui Thanh , Bich Thi Vu Thao , Thanh Le Khiet , Tuan Nguyen Dung , Tat Nguyen Cuong , Gia Vu Linh , Thu Vu Giang , Xuan Tran Bach , A. Latkin Carl , C. M. Ho Roger , S. H. Ho Cyrus
Published: March 2020

Youths and adolescents are vulnerable to HIV/STIs from unprotected sex. Promotion of young population’s awareness about risky sexual behaviors is essential to develop contextualized interventions. A cross-sectional study was conducted in five Vietnamese provinces to document current attitudes and practices regarding sexual behaviors among youths. The information on sociodemographic characteristics, substance use, and sexual behaviors was collected via self-reported questionnaires. The factors associated with risky sexual behaviors were identified by the multivariate logistic regression. Among the 1200 participants, 73.5% reported having sex in their lifetime, and 48.1% used condoms at their latest sexual intercourse. Participants in urban areas were more likely not to intend to use condoms and had a higher unintended pregnancy rate than in rural areas. Older age was positively associated with not wanting to use and not using condoms. Substance-using participants were more likely to not use condoms. The participants taking alcohol or other stimulants before sex had a higher likelihood of unintended pregnancy. Respondents’ attitudes and practices regarding sexual behaviors were associated with gender and employment. This study indicated that young population’s awareness in Vietnam is high, however, risky sexual behaviors also remain common. Sex-related educational programs about the consequences of substance use, multiple sex partners, and unprotected sex should be developed.
Relationship between Subjective Oral Discomfort and Health-Related Quality of Life in the South Korean Elderly Population
Authors: Do Kyung-Yi , Moon Sook
Published: March 2020

This study examined the relationship between oral discomfort and health-related quality of life (HRQOL) in the Korean elderly, using the datasets provided by the Korea National Health and Nutrition Examination Survey (KHNANES) over 6 consecutive years (2010–2015). A total of 13,618 participants aged 65 years and over were included in the final analysis. A complex sample logistic regression was performed to determine the impact of oral discomfort on HRQOL. The results revealed that toothache, masticatory discomfort, and pronunciation problems caused by oral health conditions were all risk factors for decreased HRQOL. In particular, masticatory discomfort (adjusted odds ratio (AOR) 1.63, Model III (adjusted for all covariates)) and pronunciation problems (AOR 1.64, Model III) negatively impacted the HRQOL of the elderly to a great extent. Masticatory discomfort had a stronger negative impact on HRQOL in the domains of “self-care” (AOR 1.83) and “usual activities” (AOR 1.66), while pronunciation problems had a similar impact on all five domains of the EuroQol 5-Dimension (EQ-5D). These findings could serve as baseline data for setting up early intervention programs for the timely prevention of oral health-related discomfort problems that greatly affect the QOL of the elderly population, and for the development of comprehensive and efficient dental insurance policies.
Comparison between Two Different Device Models 18 Hz GPS Used for Time–Motion Analyses in Ecological Testing of Football
Authors: Gimenez Jesus Vicente , Garcia-Unanue Jorge , Navandar Archit , Viejo-Romero David , Sanchez-Sanchez Javier , Gallardo Leonor , Hernandez-Martin Antonio , Felipe Jose Luis
Published: March 2020

Background: The aim of this study was to compare the validity of two different GPS device models used for time–motion analyses in ecological testing of football. Methods: Ten healthy male players from a Spanish university football team participated in this study. The team sport simulation circuit (TSCC) used was based on previous research examining the validity and interunit reliability of different GPS systems. Participants were required to complete eight laps of the TSSC, resulting in a total distance of 1320 m. The GPS units used for the current study were the 18 Hz StatsSport Apex Pro and 18 Hz RealTrack WIMU Pro. Participants were required to wear either of the two GPS units during the test. To establish the construct validity of GPS as a measure of Vmax, timing lights were used as a gold standard. Results: The results clearly suggest that it is not possible to use the same 18 Hz GPS model or interchange it. The measurement can be considered precise when the noise is at least equal to or lower than the smallest worthwhile change. In this case, all standard deviation in measurement error was higher than the smallest worthwhile change. This is due to an inconsistency in the data processing of each trademark. Conclusions: It is important to prevent a club using different GPS trademarks at the same time, since it is not possible to compare in any case any type of result obtained between different trademarks.
Malaysian Child Restraint Issues: A Brief Narrative Review
Authors: Ramli Roszalina , Mohd Yunus Siti Salmiah
Published: March 2020

