bluuebunny/crossref_metadata_2025 huggingface dataset:
“You’re Going to Have to Think a Little Bit Different” Barriers and Facilitators to Using mHealth to Increase Physical Activity among Older, Rural Cancer Survivors
Authors: Ginossar Tamar , Rishel Brakey Heidi , Sussman Andrew L. , Price Brittany , Kano Miria , Davis Sally , Blair Cindy K.
Published: August 2021

Wearable activity trackers (WATs) hold great promise in increasing physical activity among older cancer survivors. However, older cancer survivors who reside in rural regions are at increased risk of being digitally marginalized. The goal of this study was to learn about WATs adoption motivation and needs of rural older cancer survivors who live in New Mexico, one of the most rural states with the lowest broadband Internet connectivity in the United States. We conducted six key informant interviews and recruited 31 older cancer survivors from rural counties statewide who participated in interviews and focus groups. Our results show great interest in using WATs as part of an intervention to alleviate barriers associated with the digital divide. Participants were offered diverse modalities to support them in adoption of the trackers. These results will be used to inform future interventions and policies focusing on increasing physical activity in older cancer survivors who reside in rural communities.
Development and Validation of a Box and Flux Model to Describe Major, Trace and Potentially Toxic Elements (PTEs) in Scottish Soils
Authors: Gallini Luigi , Hursthouse Andrew , Scopa Antonio
Published: August 2021

The box and flux model is a mathematical tool used to describe and forecast the major and trace elements perturbations of the Earth biogeochemical cycles. This mathematical tool describes the biogeochemical cycles, using kinetics of first, second and even third order. The theory and history of the box and flux modeling are shortly revised and discussed within the framework of Jim Lovelok’s Gaia theory. The objectives of the investigation were to evaluate the natural versus anthropic load of Potentially Toxic Elements (PTEs) of the Scottish soils, investigate the soil components adsorbing and retaining the PTEs in non-mobile species, evaluate the aging factor of the anthropic PTEs and develop a model which describes the leaching of PTEs in layered soils. In the Scottish land, the soil-to-rock enrichment factorinversely correlates with the boiling point of the PTEs. The same is observed in NW Italy and USA soils, suggesting the common source of the PTEs. The residence time in soils of the measured PTEs linearly correlates with the Soil Organic Matter (SOM). The element property which mostly explains the adsorption capacity for PTEs’ is the ionic potential (IP). The downward migration rates of the PTEs inversely correlate with SOM, and in Scottish soil, they range from 0.5 to 2.0 cm·year−1. Organic Bentoniteis the most important soil phase adsorbing cation bivalent PTEs. The self-remediation time of the polluted soil examined ranged from 50 to 100 years. The aging factor, the adsorption of PTEs’ into non-mobile species, and occlusion into the soil mineral lattice was not effective. The box and flux model developed, tested and validatedhere does not describe the leaching of PTEs following the typical Gaussian shape distribution of the physical diffusion models. Indeed, the mathematical model proposed is sensitive to the inhomogeneity of the layered soils.
Mental Health of Apprentices during the COVID-19 Pandemic in Austria and the Effect of Gender, Migration Background, and Work Situation
Authors: Dale Rachel , O’Rourke Teresa , Humer Elke , Jesser Andrea , Plener Paul L. , Pieh Christoph
Published: August 2021

This study assessed the mental health of apprentices during the COVID-19 pandemic in Austria and the effect of gender, migration background, work situation, and work sector. An online survey via REDCap was performed with a sample of 1442 apprentices (female: 53.5%, male: 45.4%, diverse: 1.1%, migration background: 28.4%) from 29 March to 18 May 2021. Indicators of mental health were depression (PHQ-9), anxiety (GAD-7), well-being (WHO-5), disordered eating (EAT-8), and insomnia (ISI-7). There was a high prevalence of clinically relevant depression (cut-offs ≥11 for adolescents, ≥10 for adults: 48.3%), anxiety (cut-offs ≥11 for adolescents, ≥10 for adults: 35.4%), insomnia (cut-off ≥15: 27%), and disordered eating (cut-offs ≥2 for men, ≥3 for women: 50.6%). Linear models revealed that apprentices with female and diverse gender, migration background, and unemployed status showed the poorest scores on all mental health measures (all p-values < 0.05) except disordered eating. These findings emphasize the need for intersectional strategies to reduce and prevent adverse mental health consequences of the COVID-19 pandemic for apprentices.
Cesium in Biology, Pancreatic Cancer, and Controversy in High and Low Radiation Exposure Damage—Scientific, Environmental, Geopolitical, and Economic Aspects
Authors: Venturi Sebastiano
Published: August 2021

