bluuebunny/crossref_metadata_2025 huggingface dataset:
Use of mixed methods research in intervention studies to increase young people’s interest in STEM: A systematic methodological review
Authors: Fàbregues Sergi , Sáinz Milagros , Romano María José , Escalante-Barrios Elsa Lucia , Younas Ahtisham , López-Pérez Beatriz-Soledad
Published: January 2023

Introduction

Mixed methods research intervention studies integrate quantitative evaluation approaches, such as randomized controlled trials and quasi-experimental designs, with qualitative research to evaluate the effectiveness, efficacy, or other results of an intervention or program. These types of studies, which have attracted growing attention in recent years, enhance the scope and rigor of the evaluation. While various frameworks that summarize the justifications for carrying out these types of studies and provide implementation guidance have been published in the last few years in the health sciences, we do not know whether such frameworks have been properly implemented in the social and educational sciences. This review examined the methodological features and reporting practices of mixed methods intervention studies aimed at increasing young people’s interest in STEM.

Methods

A systematic search was carried out in APA PsycNET, ERIC, ProQuest, Scopus, and Web of Science, and a hand search in 20 journals. We included peer-reviewed English-language articles that reported intervention studies with a quantitative component measuring outcomes specific to increasing secondary school students’ interest in STEM fields, a qualitative component conducted before, during, or after the quantitative component, and evidence of integration of both components. Qualitative content analysis and ideal-type analysis were used to synthesize the findings.

Results

We found 34 studies; the majority published in the last ten years. Several patterns of mixed methods application were described in these studies, illustrating the unique insights that can be gained by employing this methodology. The reporting quality of the included studies was generally adequate, especially regarding the justification for using a mixed methods intervention design and the integration of the quantitative and qualitative components. Nonetheless, a few reporting issues were observed, such as a lack of detail in the presentation of the mixed methods design, an inadequate description of the qualitative sampling and analysis techniques, and the absence of joint displays for representing integration.

Discussion

Authors must pay attention to these issues to ensure that the insights obtained by the use of mixed methods research are effectively communicated.
Lack of family education in boarding primary schools in China's minority areas: A case study of Stone Moon Primary School, Nujiang Lisu Autonomous Prefecture
Authors: Guo Guo , Chen Yao
Published: January 2023

The lack of family education in boarding primary schools in ethnic minority areas negatively impacts students' physical and mental health. This study constructed an analytical framework for the lack of family education in boarding primary schools from the perspective of Overlapping Spheres of Influence theory. Stone Moon Primary School of Lisu in Nujiang Prefecture was used as the field site for questionnaire survey. The correlation analysis showed that “teachers' avoidance of educational risks”, “the priority in the schooling system of classic hard skills over soft skills” and “the capacity limit of policies and regulations” had significant positive correlation with the degree of “the lack of family education”. In the regression analysis, the adjusted R2 was 0.607, indicating that the proportion of “lack of family education” explained by the three factors of “teachers' avoidance of educational risks”, “the priority in the schooling system of classic hard skills over soft skills” and “the capacity limit of policies and regulations” was 60.7% through the regression relationship. Possible solutions include establishing a responsibility standard system and accountability system between teachers and parents, and strengthening the compensation management of family education function in boarding primary schools in ethnic minority areas.
Wood in office spaces: The impact of different wooden furniture on aesthetic evaluation
Authors: Zhu Yiwei , Wang Qiang , Zhao Feng
Published: January 2023

In modern urban life, individuals are spending an increasing amount of time in the office. However, working in an uncomfortable office space for extended periods can affect the physical and mental health of employees. On this basis, it is particularly important for employees to build a comfortable and healthy office environment that is conducive to their work. The present study aimed to explore the use of wood in office furniture to build a comfortable and healthy work environment. The use of wood in office spaces can effectively relieve the mental fatigue of employees. Focusing on wooden office furniture, this study explores its influence on the aesthetic evaluation of wooden office spaces by manipulating the wood color and coverage of the wooden furniture placed in office spaces. Experimenting with these changes will optimize the application of wood in office spaces, improve employees’ mental health. The results show that wood color and coverage significantly impact the aesthetic evaluation of wooden office spaces. People exhibit higher aesthetic evaluations of light and medium wood-colored office spaces and prefer spaces with low wood coverage. The findings of this study provide a reference for the use of wooden furniture to optimize workplaces.
A cross-sectional study to assess job strain of emergency healthcare workers by Karasek questionnaire: The SEEK study
Authors: Bouillon-Minois Jean-Baptiste , Trousselard Marion , Mulliez Aurélien , Adeyemi Oluwaseun John , Schmidt Jeannot , Thivel David , Ugbolue Ukadike Chris , Borel Marjolaine , Moustafa Farès , Vallet Guillaume T. , Clinchamps Maëlys , Zak Marek , Occelli Céline , Dutheil Frédéric
Published: January 2023

Background

Emergency healthcare workers (eHCWs) are particularly at risk of stress, but data using the gold standard questionnaire of Karasek are scarce. We assessed the level of stress of eHCWs and aimed to compare it with the general population.

