bluuebunny/crossref_metadata_2025 huggingface dataset:
mHealth Apps Assessment among Postpartum Women with Obesity and Depression
Authors: Bt Wan Mohamed Radzi Che Wan Jasimah , Salarzadeh Jenatabadi Hashem , Samsudin Nadia
Published: March 2020

Background: Pregnancy has become the main constituent for women to become overweight or obese during the postpartum phase. This could lead women to suffer from postpartum depression as well. Information technology (IT) has become more prevalent in the healthcare industry. It offers patients the opportunity to manage their health conditions via the use of several applications, one being the mHealth applications. Objective: The main purpose of this study is to experiment and understand the effects the mHealth applications (i.e., fitness and nutrition applications) have on the body mass index (BMI) and depression levels amongst postpartum women. Methods: Online questionnaires were sent to postpartum women within one year after their pregnancy, of which 819 completed questionnaires were returned. The frequency of the mHealth applications usage was categorized into daily, weekly, rarely and never streams. Therefore, the frequency of use of the mHealth applications for BMI and depression levels was analyzed based on the available statistical data. Descriptive statistics, ANOVA, and Dunnet tests were applied to analyze the experimental data. Results: Out of 819 respondents, 37.9% and 42.1% of them were overweight and obese, respectively. Almost 32.9% of the respondents were likely depressed, and 45.6% were at an increased risk. This study reports that only 23.4% and 28.6% of respondents never used the fitness and nutrition applications. The impact of the frequency of using the fitness applications on BMI and depression levels was obvious. This means that with the increased use of the fitness applications, there was also a significant effect in maintaining and decreasing the BMI and depression levels amongst Malaysians postpartum women. However, from the data of weekly and daily use of fitness applications, we found that the contribution toward the BMI and depression levels was high (p = 0.000). However, nutrition applications amongst the users were not significant within the main variables (p > 0.05). From the Dunnet test, the significance of using the fitness applications within the depression levels started from daily usage, whereas for BMI, it started from weekly usage. Conclusion: The efficiency of the fitness applications toward the BMI and depression levels has been proven in this research work. While nutrition applications did not affect the BMI and depression levels, some of the respondents were still categorized as weekly and daily users. Thus, the improvements in BMI and depression levels are associated with the types of mHealth app that had been used.
Improving Emergency Department Efficiency by Patient Scheduling Using Deep Reinforcement Learning
Authors: Lee Seunghoon , Lee Young Hoon
Published: March 2020

Emergency departments (ED) in hospitals usually suffer from crowdedness and long waiting times for treatment. The complexity of the patient’s path flows and their controls come from the patient’s diverse acute level, personalized treatment process, and interconnected medical staff and resources. One of the factors, which has been controlled, is the dynamic situation change such as the patient’s composition and resources’ availability. The patient’s scheduling is thus complicated in consideration of various factors to achieve ED efficiency. To address this issue, a deep reinforcement learning (RL) is designed and applied in an ED patients’ scheduling process. Before applying the deep RL, the mathematical model and the Markov decision process (MDP) for the ED is presented and formulated. Then, the algorithm of the RL based on deep Q -networks (DQN) is designed to determine the optimal policy for scheduling patients. To evaluate the performance of the deep RL, it is compared with the dispatching rules presented in the study. The deep RL is shown to outperform the dispatching rules in terms of minimizing the weighted waiting time of the patients and the penalty of emergent patients in the suggested scenarios. This study demonstrates the successful implementation of the deep RL for ED applications, particularly in assisting decision-makers under the dynamic environment of an ED.
Adjusting Daily Inpatient Bed Allocation to Smooth Emergency Department Occupancy Variation
Authors: Tsai Jeffrey Che-Hung , Weng Shao-Jen , Liu Shih-Chia , Tsai Yao-Te , Gotcher Donald F. , Chen Chih-Hao , Chou Chun-An , Kim Seung-Hwan
Published: March 2020

Study Objective: Overcrowding in emergency departments (ED) is an increasingly common problem in Taiwanese hospitals, and strategies to improve efficiency are in demand. We propose a bed resource allocation strategy to overcome the overcrowding problem. Method: We investigated ED occupancy using discrete-event simulation and evaluated the effects of suppressing day-to-day variations in ED occupancy by adjusting the number of empty beds per day. Administrative data recorded at the ED of Taichung Veterans General Hospital (TCVGH) in Taiwan with 1500 beds and an annual ED volume of 66,000 visits were analyzed. Key indices of ED quality in the analysis were the length of stay and the time in waiting for outward transfers to in-patient beds. The model is able to analyze and compare several scenarios for finding a feasible allocation strategy. Results: We compared several scenarios, and the results showed that by reducing the allocated beds for the ED by 20% on weekdays, the variance of daily ED occupancy was reduced by 36.25% (i.e., the percentage of reduction in standard deviation). Conclusions: This new allocation strategy was able to both reduce the average ED occupancy and maintain the ED quality indices.
A Systematic Review of Healthcare-Associated Infectious Organisms in Medical Radiation Science Departments
Authors: Picton-Barnes D’arcy , Pillay Manikam , Lyall David
Published: March 2020