Radionuclide contamination in terrestrial ecosystems has reached a dangerous level. The major artificial radionuclide present in the environment is cesium-137 (137-Cs). In humans, animals, and plants cesium ion (Cs+) behaves like potassium ion (K+) and it is localized mainly inside the cells. Pancreas and salivary glands secrete Cs in the intestine thus eliminating about 14% of ingested Cs with the feces, the remaining 86% is eliminated by the kidney with the urine. Ingested radiocesium can also cause in humans several cases of pancreatitis with secondary diabetes (type 3c), which are both on the rise in the world. The Author studied the correlation between the geographical map of mortality from pancreatic cancer (PC) and the map of nuclear plant accidents, atomic bomb testing, and radioactive fallout. The worldwide death rate of PC is increasing, but the exact cause is still not known. Published data in medical literature at World, European and Italian levels are reviewed and compared. 137-Cs, with a half-life of about 30 years, is still present in the environment for about 300–600 years. Autoradiographic studies in mice have shown that 137-Cs is concentrated in greater quantity in the pancreas, particularly in exocrine cells, where most malignant PCs originate. Some methods of radiocesium removal and PC prevention are also suggested. But there is still a persistent, and not entirely disinterested, the controversy between damage from high and low exposure to ionizing radiations.
Health-Related Quality of Life Assessed in Children with Adenoid Hypertrophy
Authors: Niedzielski Artur , Chmielik Lechosław Paweł , Kasprzyk Anna , Stankiewicz Tomasz , Mielnik-Niedzielska Grażyna
Published: August 2021

Introduction: The quality of life issue began to be earnestly studied in the second half of the 20th century. It had originally been used as a criterion for measuring levels of human development in the USA and Western Europe. At first, only objective parameters were assessed, such as material goods; however, later, subjective and non-material parameters were added, such as health, freedom, and happiness. Over time, more and more attention has been paid to the subjective parameters regarding any quality of life assessment. Adenoids are physiological clusters of lymphoid tissue included in Waldeyer’s ring, which play an important role in shaping and directing the child’s local and systemic lines of defence. Adenoid hypertrophy occurs due to a variety of factors, such as recurring or chronic infections of the upper respiratory tract. Study aim: To assess health status in children with adenoid system hypertrophy compared with a group of healthy children. Materials and methods: The study group consisted of children suffering from adenoid hypertrophy, this being the most common chronic disease of the upper respiratory tract. The control group was composed of children attending nursery school (kindergarten), primary school, middle school, and high school. The study was performed by using the Child Health Questionnaire—Parent Form 50 CHQ-PF-50 (CHQ-PF50), which is a general purpose research tool based on psychometric testing when assessing physical and mental well-being in children aged 5 to 18 years. Results: There were 101 filled out questionnaires for the test group (54 girls and 47 boys), mean age 8.62 years (ranging 5–17), whilst 102 questionnaires for the controls (50 girls and 52 boys), mean age 10.58 years (ranging 5–18). Insignificant differences were found between social functioning resulting from behaviour or emotional state (REB), pain and discomfort (BP), and family cohesion (FC). Conclusions: Children suffering from adenoid hypertrophy demonstrate the largest decreases in wellbeing in the following areas: behaviour, general perception of health, and mental health.
Diagnosis-Specific Work Disability before and after Lumbar Spine Decompression Surgery—A Register Study from Sweden
Authors: Dorner Thomas E. , Mittendorfer-Rutz Ellenor , Helgesson Magnus , Lallukka Tea , Ervasti Jenni , Pazarlis Konstantinos , Ropponen Annina , Svedberg Pia , Wang Mo , Rahman Syed
Published: August 2021

Low back pain (LBP) patients undergoing lumbar spine decompression surgery (LSDS) often suffer from multi-comorbidity and experience high work disability. This study aimed to identify diagnosis-specific work disability patterns in all LBP-patients before and after LSDS during 2008–2010, that were aged 19–60 years and living in Sweden (n = 10,800) and compare these patterns to LBP-patients without LSDS (n = 109,179), and to matched individuals without LBP (n = 472,191). Work disability days (long-term sickness absence (LTSA), disability pension (DP)) during the three years before to three years after the cohort’s entry date were identified by generalised estimating equations. LBP-patients undergoing LSDS had higher overall work disability during the three years following surgery (LTSA: 23.6%, DP: 6.3%) than LBP-patients without LSDS (LTSA: 19.5%, DP: 5.9%), and those without LBP (LTSA: 7.9%, DP: 1.7%). Among patients undergoing LSDS, the prevalence of work disability due to dorsopathies increased from 20 days three years before surgery to 70 days in the year after and attenuated to 30 days in the third year following surgery. Work disability for other diagnoses remained stable at a low level in this group (<10 days annually). LBP-patients undergoing LSDS have an unfavourable long-term work disability prognosis, primarily due to dorsopathies. Decompression surgery seemed to restrict further inclines in work disability in the long run.
Psychological Variables Associated with HPV Vaccination Intent in Romanian Academic Settings
Authors: Diaconescu Liliana Veronica , Gheorghe Iuliana Raluca , Cheşcheş Tamara , Popa-Velea Ovidiu
Published: August 2021

The aim of this study was to evaluate (1) the female medical students’ knowledge about HPV infection; (2) the associations between the HPV vaccination intent and coping strategies, health locus of control (HLOC), and sense of coherence; and (3) the specific differences between preclinical and clinical students in terms of the vaccination intent. Participants included 1243 female medicine students (mean age = 21.526, SD = 2.007), who completed The Multidimensional Health Locus of Control (MHLC)—Form A, the Brief COPE Scale, the Sense of Coherence Scale (SOC-13), and two questionnaires measuring the knowledge about the HPV infection and the HPV vaccination intent. Results show a good knowledge about HPV, which progressively increased during the study cycles. Still, the main contributors to vaccination intent are represented by coping strategies and health locus of control. Refusal of vaccination is associated to behavioral disengagement and the use of religion, precontemplation and contemplation to denial, and preparation to planning, positive reframing, and the powerful others component of HLOC. Sense of coherence did not predict vaccination intent. In clinical years, active coping outweighs HLOC in making the decision to get vaccinated. These results could be helpful in designing personalized strategies for addressing vaccine hesitancy in academic communities.
Assessment of Severe COVID-19 Outcomes Using Measures of Smoking Status and Smoking Intensity
Authors: Mahabee-Gittens E. Melinda , Mendy Angelico , Merianos Ashley L.
Published: August 2021

