bluuebunny/crossref_metadata_2025 huggingface dataset:
Chemical contaminants in Brazilian drinking water: a systematic review
Authors: Zini Luciano Barros , Gutterres Mariliz
Published: April 2021

The goals of this research are to evaluate which chemical contaminations were detected in Brazil's drinking water reported in papers published from 2012 to 2019, to propose guideline values for emerging contaminants and assess which are the priority parameters from a health risk perspective. The methodology used was a systematic review. The chemical contaminants quantified were evaluated according to Brazilian drinking-water standards, and Guideline Values were proposed for emerging pollutants using conservative endpoints from NOAEL and LOAEL available in literature. From 1351 articles evaluated, 15 reached the research goal. Seventy-seven parameters were quantified in Brazilian drinking water from underground, surface and rainwater sources. Soil composition, mining, sewage and agricultural activities were the main sources for the seven classes framed: pesticides, metals, organic, endocrine disruptors, drugs, personal care products and illicit drugs. Twenty-two parameters are listed in the current Brazilian drinking water quality standard and 54 are not. Water was not considered appropriate to drink due to cadmium, aluminum, iron, nickel, mercury, atrazine, propionaldehyde, beryllium, acetone and 17 α-ethinyl estradiol (carcinogenic). Measures to reduce chemical contamination in drinking water need to be taken such as the expansion of sewage treatment and upgrading to tertiary treatment, and controlling and reducing the application of pesticides.
SARS-CoV-2: fate in water environments and sewage surveillance as an early warning system
Authors: Panchal Deepak , Tripathy Purusottam , Prakash Om , Sharma Abhishek , Pal Sukdeb
Published: April 2021

Coronavirus disease has emerged as one of the greatest threats to human well-being. Currently, the whole world is fighting against this pandemic that is transmitted either through exposure to virus laden respiratory or water droplets or by touching the virus contaminated surfaces. The viral load in feces of an infected patient varies according to the severity of the disease. Subsequent detection of viral genome (SARS-CoV-2) in human feces and sewage systems is an emerging concern for public health. This also dictates to reinforce the existing sewage/wastewater treatment facilities. Rapid monitoring is the key to prevent and control the current mass transmission. Wastewater-based epidemiology (WBE) is a potential epidemiology tool that can act as a complementary approach for current infectious disease surveillance systems and an early warning system for disease outbreaks. In a developing country like India, inadequate wastewater treatment systems, low-operational facility and relaxed surface water quality criteria even in terms of fecal coliform bacteria are the major challenges for WBE. Herein, we review the occurrence, transmission, and survival of SARS-CoV-2, and disinfection and potential of sewage surveillance as an early warning system for COVID-19 spread. We also discuss the challenges of open-defecation practices affecting sewage-surveillance in real-time in densely populated developing countries like India.
Critical Residues in Hsp70 Nucleotide Binding Domain for Challenges in
Drug Design
Authors: Ergul Mustafa , Aktan Fugen , Tutar Yusuf
Published: April 2021

Background:

The association of a drug with its target protein correlates to its medicinal
activity and the microenvironment plays a key role in this association. The key challenge is to identify
mutations which unlikely to respond to designed drugs.

Objective:

Hsp70 is an anti-apoptotic factor and tumor cells overexpress Hsp70 to survive against
anti-cancer agents. The impact of pathogenic mutations on Hsp70 is unknown. Elucidation of these
alterations is essential to understand the molecular switch mechanism. Thus, critical spots on
Hsp70 Nucleotide Binding Domain (NBD) are important since mutation-driven sensitivity may be
useful in designing innovative inhibitors.

Methods:

ATP, AMP-PNP (non-hydrolyzable analog of ATP) along with commercially available
compounds VER-155008 (ATP analog and competitive inhibitor) and MKT-077 (allosteric inhibitor
of ADP bound form) were docked to Hsp70 NBD structure in silico to identify critical amino
acids of inhibition mechanism. Site-directed mutagenesis of the determined critical residues along
with ATP hydrolysis and luciferase refolding was performed. Wild-type and mutant Hsp70s were
compared to determine the effect on protein functions in the presence or absence of inhibitors.

Results:

This study identified three mutants that have a loss of function for Hsp70, which may alter
the drug inhibition activity as oncogenic cells have multiple mutations.

Conclusion:

Two commercial inhibitors employed here that mimic ATP and ADP states, respectively,
are not affected by these mutational perturbations and displayed effective interference for
Hsp70 functions. Designing inhibitors by considering these critical residues may improve drug design
and increase drug efficiency.
Pharmacognostical Standardization, Isolation of Phytoconstituents
(β-sitosterol), HPTLC Analysis of Extracts of Operculina turpethum (Linn.)
Roots and Evaluation of Cytotoxic, In vitro, and In vivo Anti-inflammatory
Activities
Authors: Ved Akash , Gupta Shweta , Singh Namrata , Shukla Karuna S. , Prakash Om , Gaur Neeru
Published: April 2021

