bluuebunny/crossref_metadata_2025 huggingface dataset:
Evaluation of the Technical Performance of Football Players in the UEFA Champions League
Authors: Yi Qing , Gómez-Ruano Miguel-Ángel , Liu Hongyou , Zhang Shaoliang , Gao Binghong , Wunderlich Fabian , Memmert Daniel
Published: January 2020

This study aimed to assess the technical match performance of top-class football players in a long-term perspective. Technical performance profiles of players according to five playing positions (central defender, full back, wide midfielder, central midfielder, forward) and five situational variables (competition stage, match location, quality of team, quality of opponent, match outcome) were established. Technical match data of players in the UEFA Champions League from season 2009–2010 to 2016–2017 were analyzed. The true effects of positional and situational variables on players’ technical performance were evaluated by the non-clinical magnitude-based inference. Results showed that the effect of competition stage on player’s performance was negligible. Quality of team, quality of opponent and match outcome revealed the strongest effects on player’s performance (ES: −0.42 ± 0.10–0.59 ± 0.10) while the effect of match location was relatively lower (ES: −0.32 ± 0.10–0.23 ± 0.07). The number of variables that showed statistical differences under five competing contexts for wide midfielders and forwards were higher than those of central defenders, full backs, and central midfielders. Differences of players’ match performance could mainly be identified in variables related to goal scoring, passing, and organizing, these findings may provide important insights for coaches and analysts during the match preparation and training session.
Serum Levels of Commonly Detected Persistent Organic Pollutants and Per- and Polyfluoroalkyl Substances (PFASs) and Mammographic Density in Postmenopausal Women
Authors: Lee Eunjung , Kinninger April , Ursin Giske , Tseng Chiuchen , Hurley Susan , Wang Miaomiao , Wang Yunzhu , Park June-Soo , Petreas Myrto , Deapen Dennis , Reynolds Peggy
Published: January 2020

There are little epidemiological data on the impact of persistent organic pollutants (POPs) and endocrine disruptors on mammographic density (MD), a strong predictor of breast cancer. We assessed MD in 116 non-Hispanic white post-menopausal women for whom serum concentrations of 23 commonly detected chemicals including 3 polybrominated diphenyl ethers (PBDEs), 8 per- and polyfluoroalkyl substances (PFASs), and 12 polychlorinated biphenyls (PCBs) had been measured. Linear regression analyses adjusting for potential confounders were used to examine the associations between the levels of the chemical compounds, modeled as continuous and dichotomized (above/below median) variables, and square-root-transformed MD. None of the associations were statistically significant after correcting for multiple testing. Prior to correction for multiple testing, all chemicals with un-corrected p-values < 0.05 had regression coefficients less than zero, suggesting inverse associations between increased levels and MD, if any. The smallest p-value was observed for PCB-153 (regression coefficient for above-median vs. below-median levels: −0.87, un-corrected p = 0.008). Neither parity nor body mass index modified the associations. Our results do not support an association between higher MD and serum levels of PBDEs, PCBs, or PFASs commonly detected in postmenopausal women.
Predictions of Mortality from Pleural Mesothelioma in Italy After the Ban of Asbestos Use
Authors: Oddone Enrico , Bollon Jordy , Nava Consuelo Rubina , Bugani Marcella , Consonni Dario , Marinaccio Alessandro , Magnani Corrado , Barone-Adesi Francesco
Published: January 2020

Even if the epidemic of malignant pleural mesothelioma (MPM) is still far from being over worldwide, the health effects of regulations banning asbestos can be evaluated in the countries that implemented them early. Estimates of MPM future burden can be useful to inform and support the implementation of anti-asbestos health policies all around the world. With this aim we described the trends of MPM deaths in Italy (1970–2014) and predicted the future number of cases in both sexes (2015–2039), with consideration of the national asbestos ban that was issued in 1992. The Italian National Statistical Institute (ISTAT) provided MPM mortality figures. Cases ranging from 25 to 89 years of age were included in the analysis. For each five-year period from 1970 to 2014, mortality rates were calculated and age–period–cohort Poisson models were used to predict future burden of MPM cases until 2039. During the period 1970–2014 a total number of 28,907 MPM deaths were observed. MPM deaths increased constantly over the study period, ranging from 1356 cases in 1970–1974 to 5844 cases in 2010–2014. The peak of MPM cases is expected to be reached in the period 2020–2024 (about 7000 cases). The decrease will be slow: about 26,000 MPM cases are expected to occur in Italy during the next 20 years (2020–2039). The MPM epidemic in Italy is far from being concluded despite the national ban implemented in 1992, and the peak is expected in 2020–2024, in both sexes. Our results are consistent with international literature.
Promoting Social and Emotional Learning and Subjective Well-Being: Impact of the “Aislados” Intervention Program in Adolescents
Authors: Cejudo Javier , Losada Lidia , Feltrero Roberto
Published: January 2020