The child restraint legislation in Malaysia becomes mandatory from 1 January 2020. Prior to commencement of the rule, a survey showed that only 36% of Malaysian parents were aware of the importance of a child restraint system (CRS) and only 27% usage was reported during travel. The Malaysian Institute of Road Safety report showed that children transported in private vehicles were the leading groups of casualties among children aged 1 to 4 years old (43.8%) and 5 to 9 years old (30.2%), respectively. We performed a narrative review using the PubMed, ScienceDirect and Google Scholar databases using keywords such as child restraint system, unrestrained injuries, Malaysia and epidemiology. The objectives of this review were: (1) to determine the prevalence on the use of CRS in Malaysia, (2) to evaluate the injuries related to unrestrained children and (3) to show the nation’s preparation towards implementation of the child restraint law. Six papers on prevalence, one paper on injury and six mainstream newspaper were included in this study. The prevalence of a CRS use was shown between 5% to 41.8%. In relation to injury, the only publication from this country showed that among 19 children involved in a car crash, five (26.3%) children had non-craniomaxillofacial (CMF) injuries, ten (52.6%) with CMF injuries only, two (10.5%) with both CMF and non-CMF injuries and two (10.5%) without any injury. Overall, the Injury Severity Score (ISS) range was between 0 to 13 (median, 1.00; interquartile range, 1). Preparation to comply with the best practice of the child restraint law is still ongoing, especially those addressing the issues related to the low-income parents in the country. Due to scarcity of publication and data on the CRS use and injuries related to its non-usage, it is advocated that parallel with the implementation legislation, vigorous forms of public education as well as good data management must be performed and monitored regularly by the road safety authority in this country.
Human Inhalation Exposure to Aerosol and Health Effect: Aerosol Monitoring and Modelling Regional Deposited Doses
Authors: Oh Hyeon-Ju , Ma Yoohan , Kim Jongbok
Published: March 2020

Since poor air quality affects human health in the short and long term, much research has been performed on indoor and outdoor aerosol exposure; however, there is a lack of specific data on the exposure and health risks of inhalable aerosols that contain bioaerosol in different environments of human life. To investigate the potential exposure to inhalable aerosols (in the monitoring of particulate matter (PM) based on R modeling, variations of PM depend on the ventilation system and bioaerosols based on size distribution) in various environments, the special viability and culturability of bioaerosols and their deposition doses in the respiratory system were evaluated. We conducted exposure assessments on inhalable aerosols in various indoor environments (childcare facilities, schools, commercial buildings, elderly and homes). The fractions of PM (PM10, PM4 and PM2.5) were investigated and, for the bioaerosol, the viability, culturability, inhalation daily dose and the deposited dose of the aerosol in the respiratory system were calculated to evaluate the human health effects. For two years, the distribution of the indoor PM concentration was high in all PM fractions in schools and commercial buildings, and low in the elderly and at homes. For airborne bacteria, the highest concentrations were shown in the childcare facility during the four seasons, while airborne fungi showed high concentrations in the buildings during the spring and summer, which showed significant differences from other investigated environments (between the buildings and elderly and homes: p < 0.05). The viability and culturability for the bioaerosol showed no significant difference in all environments, and the correlation between inhalable PM and bioaerosol obtained from the six-stage impactor showed that the coefficient of determination (R2) between coarse particles (PM10–2.5, the size of stage 2–3) and cultivable airborne bacteria ranged from 0.70 (elderly and homes) to 0.84 (school) during the summer season.
“Digging Deeper” into the Relationship Between Safety Climate and Turnover Intention Among Stone, Sand and Gravel Mine Workers: Job Satisfaction as a Mediator
Authors: Balogun Abdulrazak O. , Andel Stephanie A. , Smith Todd D.
Published: March 2020

Employee turnover has been linked to negative business performance outcomes, increased costs, and disruptions to operations. Research to explore predictors of turnover intention is important to the mining industry, including the stone, sand, and gravel mining (SSGM) industry. Safety climate has been linked to job satisfaction and reductions in turnover intention in other fields, but investigation within SSGM has virtually been non-existent, creating a knowledge gap. This research seeks to address this dearth of information. Cross-sectional data from 452 workers in the SSGM industry were analyzed to assess the influence of safety climate on turnover intention through job satisfaction. Mediation analyses showed that job satisfaction significantly mediated the relationship between safety climate and turnover intention. The implications of these novel findings are important for SSGM administrators. It suggests that bolstering safety programs and increasing safety climate perceptions will help increase job satisfaction and reduce turnover intention among workers in the SSGM industry.
Scale-Up of Doppler to Improve Intrapartum Fetal Heart Rate Monitoring in Tanzania: A Qualitative Assessment of National and Regional/District Level Implementation Factors
Authors: Plotkin Marya , George John , Bundala Felix , Tibaijuka Gaudiosa , Njonge Lusekelo , Lemwayi Ruth , Drake Mary , Bishanga Dunstan , Rawlins Barbara , Ramaswamy Rohit , Singh Kavita , Wheeler Stephanie
Published: March 2020

High-quality intrapartum care, including intermittent monitoring of fetal heart rates (FHR) to detect and manage abnormalities, is recommended by WHO and the Government of Tanzania (GoT) and creates potential to save newborn lives in Tanzania. Handheld Doppler devices have been investigated in several low-resource countries as an alternative to Pinard stethoscope and are more sensitive to detecting accelerations and decelerations of the fetal heart as compared to Pinard. This study assessed perspectives of high-level Tanzanian policymakers on facilitators and barriers to scaling up use of the hand-held Doppler for assessing FHR during labor and delivery. From November 2018–August 2019, nine high-level policymakers and subject matter experts were interviewed using a semi-structured questionnaire, with theoretical domains drawn from Proctor’s implementation outcomes framework. Interviewees largely saw use of Doppler to improve intrapartum FHR monitoring as aligning with national priorities, though they noted competing demands for resources. They felt that GoT should fund Doppler, but prioritization and budgeting should be driven from district level. Recommended ways forward included learning from scale up of Helping Babies Breathe rollout, making training approaches effective, using clinical mentoring, and establishing systematic monitoring of outcomes. To be most effective, introduction of Doppler must be concurrent with improving case management practices for abnormal intrapartum FHR. WHO’s guidance on scale-up, as well as implementation science frameworks, should be considered to guide implementation and evaluation.
Molecular Probes to Evaluate the Synthesis and Production Potential of an Odorous Compound (2-methylisoborneol) in Cyanobacteria
Authors: Kim Keonhee , Yoon Youngdae , Cho Hyukjin , Hwang Soon-Jin
Published: March 2020