Operculina turpethum (Linn.) Silva Manso belongs to the family convolvulaceae. It is an
important plant in the Indian conventional system of medicine, which is extensively employed by different
tribes in many countries to cure edema and painful conditions like arthritis, back pain, hyperlipidemia,
diabetes mellitus, liver disorders, skin disorders, and regulation of bowel functions.
The roots of O. turpethum (Linn.) were subjected to physicochemical and phytochemical standardization
and chromatographic separation, which was accomplished by column chromatography, TLC, and
HPTLC. Further, the acute toxicity, cytotoxic and anti-inflammatory activities of Operculina turpethum
roots were estimated by in vivo and in vitro models.
This study includes percentage yield of extraction and organoleptic evaluation, along with the analysis of
its physicochemical investigations and preliminary phytochemical estimation. The isolation of active
phytoconstituents was done by column chromatography, and the isolated compound was then exposed to
TLC and HPTLC analysis. Cytotoxic activity was tested by WST-1 based cell viability assay on HepG2
cells. The anti-inflammatory activity of methanol extract (ME) was evaluated against inflammation occur
by both in vitro and in vivo methods.
The methanolic extract exhibited the presence of most of the phytoconstituents out of all the extracts.
The phytoconstituent phytosterol, i.e., β-sitosterol, was isolated by column chromatography, identified,
and quantified by TLC and HPTLC, which was liable for anti-inflammatory activity. The amount of β-
sitosterol was estimated to be 14.09 μg in a 10.00 mg fraction of MEOT. MEOT was devoid of toxicity
up to 2000 mg/kg in Wistar albino rats. It was analysed that in vitro anti-inflammatory activity of MEOT
by egg albumin denaturation method exhibited an incredible decrement in turbidity and increased the
percentage inhibition of albumin denaturation (60.52%) in MEOT treated group as compared with the
control group. In egg albumin-induced edema in rats, MEOT at the dose of 400 mg/kg reduced the edema
formation (3.03 ± 0.02) induced by egg albumin at 4th h. In cotton pellet-induced granuloma in rats,
MEOT at the dose of 400 mg/kg displayed maximum granuloma inhibition (51.06%), which was similar
to that of indomethacin.
From the obtained findings, it is confirmed that O. turpethum contains β-sitosterol, which is responsible
for potent anti-inflammatory activity without causing cytotoxicity to the plant. The results suggested that
ME of O. turpethum roots had a high potential for application as an anti-inflammatory agent. The recognization
and confirmation of the plant can be obtained from the study and will present data that is aidful
in determining the quality and purity of a crude drug which further helps in preventing its adulteration.
Prevalence of Anxiety During Pregnancy in Women with Previous Spontaneous
Abortions
Authors: Radhakrishnan Keerthana , Kandavar Shraddha Shetty
Published: April 2021

Backgroundː :

Abortion results in emotional stress affecting the mental health of women.
Women become more anxious in the subsequent pregnancy. The severity of anxiety depends on
the number of prior pregnancy losses.

Aim:

To study the prevalence of anxiety during pregnancy in women with previous spontaneous
abortions.

Materials and Methods:

A case control study was conducted on 200 women (study group) with a
previous history of spontaneous abortions and compared with 200 women (control group) with a
previous normal delivery. Anxiety levels were measured using the Hamilton Anxiety Scale for all
women in the first trimester. Anxiety score <17 indicates mild severity, 18–24 mild to moderate
severity and 25–30 moderate to severe anxiety.

Results:

In the study population, most women were found to be in the age group of 26-30 years.
149 (74.5%) women had previous one spontaneous abortion and 51 ((25.5%) had previous two
spontaneous abortions in the study group. The prevalence of anxiety was observed in 42(21%) in
the study group and 20(10%) in the control group and was found to be statistically significant. In
the study group, 26(62%) women had mild anxiety, 13(31%) with moderate anxiety and 3(7%) had
severe anxiety and 14(60%) had mild anxiety, 6(40%) moderate anxiety in the control group.

Conclusions:

Women experience emotional trauma and stress following previous pregnancy losses,
which can have a negative impact on their mental health. Anxiety increases in the subsequent
pregnancy. Anxiety level depends on the number of previous pregnancy losses. Hence careful prenatal
care and psychological support should be advised to pregnant women with prior spontaneous
abortions to improve the quality of life.
Kariyer Psikolojik Danışmanlığı Öz–Yeterlik Ölçeği Türkçe Formu: Geçerlik ve Güvenirlik Çalışması
Authors: Büyükgöze-kavas Ayşenur , Şanlı Esat , İslam Ümit Yaşar
Published: April 2021