Healthcare-associated infections (HAIs) pose a significant occupational risk to medical radiation science (MRS) professionals, who have a high degree of patient contact. Current research largely focusses on HAIs in patients, with limited attention given to infectious organisms that MRS professionals are exposed to. This is a significant gap that this systematic review seeks to address by summarizing current literature to determine the infectious organisms within MRS departments, their reservoirs, and transmission modes. Reporting of this systematic review follows the preferred reporting items for systematic reviews and meta-analyses guidelines. Five databases were searched (Scopus, Medical Literature Analysis and Retrieval System Online (MEDLINE), the Cochrane Library, EMBASE, and Cumulative Index to Nursing and Allied Health Literature (CINAHL)) for relevant studies published between 1983 and 2018. Quality assessment was performed using checklists from the Johanna Briggs Institute. Nineteen studies were included in the review; twelve of which were set in diagnostic radiography departments, two in radiotherapy departments, and five in non-MRS departments. No studies were set in nuclear medicine departments, indicating a gap in the available literature. A total of 19 genera of infectious organisms were identified in the literature, with Staphylococcus, Escherichia, Bacillus, and Corynebacterium reported in all MRS departments. Infectious organisms were identified in all observational studies, indicating a need for better infection control methods and/or compliance training within MRS to minimize the risk of infections.
Tapping the Employee Perspective on the Improvement of Sustainable Employability (SE): Validation of the MAastricht Instrument for SE (MAISE-NL)
Authors: Houkes Inge , Miglioretti Massimo , Picco Eleonora , De Rijk Angelique Eveline
Published: March 2020

Background: Sustainable employability (SE) is top priority for employers. Measures based on the employee perspective of SE that would give direction to interventions to be initiated by employers currently fall short. This study aims to develop and validate an instrument that captures these issues: the MAastricht Instrument for Sustainable Employability (MAISE). Methods: MAISE items were generated from an extensive literature review and interviews with employers and employees. A questionnaire containing these items as well as proxy variables (health and vitality) and demographics was answered online by 632 employees (response rate 50.3%). Construct validity, reliability, and criterion validity were tested through Principal Component Analysis (PCA), Confirmatory Factor Analysis (CFA), Cronbach’s alpha, and correlational analyses. Results: The MAISE comprises 12 scales divided over five areas: (1) Meaning of SE; (2) Level of SE; (3) Factors affecting my SE; (4) Overall responsibility for SE; and (5) Responsibility for factors affecting my SE. Reliability, construct, and criterion validity were adequate to good. SE of the employees was relatively high, and SE was considered a shared responsibility of the employee and employer. Conclusions: This study showed the MAISE to be reliable and valid in various employee groups. More validation studies are needed. We recommend that employers use the MAISE as a needs assessment in order to develop SE interventions that will be readily accepted.
Doctor’s Preference in Providing Medical Service for Patients in the Medical Alliance: A Pilot Discrete Choice Experiment
Authors: Xu Richard Huan , Zhou Lingming , Li Yong , Wang Dong
Published: March 2020

This cross-sectional survey study explored whether doctors in Guangdong, China preferred to provide extra healthcare services within the context of their medical alliances (MAs). Specifically, a discrete choice experiment (DCE) was conducted to investigate whether doctors preferred to provide extra services at low-tier hospitals within their MAs. A literature review, focus group interview, and expert group discussion resulted in three main attributes (i.e., working time, income, and hospital location) and corresponding levels, which were combined to create 24 profiles that were randomly presented to participants. A conditional logit model was then employed to calculate utility scores for all profiles. A total of 311 doctors completed the DCE questionnaire. The coefficients for each level within the three attributes were ordered and found to be statistically significant. Working time had the greatest influence on utility scores, increasing by one hour per week (beta = 1.4, odds ratio (OR) = 4.07, p < 0.001), followed by income, which increased by 30% per month (beta = 1.19, OR = 3.3, p < 0.001). The utility scores for all profiles ranged between −0.27 and 3.07. Findings indicated that participants made trade-offs with respect to providing extra services within their MAs. Furthermore, utility varied between different subpopulations.
The Relationship between Health Disparities, Psychosocial Functioning and Health Outcomes in Pediatric Hematology-Oncology and Stem Cell Transplant Populations: Recommendations for Clinical Care
Authors: Isaac Evrosina I. , Meisman Andrea R. , Drucker Kirstin , Violante Stephanie , Behrhorst Kathryn L. , Floyd Alfonso , Rohan Jennifer M.
Published: March 2020