Objective: Smoking status does not indicate the amount or length of tobacco use, and thus, it is an imperfect measure to assess the association between cigarette smoking and severe coronavirus disease 2019 (COVID-19) outcomes. This investigation assessed whether cigarette smoking status, intensity of smoking (i.e., average daily packs of cigarettes smoked), duration of smoking, and pack-years of smoking are associated with severe outcomes among adults diagnosed with COVID-19. Methods: We conducted a retrospective, cross-sectional study in which we identified consecutive patients diagnosed with COVID-19 at the University of Cincinnati healthcare system between 13 March 2020 and 30 September 2020 who had complete information on smoking status, severe COVID-19 outcomes, and covariates (i.e., demographics and comorbidities). We used logistic regression to evaluate the associations of smoking status and intensity of smoking with COVID-19 severity, defined as hospitalization, admission to intensive care unit (ICU), or death, adjusting for sociodemographics and comorbidities. Results: Among the 4611 COVID-19 patients included in the analysis, 18.2% were current smokers and 20.7% were former smokers. The prevalence of COVID-19 outcomes was 28.9% for hospitalization, 9.8% for ICU admission, and 1.4% for death. In the adjusted analysis, current smoking (AOR: 1.23, 95% CI: 1.02–1.49), former smoking (AOR: 1.28, 95% CI: 1.07–1.54), and pack-years of smoking (AOR: 1.09, 95% CI: 1.02–1.17) were associated with a higher prevalence of hospitalization. Average daily packs of cigarettes smoked was associated with a higher prevalence of hospitalization (AOR: 1.30, 95% CI: 1.10–1.53) and ICU admission (AOR: 1.23, 95% CI: 1.04–1.44). Conclusions: Smoking status, pack-years, and intensity of smoking were associated with hospitalizations in patients with COVID-19 and intensity of smoking was associated with ICU admission. The findings underscore the need for detailed information beyond smoking status when evaluating smokers with COVID-19 so that the potential for adverse sequelae may be optimally managed in at-risk patients.
Personal Passive Air Samplers for Chlorinated Gases Generated from the Use of Consumer Products
Authors: Ha Yeonjeong , Koo Yerim , Kwon Jung-Hwan
Published: August 2021

Various chlorine-based disinfectants are being used during the COVID-19 pandemic; however, only a few studies on exposure to harmful gases resulting from the use of these disinfectants exist. Previously, we developed a personal passive air sampler (PPAS) to estimate the exposure level to chlorine gas while using chlorinated disinfectants. Herein, we investigated the color development of the passive sampler corresponding to chlorine exposure concentration and time, which allows the general population to easily estimate their gas exposure levels. The uptake and reaction rate of PPAS are also explained, and the maximum capacity of the sampler was determined as 1.8 mol of chlorine per unit volume (m3) of the passive sampler. Additionally, the effects of disinfectant types on the gas exposure level were successfully assessed using passive samplers deployed in a closed chamber. It is noteworthy that the same level of chlorine gas is generated from liquid household bleach regardless of dilution ratios, and we confirmed that the chlorine gas can diffuse out from a gel-type disinfectant. Considering that this PPAS reflects reactive gas removal, individual working patterns, and environmental conditions, this sampler can be successfully used to estimate personal exposure levels of chlorinated gases generated from disinfectants.
Analysis of Patient Safety Incidents in Primary Care Reported in an Electronic Registry Application
Authors: Gens-Barberà Montserrat , Hernández-Vidal Núria , Vidal-Esteve Elisa , Mengíbar-García Yolanda , Hospital-Guardiola Immaculada , Oya-Girona Eva M. , Bejarano-Romero Ferran , Castro-Muniain Carles , Satué-Gracia Eva M. , Rey-Reñones Cristina , Martín-Luján Francisco M.
Published: August 2021

Objectives: (1) To describe the epidemiology of patient safety (PS) incidents registered in an electronic notification system in primary care (PC) health centres; (2) to define a risk map; and (3) to identify the critical areas where intervention is needed. Design: Descriptive analytical study of incidents reported from 1 January to 31 December 2018, on the TPSC Cloud™ platform (The Patient Safety Company) accessible from the corporate website (Intranet) of the regional public health service. Setting: 24 Catalan Institute of Health PC health centres of the Tarragona region (Spain). Participants: Professionals from the PC health centres and a Patient Safety Functional Unit. Measurements: Data obtained from records voluntarily submitted to an electronic, standardised and anonymised form. Data recorded: healthcare unit, notifier, type of incident, risk matrix, causal and contributing factors, preventability, level of resolution and improvement actions. Results: A total of 1544 reports were reviewed and 1129 PS incidents were analysed: 25.0% of incidents did not reach the patient; 66.5% reached the patient without causing harm, and 8.5% caused adverse events. Nurses provided half of the reports (48.5%), while doctors reported more adverse events (70.8%; p < 0.01). Of the 96 adverse events, 46.9% only required observation, 34.4% caused temporary damage that required treatment, 13.5% required (or prolonged) hospitalization, and 5.2% caused severe permanent damage and/or a situation close to death. Notably, 99.2% were considered preventable. The main critical areas were: communication (27.8%), clinical-administrative management (25.1%), care delivery (23.5%) and medicines (18.4%); few incidents were related to diagnosis (3.6%). Conclusions: PS incident notification applications are adequate for reporting incidents and adverse events associated with healthcare. Approximately 75% and 10% of incidents reach the patient and cause some damage, respectively, and most cases are considered preventable. Adequate and strengthened risk management of critical areas is required to improve PS.
Parental Preconception Exposures to Outdoor Neighbourhood Environments and Adverse Birth Outcomes: A Protocol for a Scoping Review and Evidence Map
Authors: Mavoa Suzanne , Keevers Daniel , Kane Stefan C. , Wake Melissa , Tham Rachel , Lycett Kate , Wong Yen Ting , Chong Katherine
Published: August 2021