The aim of this study is to experimentally assess the effects of an intervention program through a video game called “Aislados” for the improvement of subjective well-being, mental health and trait emotional intelligence of a sample of adolescents (n = 187). We used well-established measures with appropriate psychometric properties. The study used a quasi-experimental design of pre-test/post-test repeated measurements with a control group. First, a multivariate analysis of variance (MANOVA) and then descriptive analyses and variance analyses (ANOVAs) were carried out by the adolescents randomly assigned to the experimental and control conditions. Then, a multivariate analysis of covariance (MANCOVA) was performed on the study’s variables as a whole. Descriptive and covariance analyses of the post-test scores were carried out (ANCOVAs post-test, co-varying pre-test scores), in order to demonstrate the impact of the program. The effect size was reckoned (Cohen’s d). The results confirm statistically-significant differences in: Health-Related Quality of life, positive affect and mental health. The study provides an effective intervention tool which has been experimentally validated. The overall results allow for emphasizing the importance of the implementation of programs aimed at encouraging social and emotional learning throughout adolescence as protective resources in fostering emotional and behavioral adjustment in adolescents.
Straining at Work and Its Relationship with Personality Profiles and Individual Consequences in Healthcare Workers (HCWs)
Authors: Ramaci Tiziana , Barattucci Massimiliano , Vella Francesca , Senia Paola , Cannizzaro Emanuele , Scorciapino Alessandro , Ledda Caterina , De Giorgio Andrea , Rapisarda Venerando
Published: January 2020

Straining is an attenuated form of mobbing, in which the continuity of vexatious actions is not driven by a discriminatory intent. With the objective of testing the possible moderating role of personality in the relationship between perceptions about straining at work and individual consequences, a correlational design research involved 374 healthcare workers (HCWs) from two Italian hospitals. The following questionnaires were administered: (1) Short Negative Acts Questionnaire (S-NAQ), to assess discriminative actions at work); (2) the Italian version of the Big Five Inventory (BFI-10 scale), to assess personality factors; (3) Occupational Stress Indicator (OSI), to measure psychological and physical health. Regression analysis and Structural Equation Models (SEM) were computed in order to test the relationships between variables. Perceived straining showed significant correlations with both psychological and physical health. Conscientiousness was inversely proportional to work-related bullying (WB), as agreeableness was to personal bullying (PB). Emotional stability was negatively correlated with all the three component scales of S-NAQ: WB, PB, and social bullying. The results seem to confirm that straining perceptions especially elicit, through emotional stability, psychological consequences. As regards the role of emotional stability in risk perceptions, it seems management has to pay thorough attention to personal factors in organizational perceptions and to straining actions.
Piercing and Oral Health: A Study on the Knowledge of Risks and Complications
Authors: Covello Francesco , Salerno Camilla , Giovannini Valentina , Corridore Denise , Ottolenghi Livia , Vozza Iole
Published: January 2020

The aim of the present study is to verify the knowledge of risks and complications of oral piercings, and to observe the main complications associated with piercings, using a sample from central Italy of patients wearing intraoral piercings. Through piercing and tattoo studios selected randomly in Rome, Latina and Campobasso, and a tattoo and piercing convention in Latina, a group of 387 individuals with oral piercings were selected and asked to complete an anonymous questionnaire. After filling in questionnaires, 70 individuals of the 387 selected agreed to be visited to allow the observation of the integrity of their teeth and gums (especially close to the oral piercing), oral hygiene conditions, piercing cleaning, bad habits and gingival recession. Among the respondents, 46.8% said they had not been informed about these risks, 48.5% claimed not to clean the piercing, 70.6% stated that they had not been made aware of gingival problems that can arise, 60.4% subjects stated that they were not informed about the complications of piercings concerning teeth, 52.8% had insufficient oral hygiene conditions, 42% showed signs of generalised gingivitis, 20% had 3–4 mm recessions and 22% had tooth fracture(s) due to piercing. From this study, it emerged that oral piercings can represent a risk to oral health and that there is a widespread lack of awareness of the complications and correct methods of maintaining oral piercings. Periodic checks by both dentists and dental hygienists, for patients with oral piercings, could play a decisive role in preventing, intercepting and treating the complications that they can cause.
Regular Moderate- to Vigorous-Intensity Physical Activity Rather Than Walking Is Associated with Enhanced Cognitive Functions and Mental Health in Young Adults
Authors: Nakagawa Takumi , Koan Ibuki , Chen Chong , Matsubara Toshio , Hagiwara Kosuke , Lei Huijie , Hirotsu Masako , Yamagata Hirotaka , Nakagawa Shin
Published: January 2020

The beneficial effect of physical activity (PA) on the brain has been well established. Both acute and regular PA can boost a range of cognitive functions and enhance mood and mental health. Notably, the effect of acute PA on the brain and cognitive functions is generally found to be dose-dependent, in terms of both the amount and intensity of the exercise episode. In contrast, in the case of regular PA, the literature has primarily focused on the amount of exercise, and limited studies have assessed the influence of the exercise intensity. Since PA in higher intensity causes more extensive, more powerful, and longer-lasting neurobiological changes, it may prove more beneficial to cognitive functions and mental health. In the present study, we set out to test this hypothesis by employing a battery of questionnaires and laboratory tests with a sample of young adults. We found that more frequent vigorous- and moderate-intensity PA rather than walking (considered low to moderate intensity) was associated with better cognitive and mental health measures. Meanwhile, compared with no moderate- to vigorous-intensity physical activity (MVPA) at all, as few as 1~2 days per week (lasting at least 10 min each time) of MVPA was associated with a variety of benefits, particularly related to coping with challenging situations. In light of the neurobiological literature, the present study speaks to the value of moderate- to vigorous- rather than low-intensity PA in enhancing cognitive functions and mental health.
Social Participation and Functional Decline: A Comparative Study of Rural and Urban Older People, Using Japan Gerontological Evaluation Study Longitudinal Data
Authors: Ide Kazushige , Tsuji Taishi , Kanamori Satoru , Jeong Seungwon , Nagamine Yuiko , Kondo Katsunori
Published: January 2020