Not only do racial and ethnic minority children and adolescents with chronic illness experience disparities in health status and health outcomes, they also experience significant healthcare disparities, including differences in healthcare coverage, access to care, and quality of care. It is well known that the interaction between psychosocial functioning, health behaviors and ethnic and racial disparities, ultimately leads to worse health and psychosocial outcomes in pediatric and AYA chronic illness patient populations, including increased rates of morbidity and mortality. Investigating the impact of racial and ethnic factors on health outcomes, and strategies for reducing these disparities, is of the utmost importance, specifically in life-threatening conditions like cancer and sickle cell disease. This commentary underscores the relative importance of identifying factors that could reduce disparities between minority and non-minority populations. This present paper will focus on the dynamic relationships between health disparities, psychosocial factors and health outcomes within pediatric cancer, sickle cell disease and bone marrow transplant populations, and will offer recommendations for healthcare professionals working with these vulnerable patient populations. The primary goal of this commentary is to provide recommendations for enhancing cultural competency and humility for those working with highly vulnerable patient populations.
Use of Ultra Wide Band Real-Time Location System on Construction Jobsites: Feasibility Study and Deployment Alternatives
Authors: Umer Waleed , Siddiqui Mohsin K.
Published: March 2020

Ultra wide band (UWB)-based real-time location systems (RTLSs) have been widely adopted in the manufacturing industry for tracking tools, materials, and ensuring safety. Researchers in the construction domain have investigated similar uses for UWB-based RTLSs on construction jobsites. However, most of these investigations comprised small-scale experiments using average accuracy only to demonstrate use cases for the technology. Furthermore, they did not consider alternative deployment scenarios for practically feasible deployment of the technology. To overcome these limitations, a series of experiments were performed to study the feasibility of a commercially available RTLS on the construction jobsites. The focus of the work was on feasibility in terms of accuracy analysis of the system for a large experimental site, the level of effort requirements for deployment, and the impact of deployment alternatives on the accuracy of the system. The results found that average accuracy was found to be a misleading indicator of the perceived system performance (i.e., 95th percentile values were considerably higher than average values). Moreover, accuracy is significantly affected by the deployment alternatives. Collectively, the results arising from the study could help construction/safety managers in decision making related to the deployment of UWB-based RTLSs for their construction sites.
Customized ViNeRS Method for Video Neuro-Advertising of Green Housing
Authors: Kaklauskas Arturas , Zavadskas Edmundas Kazimieras , Schuller Bjoern , Lepkova Natalija , Dzemyda Gintautas , Sliogeriene Jurate , Kurasova Olga
Published: March 2020

The implementation of advertising for green housing usually involves consideration of individual differences among potential buyers, their desires for residential unit features as well as location impacts on a selected property. Much more rarely, there is consideration of the arousal and valence, affective behavior, emotional, and physiological states of possible buyers of green housing (AVABEPS) while they review the advertising. Yet, no integrated consideration of all these factors has been undertaken to date. The objective of this study was to consider, in an integrated manner, the AVABEPS, individual differences, and location impacts on property and desired residential unit features. During this research, the applications for the above data involved neuromarketing and multicriteria examination of video advertisements for diverse client segments by applying neuro decision tables. All of this can be performed by employing the method for planning and analyzing and by multiple criteria and customized video neuro-advertising green-housing variants (hereafter abbreviated as the ViNeRS Method), which the authors of this article have developed and present herein. The developed ViNeRS Method permits a compilation of as many as millions of alternative advertising variants. During the time of the ViNeRS project, we accumulated more than 350 million depersonalized AVABEPS data. The strong and average correlations determined in this research (over 35,000) and data examination by IBM SPSS tool support demonstrate the need to use AVABEPS in neuromarketing and neuro decision tables. The obtained dependencies constituted the basis for calculating and graphically submitting the ViNeRS circumplex model of affect, which the authors of this article developed. This model is similar to Russell’s well-known earlier circumplex model of affect. Real case studies with their related contextual conditions presented in this manuscript show a practical application of the ViNeRS Method.
Illness, Self-Rated Health and Access to Medical Care among Waste Pickers in Landfill Sites in Johannesburg, South Africa
Authors: Made Felix , Ntlebi Vusi , Kootbodien Tahira , Wilson Kerry , Tlotleng Nonhlanhla , Mathee Angela , Ndaba Mpume , Kgalamono Spo , Naicker Nisha
Published: March 2020

Waste pickers are exposed to various environmental health hazards, and self-rated health (SRH) could influence their medical care access. This study investigated the association between illness, clinic visits and SRH, and assessed if SRH can increase clinic visits. A cross-sectional study was conducted. SRH was defined as “very good”, “good”, “fair”, and “poor”. The illnesses were mental health, infectious, and chronic diseases. Medical care access included clinic visits in the previous 12 months. An ordinal logistic regression model was fitted to assess the association. There were 361 participants, 265 (73.41%) were males. Median age was 31 years, (interquartile range (IQR): 27–39). SRH: poor (29.89%), fair (15.92%), good (43.30%) very good (10.89%). Ever smoked (adjusted odds ratio (AOR): 1.72; 95% confidence interval (CI): 1.11–2.66), mental health (AOR: 1.87; 95% CI: 1.22–2.84), chronic (AOR: 2.34; 95% CI:1.47–3.68) and infectious (AOR: 2.07; 95% CI: 1.77–3.63) diseases were significantly associated with increased odds of reporting poor health. Clinic visit was not associated with SRH. From 99 (31%) individuals who rated their health as poor and ill, 40% visited a clinic (p = 0.0606). Acute and chronic illnesses were associated with poor SRH but this did not increase clinic visits. Provision of mobile clinic services at the landfill sites could increase access to medical care.
Systematic Review of Peer-Reviewed Literature on Global Condom Promotion Programs
Authors: Evans William D. , Ulasevich Alec , Hatheway Megan , Deperthes Bidia
Published: March 2020