Methods

This is a cross-sectional nationwide study in French Emergency Departments (EDs), using the job-content questionnaire of Karasek, compared with the 25,000 answers in the French general population (controls from the SUMER study). The descriptions of job demand, job control, and social support were described as well as the prevalence of job strain and isostrain. Putative factors were searched using mixed-method analysis.

Results

A total of 166 eHCWs (37.9 ± 10.5 years old, 42% men) from five French EDs were included: 53 emergency physicians and 104 emergency paramedics, compared to 25,000 workers with other occupations. Job demand was highest for physicians (28.3 ± 3.3) and paramedics (25.9 ± 3.8), compared to controls (36.0 ± 7.2; p < 0.001). Job control was the lowest for physicians (61.2 ± 5.8) and paramedics (59.1 ± 6.8), compared to controls (70.4 ± 11.7; p < 0.001). Mean social support did not differ between groups (23.6 ± 3.4 for physicians, 22.6 ± 2.9 for paramedics, and 23.7 ± 3.6 for controls). The prevalence of job strain was massively higher for physicians (95.8%) and paramedics (84.8%), compared to controls (23.9%; p < 0.001), as well as for isostrain (45.1% for physicians, 56.8% for paramedics, and 14.3% for controls, p < 0.001). We did not find any significant impact of sociodemographic characteristics on job control, job demand, or social support.

Conclusion

Emergency healthcare workers have a dramatic rate of job strain, necessitating urgent promotion of policy to take care of them.
Childhood adversity, allostatic load, and adult mental health: Study protocol using the Avon Longitudinal Study of Parents and Children birth cohort
Authors: Finlay Sabine , Juster Robert-Paul , Adegboye Oyelola , Rudd Donna , McDermott Brett , Sarnyai Zoltán
Published: January 2023

Introduction

The cumulative burden of chronic stress and life events has been termed allostatic load. Elevated allostatic load indices are associated with different mental health conditions in adulthood. To date, however, the association between elevated allostatic load in childhood and later development of mental health conditions has not been investigated.

Methods

Using data from the Avon Longitudinal Study of Parents and Children (ALSPAC), we will calculate allostatic load indices using biomarkers representing the cardiovascular, metabolic, immune, and neuroendocrine systems, at the ages of 9 and 17 years. Bivariate and multivariable logistic regression models will be used to investigate the association between allostatic load and psychiatric disorders in adulthood. Furthermore, the role of adverse childhood experiences as a modifier will be investigated.

Discussion

This protocol describes a strategy for investigating the association between elevated allostatic load indices in childhood at the age of 9 years old and psychiatric disorders in adulthood at 24 years old.
The impact of national comprehensive medical reform on residents' medical expenses: Evidence from China
Authors: Nie Changfei , Feng Yuan
Published: January 2023

Residents' high medical expenses is the core challenge that needs to be solved urgently in China's medical reform for a long time. Based on the panel data of 30 provinces in Chinese Mainland during 2011–2019, we evaluate the impact of China's national comprehensive medical reform pilot policy on residents' medical expenses by using the difference-in-differences model. The results show that the pilot policy was generally conducive to reducing residents' medical expenses, resulting in a reduction of 2.13% in per capita medical expenses for inpatients, but the effect on per capita medical expenses for outpatients was insignificant. Mechanism analysis shows that hospital competition and institutional environment played a moderating role in the effect of the pilot policy on residents' medical expenses reduction. The more intense the hospital competition and the better the institutional environment, the more significant of the reduction effect. In addition, the reduction effect of the pilot policy was greater in the central provinces, the provinces with poor medical infrastructure, and the provinces with strong financial strength. This study provides useful policy insights for deepening medical reform and reducing residents' medical expenses.
The perinatal health challenges of emerging and re-emerging infectious diseases: A narrative review
Authors: Malange Veronica N. E. , Hedermann Gitte , Lausten-Thomsen Ulrik , Hoffmann Steen , Voldstedlund Marianne , Aabakke Anna J. M. , Eltvedt Anna K. , Jensen Jørgen S. , Breindahl Morten , Krebs Lone , Christiansen Michael , Hedley Paula L.
Published: January 2023

The world has seen numerous infectious disease outbreaks in the past decade. In many cases these outbreaks have had considerable perinatal health consequences including increased risk of preterm delivery (e.g., influenza, measles, and COVID-19), and the delivery of low birth weight or small for gestational age babies (e.g., influenza, COVID-19). Furthermore, severe perinatal outcomes including perinatal and infant death are a known consequence of multiple infectious diseases (e.g., Ebola virus disease, Zika virus disease, pertussis, and measles). In addition to vaccination during pregnancy (where possible), pregnant women, are provided some level of protection from the adverse effects of infection through community-level application of evidence-based transmission-control methods. This review demonstrates that it takes almost 2 years for the perinatal impacts of an infectious disease outbreak to be reported. However, many infectious disease outbreaks between 2010 and 2020 have no associated pregnancy data reported in the scientific literature, or pregnancy data is reported in the form of case-studies only. This lack of systematic data collection and reporting has a negative impact on our understanding of these diseases and the implications they may have for pregnant women and their unborn infants. Monitoring perinatal health is an essential aspect of national and global healthcare strategies as perinatal life has a critical impact on early life mortality as well as possible effects on later life health. The unpredictable nature of emerging infections and the potential for adverse perinatal outcomes necessitate that we thoroughly assess pregnancy and perinatal health implications of disease outbreaks and their public health interventions in tandem with outbreak response efforts. Disease surveillance programs should incorporate perinatal health monitoring and health systems around the world should endeavor to continuously collect perinatal health data in order to quickly update pregnancy care protocols as needed.
Peer mentoring for smoking cessation in public housing: A mixed-methods study
Authors: Apata Jummai , Goldman Erica , Taraji Hamideh , Samagbeyi Oluwatobi , Assari Shervin , Sheikhattari Payam
Published: January 2023

