bluuebunny/crossref_metadata_2025 huggingface dataset:
Implications of Lifestyle and Occupational Factors on the Risk of Breast Cancer in Shiftwork Nurses
Authors: Fagundo-Rivera Javier , Allande-Cussó Regina , Ortega-Moreno Mónica , García-Iglesias Juan Jesús , Romero Adolfo , Ruiz-Frutos Carlos , Gómez-Salgado Juan
Published: May 2021

Shift work that involves circadian disruption has been highlighted as a likely carcinogenic factor for breast cancer in humans. Also, unhealthy lifestyle habits observed in night work nurses could be causally related to an increase in the incidence of estrogen-positive breast tumours in this population. Assessing baseline risk of breast cancer in nurses is essential. The objective of this study was to analyze the risk of breast cancer that nurses had in relation to their lifestyle and labour factors related to shift work. A cross-sectional descriptive study through a questionnaire about sociodemographic variables, self-perception of health, and working life was designed. The sample consisted of 966 nurses. The relationship between variables was tested. A binary logistic regression and a classification and regression tree were performed. The most significant labour variables in relation to the risk of breast cancer were the number of years worked (more than 16 years; p < 0.01; OR = 8.733, 95% CI = 2.811, 27.134) and the total years performing more than 3 nights per month (10 or more years; p < 0.05; OR = 2.294, 95% CI = 1.008, 5.220). Also, the nights worked throughout life (over 500; OR = 4.190, 95% CI = 2.118, 8.287) were significant in the analysis. Nurses who had or ever had breast cancer valued their self-perceived health more negatively (p < 0.001) and referred a lower quality of sleep (p < 0.001) than the non-cases nurses. The occupational factors derived from night work could have several impacts on nurses’ health and their family-work balance. Promoting healthy lifestyles, informing about shift work risks, and adjusting shift work schedules are critical methods to decrease the possible effects of circadian disruption in nurses.
Effectiveness of Whole-Body Vibration Training to Improve Muscle Strength and Physical Performance in Older Adults: Prospective, Single-Blinded, Randomized Controlled Trial
Authors: Jo Nam-Gyu , Kang Seung-Rok , Ko Myoung-Hwan , Yoon Ju-Yul , Kim Hye-Seong , Han Kap-Soo , Kim Gi-Wook
Published: May 2021

Whole-body vibration training (WBVT) is emerging as an alternative exercise method that be easily performed by older adults. This clinical trial investigates the efficacy of WBVT in improving muscle strength and physical performance before resistance exercise, in comparison to conventional resistance exercise after stretching exercise in older adults. The WBVT group (n = 20) performed WBVT using a vibrating platform (SW-VC15™), followed by strengthening exercises. The control group (n = 20) performed stretching instead of WBVT. Both groups underwent a total of 12 sessions (50 min per session). The primary outcome was isokinetic dynamometer. The secondary outcomes were grip strength, short physical performance battery (SPPB), a 36-Item Short Form Survey (SF-36), and body composition analysis. In all results, only the time effect was significant, and the group effect or time x group effect was not. Both groups showed a significant increase in isokinetic dynamometer. Although there was no significant group effect, the increase in mean peak torque was greater in the WBVT group. The only WBVT group showed significant improvement in SPPB. In SF-36, only the control group showed significant improvements. WBVT can be safely performed by older adults and may be an alternative exercise method to boost the effect of strengthening exercise.
Mosquito-Borne Diseases: Social Representations of a University Community in Endemic Outbreaks
Authors: Delouvée Sylvain , Moloney Gail , McColl Kathleen , Lo Monaco Grégory
Published: May 2021

(1) Background: Studying social representations as lay theories allows for a better understanding of the common sense knowledge constructed around mosquito-borne diseases and the impact this may have on attitudes and behaviors. (2) Methods: A hierarchical evocation questionnaire was circulated through an Australian academic community and analyzed by prototypical analysis and correspondence factor analysis. (3) Results: Representational areas are regulated by participant age and whether or not they had contracted a mosquito-borne disease. (4) Conclusions: Collecting and understanding social representations has the potential to help social actors implement strategies that encourage people to access information and adopt behaviors in line with the scientific reality of the phenomenon, rather than limiting lay theories.
Exploring the Occupational Balance of Young Adults during Social Distancing Measures in the COVID-19 Pandemic
Authors: Rodríguez-Fernández Paula , González-Santos Josefa , Santamaría-Peláez Mirian , Soto-Cámara Raúl , González-Bernal Jerónimo J.
Published: May 2021

(1) Background: A balanced life is related to good health in young people, one of the groups most affected by confinement and social distancing measures during the COVID-19 pandemic. This study aims to explore the occupational balance of young adults during home confinement and its association with different sociodemographic factors. (2) Methods: A cross-sectional study was designed, and an online survey was disseminated to collect sociodemographic and occupational balance data, using the Occupational Balance Questionnaire (OBQ). The statistical analysis was performed using the SPSS statistical software package version 24.0. (3) Results: 965 young adults between 18 and 30 years old participated in the study. A predictive model showed that the main predictors of a lower occupational balance were a negative self-perception (β= 0.377; p = <0.0001), student status (β = 0.521; p = 0.001), not receiving enough information (β = 0.951; p = 0.001) and long periods of quarantine (β = 0.036; p = 0.007). (4) Conclusions: Considering people’s occupational health and related factors could lessen many of the psychosocial consequences of isolation and contribute to the well-being of young people.
Factors Related to Gender Violence and Sex Education in Adolescents: A Cross-Sectional Study
Authors: Guerra-Marmolejo Cristina , Fernández-Fernández Eloísa , González-Cano-Caballero María , García-Gámez Marina , del Río Francisco J. , Fernández-Ordóñez Eloisa
Published: May 2021