Öz: Bu çalışmanın amacı, O’Brien, Heppner, Flores ve Bikos (1997) tarafından geliştirilen Kariyer Psikolojik Danışmanlığı Öz- Yeterlik Ölçeğini Türkçe’ye uyarlamak, geçerlik ve güvenirlik çalışmalarını gerçekleştirmektir. Çalışmanın amacı doğrultusunda, öncelikle ölçek maddelerinin Türkçe’ye çevirisi yapılmış ardından uzman görüşü ve hedef kitleye benzer olarak küçük bir gruptan (n = 8) maddelerin anlaşılabilirliğine ilişkin görüş alınmıştır. Ölçek formu ile yaşları 22 ile 62, tecrübeleri ise 1 ile 38 yıl arasında değişen psikolojik danışmanlardan, yüksek lisans veya doktora yapan alan mezunlarından olmak üzere 154’ü kadın, 71’i erkek toplam 225 katılımcıdan veri toplanmıştır. Doğrulayıcı faktör analizi (DFA) bulgularına dayalı olarak bazı maddelere ait hatalar ilişkilendirilmiş ve önerilerin uygulanması sonucunda dört faktörlü yapının doğrulandığı görülmüştür. Ölçeğe ilişkin uyum geçerliği çalışması kapsamında, Lent ve ark., (2003) tarafından geliştirilen Psikolojik Danışma Öz- Yeterlik Ölçeği’nden yararlanılmıştır. Psikolojik danışmanların yeterlik algılarını konu alan iki ölçek arasındaki anlamlı ve beklenen yöndeki ilişkiler kariyer psikolojik danışmanlığı öz-yeterlik ölçeğinin geçerliğini destekler nitelikledir. Ölçeğin, iç tutarlılık katsayısı terapötik süreç ve iş birliği becerileri alt ölçeği için .86, mesleki değerlendirme ve yorum yapma becerileri alt ölçeği için .90, çok kültürlü danışmanlığa yönelik yeterlik alt ölçeği için .84 ve iş dünyasındaki güncel eğilimler, etik ve kariyer araştırması alt ölçeği için .67’dir. Ölçeğin bütünü için iç tutarlılık katsayısı .93’tür. Araştırma sonucunda elde edilen bulgular, tüm faktörler için hesaplanan iç tutarlık katsayılarının yeterli düzeyde ve orijinal çalışmadaki iç tutarlık katsayıları ile benzer olduğunu göstermektedir.
Kerentanan Petani Lahan Sempit Pasca Perubahan Agroforestry (Studi Kasus pada Perubahan Usaha Tani Tebu Menjadi Usaha Tani Sengon)
Authors:   Pascasarjana Ilmu Sosial Universitas Brawijaya, Yuana Ambayu
Published: April 2021

ABSTRAK Tulisan ini membahas mengenai perubahan usaha tani tebu menjadi sengon yang berdampak pada kerentanan petani lahan sempit. Dampak dirasakan petani lahan sempit akibat dari perbedaan musim panen jangka pendek menjadi panjang. Tujuan penelitian ini menganalisis perubahan aktivitas bertani pasca perubahan usaha tani tebu menjadi sengon. Selain itu, penulis ingin mengetahui strategi bertahan hidup petani lahan sempit setelah terjadi perubahan usaha tani tebu menjadi sengon. Penelitian ini menggunakanteori bertahan hidup James Scott sebagai pisau analisis mengenai proses bertahan hidup selama menunggu panen sengon yang lama. Metode yang digunakan dalam penelitian ini adalah studi kasus dengan menggunakan teknik pengumpulan data observasi, wawancara dan dokumentasi. Hasil menunjukan perubahan usaha tani tebu menjadi usaha tani sengon berawal dari harga fluktuasi tebu yang membuat petani melirik sengon sebagai usaha tani yang mengguntungkan dibandingkan dengan usaha tani tebu. Perubahan ini berdampak pada petani lahan sempit akibat lahan yang mereka miliki sedit dan mereka harus bisa bertahan hidup dikarenakan perbedaan masa panen sengon lebih panjang dibandingan tebu yang panen setiap tahunya. Petani lahan sempit melakukan tindakan bertahan hidup dengan cara bekerja non pertanian seperti buruh ke kota dan berdangang. Namun jika petani bertahan disektor pertanian maka mereka bisa menjadi buruh tani dan melakukan kegiatan tumpangsari di lahan sempit mereka.
Penyuluhan Pertanian dan Pengaruhnya terhadap Pendapatan Usahatani di Gapoktan Rorotan Jaya, Rorotan, Cilincing, Provinsi Dki Jakarta
Authors:   Dinas Ketahanan Pangan Kelautan dan Pertanian Provinsi DKI Jakarta, Descartes Descartes , Harianto Harianto , Falatehan Faroby
Published: April 2021

Penelitian ini dilatar belakangi minimnya literatur penyuluhan untuk usahatani konvensional di wilayah DKI Jakarta. Kegiatan penyuluhan merupakan bagian dari upaya Pemprov DKI Jakarta dalam memajukan sektor pertanian dan meningkatkan pendapatan petani. Keputusan mengikuti penyuluhan sebagai proses pendidikan informal dapat berbeda antar petani sasaran. Kemudian diperlukan identifikasi faktor-faktor strategis usahatani untuk mendukung penyuluh dalam menjalankan peranannya. Berdasarkan hal tersebut tujuan penelitian ini adalah (1) Mengkaji pengaruh karakteristik pribadi petani terhadap frekuensi interaksi antara penyuluh dan petani, dan (2) Menganalisis pengaruh frekuensi interaksi antara petani dan penyuluh pertanian serta karakteristik usahatani petani terhadap pendapatan usahatani. Penelitian dilakukan di Kelurahan Rorotan, Kecamatan Cilincing, Kota Administrasi Jakarta utara dengan pertimbangan bahwa lokasi tersebut merupakan tempat terkonsentrasinya usahatani padi sawah di Provinsi DKI Jakarta. Prosedur analisis data menggunakan regresi linier berganda dengan taraf nyata 10 persen, dimana interpretasi hasilnya juga dibantu oleh wawancara mendalam. Hasil penelitian ini mengidentifikasi bahwa tingkat pendidikan formal dan tingkat keaktifan dalam kelompok tani berpengaruh nyata terhadap frekuensi interaksi antara petani dan penyuluh pertanian, sedangkan variabel umur, pengalaman berusahatani, dan pemanfaatan media internet tidak memberikan pengaruh nyata. Kemudian penggunaan benih bersertifikat, pemanfaatan akses kredit formal, luas lahan, serta frekuensi interaksi antara petani dan penyuluh pertanian berpengaruh nyata terhadap pendapatan usahatani.
Analisis Kelayakan Pada Agroindustri Kopi Bubuk Desa Nogosari Kecamatan Rambipuji Kabupaten jember
Authors:   Program Studi Agribisnis Fakultas Pertanian Universitas Jember, Oka Wayan , Apriyani Bella , K.D K. Ajeng
Published: April 2021