This study compared the relationship between social participation, including work, and incidence of functional decline in rural and urban older people in Japan, by focusing on the number and types of organizations older people participated in. The longitudinal data of the Japan Gerontological Evaluation Study (JAGES) that followed 55,243 individuals aged 65 years or older for six years were used. The Cox proportional hazards model was employed to calculate the hazard ratio (HR) of the incidence of functional decline over six years and the stratification of rural and urban settings. In this model, we adjusted 13 variables as behavioral, psychosocial, and functional confounders. The more rural and urban older people participated in various organizations, the more they were protected from functional decline. Participation in sports (HR: rural = 0.79; urban = 0.83), hobby groups (HR: rural = 0.76; urban = 0.90), and work (HR: rural = 0.83; urban = 0.80) significantly protected against the incidence of decline in both rural and urban areas. For both rural and urban older people, promoting social participation, such as sports and hobby groups and employment support, seemed to be an important aspect of public health policies that would prevent functional decline.
Risk Factors Associated with Outcomes of Recombinant Tissue Plasminogen Activator Therapy in Patients with Acute Ischemic Stroke
Authors: Tseng Yi-Ju , Hu Ru-Fang , Lee Shin-Tyng , Lin Yu-Li , Hsu Chien-Lung , Lin Shih-Wei , Liou Chia-Wei , Lee Jiann-Der , Peng Tsung-I , Lee Tsong-Hai
Published: January 2020

Ischemic stroke is the most common type of stroke, and early interventional treatment is associated with favorable outcomes. In the guidelines, thrombolytic therapy using recombinant tissue-type plasminogen activator (rt-PA) is recommended for eligible patients with acute ischemic stroke. However, the risk of hemorrhagic complications limits the use of rt-PA, and the risk factors for poor treatment outcomes need to be identified. To identify the risk factors associated with in-hospital poor outcomes in patients treated with rt-PA, we analyzed the electronic medical records of patients who were diagnosed with acute ischemic stroke and treated for rt-PA at Chang Gung Memorial Hospitals from 2006 to 2016. In-hospital death, intensive care unit (ICU) stay, or prolonged hospitalization were defined as unfavorable treatment outcomes. Medical history variables and laboratory test results were considered variables of interest to determine risk factors. Among 643 eligible patients, 537 (83.5%) and 106 (16.5%) patients had favorable and poor outcomes, respectively. In the multivariable analysis, risk factors associated with poor outcomes were female gender, higher stroke severity index (SSI), higher serum glucose levels, lower mean corpuscular hemoglobin concentration (MCHC), lower platelet counts, and anemia. The risk factors found in this research could help us study the treatment strategy for ischemic stroke.
PM2.5-Related Health Economic Benefits Evaluation Based on Air Improvement Action Plan in Wuhan City, Middle China
Authors: Qu Zhiguang , Wang Xiaoying , Li Fei , Li Yanan , Chen Xiyao , Chen Min
Published: January 2020

On the basis of PM2.5 data of the national air quality monitoring sites, local population data, and baseline all-cause mortality rate, PM2.5-related health economic benefits of the Air Improvement Action Plan implemented in Wuhan in 2013–2017 were investigated using health-impact and valuation functions. Annual avoided premature deaths driven by the average concentration of PM2.5 decrease were evaluated, and the economic benefits were computed by using the value of statistical life (VSL) method. Results showed that the number of avoided premature deaths in Wuhan are 21,384 (95% confidence interval (CI): 15,004 to 27,255) during 2013–2017, due to the implementation of the Air Improvement Action Plan. According to the VSL method, the obtained economic benefits of Huangpi, Wuchang, Hongshan, Xinzhou, Jiang’an, Hanyang, Jiangxia, Qiaokou, Jianghan, Qingshan, Caidian, Dongxihu, and Hannan District were 8.55, 8.19, 8.04, 7.39, 5.78, 4.84, 4.37, 4.04, 3.90, 3.30, 2.87, 2.42, and 0.66 billion RMB (1 RMB = 0.1417 USD On 14 October 2019), respectively. These economic benefits added up to 64.35 billion RMB (95% CI: 45.15 to 82.02 billion RMB), accounting for 4.80% (95% CI: 3.37% to 6.12%) of the total GDP of Wuhan in 2017. Therefore, in the process of formulating a regional air quality improvement scheme, apart from establishing hierarchical emission-reduction standards and policies, policy makers should give integrated consideration to the relationship between regional economic development, environmental protection and residents’ health benefits. Furthermore, for improving air quality, air quality compensation mechanisms can be established on the basis of the status quo and trends of air quality, population distribution, and economic development factors.
Health and Sustainability in Public Meals—An Explorative Review
Authors: Höijer Karin , Lindö Caroline , Mustafa Arwa , Nyberg Maria , Olsson Viktoria , Rothenberg Elisabet , Sepp Hanna , Wendin Karin
Published: January 2020