Background: For school medical services and the staff responsible for sex education for adolescents, it is important to understand the factors that may influence gender violence. The aim of this study is to determine whether the presence of sexist attitudes, double standards and/or romantic myths contributes to the risk of gender violence. Methods: This cross-sectional study was carried out at five secondary schools in the province of Malaga (Spain). In total, 879 adolescents aged 12–18 years were included, studying years 1–4 of compulsory secondary education. Their attitudes were measured on the following scales: Ambivalent Sexism Inventory (ASI), Double Standard Scale (DSS) and Romantic Love Myths Scale (EMA). Results: Significant differences were observed among the age/year groups for the mean scores obtained on each of the above scales (DSS, p < 0.01; EMA, p < 0.01; ASI, p < 0.01). By gender, the boys recorded higher scores for ASI and lower ones for DSS (p < 0.01). The Spearman’s rho value revealed significant relationships between the presence of sexual double standards and that of romantic myths and ambivalent attitudes (p < 0.01). Conclusions: Adolescents commonly express romantic love myths, sexist attitudes and sexual double standards. These three factors, which are significantly correlated, influence the presence of violence in dating relationships.
Why a New Research Agenda on Green Spaces and Health Is Needed in Latin America: Results of a Systematic Review
Authors: Rojas-Rueda David , Vaught Elida , Buss Daniel
Published: May 2021

(1) Background: Increasing and improving green spaces have been suggested to enhance health and well-being through different mechanisms. Latin America is experiencing fast population and urbanization growth; with rising demand for interventions to improve public health and mitigate climate change. (2) Aim: This study aimed to review the epidemiological evidence on green spaces and health outcomes in Latin America. (3) Methods: A systematic literature review of green spaces and health outcomes was carried out for studies published in Latin America before 28 September 2020. A search strategy was designed to identify studies published in Medline via PubMed and LILACS. The search strategy included terms related to green spaces combined with keywords related to health and geographical location. No time limit for the publication was chosen. The search was limited to English, Spanish, Portuguese, and French published articles and humans’ studies. (4) Findings: This systematic review found 19 epidemiological studies in Latin America related to green spaces and health outcomes. Nine studies were conducted in Brazil, six in Mexico, three in Colombia, and one in Chile. In terms of study design, 14 were cross-sectional studies, 3 ecological, and 2 cohort studies. The population included among the studies ranged from 120 persons to 103 million. The green space definition used among studies was green density or proximity (eight studies), green presence (five studies), green spaces index (four studies), and green space visit (two studies). The health outcomes included were mental health (six studies), overweight and obesity (three studies), quality of life (three studies), mortality (two studies), cardiorespiratory disease (one study), disability (one study), falls (one study), and life expectancy (one study). Eleven studies found a positive association between green spaces and health, and eight studies found no association. (5) Conclusion: This systematic review identified 19 epidemiological studies associating green spaces and health outcomes in Latin America. Most of the evidence suggests a positive association between green spaces and health in the region. However, most of the evidence was supported by cross-sectional studies. Prioritizing longitudinal studies with harmonized exposure and outcome definitions and including vulnerable and susceptible populations is needed in the region.
Pro-Environmental Sustainability and Political Affiliation: An Examination of USA College Sport Sustainability Efforts
Authors: Casper Jonathan M. , McCullough Brian P. , Smith Danielle M. Kushner
Published: May 2021

Political ideology is one of the most powerful predictors of perceptions about environmental sustainability and related behaviors. The purpose of this study was to investigate how sport fans’ sustainability-specific values, perceptions, and norms related to awareness, engagement, and influence of USA collegiate sport sustainability efforts based on political affiliation, accounting for age and gender. Data were collected using an online survey distributed to season ticket holders after the 2019 college football season that featured three sponsored sustainability initiatives at each home game. Multivariate analysis of variance and chi-square difference tests found that self-identified Democrats reported significantly higher pro-environmental values and norms, but sustainability program engagement, sponsored initiatives awareness, and influence of initiatives on behavior were politically neutral. Path analysis found that ascription of responsibility was a significant predictor of sustainability-related engagement and behaviors for both Independents and Republicans. The results and discussion sections highlight how academics and practitioners can account for political affiliation when creating campaign messaging for environmental initiatives.
Characteristics of Technical and Tactical Preparation of Elite Judokas during the World Championships and Olympic Games
Authors: Błach Wiesław , Rydzik Łukasz , Błach Łukasz , Cynarski Wojciech J. , Kostrzewa Maciej , Ambroży Tadeusz
Published: May 2021