The volatile metabolite, 2-Methylisoborneol (2-MIB) produced by cyanobacterial species, causes odor and taste problems in freshwater systems. However, simple identification of cyanobacteria that produce such off-flavors may be insufficient to establish the causal agent of off-flavor-related problems as the production-related genes are often strain-specific. Here, we designed a set of primers for detecting and quantifying 2-MIB-synthesizing cyanobacteria based on mibC gene sequences (encoding 2-MIB synthesis-catalyzing monoterpene cyclase) from various Oscillatoriales and Synechococcales cyanobacterial strains deposited in GenBank. Cyanobacterial cells and environmental DNA and RNA were collected from both the water column and sediment of a eutrophic stream (the Gong-ji Stream, Chuncheon, South Korea), which has a high 2-MIB concentration. Primer sets mibC196 and mibC300 showed universality to mibC in the Synechococcales and Oscillatoriales strains; the mibC132 primer showed high specificity for Pseudanabaena and Planktothricoides mibC. Our mibC primers showed excellent amplification efficiency (100–102%) and high correlation among related variables (2-MIB concentration with water RNA r = 689, p < 0.01; sediment DNA r = 0.794, p < 0.01; and water DNA r = 0.644, p < 0.05; cyanobacteria cell density with water RNA and DNA r = 0.995, p < 0.01). These primers offer an efficient tool for identifying cyanobacterial strains possessing mibC genes (and thus 2-MIB-producing potential) and for evaluating mibC gene expression as an early warning of massive cyanobacterial occurrence.
Cumulative Prospect Theory: Performance Evaluation of Government Purchases of Home-Based Elderly-Care Services Using the Pythagorean 2-tuple Linguistic TODIM Method
Authors: Lu Jianping , He Tingting , Wei Guiwu , Wu Jiang , Wei Cun
Published: March 2020

The aging trend of China’s population is increasing, and the pension problem is becoming increasingly prominent. The pension mode provided by the government alone can no longer meet the social demand, and the government’s purchase of home-based care services from social organizations has become a new trend. In order to improve the efficiency and quality of pension services, a reasonable performance evaluation model needs to be established. Performance evaluations of home-based elderly-care services purchased by the government are problematic as a result of multiple-attribute group decision-making (MAGDM), as the problems are not single-attribute or single-expert issues. The extended TODIM not only integrates the advantages of cumulative prospect theory (CPT) into a consideration of the psychological factors of DMs, but also retains the superiority of the classical TODIM in relative dominance. The Pythagorean 2-tuple linguistic sets (P2TLSs) could easily depict qualitative assessment information related to the government’s purchase of home-based care services. Thus, in this paper, we extend the TODIM method based on the cumulative prospect theory (CPT) to the Pythagorean 2-tuple linguistic sets (P2TLSs) and propose a Pythagorean 2-tuple linguistic CPT-TODIM (P2TL-CPT-TODIM) method for MAGDM. The P2TL-CPT-TODIM method was proven superior to the classical one through a case study that included a performance evaluation of a home-based elderly-care service purchased by the government. Meanwhile, a comparison with the P2TL-CPT-TODIM method was performed to demonstrate the stability and effectiveness of the designed method.
Traumatic Experiences and Mental Health Risk for Refugees
Authors: Schlaudt Victoria A. , Bosson Rahel , Williams Monnica T. , German Benjamin , Hooper Lisa M. , Frazier Virginia , Carrico Ruth , Ramirez Julio
Published: March 2020

Refugees who settle in Western countries exhibit a high rate of mental health issues, which are often related to experiences throughout the pre-displacement, displacement, and post-displacement processes. Early detection of mental health symptoms could increase positive outcomes in this vulnerable population. The rates and predictors of positive screenings for mental health symptoms were examined among a large sample of refugees, individuals with special immigrant visas, and parolees/entrants (N = 8149) from diverse nationalities. Logistic regression analyses were used to determine if demographic factors and witnessing/experiencing violence predicted positive screenings. On a smaller subset of the sample, we calculated referral acceptance rate by country of origin. Refugees from Syria, Iraq, and Afghanistan were most likely to exhibit a positive screening for mental health symptoms. Refugees from Sudan, Iraq, and Syria reported the highest rate of experiencing violence, whereas those from Iraq, Sudan, and the Democratic Republic of Congo reported the highest rate of witnessing violence. Both witnessing and experiencing violence predicted positive Refugee Health Screener-15 (RHS-15) scores. Further, higher age and female gender predicted positive RHS-15 scores, though neither demographic variable was correlated with accepting a referral for mental health services. The findings from this study can help to identify characteristics that may be associated with risk for mental health symptoms among a refugee population.
Association between Food Label Unawareness and Loss of Renal Function in Diabetes: A Cross-Sectional Study in South Korea
Authors: Joo Jae Hong , Lee Doo Woong , Choi Dong-Woo , Park Eun-Cheol
Published: March 2020