Penelitian ini dilatarbelakangi oleh suatu perspektif dimana komoditas kopi merupakan salah satu komoditas yang sangat mengutungkan dan memiliki manfaat yang strategis baik dalam sisi ekonomi maupun pangan di Negara Indonesia. Perkembangan usaha di bidang olahan komoditas kopi sangat menguntungkan karena memiliki prospek dan peluang yang baik di pasar dimana hal tersebut dimanfaatkan dengan baik oleh petani kopi di Desa Nogosari Kecamatan Rambipuji Kabupaten Jember. Tujuan dari penelitian ini sendiri adalah untuk menganalisis kelayakan usaha agroindusti dari pengolah kopi bubuk di Desa Nogosari dengan melihat aspek pemasaran, teknologi metode produksi, serta manajemen dan impact dari kegiatan agroindustri tersebut dalam aspek finansial mereka. Penelitian tersebut menggunakan metode purposive sampling untuk pemilihan lokasi dan narasumber dan data akan dianalisis menggunakan metode analisis kelayakan bisnis. Hasil penelitian menunjukan bahwa dalam aspek pemasaran agroindustri kopi bubuk pengolah di Desa Nogosari menggunakan dua saluran pemasaran yaitu produsen ke konsumen dan produsen ke pengecer ke konsumen yang ditunjang oleh penggunaan metode STP serta penggunaan tekonologi yang modern, dan dari analisis kelayakan bisnis didapat hasil yaitu NPV 278.603.269,8; Net B/C 2,44 ; Gross B/C 1,32; IRR 59,61; PR 2,44; PP 2 Tahun 5 Bulan 26 Hari yang menunjukan usaha tersebut layak untuk dijalankan. Hasil menunjukan bahwa baik dalam aspek pemasaran, teknologi, teknis dan juga kelayakan finansial agroindustri kopi bubuk di Desa Nogosari Kecamatan Rambipuji Kabupaten Jember layak untuk dijalankan.
Analisis Usahatani Salak di Desa Bagorejo Kecamatan Gumukmas Kabupaten Jember
Authors:   Program Studi Agribisnis, Fakultas Pertanian, Universitas Jember, Sari Dita , Sintia Rahayu , Hendarsyah Amanda
Published: April 2021

Kabupaten Jember merupakan salah satu daerah yang memiliki sumber daya buah-buahan yang melimpah, salah satunya adalah buah salak yang berada di Desa Bagorejo Kecamatan Gumukmas Kabupaten Jember. Penelitian ini dilakukan untuk mengetahui aspek pasar, teknologi dan teknis, dan manajemen, serta mengetahui kelayakan usahatani salak dilihat dari aspek finansial usahatani salak. Metode analisis yang digunakan adalah metode analisis deskriptif, analisis NPV, Net B/C, Gross B/C. IRR, PR, dan PP. Perhitungan kelayakan usahatani didapatkan nilai NPV sebesar 29.052.788 (NPV > 0), nilai Net B/C sebesar 1,86 (Net B/C > 1), nilai Gross B/C sebesar 1,59 (Gross B/C > 1), nilai IRR sebesar 43,07% (IRR > discount factor), nilai PR sebesar 2,28 (PR > 1), dan nilai PP sebesar 94.555.633. Hasil penelitian menunjukkan bahwa aspek pasar, teknologi dan teknis, manajemen usahatani salak cukup mendukung kegiatan usahatani. Usahatani salak di Desa Bagorejo Kecamatan Gumukmas Kabupaten Jember juga telah layak dari aspek finansial.
Pengukuran Kinerja Rantai Pasok pada PT. Saudagar Buah Indonesia dengan Menggunakan Metode Supply Chain Operation Reference (SCOR)
Authors:   Program Studi Teknologi Industri Pertanian, Fakultas Teknologi Industri Pertanian, Universitas Padjadjaran, Saragih Syafrizal , Pujianto Totok , Ardiansah Irfan
Published: April 2021

Peningkatan pertumbuhan sektor industri tidak terlepas dari peran industri kecil menengah (IKM). Salah satu IKM yang belokasi di Kecamatan Jatinangor, Kabupaten Sumedang adalah PT. Saudagar Buah Indonesia yang bergerak dibidang industri pengolahan pangan dengan merek yang dikenal yaitu Frutivez. PT. Saudagar Buah Indonesia sedang mengalami masalah dalam kinerja manajemen rantai pasok. Oleh sebab itu, PT. Saudagar Buah Indonesia memerlukan pengukuran kinerja rantai pasok agar diketahui bagian-bagian dari kegiatan rantai pasok yang memiliki nilai kinerja yang rendah sehingga dapat dilakukan analisis masalah dan penemuan solusinya. Pengukuran kinerja rantai pasok dalam penelitian ini menggunakan metode Supply Chain Operations Reference (SCOR) dan penentuan nilai bobot tiap metrik kinerja rantai pasok menggunakan Analytical Hierarchy Process (AHP). Hasil dari pengukuran kinerja rantai pasok pada PT. Saudagar Buah Indonesia adalah 84,19 termasuk dalam kriteria sedang. Atribut rantai pasok yang memiliki nilai kinerja kurang maksimal adalah responsivitas, adaptabilitas, dan manajemen aset. PT. Saudagar Buah Indonesia harus melakukan perbaikan pada sektor penjualan, sektor pengolahan, dan siklus keuangan perusahaan
Development and evaluation of a mobile game as an English learning tool for ESL learners
Authors:   Department of Computer and Information Science, Faculty of Applied Science, King Mongkut’s University of Technology North Bangkok, Bangkok, Thailand, Saraubon Kobkiat
Published: April 2021