The basis for achieving success in sport is technical preparation supported by adequate level of physical fitness. During judo competitions, athletes use technique to meet tactical objectives aimed to achieve victory. The modification of the rules of combat in judo that has been carried out in recent years has changed the course of competition. It seems to be interesting if there are relations between technical and tactical preparation expressed by means of indices and modification of the course of the fight caused by changes in the rules. The purpose of the paper was to determine the values of technical and tactical preparation of judokas during competition at the elite level. A hundred and twenty bouts during the Olympic Games in London in 2012 as well as 136 bouts fought during the World Championships in Rio de Janeiro in 2013 were analyzed. Verification was performed by calculating indicators of technical and tactical preparation. The results show a significant correlation between the indicators of technical and tactical preparation and the ranking in the general classification of the analyzed competitions. There were no statistically significant correlations between the change of fighting rules and the level of the examined indices of technical and tactical preparation. The results of the study verified the appropriate method of preparation for the competitions analyzed.
Impact of Changed Use of Greenspace during COVID-19 Pandemic on Depression and Anxiety
Authors: Heo Seulkee , Desai Miraj U. , Lowe Sarah R. , Bell Michelle L.
Published: May 2021

The COVID-19 pandemic has had devastating consequences for health, social, and economic domains, but what has received far less focus is the effect on people’s relationship to vital ecological supports, including access to greenspace. We assessed patterns of greenspace use in relation to individual and environmental factors and their relationship with experiencing psychological symptoms under the pandemic. We conducted an online survey recruiting participants from social media for adults in Korea for September–December 2020. The survey collected data on demographics, patterns of using greenspace during the pandemic, and major depression (MD) and generalized anxiety disorder (GAD) symptoms. The Patient Health Questionnaire (PHQ-9) and the Generalized Anxiety Disorder 2-item (GAD-2) were applied to identify probable cases of MD and GAD. A logistic regression model assessed the association decreased visits to greenspace after the outbreak compared to 2019 and probable MD and GAD. Among the 322 survey participants, prevalence of probable MD and GAD were 19.3% and 14.9%, respectively. High rates of probable MD (23.3%) and GAD (19.4%) were found among persons currently having job-related and financial issues. Of the total participants, 64.9% reported decreased visits to greenspace after the COVID-19 outbreak. Persons with decreased visits to greenspace had 2.06 higher odds (95% CI: 0.91, 4.67, significant at p < 0.10) of probable MD at the time of the survey than persons whose visits to greenspace increased or did not change. Decreased visits to greenspace were not significantly associated with GAD (OR = 1.45, 95% CI: 0.63, 3.34). Findings suggest that barriers to greenspace use could deprive people of mental health benefits and affect mental health during pandemic; an alternative explanation is that those experiencing poor mental health may be less likely to visit greenspaces during pandemic. This implies the need of adequate interventions on greenspace uses under an outbreak especially focusing on how low-income populations may be more adversely affected by a pandemic and its policy responses.
Provision of Psychotherapy One Year after the Beginning of the COVID-19 Pandemic in Austria
Authors: Humer Elke , Haid Barbara , Schimböck Wolfgang , Reisinger Andrea , Gasser Marion , Eichberger-Heckmann Heidrun , Stippl Peter , Pieh Christoph , Probst Thomas
Published: May 2021

A previous study revealed that the majority of Austrian psychotherapists switched to remote settings during the first months of the COVID-19 pandemic. The current study investigated whether this change in treatment format was maintained after one year of the COVID-19 pandemic. From 16 February until 2 April 2021, a total of 238 Austrian psychotherapists completed an online survey. They were asked about the number of patients currently treated in-person, via telephone and via the internet. Psychotherapists rated three different aspects of psychotherapy (ability to actively listen to patients, ability to understand what is going on in the patients and ability to support patients emotionally) for three different formats (in-person with facemasks, telephone and internet) separately. The results show that, after one year of the pandemic, the majority (78.4%) of patients were treated in-person (compared to 21.7% during the first months of the COVID-19 pandemic; p < 0.001). This change in the treatment format was accompanied by a strong increase in the total number of patients treated by 77.2% on average (p < 0.001). Psychotherapists reported no differences between in-person psychotherapy with facemasks and psychotherapy via the internet with regard to the three investigated aspects of psychotherapy, while the surveyed aspects were rated less favorably for psychotherapy conducted via telephonic communication (p < 0.05). Further studies are needed to investigate the reasons why most psychotherapists switched back to the in-person format with the continuation of the COVID-19 pandemic.
Clinical Consequences of Dental Caries, Parents’ Perception of Child’s Oral Health and Attitudes towards Dental Visits in a Population of 7-Year-Old Children
Authors: Opydo-Szymaczek Justyna , Borysewicz-Lewicka Maria , Andrysiak Kinga , Witkowska Zuzanna , Hoffmann-Przybylska Alicja , Przybylski Piotr , Walicka Ewa , Gerreth Karolina
Published: May 2021