Objectives: To examine sex differences in the association between food label unawareness and loss of renal function among South Korean diabetic patients aged ≥30 year and determine whether reading food labels when choosing which food products to consume plays a potential role in slowing the progression of renal disease. Methods: Data from the 2016–2017 Korea National Health and Nutrition Examination Survey were used for the analysis. Renal function was determined by the Modification of Diet in Renal Disease estimated glomerular filtration rate, and food label unawareness was defined as being unaware of the food label when choosing a food product for consumption. Multiple regression analysis was used to investigate the association between food label unawareness and loss of renal function among South Korean diabetic patients. Results: Four hundred and eighty-seven diabetic patients (men: 274; women: 213) were enrolled. Loss of renal function was associated with food label unawareness in only male diabetic patients (men: β = –10.01, standard error (SE) = 5.08, p = 0.0506; women: β = –0.30, SE = 5.14, p = 0.9528). A strong association was found between loss of renal function and food label unawareness among socially isolated male diabetic patients who lived in a one-generational household, did not have a spouse, and ate alone. Conclusion: Cultivating habits of reading food labels and inducing social facilitation may play a potential role in managing loss of renal function among male diabetic patients.
Field Validation of Commercially Available Food Retailer Data in the Netherlands
Authors: Canalia Cesare , Pinho Maria , Lakerveld Jeroen , Mackenbach Joreintje
Published: March 2020

The aim of this study was to validate a Dutch commercial dataset containing information on the types and locations of food retailers against field audit data. Field validation of a commercial dataset (“Locatus”) was conducted in February 2019. Data on the location and classification of food retailers were collected through field audits in 152 streets from four urban and four rural neighborhoods in the Netherlands. The classification of food retailers included eight types of grocery stores (e.g., supermarkets, bakeries) and four types of food outlets (e.g., cafés, take away restaurants). The commercial dataset in the studied area listed 322 food retailers, whereas the field audit counted 315 food retailers. Overall, the commercially available data showed “good” to “excellent” agreement statistics (>0.71) with field audit data for all three levels of analysis (i.e., location, classification and both combined) and across urban as well as rural areas. The commercial dataset under study provided an accurate description of the measured food environment. Therefore, policymakers and researchers should feel confident in using this commercial dataset as a source of secondary data.
New Application of Osteogenic Differentiation from HiPS Stem Cells for Evaluating the Osteogenic Potential of Nanomaterials in Dentistry
Authors: Tetè Giulia , Capparè Paolo , Gherlone Enrico
Published: March 2020

Objective: HiPS stem cells are commonly used for the study of medical disorders. The laboratory in which this study was conducted uses these cells for examining the treatment and cure of neurodegenerative diseases. Bone regeneration poses the greatest challenge for an oral surgeon both in terms of increased implant osseointegration and reducing bone healing times. The aim of this study was to validate the protocol in the literature to produce and then test in vitro osteoblasts with different nanomaterials to simulate bone regeneration. Method: hiPS clones (#2, #4, and #8) were differentiated into an osteoblast cell culture tested for alizarin red staining and for alkaline phosphatase testing at 14, 21 and 28 days, after the cells were plated. Results: The cells showed diffuse positivity under alizarin red staining and the alkaline phosphatase (ALP)-test, showing small formations of calcium clusters. Conclusion: Despite the limitations of our study, it is a starting point for further protocols, laying a solid foundation for research in the field of bone regeneration through the use of stem cells.
Understanding Threats to Young Children’s Green Space Access in Unlicensed Daycare Centers in Japan
Authors: Rupprecht Christoph D. D. , Cui Lihua
Published: March 2020

Access to green space (GS) is vital for children’s health and development, including during daycare. In Japan, deregulation to alleviate daycare shortages has created a new category of so-called unlicensed daycare centers (UDCs) that often lack dedicated GS. UDCs rely on surrounding GS, including parks, temples and university grounds, but reports of conflicts highlight the precarity of children’s well-being in a rapidly aging country. Knowledge about GS access in Japanese UDCs remains scarce. Our mail-back survey (n = 173) of UDCs and online survey (n = 3645) of parents investigated threats to GS access during daycare across 14 Japanese cities. Results suggest that UDCs use a variety of GS and aim to provide daily access. Caregivers are vital in mediating children’s access, but locally available GS diversity, quality and quantity as well as institutional support were perceived as lacking. Parents did not rank GS high among their priorities when selecting daycare providers, and showed limited awareness of conflicts during GS visits. Implications of this study include the need for caregivers and parents to communicate and collaborate to improve GS access, and the importance of strong public investment into holistically improving GS diversity, quality and quantity from the perspective of public health and urban planning.
Behavioral, Emotional and School Adjustment in Adolescents with and without Developmental Language Disorder (DLD) Is Related to Family Involvement
Authors: Valera-Pozo Mario , Adrover-Roig Daniel , Pérez-Castelló Josep A. , Sanchez-Azanza Victor A. , Aguilar-Mediavilla Eva
Published: March 2020