Learning and memorizing irregular verbs are some of the most difficult aspects of the language for non-native English learners. Research concerning games for education reveals that educational games have a large positive impact on learners’ skills and abilities. This research was divided into two phases including 1) the design, development and deployment of a mobile game used as an English learning tool for ESL learners and 2) an evaluation of the outcome. An Android mobile game was developed and then deployed on Google Play. In the evaluation phase, a quasi-experimental set-up with a non-equivalent pre-test and post-test control group design, was used to evaluate the impact of the use of the mobile game. The sample consisted of sixty-four tenth-grade students who studied English in a Thai school. There were two groups; the treatment group (N=32) and the control group (N=32) selected by cluster sampling. Both groups were given a pre-test to measure their prior knowledge. The sample then learned English in the class using conventional methods over a six-week period. During that period, the treatment group used the mobile game as a supplementary tool. Finally, both groups were given a post-test to measure the learning outcome. In this study, an independent t-test at the significance level of 0.01 was conducted. The results revealed that students who used the mobile game as a supplementary tool had statistically significantly higher learning outcomes.
Survey of Residency Directors’ Views on Entrepreneurship
Authors: Tam Emily K , Dong Xuezhi
Published: April 2021

Medical students enter the medicine field with fresh ideas that may make them great entrepreneurs. However, medical students are uncertain about how the program directors of their desired residency would view them if they pursued business opportunities. We surveyed residency directors to obtain their views on medical students’ entrepreneurship experiences. This viewpoint article aims to help American medical students who are interested in health innovations understand how their interests and entrepreneurial experiences may affect how they are viewed by residency program directors. Most program directors had favorable views of medical students with experience in entrepreneurship, and they believed that the innovative traits gained from such experiences would add to the program.
Feasibility of an Internet-Based Intervention to Promote Exercise for People With Spinal Cord Injury: Observational Pilot Study
Authors: Ochoa Christa , Cole Maria , Froehlich-Grobe Katherine
Published: April 2021

Background

People with spinal cord injury (SCI) are less likely to be physically active and have higher chronic disease risk than those in the general population due to physical and metabolic changes that occur postinjury. Few studies have investigated approaches to promote increased physical activity (PA) for people with SCI despite evidence that they face unique barriers, including lack of accessible transportation and exercise equipment. To address these obstacles, we adapted an evidence-based phone-delivered intervention that promoted increased PA among people with SCI into a web-based platform, titled the Workout on Wheels internet intervention (WOWii). The adapted program provides participants with weekly skill-building information and activities, basic exercise equipment, and ongoing support through weekly group videoconferencing.

Objective

This pilot study was conducted to assess the feasibility of using a web-based and virtual format to deliver the WOWii program in a randomized controlled trial.

Methods

We assessed the feasibility of the web-based program by delivering an abbreviated, 4-week version to 10 participants with SCI. Rates of weekly videoconference attendance, activity completion, and exercise activity as tracked by an arm-based activity monitor were recorded for all participants.

Results

Participants averaged 3.3 of 4 (83%) weekly group videoconferences attended, 3.4 of 4 (85%) web-based module activities completed, and 2.3 of 4 (58%) weeks of using the arm-based activity monitor. The majority of the sample (9/10, 90%) synced their arm-based PA monitor at least once, and overall engagement as an average of each component across the 4 weeks was 75%.

Conclusions

The intervention had sufficiently high levels of engagement to be used in a full randomized controlled trial to test its effectiveness in improving levels of PA among people with SCI. The knowledge we gained from this pilot study informed improvements that were made in the full randomized controlled trial.
Patient-Centered Care: Transforming the Health Care System in Vietnam With Support of Digital Health Technology
Authors: Dang Thu Ha , Nguyen Tuan Anh , Hoang Van Minh , Santin Olinda , Tran Oanh Mai Thi , Schofield Penelope
Published: April 2021

Background

Over the recent decades, Vietnam has attained remarkable achievements in all areas of health care. However, shortcomings including health disparities persist particularly with a rapidly aging population. This has resulted in a shift in the disease burden from communicable to noncommunicable diseases such as dementia, cancer, and diabetes. These medical conditions require long-term care, which causes an accelerating crisis for the health sector and society. The current health care system in Vietnam is unlikely to cope with these challenges.

Objective

The aim of this paper was to explore the opportunities, challenges, and necessary conditions for Vietnam in transforming toward a patient-centered care model to produce better health for people and reduce health care costs.

Methods

We examine the applicability of a personalized and integrated Bespoke Health Care System (BHS) for Vietnam using a strength, weakness, opportunity, and threat analysis and examining the successes or failures of digital health care innovations in Vietnam. We then make suggestions for successful adoption of the BHS model in Vietnam.