This cross-sectional study aimed to assess the occurrence of the consequences of dental caries and factors affecting dental service utilization in a population of 7-year-old children. The research included oral examination of 7-year-old schoolchildren and socio-medical study of their parents/legal caregivers. It was carried out in five primary schools of two provinces, i.e., Greater Poland and Lubusz. Dental examination was performed in accordance with World Health Organization (WHO) recommendations. The socio-medical study consisted of questionnaires with close-ended questions concerning socioeconomic characteristics of the family, reasons and time of the last visit at the dental office, consequences of child’s oral health problems, parents’ attitude towards dental visits, and parental opinion about their child’s teeth. Factors affecting utilization of dental services were statistically analyzed using univariate logistic regression assuming p < 0.05. The pufa index of examined children ranged from 0 to 7 (mean 0.80 ± 1.49), while the dmf index ranged from 0 to 14 (3.86 ± 3.32). Low financial burden of oral health expenditures and university education of at least one of the parents significantly increased the chance of visiting a dentist despite lack of pain (OR = 3.0 and 2.5, respectively). In spite of the availability of free dental care for children, socioeconomic factors still determine the utilization of dental services in Poland. Poor oral health status of examined population and negligence of regular dental check-ups emphasize a need to strengthen oral health literacy of parents and children, promoting proper attitudes towards dental care.
Symptoms of Depression, Anxiety, and Stress and Prevalence of Major Depression and Its Predictors in Female University Students
Authors: Blanco Vanessa , Salmerón Mar , Otero Patricia , Vázquez Fernando L.
Published: May 2021

Depression, anxiety and stress are increasingly concerning phenomena in our society, with serious consequences on physical and mental health. The repercussions may be particularly devastating in particular population subgroups, such as female university students. The purpose of this study was to determine the levels of depression, anxiety, and stress and the prevalence of depression and associated factors, in Spanish university women. A cross-sectional study was conducted with a random sample of 871 students from the Santiago de Compostela University (mean age 20.7 years, SD = 2.8). Information was collected on sociodemographic and academic characteristics; symptoms of depression, anxiety, and stress; diagnosis of major depression; optimism, resilience, social support, life engagement, and five personality domains, using validated instruments. Of the participants, 18.1%, 22.8% and 13.5% presented with severe/very severe levels of depression, anxiety and stress, respectively. A total of 12.9% had major depression. Higher life engagement was associated with lower risk of depression (OR = 0.92, 95% CI 0.87–0.98), while higher levels of neuroticism (OR = 1.20, 95% CI, 1.12–1.28) and openness to experience (OR = 1.08, 95% CI, 1.02–1.14) were associated with greater risk. These findings reveal an alarming percentage of female university students who experience major depression and severe/very severe stress.
Event-Based Prospective Memory Deficit in Children with ADHD: Underlying Cognitive Factors and Association with Symptoms
Authors: Costanzo Floriana , Fucà Elisa , Menghini Deny , Circelli Antonella Rita , Carlesimo Giovanni Augusto , Costa Alberto , Vicari Stefano
Published: May 2021

Event-based prospective memory (PM) was investigated in children with Attention deficit/hyperactivity disorder (ADHD), using a novel experimental procedure to evaluate the role of working memory (WM) load, attentional focus, and reward sensitivity. The study included 24 children with ADHD and 23 typically-developing controls. The experimental paradigm comprised one baseline condition (BC), only including an ongoing task, and four PM conditions, varying for targets: 1 Target (1T), 4 Targets (4T), Unfocal (UN), and Reward (RE). Children with ADHD were slower than controls on all PM tasks and less accurate on both ongoing and PM tasks on the 4T and UN conditions. Within the ADHD group, the accuracy in the RE condition did not differ from BC. A significant relationship between ADHD-related symptoms and reduced accuracy/higher speed in PM conditions (PM and ongoing trials), but not in BC, was detected. Our data provide insight on the adverse role of WM load and attentional focus and the positive influence of reward in the PM performance of children with ADHD. Moreover, the relation between PM and ADHD symptoms paves the road for PM as a promising neuropsychological marker for ADHD diagnosis and intervention.
Cumulative Risks from Stressor Exposures and Personal Risk Factors in the Workplace: Examples from a Scoping Review
Authors: Fox Mary A. , Niemeier Richard Todd , Hudson Naomi , Siegel Miriam R. , Dotson Gary Scott
Published: May 2021

Protecting worker and public health involves an understanding of multiple determinants, including exposures to biological, chemical, or physical agents or stressors in combination with other determinants including type of employment, health status, and individual behaviors. This has been illustrated during the COVID-19 pandemic by increased exposure and health risks for essential workers and those with pre-existing conditions, and mask-wearing behavior. Health risk assessment practices for environmental and occupational health typically do not incorporate multiple stressors in combination with personal risk factors. While conceptual developments in cumulative risk assessment to inform a more holistic approach to these real-life conditions have progressed, gaps remain, and practical methods and applications are rare. This scoping review characterizes existing evidence of combined stressor exposures and personal factors and risk to foster methods for occupational cumulative risk assessment. The review found examples from many workplaces, such as manufacturing, offices, and health care; exposures to chemical, physical, and psychosocial stressors combined with modifiable and unmodifiable determinants of health; and outcomes including respiratory function and disease, cancers, cardio-metabolic diseases, and hearing loss, as well as increased fertility, menstrual dysfunction and worsened mental health. To protect workers, workplace exposures and modifiable and unmodifiable characteristics should be considered in risk assessment and management. Data on combination exposures can improve assessments and risk estimates and inform protective exposure limits and management strategies.
The Bibliometric Literature on Scopus and WoS: The Medicine and Environmental Sciences Categories as Case of Study
Authors: Cascajares Mila , Alcayde Alfredo , Salmerón-Manzano Esther , Manzano-Agugliaro Francisco
Published: May 2021