Background: Globally, 1.7 million people were newly infected with HIV in 2018. Condoms are inexpensive, cost-effective, reduce HIV/STI incidence, morbidity, mortality, and unintended pregnancies, and result in health care cost savings. Given the rapid increase in at-risk adolescent and young adult (AYA) populations in countries with high HIV/STI prevalence as well as the reductions in donor support, promoting consistent condom use remains crucial. We synthesized all peer-reviewed literature on condom promotion programs with a focus on promotion in low and lower middle income (LMIC) countries and with AYA users. Methods: We systematically reviewed the published literature. Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) methods, we identified 99 articles published between 2000–2019. Results: Condom promotion programs were generally effective in changing attitudes, social norms, and beliefs in favor of condom use, and 85% demonstrated positive effects on multiple condom use measures. Programs targeting AYA were at least equally as effective as those targeting others and often showed greater use of best practices, such as mass media (66%) and audience segmentation (31%). We also saw differences between programs in the intervention strategies they used and found greater effects of marketing strategies on AYA compared to the overall sample. Conclusion: Condoms remain essential to prevention, and donor support must be maintained to combat the HIV/STI epidemic.
Environmental Noise Classification Using Convolutional Neural Networks with Input Transform for Hearing Aids
Authors: Park Gyuseok , Lee Sangmin
Published: March 2020

Hearing aids are essential for people with hearing loss, and noise estimation and classification are some of the most important technologies used in devices. This paper presents an environmental noise classification algorithm for hearing aids that uses convolutional neural networks (CNNs) and image signals transformed from sound signals. The algorithm was developed using the data of ten types of noise acquired from living environments where such noises occur. Spectrogram images transformed from sound data are used as the input of the CNNs after processing of the images by a sharpening mask and median filter. The classification results of the proposed algorithm were compared with those of other noise classification methods. A maximum correct classification accuracy of 99.25% was achieved by the proposed algorithm for a spectrogram time length of 1 s, with the correct classification accuracy decreasing with increasing spectrogram time length up to 8 s. For a spectrogram time length of 8 s and using the sharpening mask and median filter, the classification accuracy was 98.73%, which is comparable with the 98.79% achieved by the conventional method for a time length of 1 s. The proposed hearing aid noise classification algorithm thus offers less computational complexity without compromising on performance.
Health Literacy among Health and Social Care University Students
Authors: Juvinyà-Canal Dolors , Suñer-Soler Rosa , Boixadós Porquet Adela , Vernay Marion , Blanchard Hervé , Bertran-Noguer Carme
Published: March 2020

Health literacy has been defined by the World Health Organization as the cognitive and social skills which determine the motivation and ability of individuals to gain access to, understand and use information in ways which promote and maintain good health. Its importance in reducing inequalities makes health literacy a thematic area that should be addressed in the training of professionals in the fields of healthcare, Social Work and Education. The objective of this study was to define the health literacy levels of students from the Universities of Girona and Barcelona (Spain) and the Regional Institute of Social Work in Perpignan (France). A cross-sectional study was conducted among students of Nursing, Social Work, Primary Education and Special Education in the 2017–2018 academic year. Sociodemographic and academic variables were considered and the HLS-EU-Q16 questionnaire was used to study health literacy levels. In total, 219 students with an average age of 24.9 participated. Of these, 64.4% were studying Social Work, 23.7% Nursing, 5.9% Primary Education, and 5.9% Special Education. Of the total sample, 36.5% were classified as sufficient in health literacy. The total average score of the health literacy index was 11.1; 13.2 among Nursing students; 10.5 among Social Work students; 10.1 among Primary Education students, and 10.1 among Special Education students (p < 0.001). Nursing students obtained the best results and healthcare was the highest rated subdomain, more than disease prevention and health promotion.
Who Drives Green Innovation? A Game Theoretical Analysis of a Closed-Loop Supply Chain under Different Power Structures
Authors: Lee Dooho
Published: March 2020

As awareness of environmental protection increases worldwide, enterprises have been building their supply chains in ways that conserve natural resources and minimize the creation of pollutants. One of the practical ways to make supply chains more sustainable is for enterprises to utilize green innovation strategies and to increase resource reuse. In this work, we focus on a closed-loop supply chain (CLSC) consisting of a manufacturer, a retailer, and a collector. In the investigated CLSC, the manufacturer and the retailer drive the green innovation strategy either individually or simultaneously to boost market demand. In the reverse flow of the CLSC, the collector is responsible for collecting consumers’ used products and transferring them to the manufacturer for remanufacturing. By combining two types of the market leadership and three types of green innovation strategies, we establish six different Stackelberg game models and solve them analytically. Through an extensive comparative analysis, we show who should have market leadership and who should drive the green innovation strategy in the CLSC. Various numerical examples are also given to support our major findings. One of our key findings suggests that the supply chain members must participate in green innovation activities at the same time to achieve a win-win scenario in the CLSC.
Understanding Different Types of Recreational Runners and How They Use Running-Related Technology
Authors: Janssen Mark , Walravens Ruben , Thibaut Erik , Scheerder Jeroen , Brombacher Aarnout , Vos Steven
Published: March 2020

