bluuebunny/crossref_metadata_2025 huggingface dataset:
Psychological Factors and Sexual Risk Behaviors: A Multidimensional Model Based on the Chilean Population
Authors: Ferrer-Urbina Rodrigo , Mena-Chamorro Patricio , Halty Marcos , Sepúlveda-Páez Geraldy
Published: August 2022

Human immunodeficiency virus (HIV) is a global health problem, with sexual risk behaviors (SRB) being the main routes of spreading the virus. Evidence indicates that different psychological factors influence SRB (e.g., attitude towards condoms, sexual self-concept, sexual sensation seeking, knowledge of sexual risk behaviors, risk perception). This study proposes an explanatory model of sexual risk behaviors in young people and adults. The sample consisted of 992 young people and adults aged between 18 and 35 years. The model presented good levels of fit (X2 = 3311.433, df = 1471, CFI = 0.964, TLI = 0.959, RMSEA = 0.036), explaining 56% of the variance of sexual activity with multiple partners, 77% of the inadequate use of protective barriers, and 58.8% of sexual activity under the influence of alcohol or drugs from a set of psychological factors in self-report measures. The details of the results offer novel contextual evidence for the prioritization of prevention-oriented psychosocial interventions.
Muscle Weakness and Walking Slowness for the Identification of Sarcopenia in the Older Adults from Northern Brazil: A Cross-Sectional Study
Authors: Lima Alex Barreto de , Henrinques-Neto Duarte , Ribeiro Gustavo dos Santos , Gouveia Elvio Rúbio , Baptista Fátima
Published: August 2022

Background: This study aimed to analyze the prevalence of sarcopenia in elderly people from Northern Brazil according to muscle weakness or walking slowness. Methods: The sample consisted of 312 elderly people (72.6 ± 7.8 years). For walking slowness, a gait speed ≤ 0.8 m/s was used as a cut-off value, and for muscle weakness the following handgrip strength criteria were used for men and women, respectively: CI: <27.0/16.0 kg; CII: <35.5/20.0 kg; CIII: grip strength corrected for body mass index (BMI) < 1.05/0.79; CIV: grip strength corrected for total fat mass: <1.66/0.65; CV: grip strength corrected for body mass: <0.45/0.34. Results: Walking speed was reduced in 27.0% of women and 15.2% of men (p < 0.05). According to grip strength criteria, 28.5% of women and 30.4% of men (CI), 58.0% of women and 75.0% of men (CII), 66.0% of women and 39.3% of men (CIII), 28.8% of women and 19.6% of men (CIV), and 56.5% of women and 50.0% of men (CV) were identified as having sarcopenia. Conclusions: Walking slowness is more prevalent in women and muscle weakness is more prevalent in men in Northern Brazil. Walking slowness proved to be more concordant with muscle weakness in both sexes when the CI for handgrip strength was adopted.
Effects of Household Air Pollution (HAP) on Cardiovascular Diseases in Low- and Middle-Income Countries (LMICs): A Systematic Review and Meta-Analysis
Authors: Adekoya Akorede , Tyagi Sudhir K. , Duru Christiana N. , Satia Imran , Paudyal Vibhu , Kurmi Om P.
Published: August 2022