In a broad sense, science can be understood as the knowledge contained in scientific manuscripts published in scientific journals. Scientific databases index only those journals that reach certain quality standards. Therefore, research and dissemination of scientific knowledge are essential activities for the growth of science itself. The aim of this manuscript is to assess the situation of medicine and environmental sciences among the bibliometric literature and to put it in perspective with the overall bibliometric publications in all scientific fields. The main countries publishing bibliometric manuscripts are China, USA and Spain. The latter country is ranked three out of the top five institutions according to the Scopus and WoS databases. In both databases, the average scientific collaboration of the top 20 institutions offers the same result, 41%. According to Scopus, the main subject categories in which this research falls are social sciences (38%), computer science (26%) and medicine (23%), while the environmental sciences category has 8%. In the analysis of the Medicine category alone, it has been observed that 136 countries have contributions in this field. The main countries are the United States, China and the United Kingdom. In the field of medicine, the main areas studied were: Epidemiology, Pediatrics, Orthopedics, Cardiology, Neurosurgery, Radiology, Ophthalmology, Oncology, Plastic Surgery and Psychiatry. With respect to environmental sciences, less international dissemination has been found, with only 83 countries having worked in this field. The main ones are China, Spain and the United States. Regarding the top 10 institutions, it can be stated that only Spain and China are relevant. Spain focuses on sustainability and China on the environment. The result of an independent keyword analysis of all published bibliometric manuscripts has shown that the main clusters are: Mapping Science (29%), Research Productivity (23%), Medicine (20%), Environmental Sciences (12%), Psychology (7%), Nursing (6%) and Engineering (4%). In short, medicine and environmental sciences are the most relevant areas in the field of bibliometrics after social sciences and computer sciences.
Lifestyle Habits and Health Indicators in Migrants and Native Schoolchildren in Chile
Authors: Suárez-Reyes Mónica , Quintiliano-Scarpelli Daiana , Fernandes Anna Pinheiro , Cofré-Bolados Cristian , Pizarro Tito
Published: May 2021

In Chile, the migrant population has increased in the last years. Migrants adopt behaviors of this new culture, which can have an effect on their health. Contradictory results regarding differences between migrant and native children have been reported. The aim of this study was to explore the associations between nationality with health indicator and lifestyle habits among schoolchildren in Chile. A cross-sectional and observational study with a non-probabilistic sample was conducted in 1033 children (86.4% Chilean and 13.6% migrant) from second to fourth grade of seven public schools from low-income municipalities from the Metropolitan Region, Chile. Anthropometric measurements (weight, height, waist circumference, triceps and subscapular folds), handgrip strength, and standing long jump measurements, physical activity, self-esteem and food guidelines accomplishments were determined. Migrant children presented lower body mass index (BMI), Z-BMI, body fat% and waist circumference values; and higher handgrip strength, standing long jump, and more satisfactory compliance with food guidelines than natives (p < 0.05). No significant difference for physical activity and self-esteem was observed. In the adjusted models, migrants presented lower odds for overweight/obesity, risk of abdominal obesity, low handgrip strength and unsatisfactory food guidelines accomplishment in all models (p < 0.05). The nutritional and muscular fitness of migrant children was better than that of the Chilean ones.
The Association of Upper Body Obesity with Insulin Resistance in the Newfoundland Population
Authors: Youssef Sherif , Nelder Matthew , Sun Guang
Published: May 2021

Body-fat distribution is a primary risk factor for insulin resistance and cardiovascular disease. Visceral fat explains only a portion of this risk. The link between upper-body fat and insulin resistance is uncertain. Furthermore, upper-body fat is not clearly defined. Dual-energy X-ray absorptiometry (DXA) can accurately quantify body fat. In this study, we explored the relationship between non-visceral upper-body adiposity and insulin resistance and other markers of metabolic syndrome. Fat proportions in the upper body, leg, and visceral regions were quantified by using DXA in 2547 adult Newfoundlanders aged 19 and older. Adjusting for remaining fat regions, we performed partial correlation analysis for each body region and insulin resistance defined by the Homeostatic Model of Assessment (HOMA). Similarly, partial correlation analysis was also performed between each fat region and other markers of metabolic syndrome, including high-density lipoprotein cholesterol (HDL), triglycerides (TG), body mass index (BMI), and blood pressure. Major confounding factors, including age, caloric intake, and physical activity, were statistically controlled by using partial correlation analysis. Interactions between sex, menopausal status, and medication status were also tested. Arm adiposity was correlated with HOMA-IR (R = 0.132, p < 0.001) and HOMA-β (R = 0.134, p < 0.001). Visceral adiposity was correlated with HOMA-IR (R = 0.230, p < 0.001) and HOMA-β (R = 0.160, p < 0.001). No significant correlation between non-visceral trunk adiposity and insulin resistance was found. Non-visceral trunk adiposity was negatively correlated with HDL in men (R = −0.110, p < 0.001) and women (R = −0.117, p < 0.001). Non-visceral trunk adiposity was correlated with TG (total: R = 0.079, p < 0.001; men: R = 0.105, p = 0.012; women: R = 0.078, p = 0.001). In menopausal women, leg adiposity was negatively correlated with HOMA-IR (R = −0.196, p < 0.001) and HOMA-β (R = −0.101, p = 0.012). Upper-body adiposity in the arms is an independent contributor to insulin resistance. Upper-body adiposity in the non-visceral trunk region is an independent contributor to metabolic syndrome. Leg adiposity is protective against metabolic syndrome in women.
What Happened Pre- and during COVID-19 in South Korea? Comparing Physical Activity, Sleep Time, and Body Weight Status
Authors: Park Jeong-Hui , Yoo Eunhye , Kim Youngdeok , Lee Jung-Min
Published: May 2021