The world is facing a number of challenges related to food consumption. These are, on the one hand, health effects and, on the other hand, the environmental impact of food production. Radical changes are needed to achieve a sustainable and healthy food production and consumption. Public and institutional meals play a vital role in promoting health and sustainability, since they are responsible for a significant part of food consumption, as well as their “normative influence” on peoples’ food habits. The aim of this paper is to provide an explorative review of the scientific literature, focusing on European research including both concepts of health and sustainability in studies of public meals. Of >3000 papers, 20 were found to satisfy these criteria and were thus included in the review. The results showed that schools and hospitals are the most dominant arenas where both health and sustainability have been addressed. Three different approaches in combining health and sustainability have been found, these are: “Health as embracing sustainability”, “Sustainability as embracing health” and “Health and sustainability as separate concepts”. However, a clear motivation for addressing both health and sustainability is most often missing.
Affective Outcomes of Group versus Lone Green Exercise Participation
Authors: Rogerson Mike , Colbeck Ian , Bragg Rachel , Dosumu Adekunle , Griffin Murray
Published: January 2020

‘Green exercise’ (being physically active within a natural environment) research has examined the influence of environmental setting on health and wellbeing-related exercise outcomes. However, it is not known whether social exercise settings influence green exercise-associated changes in mood, self-esteem, and connection to nature. This study directly compared outcomes of participating in green exercise alone compared to in a group. Using repeated measures, counterbalanced and randomized-crossover design, participants (n = 40) completed two 3 km runs around sports fields. These fields had a relatively flat grass terrain, predominant view of trees, and open grassland. On one occasion participants ran alone and on the other they ran in a group of 4–5 participants. Questionnaire measures of mood, self-esteem, and connection to nature were completed immediately pre- and post-run. Across all of the measures, two-way mixed ANOVAs found that there were statistically significant effects for time but not for time-by-condition interactions. The simplest interpretation of this finding is that social setting does not influence individuals’ attainment of the psychological outcomes of green exercise participation. However, we discuss the possibility that more complex processes might underpin this finding.
“Not Only Adults Can Make Good Decisions, We as Children Can Do That as Well” Evaluating the Process of the Youth-Led Participatory Action Research ‘Kids in Action’
Authors: Anselma Manou , Chinapaw Mai , Altenburg Teatske
Published: January 2020

In Youth-led Participatory Action Research (YPAR), youth collaborate with academic researchers to study a problem, develop actions that align with their needs and interests, and become empowered. ‘Kids in Action’ aimed to develop actions targeting healthy physical activity and dietary behavior among, and together with, 9–12-year-old children as co-researchers. This paper presents the process evaluation of ‘Kids in Action’ based on eight focus groups with children (N = 40) and eight interviews with community partners (N = 11). Interview guides were based on empowerment theory and the RE-AIM framework, in order to evaluate the study on: empowerment, collaborations, reach, effectiveness, adoption, implementation, and maintenance. Transcripts were analyzed using evaluation and provisional coding. Both children and community partners perceived an increased awareness of healthy behaviors and an improvement in confidence, critical awareness, leadership and collaboration skills, which contributed to increased feelings of empowerment. Community partners valued child participation and the co-created actions. Actions were also well-perceived by children and they liked being involved in action development. The strong relationship of researchers with both children and relevant community partners proved an important facilitator of co-creation. Future studies are recommended to attempt closer collaboration with schools and parents to gain even more support for co-created actions and increase their effectiveness.
Factors Associated with Initiation and Sustenance of Stress Management Behaviors in Veterinary Students: Testing of Multi-Theory Model (MTM)
Authors: K. Nahar Vinayak , K. Wells Julia , E. Davis Robert , C. Johnson Elizabeth , W. Johnson Jason , Sharma Manoj
Published: January 2020

Veterinary students across the United States face the challenge of stress during school every day. When managed improperly, stress can become chronic and manifest in physical and emotional consequences. The purpose of this study was to examine the utility of the multi-theory model (MTM) of health behavior change in predicting the initiation and sustenance of stress management behaviors among veterinary students. A cross-sectional design was used to study the efficacy of the MTM in predicting initiation and sustenance of stress management behaviors among veterinary students at a private College of Veterinary Medicine in the Southeast United States. Researchers collected data using a 54-item valid and reliable survey. Only students who did not already engage in daily stress management behaviors were included in the study. After recruitment and exclusion, a total of 140 students remained and participated in the study. Hierarchical multiple regression revealed that, for initiation of stress management behaviors, 49.5% of the variance was explained by depression, academic classification, and behavioral confidence. Regarding sustenance of stress management behaviors, 50.4% of the variance was explained by perceived stress, depression, academic classification, and emotional transformation. MTM serves as a promising framework for predicting initiation and sustenance of health behavior change. Based on the results of this study, interventions aimed to promote stress management behaviors in veterinary students should focus on the MTM constructs of behavioral confidence and emotional transformation.
Influencing Factors for Expatriation Willingness of Chinese Medical Aid Team Members (CMATMs) in Africa: A Qualitative Descriptive Study
Authors: Chen Xiaochang , Liu Xiaojun , Mao Zongfu
Published: January 2020