Background: Out of over 3 billion people exposed to household air pollution (HAP), approximately 4 million die prematurely, most from cardiorespiratory diseases. Although many recent studies have reported adverse effects of HAP on cardiovascular outcomes, the findings are inconsistent. Objectives: The primary aim of this systematic review is to critically appraise the published studies and report the pooled summary of the findings on the association between HAP and cardiovascular outcomes, particularly in LMICs. Methods: During this systematic review and meta-analysis, six databases were searched systematically, and the protocol was published in PROSPERO (CRD 42021248800). Only peer-reviewed English-language studies published from 1980 to March 2021 were included. We extracted data for the population ≥ 18 years old. Newcastle–Ottawa Criteria were used to assess the quality of evidence. The heterogeneity and publication bias of the studies was evaluated. A meta-analysis was conducted using a random-effect model to pool the findings from published studies. Results: In sixteen studies totaling 547,463 cases, 319,180 were exposed to HAP. The pooled estimate suggested an overall 13% higher risk of CVDs, and a 21% higher risk of CVD mortality in LMICs among those exposed to HAP. Similarly, the increased risk of stroke and cerebrovascular accidents, heart failure, and hypertension was statistically significant among those exposed to HAP but not with myocardial infarction, IHD, eclampsia/preeclampsia, and carotid intima-media thickness. Conclusions: Our findings suggest exposure to HAP increases the risk of cardiovascular outcomes.
Bullying in Adolescents: Differences between Gender and School Year and Relationship with Academic Performance
Authors: Obregon-Cuesta Ana Isabel , Mínguez-Mínguez Luis Alberto , León-del-Barco Benito , Mendo-Lázaro Santiago , Fernández-Solana Jessica , González-Bernal Jerónimo J. , González-Santos Josefa
Published: August 2022

School bullying is a phenomenon of unjustified aggression in the school environment that is widespread throughout the world and with serious consequences for both the bully and the bullied. The objectives of this research were to analyze the differences between the different bullying categories by gender and academic year in primary and secondary education students, as well as their relationship with academic performance. To categorize students according to their bullying experiences, the European Bullying Intervention Project (EBIPQ) Questionnaire was used. The Chi-square test was used to compare the scores obtained by the students in the EBIPQ based on gender and academic year, and the one-way ANOVA test was used to analyze its relationship with academic performance. Research participants were 562 students from the 5th (n = 228) and 6th (n = 186) primary school years and the 1st (n = 134) and 2nd (n = 94) secondary school years. They were males (50.5%) and females (49.5%) ranging in ages from 10 to 15 years old (mean = 11.66, standard deviation = 1.206). The results showed statistically significant differences in gender and academic year, indicating a greater number of boys in the role of the bully/victim and girls in that of non-bully/non-victim. The most aggressive students were in the 2nd year of ESO (12–13 years old). Regarding academic performance, statistically significant differences were obtained that confirm the hypothesis that performance or average grade varies according to the category of bullying in which students find themselves. The academic performance of the non-bully/non-victim and those in the victim category was found to be higher than that of bullies and bully/victim students.
Green Development Performance Evaluation Based on Dual Perspectives of Level and Efficiency: A Case Study of the Yangtze River Economic Belt, China
Authors: Zhang Rui , Ma Yong , Ren Jie
Published: August 2022

In the context of continuing to promote the construction of an ecological civilization, it is of great significance to explore green development performance. However, most of the literature is based on a single perspective of level or efficiency, lacking a comprehensive examination of both. It is not scientific to explore how to promote green development only from a single perspective, which may be a new advancement by breaking the conventional thinking focusing only on level or efficiency. On this basis, we first established evaluation index systems of green development performance based on a theoretical framework. Furthermore, green development performance was measured with the entropy weight technique for order preference by similarity to ideal solution (TOPSIS) and super-EBM models, and finally, we analyzed the spatial and temporal evolution patterns of green development performance using the ESDA method and examined its influencing factors with a geographic detector (GD) and econometric models. The main results were as follows: (1) The trend of the green development level in the Yangtze River Economic Belt from 2004 to 2017 had an inverted “N” shape, while the overall average green development efficiency continuously increased. (2) In terms of spatial and temporal patterns, both the green development level and green development efficiency showed “high in the east and low in the west” spatial divergence characteristics. In terms of the spatial and temporal evolution pattern of the green development level, the L-L clusters were mainly distributed in the western region. However, for green development efficiency, the L-L clusters were mostly distributed around the H-H clusters. (3) The results of the influencing factor analysis indicated that industrial structure and people’s welfare are still important factors of the green development level. The improvement of green development efficiency was mainly driven by economic development, and the inhibiting effect of energy consumption is significant. In addition, the effect of opening up has not yet changed from a “pollution paradise” to a “pollution halo”.
Research on Spatial Differences and Driving Effects of Ecological Well-Being Performance in China
Authors: Wang Shengyun , Duan Liancheng , Jiang Shuwen
Published: August 2022