This study aims to help professionals in the field of running and running-related technology (i.e., sports watches and smartphone applications) to address the needs of runners. It investigates the various runner types—in terms of their attitudes, interests, and opinions (AIOs) with regard to running—and studies how they differ in the technology they use. Data used in this study were drawn from the standardized online Eindhoven Running Survey 2016 (ERS2016). In total, 3723 participants completed the questionnaire. Principal component analysis and cluster analysis were used to identify the different running types, and crosstabs obtained insights into the use of technology between different typologies. Based on the AIOs, four distinct runner types were identified: casual individual, social competitive, individual competitive, and devoted runners. Subsequently, we related the types to their use of sports watches and apps. Our results show a difference in the kinds of technology used by different runner types. Differentiation between types of runners can be useful for health professionals, policymakers involved in public health, engineers, and trainers or coaches to adapt their services to specific segments, in order to make use of the full potential of running-related systems to support runners to stay active and injury-free and contribute to a healthy lifestyle.
Improving Education and Training to Reduce the Burden of Occupational Cancer. The Riga-European Association of Schools of Occupational Medicine (EASOM) Statement on Work-Related Cancer
Authors: Martínez-Jarreta Begoña , Majery Nicole , Bulat Petar , Jungewelter Soile , Păuncu Elena-Ana , Weigel Dieter , Bubas Marija , Škerjanc Alenka , Vanadzins Ivars , Eglite Maija , Larrosa Marcos , Stocks Susan Jill , Godderis Lode
Published: March 2020

Reducing the burden of occupational cancers (OCs) is currently one of the most challenging Occupational Health (OH) issues. The European Union (EU) has made efforts to improve the existing legal framework and developed specific legislation aimed at reducing the burden of OC. However, available data suggest that OC are underreported. In August 2019, the European Association of Schools of Occupational Medicine (EASOM) adopted a statement that highlighted the importance of improving the education and training of Medical Doctors (MDs) to facilitate improvements in recognizing and reporting OC. To achieve this, EASOM proposes to promote OH education and training of MDs at undergraduate and postgraduate levels, foster harmonization of OH education and teaching standards and programs across EU countries, and enhance cooperation between universities and international scientific associations. Finally, we suggest that occupational data should be recorded in cancer and medical registers. By engaging MDs more fully in the debate about OCs, they will become more aware of the Occupational Physician’s role in reducing the burden of OCs and, furthermore, embed consideration of occupation as a potential cause of cancer into their own practice. These interventions will help promote the implementation of policies and interventions aimed to reduce OC in the workplace.
Peri-implant Soft Tissue Management: Cairo Opinion Consensus Conference
Authors: Del Amo Fernando Suárez López , Yu Shan-Huey , Sammartino Gilberto , Sculean Anton , Zucchelli Giovanni , Rasperini Giulio , Felice Pietro , Pagni Giorgio , Iorio-Siciliano Vincenzo , Grusovin Maria Gabriella , Salvi Giovanni E. , Rebaudi Alberto , Luongo Giuseppe , Krauser Jack T. , Stefanini Martina , Blasi Andrea , Mouhyi Jaafar , Ben Amor Faten , Hamasni Fatme M. , Valavanis Konstantinos , Simonpieri Alain , Osman Ahmed M. , Qorri Erda , Rullo Rosario , Naipoglu Arzu , Bruno Vincenzo , Marenzi Gaetano , Riccitiello Francesco , Gasparro Roberta , Mardas Nikos , Spagnuolo Gianrico , Fortunato Leonzio , Wang Hom-Lay
Published: March 2020

Peri-implant soft tissues play a role of paramount importance, not only on the esthetic appearance, but also on the maintenance and long-term stability of implants. The present report presents the conclusions from the Consensus Conference of the South European North African Middle Eastern Implantology & Modern Dentistry Association (SENAME) (4–6 November 2016, Cairo, Egypt). The conference focused on the topic of the soft tissue around dental implants, and in particular, on the influence of implant configurations on the marginal soft tissues, soft tissue alterations after immediate, early or delayed implant placement and immediate loading, the long-term outcomes of soft tissue stability around dental implants, and soft tissue augmentation around dental implants. Thirty world experts in this field were invited to take part in this two-day event; however, only 29 experts were in the final consensus voting process.
Effect of Dog Presence on Stress Levels in Students under Psychological Strain: A Pilot Study
Authors: Machová Kristýna , Procházková Radka , Vadroňová Mariana , Součková Michaela , Prouzová Eliška
Published: March 2020