Introduction

Tobacco use disproportionately affects low-income African American communities. The recent public housing smoke-free policy has increased the demand for effective smoking cessation services and programs in such settings.

Methods

This mixed-method pilot study explored feasibility and potential impact of a peer-mentoring program for smoking cessation in a public housing unit. The quantitative study used a quasi-experimental design while qualitative data were collected via focus group discussions with peer mentors and participants. Three residents of the public housing complex were trained as peer mentors. Each peer mentor recruited up to 10 smokers in the residence and provided them individual support for 12 weeks. All participants were offered Nicotine Replacement Therapy (NRT). A follow-up investigation was conducted 3 months after completion of the 12-week intervention. At baseline and follow-up, the participants' smoking status was measured using self-report and was verified using exhaled carbon monoxide (eCO) monitoring.

Results

The intervention group was composed of 30 current smokers who received the peer-mentoring intervention. The control group was composed of 14 individuals. Overall mean eCO levels dropped from 26 ppm (SD 19.0) at baseline to 12 (SD 6.0) at follow-up (P < 0.01). Participants who were enrolled in our program were more likely to have non-smoking eCO levels (<7 ppm) at follow-up (23.3%) compared to those who did not enroll (14.3%).

Conclusion

Our program is feasible for low-income predominantly African American communities. Using peers as mentors may be helpful in providing services for hard-to-reach populations. Given the non-randomized design of our study, randomized trials are needed to test the efficacy of our program in the future.
Multimorbidity and out-of-pocket expenditure on medicine in Europe: Longitudinal analysis of 13 European countries between 2013 and 2015
Authors: Palladino Raffaele , Pan Tianxin , Mercer Stewart W. , Atun Rifat , McPake Barbara , Rubba Fabiana , Triassi Maria , Lee John Tayu
Published: January 2023

Background

Many European Health Systems are implementing or increasing levels of cost-sharing for medicine in response to the growing constrains on public spending on health despite their negative impact on population health due to delay in seeking care.

Objective

This study aims to examine the relationships between multimorbidity (two or more coexisting chronic diseases, CDs), complex multimorbidity (three or more CDs impacting at least three different body systems), and out-of-pocket expenditure (OOPE) for medicine across European nations.

Methods

This study utilized data on participants aged 50 years and above from two recent waves of the Survey of Health, Aging, and Retirement in Europe conducted in 2013 (n = 55,806) and 2015 (n = 51,237). Pooled cross-sectional and longitudinal study designs were used, as well as a two-part model, to analyse the association between multimorbidity and OOPE for medicine.

Results

The prevalence of multimorbidity was 50.4% in 2013 and 48.2% in 2015. Nearly half of those with multimorbidity had complex multimorbidity. Each additional CD was associated with a 34% greater likelihood of incurring any OOPE for medicine (Odds ratio = 1.34, 95% CI = 1.31–1.36). The average incremental OOPE for medicine was 26.4 euros for each additional CD (95% CI = 25.1–27·7), and 32.1 euros for each additional body system affected (95% CI 30.6–33.7). In stratified analyses for country-specific quartiles of household income the average incremental OOPE for medicine was not significantly different across groups.

Conclusion

Between 2013 and 2015 in 13 European Health Systems increased prevalence of CDs was associated with greater likelihood of having OOPE on medication and an increase in the average amount spent when one occurred. Monitoring this indicator is important considering the negative association with treatment adherence and subsequent effects on health.
Secular trends of cardiorespiratory fitness in children and adolescents over a 35-year period: Chronicle of a predicted foretold
Authors: Leone Mario , Levesque Patrick , Bourget-Gaudreault Sabrina , Lemoyne Jean , Kalinova Emilia , Comtois Alain Steve , Bui Hung Tien , Léger Luc , Frémont Pierre , Allisse Maxime
Published: January 2023

Background

In the context of concerns regarding the cardiorespiratory fitness (CRF) of youth populations, the aims of this study were: (1) to update reference values for the VO2max for school-aged Canadians and (2) to document secular trends in CRF after a 35-year interval.

Methods

Between September 2014 and April 2017, the CRF of 3725 students (53.2% boys; 6.0 to 17.9 yrs) was determined using the 20-m shuttle run test. The sample was collected in 36 different schools from six cities of Québec (Canada).