The essential requirement of sustainable development is to maximize economic prosperity and well-being while remaining within natural boundaries. This study focused on three aspects. First, a unique ecological well-being performance (EWP) evaluation model was developed by combining subjective and objective well-being indicators to assess China’s EWP from 2006 to 2018. Second, the evolution of spatial differences in China’s EWP was examined using the Dagum Gini coefficient and four spatial polarization indicators, from the perspective of eight economic regions. Third, we used the Logarithmic Mean Divisia Index (LMDI) method to decompose the driving factors of China’s EWP into four effects: economic, technical, objective well-being, and subjective well-being. Effective ways to promote the coordinated and sustainable enhancement of EWP in China were determined. The results showed that the overall level of EWP in China decreased from 2006 to 2018. The growth rate of China’s residents’ happiness index was not only slightly slower than the growth rate of the human development index but also significantly slower than the ecological footprint index per capita. The spatial differences of EWP in China were found to be expanding. Inter-regional differences were found to be the primary source of spatial differences in China’s EWP. Meanwhile, the capacity for sustainable development among provinces was further stretched, and, thus, the spatial polarization of China’s EWP tended to deepen. The importance of economic growth in boosting EWP cannot be overstated. China must actively encourage scientific and technological innovation, transition to a green development model, and raise human well-being in tandem with economic development. This study contributes to a scientific foundation and is a valuable reference for long-term and coordinated regional development in China and other emerging countries.
A Document Analysis of Peak Carbon Emissions and Carbon Neutrality Policies Based on a PMC Index Model in China
Authors: Lu Chenrui , Wang Bing , Chen Tinggui , Yang Jianjun
Published: August 2022

With the commitment to peaking carbon emissions by 2030 and achieving carbon neutrality by 2060, the text analysis of policies related to peak carbon emissions and carbon neutrality has become a hot research topic in China. However, current domestic and foreign research mainly focuses on the impact and enlightenment of carbon emission measurement and other aspects and rarely optimizes the road to carbon neutrality through the analysis of policy texts. Based on both domestic and international research results, this paper takes 11 central government, ministry, province, and city policies as the research object, uses the PMC index model to calculate the PMC indices of the 11 representative documents, and draws surfaces. The results indicate that nearly half of the policies have excellent scores, but some policies still have deficiencies in terms of guarantee incentives and policy coverage. Given these shortcomings, this paper proposes that the government should provide technical assistance to industrial enterprises in addition to certain subsidies to reduce the energy consumption of enterprises in production and achieve sustainable development. While popularizing and developing low-carbon technology, enterprises should pay attention to personnel training and management, and use the digital economy to empower the transition to eco-friendly production. Based on the above research, the main contributions of this paper are as follows: to make theoretical and practical preparations for carbon neutralization and to provide suggestions for optimizing policies.
Risk Factors to Persistent Pain Following Musculoskeletal Injuries: A Systematic Literature Review
Authors: Alkassabi Othman , Voogt Lennard , Andrews Pamela , Alhowimel Ahmad , Nijs Jo , Alsobayel Hana
Published: August 2022