As university students face many stressful situations, especially during the examination period, this study focused on the use of animal-assisted activities (AAAs) with a dog as a means of relieving students’ stress before a final exam. The aim was to determine whether a 10-min interaction with a dog affected subjectively evaluated stress and mood, objective blood pressure, and heart rate. Ninety-three female students (mean age = 22.5 years; standard deviation = 3.8 years) were divided into three groups according to their preference. The first group underwent AAAs (n = 26), the second group chose a relaxation technique (n = 28), and the last one was a control group (n = 39). Physiological values were measured using a pressure gauge and the subjective feelings of stress and mood were evaluated by the Likert scale 1–5. The AAA group showed significant improvement after 10 min of interaction in both mood and stress, with no change in heart rate and blood pressure. The remaining groups showed a significant decrease in blood pressure, but not in heart rate, with different evaluations of mood and stress. AAAs with a dog appear to be effective in improving students’ mood and stress without affecting their physiological parameters.
Alpha-1-Antitrypsin Deficiency and Bronchiectasis: A Concomitance or a Real Association?
Authors: Sanduzzi Alessandro , Ciasullo Emanuele , Capitelli Ludovica , Sanduzzi Zamparelli Stefano , Bocchino Marialuisa
Published: March 2020

Alpha-1-antitrypsin deficiency (AATd) is a hereditary disease, mainly characterized by early onset and the lower lobes’ predominant emphysema. Bronchiectasis is characterized by dilatation of the bronchial wall and a clinical syndrome whose features are a cough, sputum production and frequent respiratory exacerbations. In the literature, there are many papers concerning these two clinical entities, but there is still a lot of debate about a possible association between them, in particular about the frequency of their association and causal links. The aim of this short communication is to show the literature reports about the association between AATd and bronchiectasis to establish the state of the art and possible future developments in this research field.
How Servant Leadership Leads to Employees’ Customer-Oriented Behavior in the Service Industry? A Dual-Mechanism Model
Authors: Yuan Mengru , Cai Wenjing , Gao Xiaopei , Fu Jingtao
Published: March 2020

Although servant leadership has been acknowledged as an important predictor of employees’ behavioral outcomes in the service industry, there is still no cohesive understanding of the positive association between servant leadership and employees’ customer-oriented behavior (COB). This research, drawing on cognitive affective processing system theory (CAPS), empirically investigates the influence of servant leadership on employees’ COB by exploring two mediators (i.e., organizational identification and vitality). We conducted two studies in China, using a cross-sectional design to survey employees in service-oriented technical organizations (Study 1) and a time-lagged design to survey hospitality employees with frontline service jobs in star-level hotels (Study 2). Across both samples, we found that servant leadership enhanced employees’ COB by simultaneously increasing their organizational identification and vitality. We discuss the implications of these results for future research and practice.
The BioChemical Clogging of Landfill Leachate Collection System: Based on Laboratory Studies
Authors: Liu Yili , Liu Jianguo
Published: March 2020

Leachate collection system (LCS) clogging is a common operational problem in municipal solid waste (MSW) landfills in China, which can result in high leachate levels that threaten the safety of landfill operations and subsequently increase the leachate leakage risk. In our previous research, a filtration test was conducted and the physical clogging effect was evaluated. To fully analyze the LCS failure, in this study, a set of column experiments were carried out to investigate the biochemical clogging development and mechanisms. Results showed that the biofilm and deposited CaCO3 composed the primary clogging materials. During the experimental period, the hydraulic conductivities in simulated gravel and nonwoven geotextile drainage layers were observed (91.7% and five orders of magnitude reduction), and decreased to 10−4 and 10−8 m s−1, respectively. Therefore, the significance of the geotextile layer in LCS designing needs to be reconsidered. The biochemical clogging was positively correlated with volatile fatty acids (VFAs), and Ca2+ loading and the Ca2+ played the dominant role. Meanwhile, an improved method for analyzing biochemical clogging development was proposed.
Selection of Policy Instruments on Integrated Care in China: Based on Documents Content Analysis
Authors: Yue Xin , Mu Kaining , Liu Lihang
Published: March 2020

Facing the aggravating trend of an aging population and a fragmented medical service delivery system, the Chinese Central Government has introduced a series of policies to promote the development of integrated care against the background of the “Healthy China Strategy”. The achievement of integrated care depends on the choice of policy instruments. However, few studies have focused on how policy instruments promote the practice of integrated care in China. This article aims to obtain a deeper understanding of the use of policy instruments in the development of integrated care in China. Policy documents are the carriers of policy instruments. National-level integrated care policy documents from 2009 to 2019 were selected. Using the qualitative document analysis method, this paper conducts an analysis of integrated care policy instruments. In order to comprehensively view the integrated care policy instruments, a three-dimensional analytical framework consisting of the policy instruments dimension, stakeholders dimension, and health service supply chains dimension is proposed. The results are as follows. (1) From the perspective of policy instruments, the integrated care policy has adopted supply-side policy instruments, demand-side policy instruments, and environmental policy instruments. Among the three types of policy instruments, environmental policy instruments are used most frequently, supply-side policies are preferred, while demand-side policy instruments are relatively inadequate. (2) As for the stakeholders dimension, the central policy instruments focus on the health service providers, while less attention is paid to the health service demanders. (3) In terms of health service supply chains, the number of policy instruments used in the prevention stage is the highest, followed by the treatment stage, whereas less attention paid to the rehabilitation stage. Finally, suggestions were made for the development of integrated care by better perfecting policy instruments.
Type 2 Diabetes Mellitus Related Distress in Thailand
Authors: Tunsuchart Kongprai , Lerttrakarnnon Peerasak , Srithanaviboonchai Kriengkrai , Likhitsathian Surinporn , Skulphan Sombat
Published: March 2020