Developmental language disorder (DLD) refers to a language delay in the absence of other underlying causes. Individuals with DLD can also present other problems related to behavioral, scholarly, and emotional aspects of their daily lives because of their language difficulties. Moreover, these difficulties could be influenced by family and socioeconomic characteristics. Twenty-eight bilingual adolescents with and without DLD in typical schools were followed from childhood to adolescence. At age five, language and cognitive variables were assessed. In addition, language, behavior, emotional and school adjustment, and socioeconomic and family aspects were evaluated at age 12. Results reveal that adolescents with DLD show poorer school adjustment and less adaptive skills when evaluated by their tutors, and a larger index of emotional problems when self-assessed. Moreover, family involvement, but not socioeconomic status (SES), emerged as a protective factor since it was related to behavioral, emotional, and school adjustment, a result that was further confirmed by structural equation modeling. Therefore, a more global approach involving individuals, schools and families is needed to provide adolescents with DLD adequate support. It is important to stimulate their social skills and emotional adjustment so they can cope with social difficulties more easily, especially at school.
Identification, Computational Examination, Critical Assessment and Future Considerations of Distance Variables to Assess Collective Tactical Behaviour in Team Invasion Sports by Positional Data: A Systematic Review
Authors: Rico-González Markel , Pino-Ortega José , Nakamura Fabio Y. , Moura Felipe Arruda , Los Arcos Asier
Published: March 2020

The aim of the study was the identification, computational examination, critical assessment and future considerations of distance variables to assess collective tactical behaviour in team invasion sports by positional data. A total of 3973 documents were initially retrieved. Finally, 72 articles met the inclusion criteria, but only 26 suggested original tactical variables based on the distance variables. The distance variables can be classified into player–player, player–space, player–ball, and Geometrical Centre (GC)–GC /player/space/goal. In addition, several nonlinear techniques have been used to analyse the synchronisation and predictability of the distance variables in team invasion sports. Player–opponent distance is of special interest in those sports in which man-marking is commonly used, and in the micro-structure close to scoring situations in all sports. In addition, player–player distances are used to measure the length and the width of the team and player–GC distance to assess the dispersion of the team. Player–space distances have been measured to assess the distance of the player/team-line to relevant areas of the playing space. Several techniques have been applied to analyse the synchronisation (i.e., Hilbert transformation and cluster analyses) and the complexity and regularity or predictability (i.e., approximate entropies, sample entropy, cross-sample entropy and average mutual information) of the distance variables in team invasion sports, revealing the lack of consensus. Although the distance variables may be interesting tactical variables when considered in isolation, it would be enriching to analyse the relationship among these variables.
Treatment of High-Concentration Wastewater from an Oil and Gas Field via a Paired Sequencing Batch and Ceramic Membrane Reactor
Authors: Wei Yuan , Jin Yue , Zhang Wenjie
Published: March 2020

A sequencing batch reactor (SBR) and a ceramic membrane bioreactor (CMBR) were used in conjunction (SBR+CMBR) to treat high-concentration oil and gas field wastewater (HCOGW) from the China National Offshore Oil Corporation Zhanjiang Branch (Zhanjiang, Guangdong, China). The chemical oxygen demand (COD) and the oil concentrations in the wastewater were 20,000–76,000 and 600–2200 mg/L, respectively. After the SBR+CMBR process, the effluent COD and oil content values were less than 250 mg/L and 2 mg/L, respectively, which met the third level of the Integrated Wastewater Discharge Standards of China (GB8978-1996). Through microbiological analysis, it was found that the CMBR domesticated a previously unreported functional microorganism (JF922467.1) that successfully formed a new microbial ecosystem suitable for HCOGW treatment. In conjunction with the SBR process, the CMBR process effectively reduced pollutant concentrations in HCOGW. Moreover, economic analyses indicated that the total investment required to implement the proposed infrastructure would be approximately 671,776.61 USD, and the per-unit water treatment cost would be 1.04 USD/m3.
The Relationship between Frailty Syndrome and Concerns about an Implantable Cardioverter Defibrillator
Authors: Mlynarska Agnieszka , Mlynarski Rafal , Uchmanowicz Izabella , Marcisz Czeslaw , Golba Krzysztof S.
Published: March 2020

Frailty syndrome may cause cognitive decline and increased sensitivity to stressors. This can result in an increased incidence of anxiety and depression, and thus, concerns about life with an implantable cardioverter defibrillator (ICD). The aim of the study was to assess the impact of frailty syndrome on the increase in the number of device-related concerns after the implantation of an ICD. Material and methods: The study sample was a group of 103 consecutive patients (85 M; aged 71.6 ± 8.2) with an implanted ICD. The ICD Concerns Questionnaire (ICDC) was used to analyze their concerns about life with an ICD, and the Tilburg Frailty Indicator scale (TFI) was used to diagnose frailty. Results: In the group of patients with an ICD implanted, 73% had recognized frailty (83.3% women, 74.1% men); the average point value was 6.55 ± 2.67. The total ICDC questionnaire score for the patients with an implanted cardioverter defibrillator was 34.06 ± 18.15. Patients with frailty syndrome had statistically (p = 0.039) higher scores (36.14 ± 17.08) compared to robust patients (27.56 ± 20.13). In the logistic regression analysis, the presence of frailty was strongly associated with the total questionnaire score (OR = 1.0265, p = 0.00426), the severity of the concerns (OR = 1.0417, p = 0.00451), and device-specific concerns (OR = 1.0982, p = 0.00424). Conclusion: Frailty syndrome occurs in about 80% of patients after ICD implantation. The presence of frailty syndrome was strongly associated with concerns about an implantable cardioverter defibrillator.
Impact of 12-Month Smartphone Breathing Meditation Program upon Systolic Blood Pressure among Non-Medicated Stage 1 Hypertensive Adults
Authors: Chandler Jessica , Sox Luke , Diaz Vanessa , Kellam Kinsey , Neely Allison , Nemeth Lynne , Treiber Frank
Published: March 2020