Background: Musculoskeletal (MSK) injury is one of the major causes of persistent pain. Objective: This systematic literature review explored the factors that lead to persistent pain following a MSK injury in the general population, including athletes. Methods: A primary literature search of five electronic databases was performed to identify cohort, prospective, and longitudinal trials. Studies of adults who diagnosed with a MSK injury, such as sprains, strains or trauma, were included. Results: Eighteen studies involving 5372 participants were included in this review. Participants’ ages ranged from 18–95 years. Most of the included studies were of prospective longitudinal design. Participants had a variety of MSK injuries (traumatic and non-traumatic) causing persistent pain. Multiple factors were identified as influencing the development of persistent pain following a MSK injury, including high pain intensity at baseline, post-traumatic stress syndrome, presence of medical comorbidities, and fear of movement. Scarcity of existing literature and the heterogeneity of the studies made meta-analysis not possible. Conclusions: This systematic review highlighted factors that might help predict persistent pain and disability following MSK injury in the general population, including athletes. Identification of these factors may help clinicians and other health care providers prevent the development of persistent pain following a MSK injury.
The Effectiveness of the Super Skills for Life (SSL) Programme in Promoting Mental Wellbeing among Institutionalised Adolescents in Malaysia: An Interventional Study
Authors: Yoga Ratnam Kishwen Kanna , Nik Farid Nik Daliana , Yakub Nur Asyikin , Dahlui Maznah
Published: August 2022

Background: Mental health issues have become more prevalent among institutionalised adolescents. Therefore an effective intervention programme is needed to improve their mental health. Objective: To evaluate the effectiveness of the Super Skills for Life (SSL) programme in improving the mental wellbeing of institutionalised adolescents and determine the factors associated with their mental wellbeing. Methods: A quasi-experimental study involving 80 female institutionalised adolescents divided into intervention and control groups was conducted. Intervention involved implementation of the SSL programme. The effectiveness of the programme was evaluated based on several outcome parameters. Results: Factors including age, number of family members, perceived social support and self-esteem had significant correlations with mental wellbeing of participants. The SSL programme significantly improved the anxiety and stress levels of participants. Conclusion: SSL programme exclusively improves the mental wellbeing in institutionalised adolescents.
Effect of a Six Week In-Season Training Program on Wrestling-Specific Competitive Performance
Authors: Francino Lucciano , Villarroel Bayron , Valdés-Badilla Pablo , Ramirez-Campillo Rodrigo , Báez-San Martín Eduardo , Ojeda-Aravena Alex , Aedo-Muñoz Esteban , Pardo-Tamayo Carolina , Herrera-Valenzuela Tomás
Published: August 2022

The effect of multi-component training on specific performance is under-researched in wrestlers. The aim of this study was to determine the effect of six weeks of multi-component training on The Special Wrestling Fitness Test (SWFT) performances of wrestlers who were preparing for an international championship, and to, additionally, determine their inter-individual adaptive variability. The wrestlers (n = 13; 7 females; all international level) underwent technical-tactical and physical fitness training for the six weeks before the championship, 12 sessions per week (i.e., 36 h per week). Before and after the intervention the athletes were assessed with the SWFT, a wrestling-specific competitive performance test that includes measurements for throws, heart rate response to the SWFT, and the SWFT index. Significant pre–post intervention improvements were noted for throws (pre = 23.5 ± 2.9; post = 24.9 ± 3.6; p = 0.022) and SWFTindex (pre = 14.9 ± 2.2; post = 14.1 ± 2.2; p = 0.013. In conclusion, six weeks of multi-component training improved wrestling-specific competitive performances in highly-trained wrestlers, although with a meaningful inter-subject variability.
Spatiotemporal Characteristics, Decoupling Effect and Driving Factors of Carbon Emission from Cultivated Land Utilization in Hubei Province
Authors: Xiao Pengnan , Zhang Yuan , Qian Peng , Lu Mengyao , Yu Zupeng , Xu Jie , Zhao Chong , Qian Huilin
Published: August 2022