Chinese medical aid team members (CMATMs) play an important role in the implementation of China’s health assistance strategies in Africa. This paper explored the influencing factors of expatriation willingness for Chinese medical aid team members (CMATMs). We employed a qualitative descriptive study using semi-structured interviews with twenty-five participants. Participants included hospital directors and local Health and Family Planning Commission (HFPC) officers who were in charge of CMATMs dispatching, and CMATMs that had returned from medical aid service. Six influencing factors emerged: career advancement, loneliness, living conditions, personal safety, family–work conflict, and doctor–patient relationship. Career advancement is the most important factor and concern for doctor CMATMs. Social use of Internet is on the core of entertainment. Enhancing technical title promotion policies is the most important motivator. This study obtained baseline information that is useful to relevant stakeholders in their attempts to improve CMATMs’ expatriation willingness.
Efficacy of a Multicomponent Intervention for Fibromyalgia Based on Pain Neuroscience Education, Exercise Therapy, Psychological Support, and Nature Exposure (NAT-FM): Study Protocol of a Randomized Controlled Trial
Authors: Serrat Mayte , Sanabria-Mazo Juan P. , García-Troiteiro Elna , Fontcuberta Anna , Mateo-Canedo Corel , Almirall Míriam , Feliu-Soler Albert , Méndez-Ulrich Jorge Luis , Sanz Antoni , Luciano Juan V.
Published: January 2020

The study protocol of a prospective and randomized controlled trial for the assessment of the efficacy of nature activity therapy for people with Fibromyalgia (NAT-FM) is described. The primary outcome is the mean change from baseline in the Revised Fibromyalgia Impact Questionnaire (FIQR) score at post-treatment (12 weeks) and at 9 months of follow-up, and secondary outcomes are changes in the positive affect, negative affect, pain, fatigue, self-efficacy, catastrophising, and emotional regulation. A total of 160 patients with fibromyalgia will be divided into two arms: treatment-as-usual (TAU) and NAT-FM+TAU. Pre, during, post, +6, and +9 months assessments will be carried out, as well as an ecological momentary assessment (EMA) of intrasession and intersessions. Results will be subjected to a mixed group (NAT-FM+TAU vs. TAU) × phase (pre, post, +6 months, +9 months) general linear model. EMA intrasession measurements will be subjected to a 2 (pre vs. post) × 5 (type of activity) mixed-effects ANOVA. EMA between-session measurements obtained from both arms of the study will be analysed on both a time-domain and frequency-domain basis. Effect sizes and number needed to treat (NNT) will be computed. A mediation/moderation analysis will be conducted.
HIV Stigma and Moral Judgement: Qualitative Exploration of the Experiences of HIV Stigma and Discrimination among Married Men Living with HIV in Yogyakarta
Authors: Mahamboro Dionius B. , Fauk Nelsensius K. , Ward Paul R. , Merry Maria S. , Siri Theodorus A. , Mwanri Lillian
Published: January 2020

It is well acknowledged that human immunodeficiency virus stigma (HIV stigma) challenges people living with HIV globally. There is a scarcity of information about determinants of HIV stigma and discrimination among married men in the Indonesian context. This study aimed to explore factors that contribute to stigma and discrimination against HIV-positive men married to women in Yogyakarta, Indonesia. Face-to-face in-depth interviews were conducted to collect data from participants using a snowball sampling technique. A framework analysis was used to guide the analysis of the data. HIV stigma framework was also applied in the conceptualisation and the discussion of the findings. The findings indicate that participants experienced external stigma within healthcare facilities, communities and families. This external stigma was expressed in various discriminatory attitudes and behaviours by healthcare professionals and community and family members. Similarly, participants experienced anticipated stigma as a result of HIV stigma and discrimination experienced by other people living with HIV. Individual moral judgement associating HIV status with amoral behaviours and participants’ negative self-judgement were determinants of perceived stigma. The current findings indicate the need for training programs about HIV stigma issues for healthcare professionals. There is also a need to disseminate HIV information and to improve HIV stigma knowledge among families and communities.
Determinants and Consequences of Limited Health Literacy in Polish Society
Authors: Duplaga Mariusz
Published: January 2020

Background: Health literacy (HL) is perceived as one of the most important concepts for modern health promotion activities to be successful. The research undertaken in the context of HL usually focuses on its antecedents and consequences, either for specific groups of patients or society or for the whole population. Objectives: The main aim of this study was to assess the antecedents and consequences of limited health literacy (HL) in a nationally representative sample of the Polish population. Methods: The analysis was carried out on the data obtained from a sample of 1000 Polish citizens through a telephone-based survey undertaken using a short, 16-item questionnaire developed within the European Health Literacy Project (HLS-EU). The total HLS score was calculated according to the guidelines published by the HLS-EU project. Chi2 test and logistic regression models were used for the analysis of the relationships between the variables. Results: The mean HL score (standard deviation) in the study sample was 12.99 (3.11). HL was related to age, marital and vocational status. Limited HL was associated with a lower self-assessment of health (OR, 95% CI: 2.52, 1.54–4.13), the prevalence of obesity and disability (1.71, 1.13–2.57, and 1.92, 1.25–2.94, respectively), less frequent physical activity (0.70, 0.49–0.99), a lower consumption of fruits and vegetables (0.47, 0.34–0.65), and with more frequent hospitalisations (2.02, 1.38–2.95). Conclusions: The assessment of HL using the16-item HLS-EU questionnaire may be a useful tool to enable health behaviours and utilisation of health care resources by society to be predicted.
Evolution, Prehistory and Vitamin D
Authors: Jarrett Paul , Scragg Robert
Published: January 2020