The purpose of the current study is to investigate the changes in physical activity (PA), sleep time (ST), and body weight (BW) Pre- and during COVID-19 in South Korea, and specifically, PA data were obtained during COVID-19 at three-time points based on the multilevel social distancing policies. All data were surveyed by questionnaires online and offline, and participants were required to fill in the monthly average of daily step counts were recorded an application on participants’ smartphone devices from Pre-COVID-19 (2019 year) and during COVID-19 (2020 year). Participants were 834 adults (males: 54.4%, female: 45.6%) and all statistical analyses were summarized by SPSS 25.0 program. The monthly average of daily step counts was 6747.09 during Pre-COVID-19, but the PA during COVID-19 was 5812.11 daily step counts per month. Also, there were significant pairwise differences between average PA Pre-COVID-19 and each level of social distancing (p < 0.001). After COVID-19, the participants who slept less than 7 h decreased by 3.6%, while those who slept more than 9 h increased by that much. As a result of BW, 269 participants responded their BW changed during COVID-19, and 199 of them reported they gained BW during COVID-19 (74.0%). Although self-reported questionnaires may have led to an under-or over-estimation of ST and BW, the present study found that the environment in which the COVID-19 is prevalent had adverse relationships on PA, ST, and BW. Therefore, it is important to identify strategies to motivate individuals for remaining physically active and getting adequate sleep while maintaining social distancing due to the presence of the COVID-19 global pandemic.
Determinants of Alcohol Consumption among Medical Students: Results from POLLEK Cohort Study
Authors: Gajda Maksymilian , Sedlaczek Katarzyna , Szemik Szymon , Kowalska Małgorzata
Published: May 2021

Background: The use of alcohol is a serious public health concern all over the world, especially among young people, including students. Medical students are often exposed to higher levels of distress, which may lead to a higher prevalence of psychoactive substance use and psychiatric co-morbidities. Alcohol abuse can be one of the detrimental methods of coping with distress. The aim of this study was to assess the prevalence of alcohol use among medical students in Poland. Methods: We analyzed data from the POLLEK cohort study on alcohol consumption and possible influencing factors. Results: Among the 540 students included, 167 (30.9%) were hazardous drinkers (HAZ) according to the AUDIT test. The main identified risk factors of hazardous/harmful drinking were male gender and smoking cigarettes. Conclusions: Given the fairly widespread alcohol abuse among medical students, it is necessary to implement screening (and intervention in the next stage) programs in these groups.
Influenza Vaccination Campaign during the COVID-19 Pandemic: The Experience of a Research and Teaching Hospital in Milan
Authors: Perrone Pier Mario , Biganzoli Giacomo , Lecce Maurizio , Campagnoli Emanuela Maria , Castrofino Ambra , Cinnirella Andrea , Fornaro Federica , Gallana Claudia , Grosso Francesca Maria , Maffeo Manuel , Shishmintseva Viktoriia , Pariani Elena , Castaldi Silvana
Published: May 2021

Background: During the COVID-19 pandemic, more than ever, optimal influenza vaccination coverage among healthcare workers (HCWs) is crucial to avoid absenteeism and disruption of health services, as well as in-hospital influenza outbreaks. The aim of this study is to analyze the 2020 influenza vaccination campaign, comparing it with the previous year’s in a research and teaching hospital in Northern Italy. Methods: adopting an approach based on combined strategies, three interventions were deployed: a promotional and educational campaign, vaccination delivery through both ad hoc and on-site ambulatories, and a gaming strategy. Personal data and professional categories were collected and analyzed using univariate logistic regression. Vaccinated HCWs were asked to fill in a questionnaire to describe their reasons for vaccination adherence. Results: the vaccination coverage rate (VCR) was 43.1%, compared to 21.5% in 2019. The highest increase was registered among administrative staff (308.3%), while physicians represent the most vaccinated category (n = 600). Moreover, residents (prevalence ratio (PR): 1.12; 95% CI 1.04–1.20), as well as intensive care (PR: 1.44; 95% CI: 1.24–1.69) and newborn workers (PR: 1.41; 95% CI: 1.20–1.65) were, respectively, the categories most frequently vaccinated for the first time. Conclusion: the significant increase in vaccination coverage rate confirms the suitability of the combined strategy of delivering the flu vaccination campaign and represents a first step towards reaching WHO recommended vaccination rates.
Resilience in the Storm: Impacts of Changed Daily Lifestyles on Mental Health in Persons with Chronic Illnesses under the COVID-19 Pandemic
Authors: Lau Bobo H. P. , Cheung Mike K. T. , Chan Lucian T. H. , Chan Cecilia L. W. , Leung Pamela P. Y.
Published: May 2021