Results

Median values of VO2max decreased with age in both sexes (p ≤ 0.05). By the age of 10, more than 20% of boys showed VO2max values below the recommended value (42 ml·kg−1·min−1). At the age of 17, that proportion reached 56.8%. A similar proportion of 12 yrs girls (20%) were under the recommended minimal value (37 ml·kg−1·min−1) and that value reached 69.9% at the age of 17. Compared to 1982, the VO2max at age 17 has declined by 18% for boys and 12% for girls. The situation is worse in terms of functional capacity (number of stages completed) with an overall decrease of more than 30%.

Conclusion

This study demonstrates that, compared to data obtained using the same methodology 35 years ago, the CRF and functional capacity of children and adolescents has declined to levels that should raise concerns from a public health perspective. Thus, the development of strategies to promote a physically active lifestyle in youth is more relevant than ever.
Short-term exposure to fine particulate matter and genome-wide DNA methylation in chronic obstructive pulmonary disease: A panel study conducted in Beijing, China
Authors: Duan Ruirui , Niu Hongtao , Dong Fen , Yu Tao , Li Xuexin , Wu Hanna , Zhang Yushi , Yang Ting
Published: January 2023

Background

Fine particulate matter (PM2.5) is a crucial risk factor for chronic obstructive pulmonary disease (COPD). However, the mechanisms whereby PM2.5 contribute to COPD risk have not been fully elucidated. Accumulating evidence suggests that epigenetics, including DNA methylation, play an important role in this process; however, the association between PM2.5 exposure and genome-wide DNA methylation in patients with COPD has not been studied.

Objective

To evaluate the association of personal exposure to PM2.5 and genome-wide DNA methylation changes in the peripheral blood of patients with COPD.

Methods

A panel study was conducted in Beijing, China. We repeatedly measured and collected personal PM2.5 data for 72 h. Genome-wide DNA-methylation of peripheral blood was analyzed using the Illumina Infinium Human Methylation BeadChip (850 k). A linear-mixed effect model was used to identify the differentially methylated probe (DMP) associated with PM2.5. Finally, we performed a functional enrichment analysis of the DMPs that were significantly associated with PM2.5.

Results

A total of 24 COPD patients were enrolled and 48 repeated DNA methylation measurements were associated in this study. When the false discovery rate was < 0.05, 19 DMPs were significantly associated with PM2.5 and were annotated to corresponding genes. Functional enrichment analysis of these genes showed that they were related to the response to toxic substances, regulation of tumor necrosis factor superfamily cytokine production, regulation of photosensitivity 3-kinase signaling, and other pathways.

Conclusion

This study provided evidence for a significant relationship between personal PM2.5 exposure and DNA methylation in patients with COPD. Our research also revealed a new biological pathway explaining the adverse effects of PM2.5 exposure on COPD risk.
Patients' choice preferences for specialist outpatient online consultations: A discrete choice experiment
Authors: Wu Mengqiu , Li Yuhan , Ma Chengyu
Published: January 2023

Background

Internet hospitals are multiplying with solid support from the Chinese government. In internet hospitals, specialist outpatient online consultations (SOOC) are the primary services. However, the acceptance and utilization rates of this service are still low. Thus, the study of patients' choice preferences for SOOC is needed.

Objective

To analyze the choice preference of patients' SOOC via a discrete choice experiment, understand the influence of each factor and promote the development of internet hospitals.

Methods

Via a discrete selection experiment, a total of 162 patients from two general hospitals and three specialized hospitals in Beijing were selected for the questionnaire survey. The choice preferences were analyzed by conditional logit regression.

Results

From high to low, patients' willingness to pay (WTP) for the attributes of SOOC is as follows: doctors' recommendation rate (βhighly recommend = 0.999), the convenience of applying SOOC services (βConvenient = 0.760), the increasing ratio of medical insurance payment for online services compared to offline (βIncrease by 10% = 0.545), and the disease's severity (βsevere = −3.024). The results of the subgroup analysis showed differences in patient choice preference by age, whether the patients had chronic diseases, income, and medical insurance types.

Conclusion

Both price and nonprice attributes influence the choice preference of SOOC for patients. Among them, patients are more inclined to choose SOOC when doctors highly recommend it, when it is convenient to apply, when medical insurance increases by 10%, and when disease severity is mild. The current findings show the government and medical institutions formulate auxiliary policies and welfare strategies by clarifying core attributes and adjusting the levels of different attributes to improve patients' acceptance of SOOC. The utility of SOOC and the further development of internet hospitals are radically promoted.
How does the turnover intention of village clinic doctors change after China's new health care system reform? A comparison based on three surveys in a province in eastern China
Authors: Lv Haiyuan , Zhou Lifang , Yu Zhaofeng , Shao Jiaxian , Yu Yuncong , Yin Wenqiang , Chen Zhongming
Published: January 2023

Objectives

This study aims to analyze the changes in village clinic doctors' turnover intention following the new health care system reform (NHCSR).

Methods

All the data were obtained from three surveys conducted in 2012, 2015, and 2018 in a province in eastern China. Descriptive analysis and analysis of variance (ANOVA) were used to analyze the changes in village clinic doctors' turnover intention.