(1) Background: Hypertension (HTN) affects ~50% of adults and is a major risk factor for stroke and cardiovascular disease. In 2017, the SPRINT trial outcomes led to lowering of HTN cutoffs by the American College of Cardiology (ACC) and American Heart Association (AHA). The Joint National Committee (JNC8) and National High BP Education Program recommend that lifestyle modifications be used as first-line HTN treatment. Chronic stress is a risk factor for HTN and cardiovascular disease. A recently completed 12 month randomized controlled trial (RCT) of a breathing meditation smart phone app (Tension Tamer, TT) involving JNC8 designated pre-HTN adults provided an opportunity to examine its impact upon individuals now classified as having stage 1 HTN. The TT app captures continuous real-time heart rate (HR) from a user’s fingertip placed over a video camera lens during sessions. Users receive immediate feedback graphs after each session, showing their HR changes. They also receive motivational and social reinforcement SMS text messages the following day based upon levels of adherence. We conducted ancillary analyses of a 2-arm, 12-month, small-scale efficacy RCT among a subgroup of our total sample of participants, who are now classified as having stage 1 non-medicated systolic HTN. Primary outcome was change in resting systolic blood pressure (SBP). Secondary outcomes were change in resting diastolic blood pressure, adherence to the TT protocol, and perceived stress levels. (2) Methods: 30 adults (mean age: 45.0 years; 15 males; 16 White; 14 Black) with ACC/AHA 2017 defined systolic HTN (130–139 mmHg) on 3 consecutive sessions (mean SBP: 132.6 mmHg) were randomly assigned to TT or lifestyle education program delivered via smartphone (SPCTL). Each group received a twice-daily dosage schedule of TT or walking (month 1: 15 min; months 2 and 3: 10 min; months 4–12: 5 min). (3) Results: Mixed modeling results revealed a significant group x time effect for SBP (p<.01). The TT group showed greater SBP reductions at months 3 (−8.0 vs. −1.9), 6 (−10.0 vs. −0.7), and 12: (−11.6 vs. −0.4 mmHg; all p-values <0.04). (4) Conclusion: The TT app was beneficial in reducing SBP levels among adults with stage 1 systolic HTN. The TT app may be a promising, scalable first-line tactic for stage 1 HTN. Preparations are underway for an efficacy RCT involving uncontrolled stage 1 HTN patients.
The Effects of Temperature on Accident and Emergency Department Attendances in London: A Time-Series Regression Analysis
Authors: Corcuera Hotz Ines , Hajat Shakoor
Published: March 2020

The epidemiological research relating mortality and hospital admissions to ambient temperature is well established. However, less is known about the effect temperature has on Accident and Emergency (A&E) department attendances. Time-series regression analyses were conducted to investigate the effect of temperature for a range of cause- and age-specific attendances in Greater London (LD) between 2007 to 2012. A seasonally adjusted Poisson regression model was used to estimate the percent change in daily attendances per 1 °C increase in temperature. The risk of overall attendance increased by 1.0% (95% CI 0.8, 1.4) for all ages and 1.4% (1.2, 1.5) among 0- to 15-year-olds. A smaller but significant increase in risk was found for cardiac, respiratory, cerebrovascular and psychiatric presentations. Importantly, for fracture-related attendances, the risk rose by 1.1% (0.7, 1.5) per 1 °C increase in temperature above the identified temperature threshold of 16 °C, with the highest increase of 2.1% (1.5, 3.0) seen among 0- to 15-year-olds. There is a positive association between increasing temperatures and A&E department attendance, with the risk appearing highest in children and the most deprived areas. A&E departments are vulnerable to increased demand during hot weather and therefore need to be adequately prepared to address associated health risks posed by climate change.
Influence of Individual and Contextual Perceptions and of Multiple Neighborhoods on Depression
Authors: Traoré Médicoulé , Vuillermoz Cécile , Chauvin Pierre , Deguen Séverine
Published: March 2020