Studies have shown individuals with chronic illnesses tend to experience poorer mental health compared to their counterparts without a chronic illness under the COVID-19 pandemic. The pervasive disruption on daily lifestyles due to social distancing could be a contributing factor. In this study, we collaborated with local patient support groups to explore the psychological adjustment among a group of community-dwelling individuals with chronic illnesses under the COVID-19 pandemic in Hong Kong. We collected responses from 408 adults with one or more chronic illnesses using an online survey. Results show that about one in four participants experienced moderate to high levels of depression (26.0%), anxiety (26.2%) and stress (20.1%) symptoms measured by the Depression, Anxiety and Stress Scale and the World Health Organisation-Five Well-Being Index. While 62.3% (gatherings) to 91.9% (contact with others) of participants reported changes in their daily lifestyles, these changes—both an increase and a decrease—were related to poorer mental health. The relationship was mediated by psychological resilience, measured by the Connor–Davidson Resilience Scale, with an estimate of indirect effect of −0.28 (95% confidence interval −0.44 to −0.10). In light of our findings, we urge social and healthcare professionals to support chronic illness patients to continue their daily lifestyles such as exercises and social contacts as much as possible by educating the public on feasible and practical preventive measures and enhance the psychological resilience of community-dwelling patients with scalable and efficacious psychological interventions.
Urinary Incontinence in Physically Active Older Women of Northeast Brazil
Authors: Guedes Thais Sousa Rodrigues , Guedes Marcello Barbosa Otoni Gonçalves , de Oliveira Hévila Kilvia Miguel , Soares Rodrigo Lopes , da Cunha Vitor Leandro , Lopes Johnnatas Mikael , de Oliveira Nayara Priscila Dantas , Jerez-Roig Javier , de Souza Dyego Leandro Bezerra
Published: May 2021

Low- and moderate-impact physical activity (PA) is associated with the prevention of urinary incontinence (UI). The objective of the cross-sectional study presented herein is to analyze the factors associated with UI in physically older active women who participate in senior community groups. The variable UI was measured by the International Consultation Incontinence Questionnaire Short Form (ICIQ-SF). Socioeconomic variables were also collected, along with data on life habits and clinical history. The multivariate analysis employed Poisson’s Regression with robust variance for factors associated with UI. Of the 106 participants evaluated, 54.7% presented UI, of which stress incontinence was more frequent, with 40.6%. UI presented a statistically significant association with dizziness/loss of balance during Activities of Daily Living (ADL) (prevalence ratio-PR 1.48; 95% CI 1.06–2.07) and nocturia (PR 1.63; 95% CI 1.05–2.55). Despite PA being a protection factor, UI presented an elevated prevalence in the older population, and therefore, other biological, social, and cultural aspects could also contribute to the occurrence of UI in this age group. Moreover, physically active older women with UI presented nocturia and dizziness/loss of balance during ADL, regardless of education levels and the number of births. These findings can help improve multi-professional programs aimed at promoting, preventing, and managing UI in the public.
Which Risk Factors Matter More for Psychological Distress during the COVID-19 Pandemic? An Application Approach of Gradient Boosting Decision Trees
Authors: Chen Yiyi , Liu Ye
Published: May 2021

Background: A growing body of scientific literature indicates that risk factors for COVID-19 contribute to a high level of psychological distress. However, there is no consensus on which factors contribute more to predicting psychological health. Objectives: The present study quantifies the importance of related risk factors on the level of psychological distress and further explores the threshold effect of each rick factor on the level of psychological distress. Both subjective and objective measures of risk factors are considered in the model. Methods: We sampled 937 individual items of data obtained from an online questionnaire between 20 January and 13 February 2020 in China. Objective risk factors were measured in terms of direct distance from respondents’ housing to the nearest COVID-19 hospital, direct distance from respondents’ housing to the nearest park, and the air quality index (AQI). Perceived risk factors were measured in regard to perceived distance to the nearest COVID-19 hospital, perceived air quality, and perceived environmental quality. Psychological distress was measured with the Kessler psychological distress scale K6 score. The following health risk factors and sociodemographic factors were considered: self-rated health level, physical health status, physical activity, current smoker or drinker, age, gender, marital status, educational attainment level, residence location, and household income level. A gradient boosting decision tree (GBDT) was used to analyse the data. Results: Health risk factors were the greatest contributors to predicting the level of psychological distress, with a relative importance of 42.32% among all influential factors. Objective risk factors had a stronger predictive power than perceived risk factors (23.49% vs. 16.26%). Furthermore, it was found that there was a dramatic rise in the moderate level of psychological distress regarding the threshold of AQI between 40 and 50, and 110 and 130, respectively. Gender-sensitive analysis revealed that women and men responded differently to psychological distress based on different risk factors. Conclusion: We found evidence that perceived indoor air quality played a more important role in predicting psychological distress compared to ambient air pollution during the COVID-19 pandemic.
Exercise in an Overweight Patient with Covid-19: A Case Study
Authors: Hekmatikar Amir Hossein Ahmadi , Shamsi Mahdieh Molanouri , Ashkazari Zahra Sadat Zabhi , Suzuki Katsuhiko
Published: May 2021