The carbon emission level and spatiotemporal characteristics in Hubei Province were estimated and studied using the Intergovernmental Panel on Climate Change (IPCC) carbon emission coefficient technique based on county data from Hubei Province from 2000 to 2020. The relationship between carbon emissions from cultivated land utilization and agricultural economic growth was examined using the Tapio decoupling index, and the factors influencing carbon emissions in Hubei Province were further examined using the Logarithmic Mean Divisia Index (LMDI model). The results demonstrate that: (1) Spatiotemporal variations in carbon emissions are evident. In terms of time, the volume of carbon emissions in Hubei Province is still substantial, and the transition to low-carbon land use is quite gradual. Geographically, the high-value region of the middle east coexists with the low-value zone of the west, with apparent regional contrasts. (2) The decoupling between carbon emissions and agricultural economic growth is becoming more and more obvious in Hubei Province. The number of counties and cities in a negative decoupling state has significantly decreased, and the majority of counties are now in a strong decoupling condition. (3) Agricultural production efficiency is the most significant driving factor for restricting carbon emission, according to the decomposition results of carbon emission driving factors based on the LMDI model. In addition, the results of sample decomposition based on topographic characteristics indicate that agricultural production efficiency is primarily responsible for the suppression of carbon emissions in flat regions. The increase in carbon emissions in hilly regions is primarily influenced by agricultural productivity. The increase in carbon emissions in mountainous regions is mostly influenced by agricultural labor intensity. This study′s finding has enlightening implications for the high-quality growth of agriculture.
The Effects of Pedestrian Environment on Ambulation with a Walking Frame in Elderly Individuals: A Survey and Experimental Study
Authors: Yang Jiemeng , He Chen , Mo Zhongjun , Guo Junchao , Ji Run , Wang Yu , Tao Chunjing , Fan Yubo
Published: August 2022

Understanding the effects of sloped roads in the pedestrian environment on the body during ambulation with a walking frame can help design friendlier living environments for elderly individuals. A survey of the characteristics of walking frames used in different pedestrian environments was investigated in five communities, and a controlled study of the effects of a sloped road on a subject with different walking frames was carried out as foundational research in the laboratory. A synchronous acquisition system consisting of a wireless motion capture module and a physiological information recording module was applied to collect data on the motion of the shoulder joint and skin conductance response (SCR) of fingers in one participant. Force data were collected from sensors placed on the four legs of the walking frame. The experimental data obtained during different tasks were quantitatively analyzed. Compared to flat ground, the shoulder joint rotated in the opposite direction in horizontal and internal/external planes when using a wheeled walking frame on an uphill road, and the supportive force decreased on both uphill and downhill roads. The range of motion of the shoulder joint reduced and the direction of the shoulder joint motion changed when using a footed walking frame on both uphill and downhill roads. Additionally, the peak value of the supportive force on the uphill road appeared in the first 50% of the gait cycle, which was earlier than in the other cases. In addition, walking on the uphill road with a walking frame had a maximum SCR value, which means a greater impact of psychological arousal. Biomechanics of the shoulder joint and psychological arousal are closely related to the ease of walking on a sloped road with a walking frame. These findings are beneficial for designing more appropriate environments for elderly individuals who walk with aids.
Psychological Distress after the COVID-19 Pandemic among Anesthesiologists in Poland—An Observational Study
Authors: Podhorodecka Katarzyna , Radkowski Paweł , Boniecka Paulina , Wojtkiewicz Joanna
Published: August 2022

Introduction: The response to the COVID-19 pandemic by anesthesiologists has been simply heroic. Unfortunately, there are very few evidence-based studies in the literature that focus on anesthesiologists’ burnout during that time. The purpose of our study was to examine the psychological distress, after the COVID-19 pandemic, among anesthesiologists in Poland. Methods: We conducted an anonymous internet survey among a group of anesthesiologists in Poland. It contained a questionnaire, entitled “Oldenburg Burnout Inventory (OLBI)”, with demographic questions about sex, age, and family, as well as questions related to working conditions during the COVID-19 pandemic. We received data from 158 people, including 109 women and 49 men. Results: Results from the analysis showed that 73% (115/158) of the participants suffered from burnout. Moreover, 95.6% of the participants thought that the COVID-19 pandemic had had an influence on their level of burnout, and 97.3% found that it had had a negative impact. Conclusions: There is no doubt that healthcare workers, despite the difficulties associated with their daily work, have not faced challenges on such a scale in a very long time. Support for their mental health should be an essential component of the modern public healthcare system.
Spatial Distribution Characteristics of the Rural Tourism Villages in the Qinghai-Tibetan Plateau and Its Influencing Factors
Authors: Qi Jianwei , Lu Yayan , Han Fang , Ma Xuankai , Yang Zhaoping
Published: August 2022