Results

The mean scores of village clinic doctors' turnover intention were 2.87 ± 1.07, 2.76 ± 1.12, and 2.99 ± 1.14 in 2012, 2015, and 2018, respectively, with a significant difference (F = 3.60, P = 0.03). During the 3 years, the turnover intention scores of village clinic doctors who were male, aged 40 years and below, secondary technical school graduates, had the qualifications to practice as village clinic doctors, and were under village-township integrated management first decreased and then increased. The turnover intention scores of village clinic doctors with medical practitioner qualifications increased; however, the scores, decreased for those without village-township integrated management.

Conclusion

The turnover intention of village clinic doctors has increased, and the possible reasons for this phenomenon include changes in the demographic characteristics of village clinic doctors and policy factors. The government should pay more attention to the problems that village clinic doctors consider of urgent concern, such as the treatment of income and pension insurance, and provide greater career development and training opportunities for village clinic doctors to maintain their motivation and stability.
Artificial intelligence and digital medicine for integrated home care services in Italy: Opportunities and limits
Authors: Cingolani Mariano , Scendoni Roberto , Fedeli Piergiorgio , Cembrani Fabio
Published: January 2023

Home healthcare in the Italian health system has proven to be an essential factor in adequately responding to the health needs of an increasingly aging population. The opportunities offered by digitization and new technologies, such as artificial intelligence (AI) and robotics, are a lever for making home care services more effective and efficient on the one hand, and on the other for improving remote patient monitoring. Telemedicine devices have enormous potential for telemonitoring and telerehabilitation of patients suffering from chronic disabling diseases; in particular, AI systems can now provide very useful managerial and decision-making support in numerous clinical areas. AI combined with digitalization, could also allow for the remote monitoring of patients' health conditions. In this paper authors describe some digital and healthcare tools or system of AI, such as the Connected Care model, the Home Care Premium (HCP) project, The Resilia App and some professional service robotics. In this context, to optimize potential and concrete healthcare improvements, some limits need to be overcome: gaps in health information systems and digital tools at all levels of the Italian National Health Service, the slow dissemination of the computerized medical record, issues of digital literacy, the high cost of devices, the poor protection of data privacy. The danger of over-reliance on such systems should also be examined. Therefore the legal systems of the various countries, including Italy, should indicate clear decision-making paths for the patient.
“A reinstilled hope that they can change”: Facilitator perspectives on a self-care and health promotion peer group program for veterans
Authors: Richard Bonnie O. , Abadi Melissa H. , Drake Connor D. , Rychener David , Bauer Rachel
Published: January 2023

Introduction

This study assessed the relevance, value, and effectiveness of “Taking Charge of My Life and Health” (TCMLH), a patient wellbeing peer group program for U.S. veterans focused on empowering them to identify what really matters in their lives and to work toward health goals that align with their mission, aspirations, or purpose in life. The potential of TCMLH to empower veterans to engage in self-care behaviors, make health behavior changes, and participate in health care decision making is important, as veterans are more likely than the general population to suffer from multiple chronic conditions that require ongoing self-management.

Methods

We conducted individual semi-structured interviews with 19 TCMLH facilitators serving in eight U.S. Veteran's Health Administration medical centers. Data were analyzed using an inductive approach to identify salient themes in facilitators' experiences.

Results

Facilitators reported that TCMLH participants demonstrated positive attitude changes (e.g., greater confidence and hope) and behavior changes (e.g., making healthcare appointments and implementing self-care practices) by program completion. Further, findings show that mindful awareness practices, the peer group setting, Whole Health assessment tools, and goal setting tools were perceived as the most impactful program elements leading to positive health behavior change.

Conclusion

Overall, findings suggest that this non-clinical peer group program can enhance patient wellbeing, and that there are certain program elements of TCMLH that are driving key attitudinal and behavioral changes.
NK- and T-cell granzyme B and K expression correlates with age, CMV infection and influenza vaccine-induced antibody titres in older adults
Authors: Verschoor Chris P. , Picard Emilie , Andrew Melissa K. , Haynes Laura , Loeb Mark , Pawelec Graham , Kuchel George A.
Published: January 2023