Parental preconception exposures to built and natural outdoor environments could influence pregnancy and birth outcomes either directly, or via a range of health-related behaviours and conditions. However, there is no existing review summarising the evidence linking natural and built characteristics, such as air and noise pollution, walkability, greenness with pregnancy and birth outcomes. Therefore, the planned scoping review aims to collate and map the published literature on parental preconception exposures to built and natural outdoor environments and adverse pregnancy and birth outcomes. We will search electronic databases (MEDLINE, EMBASE, Scopus) to identify studies for inclusion. Studies will be included if they empirically assess the relationship between maternal and paternal preconception exposures to physical natural and built environment features that occur outdoors in the residential neighbourhood and adverse pregnancy and birth outcomes. Two reviewers will independently screen titles and abstracts, and then the full text. Data extraction and assessment of study quality will be performed by one researcher and checked by a second researcher. Results will be summarised in a narrative synthesis, with additional summaries presented as tables and figures. The scoping review will be disseminated via a peer-reviewed publication, at academic conferences, and published on a website.
Evaluation of an Online Gottman’s Psychoeducational Intervention to Improve Marital Communication among Iranian Couples
Authors: Deylami Neda , Hassan Siti Aishah , Alareqe Naser Abdulhafeeth , Zainudin Zaida Nor
Published: August 2021

Amounting evidence indicates that insufficient knowledge of marital communication skills leads to destructive interactions and poor marital adjustments in couples, especially during stressful situations. Despite the high effectiveness of Gottman’s psychoeducational intervention, there is a lack of study on the online Gottman’s psychoeducation intervention (O-GPI) to improve marital communication and dyadic adjustments. The aim of this study was to evaluate the effectiveness of O-GPI on the improvement of marital communication patterns among Iranian couples. Method: The study followed a single-blind parallel group in a randomized controlled trial using an experimental longitudinal design, comprising 72 heterosexual couples living in Shiraz, Iran, with a 1–7-year marital age and no severe marital problems. The experimental group received eight consecutive O-GPIs via the Zoom platform, while the control group received information related to parenting skills via email. The outcome measures were the three patterns of communication: (i) constructive communication; (ii) demand–withdraw communication; and (iii) mutual avoidance communication—the screening measure was the dyadic adjustment scale. Results: The findings indicated that O-GPI could improve couples’ constructive communication significantly (45% for husbands and 40% wives) and decrease their total demand–withdrawal (51% for husbands and 65% wives) and mutual avoidance communication (60% for husbands and 62% wives). Limitations: Due to the homogenous nature of the sample, generalizations should be made with caution. Conclusions: This study demonstrates the feasibility and effectiveness of the online Gottman’s psychoeducational intervention to improve couples’ communication patterns.
Characteristics of the Passive Muscle Stiffness of the Vastus Lateralis: A Feasibility Study to Assess Muscle Fibrosis
Authors: Maeda Akifumi , Yamagishi Maito , Otsuka Yuta , Izumo Takayuki , Rogi Tomohiro , Shibata Hiroshi , Fukuda Masahiro , Arimitsu Takuma , Yamada Yosuke , Miyamoto Naokazu , Hashimoto Takeshi
Published: August 2021

Skeletal muscle fibrosis occurs with aging and has been suggested to impair muscle performance, thereby decreasing quality of life. Recently, muscle stiffness, a surrogate measure of muscle fibrosis, was noninvasively quantified as the shear modulus using ultrasound shear wave elastography (SWE) in humans. We aimed to investigate thigh muscle stiffness in females and males, respectively, across a broad range of ages by using SWE. Eighty-six community-dwelling Japanese people who were aged 30 to 79 years and did not regularly exercise participated in this study. The vastus lateralis (VL) shear modulus was measured at three different knee joint angles: full extension, 90° of flexion, and full flexion. There were no significant main effects of sex or age on the VL shear modulus in full extension or 90° of flexion of the knee. However, the VL shear modulus in knee full flexion was significantly smaller in females than in males and increased with age from 47.9 years. The results suggest that the accelerated increase in VL stiffness that occurs after an individual passes their late 40s may be an important therapeutic target for developing effective treatments and programs that preserve and improve quality of life.
Effects of a Multifaceted Intervention Program on the Eating Ability of Nursing Home Residents
Authors: Chen Mei-Ling , Chiu Chia-Hui , Hwu Yueh-Juen , Kuo Shu-Chen
Published: August 2021