The risk of depression is related to multiple various determinants. The consideration of multiple neighborhoods daily frequented by individuals has led to increased interest in analyzing socio-territorial inequalities in health. In this context, the main objective of this study was (i) to describe and analyze the spatial distribution of depression and (ii) to investigate the role of the perception of the different frequented spaces in the risk of depression in the overall population and in the population stratified by gender. Data were extracted from the 2010 SIRS (a French acronym for “health, inequalities and social ruptures”) cohort survey. In addition to the classic individual characteristics, the participants reported their residential neighborhoods, their workplace neighborhoods and a third one: a daily frequented neighborhood. A new approach was developed to simultaneously consider the three reported neighborhoods to better quantify the level of neighborhood socioeconomic deprivation. Multiple simple and cross-classified multilevel logistic regression models were used to analyze the data. Depression was reported more frequently in low-income (OR = 1.89; CI = [1.07–3.35]) or middle-income (OR = 1.91; CI = [1.09–3.36]) neighborhoods and those with cumulative poverty (OR = 1.64; CI = [1.10–2.45]). In conclusion, a cumulative exposure score, such as the one presented here, may be an appropriate innovative approach to analyzing their effects in the investigation of socio-territorial inequalities in health.
Healthy Water-Based Tourism Experiences: Their Contribution to Quality of Life, Satisfaction and Loyalty
Authors: Campón-Cerro Ana María , Di-Clemente Elide , Hernández-Mogollón José Manuel , Folgado-Fernández José Antonio
Published: March 2020

The scientific literature on tourism identifies two driving trends: the quest for experientiality and the growing connection between holidays and quality of life. The present research focuses on water-based activities practiced with a healthy purpose, capable of driving positive economic, social and environmental effects on the territory where this type of tourism is developed. Considering the growing demand of experiential tourism, it is important to assess the experiential value of these practices and their impact on the quality of life, satisfaction and loyalty. A sample of 184 customers of thermal spas and similar establishments was used to test the structural model proposed, employing the partial least squares technique. The results show the experiential value of healthy water-based activities and confirm their positive impact on the individuals’ quality of life, satisfaction and loyalty towards both the experience and the destination.
The Development and Exploratory Psychometric Properties of the Traumatic and Routine Stressors Scale on Emergency Nurses (TRSS-EN)
Authors: Campillo-Cruz Manuel , González-Gutiérrez José Luís , Ardoy-Cuadros Juan , Fernández-Muñoz Juan José
Published: March 2020

Emergency nurses are exposed to traumatic events and routine stressors, both of which can lead to the development of PTSD (Post Traumatic Stress Disorder) symptomatology. However, there are currently no instruments designed to assess the impact and frequency of such sources of stress in nurses. The Traumatic and Routine Stressors Scale on Emergency Nurses (TRSS-EN) was built for this purpose. A sample of 147 emergency nurses from three hospitals in Madrid (Spain) completed this 13-item scale. The analyses showed a factorial structure composed of two factors. The first is characterized by items regarding traumatic and stressful events and procedures of severe magnitude (traumatic stressors), and the second by items related to stressful events and procedures of moderate magnitude (routine stressors) but hypothesized to possess a substantial traumatic potential. Analyses provided evidence of both adequate internal consistency (Cronbach’s α = 0.92; first factor α = 0.91 and second factor α = 0.86) and test–retest reliability. In addition, concurrent validity also proved to be satisfactory. In short, TRSS-EN seems to be a reliable and valid tool in a healthcare emergency nursing setting for screening the frequency and impact of exposure to everyday work-related traumatic stressors, either event-related or routine.
Are Physical Education Lessons Suitable for Sport Talent Identification? A Systematic Review of the Literature
Authors: Prieto-Ayuso Alejandro , Pastor-Vicedo Juan Carlos , González-Víllora Sixto , Fernández-Río Javier
Published: March 2020

Objectives: The goal of this study was to shed light on the existent knowledge, internationally published over the last decade (2009–2019), on how to deal with talented children in physical education (PE). Methods: A mixed systematic review (SR) was conducted following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and registered in the International Prospective Register of Systematic Reviews (PROSPERO), registration number: CRD42019117211. Study eligibility criteria: The articles included were selected using the following criteria: (a) studies published in peer-reviewed international journals; (b) studies published from 2009 to 2019 (both inclusive); (c) studies that included quantitative and/or qualitative methods and findings; (d) research conducted within school contexts; (e) articles that focused on both talent/gift and PE, and (f) studies published in English or Spanish. Results: A total of 11 articles were identified. Results showed a gradual change in both methods and instruments used for talent identification (TI) in PE, focused currently on children’s health and involvement in sports. Second, there is consensus on the lack of clarity in schools’ policies and guidelines on how to deal with talented children in PE. Conclusions: Finally, there are alternative programs to elite athlete models that better fit in PE to deal with talented children and to avoid child disengagement in PE and sports.
Women’s Well-Being and Rural Development in Depopulated Spain
Authors: Cobano-Delgado Veronica , Llorent-Bedmar Vicente
Published: March 2020

The threat of depopulation in the rural areas making up what has become to be known as “empty Spain” is currently an extremely urgent national issue. Women are a fundamental pillar of rural sustainability, but the lack of decent living conditions has led to their mass exodus to the country’s cities. We analysed the factors undermining their health and well-being, thus leading to their dissatisfaction and their subsequent desire to abandon the countryside for a better life. A mixed methodology was employed, combining qualitative and quantitative data collection techniques. For data collection, an ad hoc questionnaire was developed before being administered to members of the Rural Development Groups of the Celtiberian Highlands, while some of their number were also interviewed. Rural women experience personal dilemmas that prompt them to migrate. These include choosing between living in the place where they were born, close to their families and neighbours, and a decent productive job, the availability of basic services and a broader range of leisure opportunities, among other aspects. It is essential to acknowledge the socio-economic importance of women’s work, to identify invisible burdens and their risks and to adopt measures that facilitate the reconciliation of work and family life.
Spatiotemporal Variation and Pollution Assessment of Pb/Zn from Smelting Activities in China
Authors: Zang Zhenfeng , Li Yonghua , Li Hairong , Guo Zhaohui , Zhang Ru
Published: March 2020