Results

The BHS model of patient-centered care empowers patients to become active participants in their own health care. Vietnam’s current policy, social, technological, and economic environment favors the transition of its health care system toward the BHS model. Nevertheless, the country is in an early stage of health care digitalization. The legal and regulatory system to protect patient privacy and information security is still lacking. The readiness to implement electronic medical records, a core element of the BHS, varies across health providers and clinical practices. The scarcity of empirical evidence and evaluation regarding the effectiveness and sustainability of digital health initiatives is an obstacle to the Vietnamese government in policymaking, development, and implementation of health care digitalization.

Conclusions

Implementing a personalized and integrated health care system may help Vietnam to address health care needs, reduce pressure on the health care system and society, improve health care delivery, and promote health equity. However, in order to adopt the patient-centered care system and digitalized health care, a whole-system approach in transformation and operation with a co-design in the whole span of a digital health initiative developing process are necessary.
Planning Engaging, Remote, Synchronous Didactics in the COVID-19 Pandemic Era
Authors: Rivera Ronald , Smart Jonathan , Sakaria Sangeeta , Wray Alisa , Wiechmann Warren , Boysen-Osborn Megan , Toohey Shannon
Published: April 2021

As part of the Accreditation Council for Graduate Medical Education requirements, residents must participate in structured didactic activities. Traditional didactics include lectures, grand rounds, simulations, case discussions, and other forms of in-person synchronous learning. The COVID-19 pandemic has made in-person activities less feasible, as many programs have been forced to transition to remote didactics. Educators must still achieve the goals and objectives of their didactic curriculum despite the new limitations on instructional strategies. There are several strategies that may be useful for organizing and creating a remote residency didactic curriculum. Educators must master new technology, be flexible and creative, and set rules of engagement for instructors and learners. Establishing best practices for remote didactics will result in successful, remote, synchronous didactics; reduce the impact of transitioning to a remote learning environment; and keep educators and learners safe as shelter-at-home orders remain in place.
Participant Perceptions of Facilitators and Barriers to Adherence in a Digital Mental Health Intervention for a Nonclinical Cohort: Content Analysis
Authors: Renfrew Melanie Elise , Morton Darren Peter , Northcote Maria , Morton Jason Kyle , Hinze Jason Scott , Przybylko Geraldine
Published: April 2021

Background

Digital mental health promotion interventions (MHPIs) present a scalable opportunity to attenuate the risk of mental health distress among nonclinical cohorts. However, adherence is frequently suboptimal, and little is known about participants’ perspectives concerning facilitators and barriers to adherence in community-based settings.

Objective

This study aimed to examine participants’ perceptions of facilitators and barriers to adherence in a web- and mobile app–based MHPI for a nonclinical cohort.

Methods

This qualitative study used inductive, reflexive thematic analysis to explore free-text responses in a postintervention evaluation of a 10-week digital MHPI. The intervention was administered using a web and mobile app from September to December 2018. Participants (N=320) were Australian and New Zealand members of a faith-based organization who self-selected into the study, owned a mobile phone with messaging capability, had an email address and internet access, were fluent in English, provided informed consent, and gave permission for their data to be used for research. The postintervention questionnaire elicited participants’ perceptions of facilitators and barriers to adherence during the intervention period.

Results

Key factors that facilitated adherence were engaging content, time availability and management, ease of accessibility, easy or enjoyable practical challenges, high perceived value, and personal motivation to complete the intervention. The primary perceived barrier to adherence was the participants’ lack of time. Other barriers included completing and recording practical activities, length of video content, technical difficulties, and a combination of personal factors.

Conclusions

Time scarcity was the foremost issue for the nonclinical cohort engaged in this digital MHPI. Program developers should streamline digital interventions to minimize the time investment for participants. This may include condensed content, optimization of intuitive web and app design, simplified recording of activities, and greater participant autonomy in choosing optional features. Nonetheless, participants identified a multiplicity of other interindividual factors that facilitated or inhibited adherence.
Exploring the Association Between Physical Activity and Risk of Mental Health Disorders in Saudi Arabian Adults: Cross-sectional Study
Authors: Althumiri Nora A , Basyouni Mada H , BinDhim Nasser F
Published: April 2021

Background

The relationship between physical activity and mental health, especially the symptoms of major depressive disorder (MDD) and generalized anxiety disorder (GAD), has received increasing attention in recent years.

Objective

The aim of this study was to explore the association between fulfilling the World Health Organization (WHO) global recommendations on physical activity and the risk and symptoms of MDD and GAD in the Saudi population.

Methods

This study was a secondary analysis of data from a large nationwide cross-sectional survey conducted via phone interviews in June and July 2020. In this study, a proportional quota sampling technique was used to obtain an equal distribution of participants, stratified by age and gender, across the 13 regions of Saudi Arabia. The main mental health screening tool used for the risk of MDD was the Patient Health Questionnaire-9 (PHQ-9). Risk of GAD was measured using the Generalized Anxiety Disorder-7 (GAD-7) scale. Participants self-reported whether they fulfill the WHO global recommendations on (1) moderate-intensity aerobic physical activity (MIPA) and (2) vigorous-intensity aerobic physical activity (VIPA). The results were then analyzed based on the following two categories: fulfilling the WHO global recommendations or not.