Oropharyngeal dysphagia is a common problem for nursing home residents that leads to aspiration pneumonia and malnutrition. Musculature surrounding head and neck and tongue strength are crucial for safe and efficient oropharyngeal swallowing. Oral hygiene facilitates the smooth swallowing. The aim of this study was thus to investigate the effects of a multifaceted intervention program which combines the interactive oral activities, tongue strength training and oral cleaning procedure on the eating ability of nursing home residents. A sequential, multiple time series, single-group quasi-experimental research design was used, and 41 residents were recruited to participate in this study. The study was divided into three phases, each lasting two months. In phase 1, the participants were conducting their usual activities, except that the outcome variables were measured on five occasions to obtain baseline data. Phase 2 was a two-month washout period, and phase 3 was the intervention period. Thirty-six residents completed phase 1, and 34 residents completed the phase 3 intervention period. The eight-week phase 3 intervention program comprised three sessions per day, conducted seven days a week, with each session lasting 15–20 min. Outcome variables were measured at weeks 0, 2, 4, 6, and 8 in phases 1 and 3 to evaluate the feasibility of the program. Following the intervention program, controlling for baseline differences, the patients’ tongue strength, food consumption, mealtime duration, oral health, and dysphagia severity were significantly improved in phase 3 relative to phase 1. These improvements lasted through to at least 2 months posttest. The study illustrates that this multifaceted intervention program may be an effective approach for improving the eating ability of nursing home residents.
Physiotherapy Rehabilitation in Subjects Diagnosed with Subacromial Impingement Syndrome Does Not Normalize Periscapular and Rotator Cuff Muscle Onset Time of Activation
Authors: Ortega-Cebrián Silvia , Girabent-Farrés Monserrat , Whiteley Rodney , Bagur-Calafat Caritat
Published: August 2021

Clinicians suggest that rehabilitation of Subacromial Impingement Syndrome (SIS) should target improving movement patterns to ensure better clinical outcomes. Understanding changes in onset time of activation patterns and associated changes in clinical outcomes could improve our understanding of rehabilitation strategies. In this prospective longitudinal study, we examined neuromuscular firing patterns and clinical features before and after a standardized physiotherapy program in subjects diagnosed with SIS. Electromyography (EMG) recordings of eleven shoulder muscles were taken at the initial and discharge consultation in 34 male volunteers diagnosed with SIS. EMG recording was performed during flexion, scaption, and abduction at slow, medium, and fast speeds with a loaded (3 kg) and unloaded arm, as well as rotational motion, rotational strength, pain, and shoulder function. Completion of standardized shoulder physiotherapy program for SIS resulted in improvements in clinical outcomes. Resulted showed inconsistent differences of onset time of activation mainly in some of the periscapular muscles for all movements. No differences were seen on the EMG recordings for rotator cuff muscles. Differences in range of motion, strength and function were shown. Despite some changes in onset time of activation, this study was not able to demonstrate consistent changes of onset time of activation of the periscapular and rotator cuff muscles.
“To Protect Myself, My Friends, Family, Workmates and Patients …and to Play My Part”: COVID-19 Vaccination Perceptions among Health and Aged Care Workers in New South Wales, Australia
Authors: Bolsewicz Katarzyna T. , Steffens Maryke S. , Bullivant Bianca , King Catherine , Beard Frank
Published: August 2021

The 2019 coronavirus disease (COVID-19) pandemic has globally caused widespread disruption, morbidity and mortality. The uptake of COVID-19 vaccination is critical for minimising further impacts of the pandemic. Health and aged care workers (HACWs) play a central role in public confidence in vaccines and are one of the priority groups for COVID-19 vaccination in Australia. Qualitative phone interviews with 19 HACWs aged 21–50 years old from New South Wales, Australia, were conducted, and the data were analysed thematically in order to understand the factors influencing HACWs’ acceptance of COVID-19 vaccination. We found that HACWs reported a continuum of COVID-19 vaccination intentions with 12 enthusiastically accepting and 7 hesitant. Using the Behavioral and Social Drivers of COVID-19 Vaccination (BeSD) Framework, we found that participants’ acceptance of vaccination was primarily driven by their perceptions of COVID-19 vaccination (such as safety, risk and benefits) and by the information sources, people and norms they trusted. Informed by study findings, we propose several communication strategies which may be helpful in addressing HACWs vaccination acceptance. We note however that as the pandemic continues, further studies with HACWs from diverse backgrounds are needed in order to provide accurate data on diverse motivational and practical drivers of evolving perceptions and attitudes towards vaccination.
Effectiveness of Pulmonary Rehabilitation in Severe and Critically Ill COVID-19 Patients: A Controlled Study
Authors: Büsching Gilbert , Zhang Zhongxing , Schmid Jean-Paul , Sigrist Thomas , Khatami Ramin
Published: August 2021