Granzymes are a family of serine-proteases that act as critical mediators in the cytolytic and immunomodulatory activities of immune cells such as CD8+ T-cells and natural killer (NK) cells. Previous work indicates that both granzyme B (GZB) and K (GZK) are increased with age in CD8+ T-cells, and in the case of GZB, contribute to dysfunctional immune processes observed in older adults. Here, we sought to determine how GZB and GZK expression in NK-cells, and CD4+, CD8+, and gamma-delta T-cells, quantified in terms of positive cell frequency and mean fluorescence intensity (MFI), differed with age, age-related health-traits and the antibody response to high-dose influenza vaccine. We found that the frequency and MFI of GZB-expressing NK-cells, and CD8+ and Vδ1+ T-cells, and GZK-expressing CD8+ T-cells was significantly higher in older (66–97 years old; n = 75) vs. younger (24–37 years old; n = 10) adults by up to 5-fold. There were no significant associations of GZB/GZK expression with sex, frailty or plasma levels of TNF or IL-6 in older adults, but those who were seropositive for cytomegalovirus (CMV) exhibited significantly higher frequencies of GZB+ NK-cells, and CD4+, CD8+ and Vδ1+ T-cells, and GZK+ CD8+ T-cells (Cohen’s d = .5–1.5). Pre-vaccination frequencies of GZB+ NK-cells were positively correlated with vaccine antibody responses against A/H3N2 (d = .17), while the frequencies of GZK+ NK and CD8+ T-cells were inversely associated with A/H1N1 (d = −0.18 to −0.20). Interestingly, GZK+ NK-cell frequency was inversely correlated with pre-vaccination A/H1N1 antibody titres, as well as those measured over the previous 4 years, further supporting a role for this subset in influencing vaccine antibody-responses. These findings further our understanding of how granzyme expression in different lymphoid cell-types may change with age, while suggesting that they influence vaccine responsiveness in older adults.
Predictive keywords: Using machine learning to explain document characteristics
Authors: Kyröläinen Aki-Juhani , Laippala Veronika
Published: January 2023

When exploring the characteristics of a discourse domain associated with texts, keyword analysis is widely used in corpus linguistics. However, one of the challenges facing this method is the evaluation of the quality of the keywords. Here, we propose casting keyword analysis as a prediction problem with the goal of discriminating the texts associated with the target corpus from the reference corpus. We demonstrate that, when using linear support vector machines, this approach can be used not only to quantify the discrimination between the two corpora, but also extract keywords. To evaluate the keywords, we develop a systematic and rigorous approach anchored to the concepts of usefulness and relevance used in machine learning. The extracted keywords are compared with the recently proposed text dispersion keyness measure. We demonstrate that that our approach extracts keywords that are highly useful and linguistically relevant, capturing the characteristics of their discourse domain.
Effectiveness of active occupational therapy in patients with acute stroke: A propensity score-weighted retrospective study
Authors: Yamakawa Shiori , Nagayama Hirofumi , Tomori Kounosuke , Ikeda Kohei , Niimi Ayaka
Published: January 2023

Background and purpose

The effects of therapy and patient characteristics on rehabilitation outcomes in patients with acute stroke are unclear. We investigated the effects of intensive occupational therapy (OT) on patients with acute stroke.

Methods

We performed a retrospective cohort study using the 2005–2016 Japan Rehabilitation Database, from which we identified patients with stroke (n = 10,270) who were admitted to acute care hospitals (n = 37). We defined active OT (AOT) and non-AOT as OT intervention times (total intervention time/length of hospital stay) longer or shorter than the daily physical therapy intervention time, respectively. The outcomes assessed were the Functional Independence Measure (FIM) and National Institutes of Health Stroke Scale (NIHSS) scores, duration of hospitalization, and rate of discharge. Propensity scores and inverse probability of treatment weighting analyses adjusted for patient characteristics were performed to investigate the effects of AOT on patient outcomes.

Results

We enrolled 3,501 patients (1,938 and 1,563 patients in the AOT and non-AOT groups, respectively) in the study. After inverse probability of treatment weighting, the AOT group had a shorter length of hospitalization (95% confidence interval: −3.7, −1.3, p < 0.001), and the FIM (95% confidence interval: 2.0, 5.7, p < 0.001) and NIHSS (95% confidence interval; 0.3, 1.1, p < 0.001) scores improved significantly. Subgroup analysis showed that lower NHISS scores for aphasia, gaze, and neglect and lower overall NIHSS and FIM scores on admission led to a greater increase in FIM scores in the AOT group.

Conclusions

AOT improved the limitations in performing activities of daily living (ADL) and physical function in patients with acute stroke and reduced the length of hospitalization. Additionally, subgroup analysis suggested that the increase in FIM score was greater in patients with severe limitations in performing ADLs and worse cognitive impairment, such as neglect, on admission.
Promoting early childhood oral health and preventing early childhood caries on Instagram
Authors: Lee Victor H. K. , Kyoon-Achan Grace , Levesque Josh , Ghotra Suhird , Hu Ralph , Schroth Robert J.
Published: January 2023

Introduction

Early childhood caries (ECC) is prevalent worldwide. Oral health promotion effectively utilizes key messages to educate parents/caregivers and the public on how to prevent ECC. Instagram is one of the biggest social media platforms, and could be used to promote early childhood oral health. The purpose of this study was to determine if and how young children's oral health is promoted and supported on Instagram.

Methods

This study used inductive content analysis to categorize, quantify, and interpret pictorial and textual data derived from Instagram posts containing the most commonly used ECC-related hashtags in their captions (determined by an extensive search through Instagram's search bar).

Results

A total of 1,071 images and 3,228 comments were analyzed based on 13 hashtags. The most common types of images were those of people (57.5%) and graphics/memes (37.8%). Most people were older children (32.5%) or adults (20.3%), and were White (19.6%) or Asian (18.5%). A majority of images had people posing (79.1%) in dental clinics (81.3%). Most graphics/memes were instructional/informational (76.3%). A total of 173 posts had substantial discussions that were positive/constructive in nature. The majority of discussions had at least one comment providing advice, tips, or explanations (79.8%), or had users requesting further information (73.4%).