Results

The data analysis included 8333 participants recruited in the main study between June and July 2020. The response rate was 81.45% (8333/10,231). Of them, 50.3% (4192/8333) were female, and the mean age was 36.5 years, with a median age of 36 years and a range from 18 to 90 years. The average total PHQ-9 score was 5.61, and the average total GAD-7 score was 4.18. For men, the average total PHQ-9 and GAD-7 scores were associated with fulfilling recommendations for MIPA; however, there were no associations for VIPA in both sexes. Fulfilling the WHO’s recommendations for MIPA was associated with considerably fewer depressive symptoms in six of the nine items in the PHQ-9. Moreover, fulfilling recommendations for MIPA was associated with considerably fewer anxiety symptoms in six of the seven items in the GAD-7. However, fulfilling recommendations for VIPA was significantly associated with more depressive symptoms in one of the PHQ-9 items (“Thoughts that you would be better off dead or thoughts of hurting yourself in some way;” P<.001).

Conclusions

This study has shown that fulfilling guidelines on MIPA is associated with less overall risk of MDD and GAD in males and fewer depressive and anxiety symptoms generally in a nonclinical population. In the general population, an increase in MIPA may improve well-being and general mental health.
Pretesting a Poster on Recommended Stress Management During the COVID-19 Pandemic in Indonesia: Qualitative Study
Authors: Wati Risa Laras , Ulfa Annisa Sayyidatul , Kevaladandra Zulfa , Shalihat Shelly , Syahadatina Bella , Pratomo Hadi
Published: April 2021

Background

The COVID-19 Peritraumatic Distress Index (CPDI) is a self-report questionnaire developed to evaluate the frequency of anxiety and depression symptoms among individuals during the COVID-19 pandemic. A recent study in China showed high CPDI scores among individuals in the 18-30 years age group and those over 60 years. During the COVID-19 outbreak, people were expected to maintain their mental health conditions, especially stress levels. Therefore, many national governments actively published health promotion media in an effort to educate the public. One such media developed by the Ministry of Health, Republic of Indonesia, was a poster titled “Hindari Stres dan Tetap Optimis dengan Melakukan Aktivitas Sehari-hari dan Tetap Menjaga Jarak.”

Objective

The aim of this study is to conduct a test on a stress management recommendation poster developed by the Ministry of Health, Republic of Indonesia, in response to the COVID-19 outbreak by using pretesting communication theory.

Methods

In-depth interviews were conducted among 8 key informants and 1 graphic design expert.

Results

Pretesting can identify the strengths and weaknesses of media. The large amount of text and the lack of illustrations made the poster less attractive to readers. Moreover, there was a discrepancy between the title and contents of the poster. The poster was not able to persuade the informants to change their behavior in the near future.

Conclusions

The poster was understood and accepted by the informants, but there was still much to be improved considering the poster was a product of the Ministry of Health, Republic of Indonesia.
The Role of Mental Well-Being and Perceived Parental Supportiveness in Adolescents’ Problematic Internet Use: Moderation Analysis
Authors: Hwang Juwon , Toma Catalina L
Published: April 2021

Background

Given the growing number of adolescents exhibiting problematic internet use (PIU) and experiencing its harmful consequences, it is important to examine the factors associated with PIU. Existing research has identified perceived parental supportiveness and adolescents’ subjective mental well-being as strong predictors of PIU. However, it is unknown how these factors work together in shaping adolescents’ engagement in PIU.

Objective

This paper aimed to examine the role played by adolescents’ perception of parental supportiveness in conjunction with their subjective mental well-being in shaping their PIU.

Methods

The study analyzed one of the Technology & Adolescent Mental Wellness (TAM) data sets that were collected from a nationally representative cross-sectional sample. Adolescents self-reported their internet use behavior, perceived parental supportiveness, and subjective mental well-being through an online research panel survey. Hierarchical linear regression analysis with an interaction term was performed.

Results

A total of 4592 adolescents, aged 12 to 17 years, completed the survey. Adolescents reported a mean age of 14.61 (SD 1.68) and were 46.4% (2130/4592) female and 66.9% (3370/4592) White. Findings revealed that, controlling for adolescents’ demographics and social media use, higher levels of perceived parental supportiveness (β=–.285, P<.001) and higher levels of subjective mental well-being (β=–.079, P<.001) were associated with a lower likelihood of adolescent PIU. The moderation analysis showed that the negative association between perceived parental supportiveness and PIU was stronger when adolescents reported high (vs low) levels of mental well-being (β=–.191, P<.001).

Conclusions

This study shows that perceived parental supportiveness was a stronger protective factor than adolescents’ mental well-being against PIU. The protective power of perceived parental supportiveness against PIU was strongest when adolescents had high mental well-being. The highest risk of PIU occurred when adolescents’ mental well-being was high, but parents were perceived as unsupportive. Our findings suggest that parental supportiveness should be targeted as part of PIU prevention efforts.
Optimization of Patient Flow in Urgent Care Centers Using a Digital Tool for Recording Patient Symptoms and History: Simulation Study
Authors: Montazeri Maryam , Multmeier Jan , Novorol Claire , Upadhyay Shubhanan , Wicks Paul , Gilbert Stephen
Published: April 2021

Background

Crowding can negatively affect patient and staff experience, and consequently the performance of health care facilities. Crowding can potentially be eased through streamlining and the reduction of duplication in patient history-taking through the use of a digital symptom-taking app.

Objective

We simulated the introduction of a digital symptom-taking app on patient flow. We hypothesized that waiting times and crowding in an urgent care center (UCC) could be reduced, and that this would be more efficient than simply adding more staff.