Background: Severe and critically ill COVID-19 patients frequently need pulmonary rehabilitation (PR) after hospitalization. However, little is known about the effectiveness of PR in COVID-19 patients. Methods: We compared the performances in the six-min walk test (6MWT), chronic respiratory questionnaire (CRQ), and Functional Independence Measure (FIM) from inpatient PR between 51 COVID-19 patients and 51 other patients with common pneumonia. We used multivariate linear regression controlled for baseline values at entrance, age, sex, and cumulative illness rating scale. The odds ratios (ORs) of non-improvement/improvement in 6MWT (>30-m) and CRQ (>10-point) at discharge were compared between the two groups (Fisher’s exact test). Results: The two groups had similar improvements in 6MWT and CRQ, but the COVID-19 group achieved a 4-point higher FIM (p-value = 0.004). The OR of non-improvement/improvement in 6MWT was 0.30 (p-value = 0.13) between COVID-19 and controls; however, the odds of non-improvement in CRQ tended to be 3.02 times higher (p-value = 0.075) in COVID-19 patients. Severe and critical COVID-19 patients had similar rehabilitation outcomes. Conclusions: Inpatient PR can effectively improve physical functions and life quality in COVID-19 patients, irrespective of disease severity. Whether the relatively low gains in CRQ is an indicator of chronic disease development in COVID-19 patients needs further studies.
Immunological Traits of Patients with Coexistent Inflammatory Bowel Disease and Periodontal Disease: A Systematic Review
Authors: de Mello-Neto João Martins , Nunes Jessica Gomes Rodrigues , Tadakamadla Santosh Kumar , da Silva Figueredo Carlos Marcelo
Published: August 2021

This systematic review assessed studies that evaluated the immunological traits of patients with both inflammatory bowel disease (IBD) and periodontal disease. An electronic search for literature was conducted on PubMed, Embase, Scopus, Cochrane and Web of Science. Studies that evaluated the immunological response in patients with IBD and periodontal disease were considered eligible for inclusion. A total of 6 cross-sectional studies of 275 patients were included. Immunological analyses were performed in gingival crevicular fluid, saliva, serum, intestinal and gingival biopsies. Four studies identified that the presence of IBD and periodontal disease was associated with higher levels of prostaglandin E2, aMMP8, IL-18 and S100A12, respectively, when compared to patients without the coexistence of both diseases. Furthermore, another study identified higher aMMP-8 levels with increasing severity of periodontitis in Crohn’s disease patients. The quality of overall evidence ranged from high to low due to the observational nature of contributing studies. The coexistence of IBD and periodontal disease seems to be associated with a more responsive inflammatory reaction compared with individuals having one or the other. More randomized controlled studies evaluating the coexistence of IBD and periodontitis are required to better explore the immunological interplay between them.
Aging Living at Home: Residential Satisfaction among Active Older Adults Based on the Perceived Home Model
Authors: Amián Josue G. , Alarcón David , Fernández-Portero Cristina , Sánchez-Medina Jose A.
Published: August 2021

Background: Housing plays an important role in the aging process and health. The house and its nearby environment host most of the daily activities of older adults. Residential satisfaction (RS) has been relegated to physical issues such as accessibility. However, RS is also constituted by older adults’ perceptions about housing. This study analyzes the perceived home that develops RS in older adults. Methods: A random sample of 714 participants aged 50 to 84 (mean = 65; SD = 0.98) were used. Participants lived in ordinary housing in southern Spain. Scales measure perceptions of RS, meaning, functionality and belief of control over the home. Results: Analyses were performed using structural equation models to evaluate the dependence relationships between the different perceptions evaluated. We observe a direct influence of internal control on usability (β = 0.84) and perceived meanings (β = 0.49). However, external control shows a negative influence on the meaning of home (β = −0.14). Perceived usability (β = 0.68) and meaning (β = 0.32) positively influence RS. Conclusion: Perceptions of meaning, functionality and RS itself depend on internal housing-related control beliefs. Active older adults with higher internal control perceived their home fit better to the need of everyday life and improve RS.
Assessment of Future Water Yield and Water Purification Services in Data Scarce Region of Northwest China
Authors: Yang Xu , Chen Ruishan , Ji Guangxing , Wang Chao , Yang Yuanda , Xu Jianhua
Published: August 2021

Water shortage and pollution have become prominent in the arid regions of northwest China, seriously affecting human survival and sustainable development. The Bosten Lake basin has been considered as an example of an arid region in northwest China, and the Integrated Valuation of Ecosystem Services and Tradeoffs (InVEST) model has been used to quantitatively evaluate the future water yield and water purification services for four representative concentration pathways (RCP) scenarios. The results show that for the four RCP scenarios, the annual average precipitation in 2020–2050 decreases compared to that in 1985–2015; the area of cultivated land and unused land decreases, and the area of other land-use types increases from 2015 to 2050. The water yield service reduces, while the water purification service increases from 2015 to 2050 in the Bosten Lake basin. In 2050, the water yield and water purification services are the best for the RCP6.0 scenario, and are the worse for the RCP4.5 scenario and RCP8.5 scenario, respectively. The distribution of the water yield and water purification services show a gradual decline from northwest to southeast.
Modification of Diurnal Cortisol Secretion in Women’s Professional Basketball. A Pilot Study
Authors: Sánchez Irene , de la Rubia Ortí Jose Enrique , Platero Jose Luis , Mariscal Gonzalo , Barrios Carlos
Published: August 2021

Elite basketball training causes high levels of physiological stress, which can lead to negative physiological disorders in female athletes. The aim of this study was to establish the impact of physical activity on the rhythm of salivary cortisol secretion in elite female basketball players over one week. The population sample included 9 women professional basketball players. The control group was made up of 9 women who did not do any exercise. Saliva samples were collected from all participants at 9:00 a.m. and 11:00 p.m. on training days. Samples from the basketball group showed a significantly higher cortisol secretion. Moreover, from the second night, the pattern of cortisol secretion of these players was reversed, showing higher levels of cortisol in saliva at night than in the morning. The results suggest that the secretion rhythm changed over the course of the week and according to competitive demands.
Current Update on the Clinical Utility of MMSE and MoCA for Stroke Patients in Asia: A Systematic Review
Authors: Khaw Julia , Subramaniam Ponnusamy , Abd Aziz Noor Azah , Ali Raymond Azman , Wan Zaidi Wan Asyraf , Ghazali Shazli Ezzat
Published: August 2021