Aspects of human evolutionary biology and prehistory are discussed in relation to vitamin D. The evolution of hairlessness, combined with the need for efficient eccrine sweat production for cooling, provided evolutionary pressure to protect the skin from ultraviolet damage by developing cutaneous pigmentation. There was a subsequent loss of pigmentation as humans journeyed to northern latitudes. Their increasing mastery of technology outstripped evolution’s finite pace as further dispersal occurred around the globe. A timeline for the development of clothing to provide warmth, and the consequent shielding from ultraviolet light, which diminished vitamin D synthesis, can be inferred by an examination of mutations in the human louse.
Characteristics and Distribution of Organic Phosphorus Fractions in the Surface Sediments of the Inflow Rivers around Hongze Lake, China
Authors: Wan Jie , Yuan Xuyin , Han Lei , Ye Hongmeng , Yang Xiaofan
Published: January 2020

In this study, the characteristics and distribution of the organic phosphorus (Po) fractions in the surface sediments of seven inflow rivers around Hongze Lake in China were analyzed with a soil Po fraction method, as used by Ivanoff. The relationships between the Po fractions and physiochemical features of sediments were also discussed. The results showed that, the sediments of the rivers had been moderately pollution with certain ecological risk effects except the Waste Yellow River. The relative contribution order of the Po fractions in the sediments was residual Po > HCl-Po > fulvic acid-Po > humic acid-Po > labile organic phosphorus (LOP). Moderately labile organic phosphorus (MLOP) was the main part of the Po forms in the whole sediments. The risk of phosphorus released from river sediments was the highest in the western region, followed by the southwestern region, and finally the northwestern region. There were significant correlations between Po forms and total phosphorus (TP), inorganic phosphorus (Pi), and Po. Non labile organic phosphorus (NLOP) had the strongest correlation with TP. The distribution of Po forms in each region was different due to the impact of human activities, industrial and agricultural production and the land types; the heaver polluted sediments with higher Po fractions. It is suggested that most of the sediments of the inflow rivers in the regions have certain ecological risk effects and P of them have an important contributions on the eutrophication of Hongze Lake. Po forms can provide a reliable theoretical basis for dealing with the change of water quality and should be paid more attention in the lake eutrophication investigation. There was reciprocal transformation between different Po forms, especially non-bioavailable fraction can change into bio-available ones. The results can provide a basis for the earth cycle of phosphorus and a new perspective of eutrophication control of shallow lakes.
Development of the Nurses’ Occupational Stressor Scale
Authors: Chen Yi-Chuan , Guo Yue-Liang Leon , Lin Li-Chan , Lee Yu-Ju , Hu Pei-Yi , Ho Jiune-Jye , Shiao Judith Shu-Chu
Published: January 2020

Although nurses work in stressful environments, stressors in such environments have yet to be clearly assessed. This study aimed to develop a Nurses’ Occupational Stressor Scale (NOSS) with high reliability and validity. Candidate questions for the NOSS were generated by expert consensus following focus group feedback, and were used to survey in 2013. A shorter version was then developed after examination for validity and reproducibility in 2014. The accuracy of the short version of the NOSS for predicting nurses’ stress levels was evaluated based on receiver operating characteristic curves to compare existing instruments for measuring stress outcomes, namely personal burnout, client-related burnout, job dissatisfaction, and intention to leave. Examination for validity and reproducibility yielded a shorter version of NOSS with only 21 items was considered sufficient for measuring stressors in nurses’ work environments. Nine subscales were included: (1) work demands, (2) work–family conflict, (3) insufficient support from coworkers or caregivers, (4) workplace violence and bullying, (5) organizational issues, (6) occupational hazards, (7) difficulty taking leave, (8) powerlessness, and (9) unmet basic physiological needs. The 21-item NOSS proved to have high concurrent and construct validity. The correlation coefficients of the subscales for test-retest reliability ranged from 0.71 to 0.83. The internal consistency (Cronbach’s α) coefficients ranged from 0.35 to 0.77. The NOSS exhibited accurate prediction of personal burnout, client-related burnout, job dissatisfaction, and intention to leave.
Intervention Strategies to Elicit MVPA in Preschoolers during Outdoor Play
Authors: Wadsworth Danielle D. , Johnson Jerraco L. , Carroll Alexandra V. , Pangelinan Melissa M. , Rudisill Mary E. , Sassi Julia
Published: January 2020

Approximately 50% of preschoolers do not meet physical activity recommendations and children who reside in low-income rural communities may be further at risk for higher levels of sedentary behavior. Outdoor play is essential for preschool children; however, literature is unclear as to which types of interventions elicit moderate-to-vigorous physical activity (MVPA) for all preschoolers. The aim of this study was to determine which type of intervention, physical activity or fundamental motor skill focus, elicits MVPA during outdoor play. Ninety-eight preschool children (M age = 4.48 years) from one Head Start center participated in an outdoor play intervention two days per week for 7 weeks. Classes were randomly assigned to one of four groups: fundamental motor skill focus (FMS), physical activity focus (PA), FMS and PA (FMS + PA), and control. An accelerometer worn on the hip measured MVPA. Results showed that age, sex and group assignment contributed to MVPA at the beginning of the intervention and age, sex, group assignment and MVPA during the beginning of the intervention contributed to MVPA at the end of the intervention. Overall, the FMS + PA group elicited MVPA from males and females of all ages. Interventions that combine both FMS and PA may reduce physical activity disparities in preschool children.
Bacterial Profile, Multi-Drug Resistance and Seasonality Following Lower Limb Orthopaedic Surgery in Tropical and Subtropical Australian Hospitals: An Epidemiological Cohort Study
Authors: Vickers Mark L. , Ballard Emma L. , Harris Patrick N. A. , Knibbs Luke D. , Jaiprakash Anjali , Dulhunty Joel M. , Crawford Ross W. , Parkinson Benjamin
Published: January 2020