Conclusion

As more people engage with social media, health professionals should consider the potential for Instagram as a tool to promote early childhood oral health and to prevent ECC. Our study shows that many different users are providing and consuming content related to ECC. Targeted messaging, monitoring of content, and professional guidance could be beneficial to those seeking oral health information on this platform.
Pinpointing drivers of widespread colonization of Legionella pneumophila in a green building: Roles of water softener system, expansion tank, and reduced occupancy
Authors: Joshi Sayalee , Richard Rain , Levya Carlos , Harrison Joanna Ciol , Saetta Daniella , Sharma Naushita , Crane Lucas , Mushro Noelle , Dieter Lucien , Morgan Grace V. , Heida Ashley , Welco Bennett , Boyer Treavor H. , Westerhoff Paul , Hamilton Kerry A.
Published: January 2023

Introduction

Legionella pneumophila is an opportunistic pathogen that is a key contributor to drinking water-associated disease outbreaks in the United States. Prolonged water stagnation periods in building plumbing systems due to low occupancy, especially during building shutdowns, breaks, and holidays, can lead to water quality deterioration and (re)colonization of buildings with L. pneumophila. Water monitoring in buildings typically relies on grab samples with small datasets.

Methods

In this study, a larger dataset was created by sampling a Leadership in Energy and Environmental Design (LEED)-certified data-rich commercial building for L. pneumophila and physical-chemical water quality during the COVID-19 pandemic after reduced building occupancy. A proxy for human occupancy rates using WIFI logins was recorded throughout the study period.

Results

L. pneumophila was observed in grab samples taken throughout the building, where concentrations generally increased with greater distances from the building point of entry to locations throughout the building. Factors conducive to microbial growth were identified in the building including fluctuations in water temperatures, lack of chlorine residual, a low water heater setpoint, colonized water-saving fixtures, prolonged stagnation throughout the building; especially in an expansion tank designed to reduce pressure issues during demand fluctuations, and the presence of oversized softener tanks with ion exchange resin that contributed to chlorine residual removal as well as colonization of the resin with L. pneumophila.

Discussion

Flushing and thermal disinfection alone did not resolve the problem, and replacement of the expansion tank ultimately resolved the L. pneumophila issue. As ad-hoc approaches are logistically- and time-intensive, more proactive approaches are needed for informing preventative and corrective actions for reducing the risk of exposure to opportunistic pathogens in the building plumbing.
Impact of 3 months of detraining after high intensity exercise on menopause-related symptoms in early postmenopausal women – results of the randomized controlled actlife project
Authors: Jungmann Sophia , Hettchen Michael , Kohl Matthias , Kemmler Wolfgang
Published: January 2023

Regular exercise might reduce postmenopausal symptoms, however even short-moderate periods of absence from exercise training might significantly reduce these positive effects. The aim of the study was thus to determine detraining effects on postmenopausal symptoms after a 3-month detraining period in early post-menopausal women. After 13 months, the exercise group (EG: n = 27; 54.6 ± 2.0; 23.6 ± 3.3 kg/m2) had to abruptly stop their supervised, facility-based, high intensity aerobic and resistance group exercise conducted three times per week due to the COVID-19 pandemic and the corresponding lockdown of all training facilities in Germany. In parallel, the control group (CG: n = 27; 55.6 ± 1.6 years, 25.2 ± 5.2 kg/m2) had to terminate their low-intensity exercise program performed once per week. Study endpoint as determined after 3 months of detraining was menopausal symptoms as determined by the Menopausal Rating Scale II (MRS II). The intention to treat principle with multiple imputation was applied. After 13 months of intense multicomponent exercise and significant exercise-induced effects on menopausal symptoms, a further 3 months of detraining resulted in non-significant deteriorations (p = .106) in the exercise group, while non-significant improvements were observed in the control group (p = .180). Corresponding group differences were significant (p = .036) after detraining. Of importance, self-reported individual outdoor activities increased by about 40% in both groups during the three-month lock-down period. Three months of absence from a supervised high-intensity group exercise protocol resulted in detraining effects on postmenopausal symptoms even when outdoor physical activity was increased significantly.

Trial registration number

ClinicalTrials.gov: NCT03959995
Livelihood resilience and livelihood construction path of China's rural reservoir resettled households in the energy transition
Authors: Chen Shaojun , Wu Jing , Zhou Kexin , Li Ru
Published: January 2023