Objective: Primary care clinicians in Asia employed the Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA) to aid dementia diagnosis post-stroke. Recent studies questioned their clinical utility in stroke settings for relying on verbal abilities and education level, as well as lack of consideration for aphasia and neglect. We aimed to review the clinical utility of the MMSE and MoCA for stroke patients in Asia and provide recommendations for clinical practice. Methods: PubMed, Scopus, Web of Science, and Science Direct were searched for relevant articles. Included studies were assessed for risk of bias. RevMan 5.4 was used for data synthesis (sensitivity and specificity) and covariates were identified. Results: Among the 48 full-text articles reviewed, 11 studies were included with 3735 total subjects; of these studies, 7 (77%) were conducted in China, 3 (27%) in Singapore, and 1 (9%) in South Korea. Both the MMSE and MoCA generally showed adequate sensitivity and specificity. Education was identified as a covariate that significantly affected detection accuracy. Due to heterogeneity in cutoff scores, methodologies, and languages, it was not feasible to suggest a single cutoff score. One additional point is recommended for MoCA for patients with <6 years of education. Conclusion: Clinicians in Asia are strongly recommended to consider the education level of stroke patients when interpreting the results of the MMSE and MoCA. Further studies in other Asian countries are needed to understand their clinical value in stroke settings.
Impact of Different Aquatic Exercise Programs on Body Composition, Functional Fitness and Cognitive Function of Non-Institutionalized Elderly Adults: A Randomized Controlled Trial
Authors: Farinha Carlos , Teixeira Ana Maria , Serrano João , Santos Hélder , Campos Maria João , Oliveiros Bárbara , Silva Fernanda M. , Cascante-Rusenhack Márcio , Luís Paulo , Ferreira José Pedro
Published: August 2021

Aquatic physical exercise programs have become progressively more popular among elderly people. Some of the major physical exercise program disadvantages on land are minimized due to the specific properties of the aquatic environment. The purpose of the present randomized controlled study is to verify the effects of different aquatic physical exercise programs on body composition, functional fitness and cognitive function in non-institutionalized elderly people. For this study, 102 elderly individuals were randomly allocated into four different groups: AerG (n = 25, 71.44 ± 4.84 years); IntG (n = 28, 72.64 ± 5.22 years); ComG (n = 29, 71.90 ± 5.67 years) and CG (n = 20, 73.60 ± 5.25 years). Individuals from the groups AerG, IntG and ComG participated in three different aquatic physical exercise programs for a period of 28 weeks. The CG participants kept to their usual routines. All participants were evaluated for body composition, functional fitness and cognitive function at two time moments, i.e., pre- (M1) and post-intervention (M2). Significant differences for body composition were found between M1 and M2 for FM (p < 0.001), LBM (p < 0.001) and WCir (p < 0.01) in the AerG, for BMI (p < 0.05), FM (p < 0.05), LBM (p < 0.001) and LCir-R (p < 0.05) in the IntG, and for WGT (p < 0.01), FM (p < 0.05), LBM (p < 0.01), LCir-R (p < 0.05) and LCir-L (p < 0.01) in the ComG groups. For functional fitness, differences were found between M1 and M2 for 2m-ST (p < 0.000), 30s-CS (p < 0.000), 30s-AC (p < 0.05), HG-T-R (p < 0.000) and HG-T-L (p < 0.000) in the AerG, for 2m-ST (p < 0.05), BS-R (p < 0.05), 30s-CS (p < 0.000), 30s-AC(p < 0.01), HG-T-R (p < 0.000) and HG-T-L (p < 0.000) in the IntG, and for 30s-CS (p < 0.000), HG-T-R (p < 0.000) and HG-T-L (p < 0.000) in the ComG groups. The present study evidenced the beneficial effects of physical exercise in an aquatic environment on body composition, functional fitness and cognitive function in non-institutionalized elderly adults. The ComG water-based exercise program showed more beneficial effects in the improvement of body composition and cognitive function variables, while the IntG and AerG programs were more effective in the improvement of functional fitness.
Do Multicomponent Workplace Health and Wellbeing Programs Predict Changes in Health and Wellbeing?
Authors: Daniels Kevin , Fida Roberta , Stepanek Martin , Gendronneau Cloé
Published: August 2021

Organizations typically deploy multiple health and wellbeing practices in an overall program. We explore whether practices in workplace health and wellbeing programs cohere around a small number of archetypal categories or whether differences between organizations are better explained by a continuum. We also examine whether adopting multiple practices predicts subsequent changes in health and wellbeing. Using survey data from 146 organizations, we found differences between organizations were best characterized by a continuum ranging from less to more extensive adoption of practices. Using two-wave multilevel survey data at both individual and organizational levels (N = 6968 individuals, N = 58 organizations), we found that, in organizations that adopt a wider range of health and wellbeing practices, workers with poor baseline psychological wellbeing were more likely to report subsequent improvements in wellbeing and workers who reported good physical health at baseline were less likely to report experiencing poor health at follow-up. We found no evidence that adopting multiple health and wellbeing practices buffered the impact of individuals’ workplace psychosocial hazards on physical health or psychological wellbeing.
The Association of Renal Function and Plasma Metals Modified by EGFR and TNF-α Gene Polymorphisms in Metal Industrial Workers and General Population
Authors: Chen Tzu-Hua , Huang Joh-Jong , Lee Hsiang-Ying , Kung Wei-Shyang , Luo Kuei-Hau , Lu Jia-Yi , Chuang Hung-Yi
Published: August 2021