We aimed to describe the epidemiology, multi-drug resistance and seasonal distribution of bacteria cultured within 12 months following lower limb orthopaedic surgery in tropical and subtropical Australian hospitals between 2010 and 2017. We collected data from four tropical and two subtropical hospitals. Categorical variables were examined using the Pearson Chi-squared test or Fisher’s Exact test, and continuous variables with the Student t-test or Mann–Whitney U test. A Poisson regression model was used to examine the relationship between season, weather and the incidence of Staphylococcus and nonfermentative species. We found that at tropical sites, nonfermenters (Pseudomonas aeruginosa and Acinetobacter baumannii) were more common (28.7% vs. 21.6%, p = 0.018), and patients were more likely to culture multi-drug-resistant (MDR) nonfermenters (11.4% vs. 1.3%, p = 0.009) and MDR Staphylococcus aureus (35.9% vs. 24.6%, p = 0.006). At tropical sites, patients were more likely to be younger (65.9 years vs. 72.0, p = < 0.001), male (57.7% vs. 47.8%, p = 0.005), having knee surgery (45.3% vs. 34.5%, p = 0.002) and undergoing primary procedures (85.0% vs. 73.0%, p = < 0.001). Species were similar between seasons in both tropical and subtropical hospitals. Overall, we found that following lower limb orthopaedic surgery in tropical compared with subtropical Australia, patients were more likely to culture nonfermenters and some MDR species.
Factorial Structure and Measurement Invariance of the Acceptance and Action Questionnaire-Stigma (AAQ-S) in Spain
Authors: Trigueros Rubén , Navarro-Gómez Noelia , Aguilar-Parra José M. , Cangas Adolfo J.
Published: January 2020

The objective of the present study was to validate and adapt the Acceptance and Action Questionnaire-Stigma (AAQ-S) to the Spanish context. Method: The study included the participation of 1212 subjects, with an average age of 17.12 years old. Results: The confirmatory factorial analysis revealed a number of adequate fit indices for the new version of the scale χ2/df = 3.24; Comparative Fit Index = 0.96; Incremental Fit Index = 0.96; Root Mean Square Error of Approximation = 0.060; Standardized Root Mean Square Residual = 0.035, in which the factorial structures displayed gender invariance. The two factors comprise the scale both exhibited high internal consistency (+0.90) and temporal stability. Conclusion: The Spanish version of the AAQ-S proved to be a robust and adequate psychometric instrument. In this sense, future lines of research focused on determining the role of psychological flexibility in stigma and the processes of change at the base of interventions could benefit substantially from the use of AAQ-S.
Night Shift Work—A Risk Factor for Breast Cancer
Authors: Szkiela Marta , Kusideł Ewa , Makowiec-Dąbrowska Teresa , Kaleta Dorota
Published: January 2020

Shift work is considered a risk factor for some health problems. This study aimed to determine whether night shift work is a significant factor for breast cancer risk. The case–control study was conducted from 2015–2019 in the Łódź region. The case group included 494 women diagnosed with malignant breast cancer; the control group included 515 healthy women. The research tool was an anonymous questionnaire. In the case group, the percentage of women working shift work was 51.9%, whereas in the control group, it was 34.1% (OR = 2.08 (95% CI: 1.61; 2.69)). A more insightful examination of shift work showed that only night work has a significant impact on breast cancer (OR = 2.61 (95% CI: 1.94; 3.53)). Even after considering the effect of other possible cancer factors (like high BMI, smoking, early menstruation, late menopause, pregnancy history, age, place of living, education), the odds of developing cancer were twice as high in the group of shift workers (OR = 2.20 (95% CI: 1.57; 3.08)). Considering a significantly higher risk of cancer among people working at night and a high percentage of such employees in Poland, the government should consider special action in the prophylactic treatment of cancers.
Spatiotemporal Epidemiology of Varicella in Chongqing, China, 2014–2018
Authors: Zhu Hua , Zhao Han , Ou Rong , Zeng Qing , Hu Ling , Qiu Hongfang , Sharma Manoj , Ye Mengliang
Published: January 2020