This study aimed to investigate prevalence and factors potentially associated with diabetes-related distress (DRD) among type 2 diabetes mellitus (T2DM) patients in a primary health care center in Thailand. This cross-sectional study was conducted with a total of 370 patients with T2DM. Data were collected at primary health care centers in Hang Dong District, Chiang Mai Province, Thailand. DRD was assessed using the Diabetes Distress Scale (DDS-17). The association between sociodemographic characteristics and other factors with DRD was analyzed using the Fisher t-test, Chi-square test, and Pearson’s correlation coefficient test. The association between Hemoglobin A1c (HbA1c) and DRD was analyzed using multiple linear regression analysis. The participants had a mean age of 60.95 ± 7.96, and most were female (68.1%). Of the participants with DRD, 8.9% had moderate to high levels of distress. Education level and family support were significantly associated with the overall level of DRD. Additionally, HbA1c and co-morbidity were also significantly associated with DRD, as were emotional burden and regimen distress. Multiple linear regression analysis found that increased HbA1c was positively associated with increased DRD after adjusting for age, sex, education, duration of T2DM, co-morbidity, diabetic complications, and family support. Screening with DRD may be beneficial in T2DM patients.
Biotic and Abiotic Factors Influencing Arsenic Biogeochemistry and Toxicity in Fluvial Ecosystems: A Review
Authors: Barral-Fraga Laura , Barral María Teresa , MacNeill Keeley L. , Martiñá-Prieto Diego , Morin Soizic , Rodríguez-Castro María Carolina , Tuulaikhuu Baigal-Amar , Guasch Helena
Published: March 2020

This review is focused on the biogeochemistry of arsenic in freshwaters and, especially, on the key role that benthic microalgae and prokaryotic communities from biofilms play together in through speciation, distribution, and cycling. These microorganisms incorporate the dominant iAs (inorganic arsenic) form and may transform it to other arsenic forms through metabolic or detoxifying processes. These transformations have a big impact on the environmental behavior of arsenic because different chemical forms exhibit differences in mobility and toxicity. Moreover, exposure to toxicants may alter the physiology and structure of biofilms, leading to changes in ecosystem function and trophic relations. In this review we also explain how microorganisms (i.e., biofilms) can influence the effects of arsenic exposure on other key constituents of aquatic ecosystems such as fish. At the end, we present two real cases of fluvial systems with different origins of arsenic exposure (natural vs. anthropogenic) that have improved our comprehension of arsenic biogeochemistry and toxicity in freshwaters, the Pampean streams (Argentina) and the Anllóns River (Galicia, Spain). We finish with a briefly discussion of what we consider as future research needs on this topic. This work especially contributes to the general understanding of biofilms influencing arsenic biogeochemistry and highlights the strong impact of nutrient availability on arsenic toxicity for freshwater (micro) organisms.
Prevention and Control of Multidrug-Resistant Bacteria in The Netherlands and Germany—The Impact of Healthcare Structures
Authors: Köck Robin , Becker Karsten , Idelevich Evgeny A. , Jurke Annette , Glasner Corinna , Hendrix Ron , Friedrich Alexander W.
Published: March 2020

The Netherlands and Germany are neighbouring countries within the European Union but are differently affected by multidrug-resistant microorganisms (MDRO). In this narrative review, we summarize data about antibiotic use, the occurrence of MDRO and healthcare-associated infections in these two countries, as well as data about organizational and structural differences between the Dutch and German healthcare systems. These results are discussed with a focus on whether or how the organization of healthcare influences MDRO prevention. We found that from the point of view of MDRO prevention, a higher density of inpatient care, a higher number of hospitals, a longer length of stay and lower staffing ratios might facilitate MDRO dissemination in German hospitals.
Prevalence and Factors Associated with Thinness in Rural Polish Children
Authors: Suder Agnieszka , Jagielski Paweł , Piórecka Beata , Płonka Małgorzata , Makiel Karol , Siwek Matylda , Wronka Iwona , Janusz Mariusz
Published: March 2020