The development of rural tourism (RT) has great significance in reducing poverty and achieving rural vitalization. Qinghai-Tibetan Plateau (QTP) is a depressed area with rich RT resources due to its unspoiled nature and diverse culture. For future sustainable development of RT in QTP, this paper analyzes the spatial distribution characteristics and its influencing factors of RT villages using various spatial analysis methods, such as nearest neighbor index, kernel density estimation, vector buffer analysis, and geographic detectors. The results show the following. First, the RT villages present an agglomeration distribution tendency dense in the southeast and spare in the northwest. The inter-county imbalance distribution feature is obvious and four relatively high-density zones have been formed. Second, the RT villages have significant positive spatial autocorrelation, and the area of cold spots is larger and of hot spots is smaller. Third, the RT villages are mainly distributed with favorable topographic and climate conditions, near the road and water, around the city, and close to tourism resources. Fourth, the spatial distribution is the result of multifactor interactions. Socio-economic and tourism resource are the dominant factor in the mechanism network. Fifth, based on the above conclusions this study provides scientific suggestions for the sustainable development of the RT industry.
Self-Testing as a Hope to Reduce HIV in Transgender Women—Literature Review
Authors: Budzyńska Julia , Patryn Rafał , Kozioł Ilona , Leśniewska Magdalena , Kopystecka Agnieszka , Skubel Tomasz
Published: August 2022

So far, the rate of HIV-positive people who do not know their sero-status is about 14% and the percentage is higher among transgender women (TGW). They represent one of the most vulnerable groups to infection. HIV self-testing (HIVST) may be a way to reduce transmission of the virus. The aim of this analysis and in-depth review was to collect available data on factors that may influence the use and dissemination of HIVST among TGW. This review was conducted in accordance with PRISMA guidelines for systematic reviews and meta-analyses. All data from 48 papers were used. From the available literature, HIVST is a convenient and preferred method of testing due to its high confidentiality and possibility of being performed at home. However, there are barriers that limit its use, including marginalization of transgender people, stigma by medical personnel, lack of acceptance of sexual partners, and even cultural standards. Therefore, there is a need for activities that promote and inform on the possibility of using HIVST as well as enable easier access to it.
Factors Affecting the Job Satisfaction of Caregivers in a Home-Based Elderly Care Program
Authors: Rong Xiao , Zhou Zhipeng , Su Yihui
Published: August 2022

Population aging has increased the demand for elderly care worldwide. The home-based elderly care system plays an important role in meeting this demand in developing countries. The quality of home-based elderly care is associated with the job satisfaction of caregivers in home-based elderly care programs, which has rarely been studied. This paper explores the factors that affect the job satisfaction of these elderly caregivers, including personal characteristics, working conditions, employment status, training, caregiver–client relationships, welfare, work experience, and burnout. It utilizes data from the Shanghai Domestic-work Professionalization Survey (SDPS), which was conducted among four types of in-home caregivers (n = 1000) in Shanghai over the period from May to September 2021. This paper selected a sample of elderly caregivers (n = 285) to examine their job satisfaction. The results show that gender, age, marital status, how they earned the job, relation with clients, social insurance, and work experience are significantly associated with the job satisfaction of in-home elderly caregivers, and their job satisfaction is negatively associated with their burnout levels. However, training and working conditions have no significant effect on the job satisfaction of in-home elderly caregivers, which is different from previous studies on formal care workers, such as nurses, in the institutional care system.
Transfer of Metals to the Aerosol Generated by an Electronic Cigarette: Influence of Number of Puffs and Power
Authors: Rastian Brian , Wilbur Chase , Curtis Daniel B.
Published: August 2022