Although immunization against varicella using vaccines has been proven to be significant and effective in the past decades, varicella remains a major public health concern for many developing countries. Varicella vaccination has not been introduced into routine immunization programs in China, and varicella outbreaks have continued to occur. Taking the city of Chongqing, which has a high prevalence of varicella, as an example, this study explored the spatiotemporal epidemiology of varicella. Based on the reported data of varicella cases from 1 January 2014 to 31 December 2018 in Chongqing, hot spots and space-time clusters of varicella were identified using spatial autocorrelation analysis and scan statistics. Within this period, a total of 112,273 varicella cases were reported in Chongqing (average annual incidence: 73.44 per 100,000), including one death. The incidence of varicella showed an increasing trend with significant seasonal peaks, which occurred during April to July and October to January of the following year. The total ratio of male to female patients affected was 1.10:1. Children under the age of 15 and students accounted for the majority of the patient population. The hotspots detected through local spatial autocorrelation analysis, and the most likely clusters identified by scan analysis, were primarily in the main urban districts of Chongqing. The secondary clusters were mostly detected in northeast and southwest Chongqing. There were obvious spatial dependence and spatiotemporal clustering characteristics of varicella in Chongqing from 2014 to 2018. High-risk districts, populations, and peak periods were found in this study, which could be helpful in implementing varicella prevention and control programs, and in adjusting vaccination strategies for the varicella vaccine based on actual conditions.
Multi-Parameter Estimation of Average Speed in Road Networks Using Fuzzy Control
Authors: Guth Johanna , Wursthorn Sven , Keller Sina
Published: January 2020

Average speed is crucial for calculating link travel time to find the fastest path in a road network. However, readily available data sources like OpenStreetMap (OSM) often lack information about the average speed of a road. However, OSM contains other road information which enables an estimation of average speed in rural regions. In this paper, we develop a Fuzzy Framework for Speed Estimation (Fuzzy-FSE) that employs fuzzy control to estimate average speed based on the parameters road class, road slope, road surface and link length. The OSM road network and, optionally, a digital elevation model (DEM) serve as free-to-use and worldwide available input data. The Fuzzy-FSE consists of two parts: (a) a rule and knowledge base which decides on the output membership functions and (b) multiple Fuzzy Control Systems which calculate the output average speeds. The Fuzzy-FSE is applied exemplary and evaluated for the BioBío and Maule region in central Chile and for the north of New South Wales in Australia. Results demonstrate that, even using only OSM data, the Fuzzy-FSE performs better than existing methods such as fixed speed profiles. Compared to these methods, the Fuzzy-FSE improves the speed estimation between 2% to 12%. In future work, we will investigate the potential of data-driven machine learning methods to estimate average speed. The applied datasets and the source code of the Fuzzy-FSE are available via GitHub.
Immunological Memory of Psoriatic Lesions
Authors: Owczarczyk-Saczonek Agnieszka , Krajewska-Włodarczyk Magdalena , Kasprowicz-Furmańczyk Marta , Placek Waldemar
Published: January 2020

The natural course of psoriasis is the appearance of new lesions in the place of previous ones, which disappeared after a successful therapy. Recent studies of psoriasis etiopathogenesis showed that after psoriatic plaques have disappeared, in healthy skin we can still find a trace of inflammation in the form of tissue resident memory cells (TRM). They are originally responsible for protection against viral and bacterial infections in non-lymphatic tissues. In psoriatic inflammation, they are characterized by heterogeneity depending on their origin. CD8+ T cells TRM are abundantly present in psoriatic epidermis, while CD4+ TRM preferentially populate the dermis. In psoriasis, epidermal CD8+ TRM cells express CLA, CCR6, CD103 and IL-23R antigen and produce IL-17A during ex vivo stimulation. However, CD4+ CD103+ TRM can also colonize the epidermis and produce IL-22 during stimulation. Besides T cells, Th22 and epidermal DCs proved that epidermal cells in healed skin were still present and functioning after several years of disease remission. It explains the clinical phenomenon of the tendency of psoriatic lesions to relapse in the same location and it allows to develop new therapeutic strategies in the future.
Placenta-Specific Genes, Their Regulation During Villous Trophoblast Differentiation and Dysregulation in Preterm Preeclampsia
Authors: Szilagyi Andras , Gelencser Zsolt , Romero Roberto , Xu Yi , Kiraly Peter , Demeter Amanda , Palhalmi Janos , Gyorffy Balazs A. , Juhasz Kata , Hupuczi Petronella , Kekesi Katalin Adrienna , Meinhardt Gudrun , Papp Zoltan , Draghici Sorin , Erez Offer , Tarca Adi Laurentiu , Knöfler Martin , Than Nandor Gabor
Published: January 2020

The human placenta maintains pregnancy and supports the developing fetus by providing nutrition, gas-waste exchange, hormonal regulation, and an immunological barrier from the maternal immune system. The villous syncytiotrophoblast carries most of these functions and provides the interface between the maternal and fetal circulatory systems. The syncytiotrophoblast is generated by the biochemical and morphological differentiation of underlying cytotrophoblast progenitor cells. The dysfunction of the villous trophoblast development is implicated in placenta-mediated pregnancy complications. Herein, we describe gene modules and clusters involved in the dynamic differentiation of villous cytotrophoblasts into the syncytiotrophoblast. During this process, the immune defense functions are first established, followed by structural and metabolic changes, and then by peptide hormone synthesis. We describe key transcription regulatory molecules that regulate gene modules involved in placental functions. Based on transcriptomic evidence, we infer how villous trophoblast differentiation and functions are dysregulated in preterm preeclampsia, a life-threatening placenta-mediated obstetrical syndrome for the mother and fetus. In the conclusion, we uncover the blueprint for villous trophoblast development and its impairment in preterm preeclampsia, which may aid in the future development of non-invasive biomarkers for placental functions and early identification of women at risk for preterm preeclampsia as well as other placenta-mediated pregnancy complications.