Nonferrous smelting is an important source of heavy metals in soil, which causes different degrees of soil pollution, especially in lead–zinc (Pb/Zn) smelting areas. Based on the Pb/Zn environmental release during the Pb/Zn mineral smelting processes in 31 Chinese provinces from the period 2000 to 2015, the study analyzed the spatiotemporal variations in Pb/Zn environmental release at the national level and then evaluated the degree of soil pollution and potential ecological risk based on the heavy metal content in soil from Pb/Zn smelting areas. The results showed that from the period 2000 to 2015, the Pb release had a discrete trend, transferring from the middle east to the west, and the provinces with higher Pb releases were Henan Province, Yunnan Province, and Hunan Province. However, the Zn release showed a tendency towards spatial aggregation, and the release center of this heavy metal presented a shifting trend from south to north; additionally, the release of Zn was highest in Hunan Province. The pollution index analyses indicated that Cd, Pb, Cu, and Zn in Zhuzhou and Huludao all reached extremely polluted levels, while Tongguan was at a safe level. In Gejiu, Mianxian, Fengxian, Zhuzhou, Huludao, and Shaoguan, there were very high potential ecological risks, with Cd having the highest potential ecological risk in most smelting areas, followed by Pb.
Increased Risk of Sensorineural Hearing Loss as a Result of Exposure to Air Pollution
Authors: Chang Kuang-Hsi , Tsai Stella Chin-Shaw , Lee Chang-Yin , Chou Ruey-Hwang , Fan Hueng-Chuen , Lin Frank Cheau-Feng , Lin Cheng-Li , Hsu Yi-Chao
Published: March 2020

Whether exposure to air pollution is associated with developing sensorineural hearing loss (SHL) remains controversial. Using data from the National Health Insurance Research Database, we recruited a total of 75,767 subjects aged older than 20 years with no history of SHL from 1998 to 2010, and they were followed up until SHL was observed, they withdrew from the National Health Insurance program, or the study ended. The subjects were evenly exposed to low-level, mid-level, and high-level carbon monoxide (CO) and nitrogen dioxide (NO2). The incidence rate ratio of SHL for patients exposed to high-level CO was 1.24 (95% confidence interval (CI) = 1.14–1.36). The NO2 pollutants increased the incidence rate ratios of SHL in mid-level NO2 and high-level NO2 exposures by 1.10 (95% CI = 1.10–1.32) and 1.36 (95% CI = 1.24–1.49) times, respectively. The adjusted hazard ratio (adj. HR) of SHL in patients exposed to high-level CO was 1.45 (95% CI = 1.31–1.59), relative to that of patients exposed to low-level CO. Compared to patients exposed to low-level NO2, patients exposed to mid-level NO2 (adj. HR = 1.40, 95% CI = 1.27–1.54) and high-level NO2 (adj. HR = 1.63, 95% CI = 1.48–1.81) had a higher risk of developing SHL. The increased risk of SHL following the increased concentrations of air pollutants (CO and NO2) was statistically significant in this study. In conclusion, the subjects’ exposure to air pollution exhibited a significantly higher risk of developing SHL in Taiwan.
Analysis of Environmental Activities for Developing Public Health Investments and Policies: A Comparative Study with Structure Equation and Interval Type 2 Fuzzy Hybrid Models
Authors: Zhang Cuina , Li Ruobing , Xia Yun , Yuan Yixing , Dinçer Hasan , Yüksel Serhat
Published: March 2020

The design of elements which exert pivotal effects on leisurely physical activity (LPA) in open space is an important part of urban development. However, little research has been done about the influence and discrepancies of those elements in different types of open space. To research these issues and to guide the design of urban open space, a survey from 8 open spaces (2 curtilage, 2 neighborhood squares (NS), 2 parks, and 2 campus) is conducted and a questionnaire is administered. Simultaneous analysis of several groups (SASG) of Structure equation model (SEM) is used, and the effects and discrepancies are acquired. In addition to this situation, interval type 2 (IT2) fuzzy hybrid decision making model is proposed in the second analysis. In this framework, IT2 fuzzy decision-making trial, evaluation laboratory (DEMATEL), and IT2 fuzzy technique for order preference by similarity to ideal solution (TOPSIS) methods are used. The results show that the influence relationships between elements and LPA did exist in four groups. Another important conclusion is that there were discrepancies of influence among different space groups. Physical environment (PE) has the greatest influence on LPA in the curtilage, whereas facilities exert the most effect in NS group. Additionally, amenities only have significant impact in parks and facilities only exercise remarkable influence on duration on campus. In addition to them, it is also identified that key design elements are presented for different types of space and that design strategy is provided through 4 specific examples.