Electronic cigarettes (e-cigarettes) are increasing in popularity despite uncertainties about their health hazards. Literature studies have shown that e-cigarettes may be a source of toxic heavy metal exposure to the user, but the mechanism by which metals are transferred from the e-cigarette parts into the aerosol plume that is inhaled by the user is poorly understood. The goal of this study was to quantify the potentially harmful heavy metals chromium, nickel, copper, and lead systematically during the simulated use of a mod-type e-cigarette in order to better understand the mechanism of metal transfer from the e-cigarette parts into the aerosol plume and into the liquid in the storage tank. Aerosol was collected and aliquots of the remaining liquid in the storage tank were collected from 0 to 40 puffs in 10 puff increments and analyzed with atomic absorption spectroscopy. It was found that the concentration of metals increased in both the aerosol and tank liquid the more times the e-cigarette was puffed, but at varying rates for each element and depending on the power applied to the heating coil. For copper, lead, and nickel, the concentrations of metals in the aerosol and tank increased with increasing power but for chromium, the concentration varied with power. Additionally, it was observed that chromium and nickel concentrations were greater in the aerosol than in tank liquid, consistent with the direct transfer of those metals to the aerosol from heating of the nichrome coil element used in this study. For copper and lead, the concentrations were similar or greater in the tank compared to the aerosol, consistent with transfer first into the storage tank liquid, followed by vaporization into the aerosol.
Examining the Utility of a Sleep Resource in Transdiagnostic Internet-Delivered Cognitive Behavior Therapy: An Observational Study
Authors: Peynenburg Vanessa , Ababei Andreea , Wilhelms Andrew , Edmonds Michael , Titov Nick , Dear Blake F. , Kaldo Viktor , Jernelöv Susanna , Hadjistavropoulos Heather D.
Published: August 2022

Patients seeking transdiagnostic internet-delivered cognitive behavior therapy (T-ICBT) for anxiety or depression often have sleep difficulties. A brief resource that includes sleep psychoeducation and strategies for improving sleep (e.g., stimulus control and sleep restriction) may address comorbid insomnia without the need for an insomnia-specific ICBT course. This observational study explored patient use and feedback of a brief sleep resource available to all patients (n = 763) enrolled in an 8-week T-ICBT course. Overall, 30.1% of patients (n = 230) reviewed the resource and were older, more engaged with the ICBT course (i.e., more likely to complete the program, more logins, and greater number of days enrolled in the course) and had higher pretreatment insomnia symptoms than those who did not review the resource. Resource reviewers did not report larger improvements in symptoms of insomnia than non-reviewers, even among patients with clinical levels of insomnia, and average insomnia levels remained above the clinical cutoff at posttreatment. While patients were satisfied with the resource and it was beneficial to some patients, more research is needed to further explore how it may be integrated into T-ICBT and how therapists can encourage the use of the resource among patients who may benefit from the resource.
Can Agricultural Productive Services Promote Agricultural Environmental Efficiency in China?
Authors: Zhu Yingyu , Deng Junmiao , Wang Menghan , Tan Yuanchang , Yao Wei , Zhang Yan
Published: August 2022