Coronavirus (COVID-19) is a dangerous infectious disease that is easily transmitted and which is called an acute respiratory syndrome. With the spread of the coronavirus around the world and its epidemic among humans, we are losing many humans. The long process of treatment in hospitalized patients who are receiving intensive care and medication is associated with physical weakness. It has been suggested that lifelong exercise can create a safe margin for a person that allows them to avoid becoming infected with the virus. The current study was conducted to assess the effects of low-intensity exercise and breathing exercises on cardiorespiratory responses and physical status in an overweight 20-year-old woman infected with COVID-19. The patient was referred to Hazrat Ali Ibn Abitaleb Hospital in Rafsanjan. The patient had initial symptoms of coronavirus including weakness, shortness of breath, fever, and chills, and the initial tests confirmed that the person was infected with the coronavirus. Although COVID-19 reduces respiration and blood oxygen and severely reduces movement and physical activity, low-intensity rehabilitation and breathing exercises along with medication can improve blood oxygen status, resting heart rate, blood pressure, and hand power status in patients and possibly speeding up the healing process. The results of the present study show that low-intensity exercise and breathing exercises in patients with COVID-19, whose disease severity is mild to moderate, can be performed safely under the supervision of their physicians to prevent the disease process.
Assessment of the Dynamic Exposure to PM2.5 Based on Hourly Cell Phone Location and Land Use Regression Model in Beijing
Authors: Liu Junli , Cai Panli , Dong Jin , Wang Junshun , Li Runkui , Song Xianfeng
Published: May 2021

The spatiotemporal locations of large populations are difficult to clearly characterize using traditional exposure assessment, mainly due to their complicated daily intraurban activities. This study aimed to extract hourly locations for the total population of Beijing based on cell phone data and assess their dynamic exposure to ambient PM2.5. The locations of residents were located by the cellular base stations that were keeping in contact with their cell phones. The diurnal activity pattern of the total population was investigated through the dynamic spatial distribution of all of the cell phones. The outdoor PM2.5 concentration was predicted in detail using a land use regression (LUR) model. The hourly PM2.5 map was overlapped with the hourly distribution of people for dynamic PM2.5 exposure estimation. For the mobile-derived total population, the mean level of PM2.5 exposure was 89.5 μg/m3 during the period from 2013 to 2015, which was higher than that reported for the census population (87.9 μg/m3). The hourly activity pattern showed that more than 10% of the total population commuted into the center of Beijing (e.g., the 5th ring road) during the daytime. On average, the PM2.5 concentration at workplaces was generally higher than in residential areas. The dynamic PM2.5 exposure pattern also varied with seasons. This study exhibited the strengths of mobile location in deriving the daily spatiotemporal activity patterns of the population in a megacity. This technology would refine future exposure assessment, including either small group cohort studies or city-level large population assessments.
Effects of an Adaptive Education Program on the Learning, Mental Health and Work Intentions of New Graduate Nurses
Authors: Chen Shu-Fen , Fang Yu-Wen , Wang Mei-Hua , Wang Tze-Fang
Published: May 2021

Health care workers are at a higher risk of psychological distress than ordinary people. Stress affects physical and mental health, and can even produce an intention to leave. The current training for new graduate nurses (NGNs) during this transitional period mostly focuses on the cultivation of professional ability, with less attention to mental health or emotional feelings, and thus there are insufficient structured support strategies. As such, this study explores the effects of intervention through an appropriate education program on the learning, mental health and work intentions of new recruits during the transition period. A pre-test and post-test for a single group was designed for new nursing staff in a large teaching hospital in northern Taiwan. The test period was from May 2017 to December 2018, and a total of 293 cases were accepted. A three-month adaptive education program was provided and evaluated in terms of: care for learning, care for health, improving professional ability, and individualized guidance on satisfaction, mental health disturbance and work intention. The new graduate nurses who received gentle care and counseling showed a downward trend in their BSRS-5 scores and statistical differences over time (p < 0.001). The higher the BSRS-5 score, the easier it is for new graduate nurses in acute and intensive care units. There is a tendency for turnover leave (p = 0.03). After the intervention of the overall plan, the turnover rate of new graduate nurses within three months was 12.6%, and the one-year retention rate was 87.9%. The adaptive education program uses multiple support strategies to improve learning and professional abilities, to reduce psychological emotions, and thereby to increase retention. Today will face new medical challenges; the education programs will become more important across clinical care settings, and it will be important to rigorously validate their performance in helping NGNs.