Methods

A discrete-event approach was used to simulate patient flow in a UCC during a 4-hour time frame. The baseline scenario was a small UCC with 2 triage nurses, 2 doctors, 1 treatment/examination nurse, and 1 discharge administrator in service. We simulated 33 scenarios with different staff numbers or different potential time savings through the app. We explored average queue length, waiting time, idle time, and staff utilization for each scenario.

Results

Discrete-event simulation showed that even a few minutes saved through patient app-based self-history recording during triage could result in significantly increased efficiency. A modest estimated time saving per patient of 2.5 minutes decreased the average patient wait time for triage by 26.17%, whereas a time saving of 5 minutes led to a 54.88% reduction in patient wait times. Alternatively, adding an additional triage nurse was less efficient, as the additional staff were only required at the busiest times.

Conclusions

Small time savings in the history-taking process have potential to result in substantial reductions in total patient waiting time for triage nurses, with likely effects of reduced patient anxiety, staff anxiety, and improved patient care. Patient self-history recording could be carried out at home or in the waiting room via a check-in kiosk or a portable tablet computer. This formative simulation study has potential to impact service provision and approaches to digitalization at scale.
A Resilience-Building App to Support the Mental Health of Health Care Workers in the COVID-19 Era: Design Process, Distribution, and Evaluation
Authors: Golden Eddye A , Zweig Micol , Danieletto Matteo , Landell Kyle , Nadkarni Girish , Bottinger Erwin , Katz Lindsay , Somarriba Ricardo , Sharma Vansh , Katz Craig L , Marin Deborah B , DePierro Jonathan , Charney Dennis S
Published: April 2021

Background

The COVID-19 pandemic has resulted in increased strain on health care systems and negative psychological effects on health care workers (HCWs). This is anticipated to result in long-term negative mental health effects on the population, with HCWs representing a particularly vulnerable group. The scope of the COVID-19 pandemic necessitates the development of a scalable mental health platform to provide services to large numbers of at-risk or affected individuals. The Mount Sinai Health System in New York City was at the epicenter of the pandemic in the United States.

Objective

The Center for Stress, Resilience, and Personal Growth (CSRPG) was created to address the current and anticipated psychological impact of the pandemic on the HCWs in the health system. The mission of the Center is to support the resilience and mental health of employees through educational offerings, outreach, and clinical care. Our aim was to build a mobile app to support the newly founded Center in its mission.

Methods

We built the app as a standalone digital platform that hosts a suite of tools that users can interact with on a daily basis. With consideration for the Center’s aims, we determined the overall vision, initiatives, and goals for the Wellness Hub app, followed by specific milestone tasks and deliverables for development. We defined the app’s primary features based on the mental health assessment and needs of HCWs. Feature definition was informed by the results of a resilience survey widely distributed to Mount Sinai HCWs and by the resources offered at CSRPG, including workshop content.

Results

We launched our app over the course of two phases, the first phase being a “soft” launch and the second being a broader launch to all of Mount Sinai. Of the 231 HCWs who downloaded the app, 173 (74.9%) completed our baseline assessment of all mental health screeners in the app. Results from the baseline assessment show that more than half of the users demonstrate a need for support in at least one psychological area. As of 3 months after the Phase 2 launch, approximately 55% of users re-entered the app after their first opening to explore additional features, with an average of 4 app openings per person.

Conclusions

To address the mental health needs of HCWs during the COVID-19 pandemic, the Wellness Hub app was built and deployed throughout the Mount Sinai Health System. To our knowledge, this is the first resilience app of its kind. The Wellness Hub app is a promising proof of concept, with room to grow, for those who wish to build a secure mobile health app to support their employees, communities, or others in managing and improving mental and physical well-being. It is a novel tool offering mental health support broadly.
Estimating the Proportion of COVID-19 Contacts Among Households Based on Individuals With Myocardial Infarction History: Cross-sectional Telephone Survey
Authors: Fraticelli Laurie , Freyssenge Julie , Claustre Clément , Martinez Mikaël , Redjaline Abdesslam , Serre Patrice , Bochaton Thomas , El Khoury Carlos
Published: April 2021

Background

Adults with cardiovascular diseases were disproportionately associated with an increased risk of a severe form of COVID-19 and all-cause mortality.

Objective

The aims of this study are to report the associated symptoms for COVID-19 cases, to estimate the proportion of contacts, and to describe the clinical signs and behaviors among individuals with and without myocardial infarction history among cases and contacts.

Methods

A 2-week cross-sectional telephone survey was conducted during the first lockdown period in France, from May 4 to 15, 2020. A total of 668 households participated, representing 703 individuals with pre-existing cardiovascular disease in the past 2 years and 849 individuals without myocardial infarction history.

Results

High rates of compliance with health measures were self-reported, regardless of age or risk factors. There were 4 confirmed COVID-19 cases that were registered from 4 different households. Based on deductive assumptions of the 1552 individuals, 9.73% (n=151) were identified as contacts, of whom 71.52% (108/151) were asymptomatic. Among individuals with a myocardial infarction history, 2 were COVID-19 cases, and the estimated proportion of contacts was 8.68% (61/703), of whom 68.85% (42/61) were asymptomatic. The cases and contacts presented different symptoms, with more respiratory signs in those with a myocardial infarction history.

Conclusions

The telephone survey could be a relevant tool for reporting the number of contacts during a limited period and in a limited territory based on the presence of associated symptoms and COVID-19 cases in the households. This study advanced our knowledge to better prepare for future crises.