A lot of attention has been focused on obesity, however, the other extreme—thinness—may lead to inhibition of physical and intellectual development. The aim was to assess the prevalence of thinness and determine the associated factors in children from rural populations. We used data from the cross-sectional sample of 3048 children, examined in schools from a district in southern Poland. The sample included 89% of the district departments, and included a proportion of rural and small town populations—a representative one for the region. Thinness was determined based on the criteria proposed by Cole and Lobstein. Biological, sociodemographic and lifestyle factors were analysed. The odds ratio (OR) and 95% confidence interval (CI) were calculated using logistic regression analysis. The prevalence of thinness was 11.5% in boys and 13.5% in girls. In the younger group, it was similar in boys and girls at 11.8%; whereas in the older group, it was 11.1% and 14.5%, respectively. The prevalence of thinness Grade 3 in girls was two times higher than in boys. The increased index of leisure time physical activity was connected with thinness in prepubertal boys. The mechanism determining the development of thinness is very complex and further exploration of this trend is recommended.
Parenting Styles, Internalization of Values and Self-Esteem: A Cross-Cultural Study in Spain, Portugal and Brazil
Authors: Martinez Isabel , Garcia Fernando , Veiga Feliciano , Garcia Oscar F. , Rodrigues Yara , Serra Emilia
Published: March 2020

The present study analyzes the impact of parenting styles on adolescents’ self-esteem and internalization of social values in three countries, Spain, Portugal and Brazil. The sample of the study was comprised of 2091 adolescents from Spain (n = 793), Portugal (n = 675), and Brazil (n = 623) from 12–18 years old (52.1% females). The four types of parenting styles, authoritative, indulgent, authoritarian and neglectful, were measured through the warmth and strictness dimensions of the Scale of Parental Socialization ESPA29. The two criteria variables were captured with the five dimensions of the AF5, Five-Factor Self-Concept Questionnaire, and with self-transcendence and conservation Schwartz values. Results confirm emergent research in parenting socialization: the use of parental warmth is evidenced as key for adolescent self-esteem and internalization of social values in the three countries analyzed. Indulgent and authoritative parenting (both characterized by parental warmth) are associated with the highest value internalization in the three countries. Furthermore, indulgent parenting (use of warmth) is associated with the highest adolescent self-esteem, overcoming authoritative parenting (use of warmth and strictness). The influence of parenting over adolescent self-esteem and values internalization is maintained independent of the differences in self-esteem and value priorities observed in the cultural context, the sex and age of the participants.
Distribution Pattern of Coseismic Landslides Triggered by the 2017 Jiuzhaigou Ms 7.0 Earthquake of China: Control of Seismic Landslide Susceptibility
Authors: Chen Xiao-li , Shan Xin-jian , Wang Ming-ming , Liu Chun-guo , Han Na-na
Published: March 2020

On 8 August 2017 an earthquake (MS7.0) occurred within Jiuzhaigou County, Northern Aba Prefecture, Sichuan Province, China, triggering 4834 landslides with an individual area greater than 7.8 m2 over a more than 400 km2 region. Instead of correlating geological and topographic factors with the coseismic landslide distribution pattern, this study has attempted to reveal the control from seismic landslide susceptibility mapping, which relies on the calculation of critical acceleration values using a simplified Newmark block model. We calculated the average critical acceleration for each cell of the gridded study area (1 km×1 km), which represented the seismic landslide susceptibility of the cell. An index of the potential landslide area generation rate was defined, i.e., the possible landsliding area in each grid cell. In combination with PGA (peak ground acceleration) distribution, we calculated such indexes for each cell to predict the possible landslide hazard under seismic ground shaking. Results show that seismic landslide susceptibility plays an important role in determining the coseismic landslide pattern. The places with high seismic landslide susceptibility tends to host many landslides. Additionally, the areas with high potential landslide area generation rates have high real landslide occurrence rates, consistent with dominant small-medium scale landslides by this earthquake. This approach can aid assessment of seismic landslide hazards at a preliminary stage. Additionally, it forms a foundation for further research, such as the rapid evaluation of post-earthquake landslides and identifying highly impacted areas to help decision makers prioritize disaster relief efforts.
Contribution of Connectivity Assessments to Green Infrastructure (GI)
Authors: Bolliger Janine , Silbernagel Janet
Published: March 2020

A major goal of green infrastructure (GI) is to provide functional networks of habitats and ecosystems to maintain biodiversity long-term, while at the same time optimizing landscape and ecosystem functions and services to meet human needs. Traditionally, connectivity studies are informed by movement ecology with species-specific attributes of the type and timing of movement (e.g., dispersal, foraging, mating) and movement distances, while spatial environmental data help delineate movement pathways across landscapes. To date, a range of methods and approaches are available that (a) are relevant across any organism and movement type independent of time and space scales, (b) are ready-to-use as standalone freeware or custom GIS implementation, and (c) produce appealing visual outputs that facilitate communication with land managers. However, to enhance the robustness of connectivity assessments and ensure that current trends in connectivity modeling contribute to GI with their full potential, common denominators on which to ground planning and design strategies are required. Likewise, comparable, repeatable connectivity assessments will be needed to put results of these scientific tools into practice for multi-functional GI plans and implementation. In this paper, we discuss use and limitations of state-of-the-art connectivity methods in contributing to GI implementation.