Exposure to metals may be associated with renal function impairment, but the effect modified by genetic polymorphisms was not considered in most studies. Epidermal growth factor receptor (EGFR) and tumor necrotic factor-α (TNF-α) play important roles in renal hemodynamics, and they have been reported to be associated with some renal diseases. The aim of our research is to explore whether genetic variations in EGFR and TNF-α have influence on renal function under exposure to various metals. This cross-sectional study consisted of 376 metal industrial workers, 396 participants of Taiwan Biobank, and 231 volunteers of health examinations. We identified 23 single nucleotide polymorphisms (SNPs) on the EGFR gene and 6 SNPs on the TNF-α gene, and we also measured their plasma concentration of cobalt, copper, zinc, selenium, arsenic, and lead. Multiple regression analysis was applied to investigate the association between various SNPs, metals, and renal function. Our results revealed some protective and susceptible genotypes under occupational or environmental exposure to metals. The individuals carrying EGFR rs2280653 GG might have declined renal function under excessive exposure to selenium, and those with EGFR rs3823585 CC, rs12671550 CC, and rs4947986 GG genotypes might be susceptible to lead nephrotoxicity. We suggest the high-risk population to prevent renal diseases.
The Relative Age Effects in Educational Development: A Systematic Review
Authors: Urruticoechea Alar , Oliveri Andrés , Vernazza Elena , Giménez-Dasí Marta , Martínez-Arias Rosario , Martín-Babarro Javier
Published: August 2021

There is a large number of variables, studied in the literature, that affect the integral development of students in the educational stage, but few research analyze the effects that relative age can have on development. The aim of this study is to review and summarize the results obtained, on this subject, in recent research. The methodology used has followed the PRISMA declaration. The final sample is composed by 21 articles, which use data from 24 countries and 32 assessments. The main conclusions indicate that relatively younger children in same class groups: (a) obtain significantly lower mean scores in cognitive and motor tests, (b) have a higher repetition rate, and (c) have a less capacity of socialization. Finally, it should be noted that considering the results obtained by the research on relative age effect on child development, some authors propose to adapt educational practices to minimize these effects.
Factors Associated with Insomnia Symptoms in a Longitudinal Study among New York City Healthcare Workers during the COVID-19 Pandemic
Authors: Abdalla Marwah , Chiuzan Codruta , Shang Yimeng , Ko Gavin , Diaz Franchesca , Shaw Kaitlin , McMurry Cara L. , Cannone Diane E. , Sullivan Alexandra M. , Lee Sung A. J. , Venner Hadiah K. , Shechter Ari
Published: August 2021

Background: Few studies have examined the longer-term psychological impact of COVID-19 in healthcare workers (HCWs). Purpose: We examined the 10-week trajectory of insomnia symptoms in HCWs during the COVID-19 pandemic. Methods: HCWs completed a web-based survey at baseline (9 April–11 May 2020) and every 2 weeks for 10 weeks. The main outcome was the severity of insomnia symptoms in the past week. Multivariable-adjusted generalized estimating equation analyses examined factors associated with insomnia symptoms. Results: n = 230 completed surveys at baseline. n = 155, n = 130, n = 118, n = 95, and n = 89 completed follow-ups at weeks 2, 4, 6, 8, and 10, respectively. Prevalence of insomnia symptoms of at least moderate severity was 72.6% at baseline, and 63.2%, 44.6%, 40.7%, 34.7%, and 39.3% at weeks 2, 4, 6, 8, and 10, respectively. In multivariable analyses, factors significantly associated with increased odds of insomnia symptoms were younger age (OR: 0.98, 95% CI: 0.96–1.00), working in a COVID-facing environment (OR: 1.75, 95% CI: 1.15–2.67) and hours worked (OR: 1.16, 95% CI: 1.06–1.27). Conclusions: The initial high rates of insomnia symptoms improved as time passed from the peak of local COVID-19 cases but four out of ten HCWs still had moderate-to-severe insomnia symptoms ten weeks after baseline.
The Effectiveness of Free Face Mask Distribution on Use of Face Masks. A Cluster Randomised Trial in Stovner District of Oslo, Norway
Authors: Fretheim Atle , Elgersma Ingeborg Hess , Kristiansen Fredrik Aaeng , Varmbo Caroline Rømming , Olsbø Miriam Kristine Salame , Glover Iselin Havstein Strand , Flatø Martin
Published: August 2021

Face masks are recommended as a means of reducing the spread of COVID-19, but there are practically no studies of interventions to increase face mask use. Over three weeks, nine grocery stores in the Stovner District of Oslo were randomly selected each day to have distribution of free face masks outside their entrance. Free face mask distribution increased the proportion of customers wearing a mask by 6.0 percentage points (adjusted, 95% CI 3.5–8.5). Mean mask usage was 91.7% in the control group and 97.1% in the treatment group (pooled SD 5.3%). Practically all those who wore masks had both nose and mouth covered. We conclude that free distribution of face masks increased their use. Similar trials can be conducted within a short period of time.