The construction of reservoirs has led to difficult livelihood transitions of resettled households after relocation and resettlement, resulting in a series of socioeconomic problems. How to scientifically integrate regional resource advantages and improve the livelihood resilience of resettled households has become an important problem to be solved to prevent and resolve social equity and justice risks and sustainable livelihood development. Taking Xiangjiaba Hydropower Station (Yunnan Reservoir area) as an example, the evaluation index system was constructed from the three dimensions of buffer capacity, self-organization capacity and learning capacity, the gray correlation degree method was used to evaluate index system, and the clustering method was selected to screen the indices that have a great impact on livelihood resilience. On this basis, the comprehensive index method was used to calculate the livelihood resilience, and the contribution degree model was used to identify the main contribution factors of livelihood resilience and to explore the path of livelihood construction to improve the livelihood resilience of resettled households. The results showed that (1) the level of livelihood resilience of resettled households was not high as a whole, in which the self-organization capacity was the strongest, the buffer capacity was the second strongest, and the learning capacity was the weakest; (2) there were differences in the livelihood resilience of resettled households who choose different livelihood modes. Among them, buffer capacity, learning capacity and livelihood resilience were characterized by wage operation type > part-time balanced type > agricultural operation type > subsidy dependent type, while self-organization capacity was characterized by agricultural operation type > part-time balanced type > wage operation type > subsidy dependent type. (3) The main contribution factors of the livelihood resilience of resettled households who choose different livelihood modes are similar. The number of laborers, participation in social organizations, skills training opportunities and 11 other main indices promote the formation and development of livelihood resilience from different dimensions. (4) The livelihood of resettled households should follow the construction path of “identifying transition capacity, clarifying resource advantages, strengthening livelihood support, and promoting livelihood reorganization” to promote the comprehensive improvement of livelihood resilience, ultimately achieving sustainable livelihood and high-level welfare. The livelihood resilience of resettled households is a continuous and dynamic development process, therefore, it is necessary to further improve the dynamic monitoring and evolution process of livelihood resilience, incorporate the impact of diverse data. This is also an important breakthrough in the study of livelihood resilience.
Developing a conceptual framework for the relationship between food security status and mental health among low-income mothers
Authors: Liebe Rachel A. , Adams Leah M. , Hedrick Valisa E. , Serrano Elena L. , Porter Kathleen J. , Cook Natalie E. , Misyak Sarah A.
Published: January 2023

Introduction

Building household resiliency is one strategy that may help insulate households from the effects of food system volatility that contributes to in food insecurity. A stronger understanding of the relationship between food security and mental health is needed to identify potential factors for intervention to improve household resiliency to food system stressors. Because mothers often make household food decisions, they are an important population for building household resiliency. The purpose of this study was to develop and test a conceptual framework for the relationship between food security and mental health for low-income mothers and to identify potential targets for intervention.

Methods

A conceptual framework was developed based on the existing literature on mental health and food security, as well as factors that impact both constructs. This framework was tested by a path analysis using data from a 2021 cross-sectional survey of low-income Virginia mothers that used validated scales to assess food security status, indicators of mental and physical health, food coping strategies, and social support.

Results and discussion

The initial model was systematically adapted to develop the final retained model. The retained model did not include a direct effect of food security on mental health, but highlighted two significant mediators of the relationship, food coping strategies and social support. While the effect of social support was not practically significant, the effects of food coping strategies as a mediator from food security to perceived stress and life satisfaction were small (β = 0.21, 0.14, respectively; p < 0.001). The retained model provides a framework for understanding the relationship between food security and mental health and highlights potential targets for intervention. Notably, reducing the need for mothers to utilize food coping strategies should be targeted on multiple levels to reduce the impact on mental health and ultimately improve resiliency to future food system shocks.
Prognostic value of log odds of positive lymph nodes, lymph node ratio, and N stage in patients with colorectal signet ring cell carcinoma: A retrospective cohort study
Authors: Hu Xing , Jiang Lixin , Wu Jingzhou , Mao Weida
Published: January 2023

Aim

Little attention has been paid in the prognosis of colorectal signet ring cell carcinoma (SRCC). This study aims to explore the predictive capacity of log odds of positive lymph nodes (LODDS), lymph node ratio (LNR), and pN stage in the prognosis of patients with colorectal SRCC.

Methods

A retrospective cohort study was designed, and data were extracted from the Surveillance, Epidemiology and End Results (SEER) database. Data on demographic characteristics, clinicopathological features, and treatment were extracted. Outcomes were overall survival (OS) and cancer-specific survival (CSS). Association of LODDS, LNR, and pN stage with OS and CSS were explored using Cox proportional hazard model and Cox competing risk model, respectively, with results showing as hazard ratio and 95% confidence interval (CI). Predictive performance of LODDS, LNR, and pN stage in OS and CSS was assessed by calculating C-index.

Results

A total of 2,198 patients were included in this study. LODDS, LNR, and pN stage were associated with the OS and CSS of colorectal SRCC patients (all P < 0.05). LODDS showed a good performance in the OS (C-index: 0.704, 95% CI: 0.690–0.718), which was superior to LNR (C-index: 0.657, 95% CI: 0.643–0.671) and pN stage (C-index: 0.643, 95% CI: 0.629–0.657). The C-index of LODDS, LNR, and pN stage for CSS was 0.733 (95% CI: 0.719–0.747), 0.713 (95% CI: 0.697–0.729), and 0.667 (95% CI: 0.651–0.683), respectively.

Conclusions

LODDS displayed a better predictive capacity in the OS and CSS than LNR and pN stage, indicating that LODDS may be effective to predict the prognosis of colorectal SRCC in the clinic.