Agricultural productive services are important paths to realize the development of green agriculture, while the effect of agricultural productive services on the agricultural environment and its influencing mechanism are not yet clear. With the panel data of agricultural production in China from 2004 to 2019, by using multi-output stochastic frontier analysis with an output-oriented distance function, this study investigates agricultural environmental efficiency based on net carbon sinks. Then, this study explores the effect of agricultural productive services on agricultural environmental efficiency and its mechanisms by adopting ordinary least squares regression with fixed-effect panel model, causal steps approach, and spatial econometric method. The main findings are as follows: Firstly, agricultural productive services enhance agricultural productivity and agricultural environment by optimizing inputs and increasing outputs, and thus improve agricultural environmental efficiency. This result holds steadily after using instrumental variables to deal with endogeneity, changing the measurement of the dependent and independent variables, and subdividing the sample. Secondly, the pathways of agricultural productive services affecting agricultural environmental efficiency are mainly reflected in technology progress, planting structure adjustment, factor allocation optimization, and spatial spillover. Thirdly, due to the law of diminishing marginal returns, the impact of agricultural productive services on agricultural environmental efficiency is more significant when the level of agricultural productive services is relatively low. To improve agricultural environmental efficiency, we suggest implementing different productive service strategies in different regions, strengthening information integration, and improving infrastructure.
Volunteer Engagement in a Stroke Self-Management Program: Qualitative Analysis of a Hybrid Team of Healthcare Providers and Trained Volunteers
Authors: Lo Suzanne Hoi Shan , Chau Janita Pak Chun , Saran Ravneet
Published: August 2022

Stroke recovery is a complex, multidimensional and heterogeneous process. Volunteer engagement improves the delivery of interventions in stroke rehabilitation programs but is under-utilized due to poor role clarity and other program-related concerns. We evaluated healthcare providers’ and volunteers’ perceptions of volunteer engagement in an 8-week self-management program that provided self-management support for community-dwelling stroke survivors. Using a qualitative design, we conducted individual, semi-structured interviews with a purposive sample of 5 trained healthcare providers and 18 volunteers. The participants shared their experiences of supporting survivors, perceptions of volunteer engagement, and areas of improvement to optimize volunteer support. Three main themes and six subthemes emerged: bilateral exchange between healthcare providers/volunteers and survivors; adoption of individualized approaches; and suggestions for optimizing volunteer contributions. Volunteer engagement can be optimized by developing well-designed programs with sufficient role clarity, strengthened collaborations with healthcare providers and adequate training. Our findings highlighted the contributions of trained volunteers in supporting stroke survivors’ self-management. Future research should evaluate the use of peer and healthcare professional volunteers in such programs and build community capacity to support stroke survivors’ recovery.
Low Interleukin-12 Levels concerning Severe Malaria: A Systematic Review and Meta-Analysis
Authors: Wilairatana Polrat , Kwankaew Pattamaporn , Kotepui Kwuntida Uthaisar , Kotepui Manas
Published: August 2022

Although many studies have investigated the role of interleukin (IL)-12 cytokine in the pathogenesis of severe malaria, these studies were based on a limited number of participants, possibly affecting their outcomes. We analyzed the difference in IL-12 levels between patients with severe and uncomplicated malaria through a meta-analysis. A systematic review was conducted following the Cochrane Handbook for Systematic Reviews of Interventions and was reported according to the Preferred Reporting Items for Systematic reviews and Meta-Analyses statement. Systematic literature searches were performed between 20 February and 2 March, 2022 in PubMed, Scopus, and Embase to identify studies reporting IL-12 levels in patients with severe and uncomplicated malaria. The quality of included studies was determined using the Strengthening the Reporting of Observational Studies in Epidemiology guidelines. The pooled mean difference (MD) in IL-12 between patients with severe and uncomplicated malaria was estimated using the DerSimonian–Laird method for the random-effects model. Altogether, 1885 potentially relevant articles were identified, and 10 studies enrolling 654 patients with severe malaria and 626 patients with uncomplicated malaria were included in the meta-analysis. Patients with severe malaria had lower mean IL-12 levels than those with uncomplicated malaria (p = 0.01, MD: −33.62, 95% confidence interval [CI]: −58.79 to −8.45, I2: 99.29%, 10 studies). In conclusion, decreased IL-12 levels might significantly contribute to the development of severe malaria. As most published literature demonstrated the role of IL-12 in animal models, human studies are required to understand the mechanisms involved in low IL-12 levels in patients with severe malaria.
Women-Reported Barriers and Facilitators of Continued Engagement with Medications for Opioid Use Disorder
Authors: Fiddian-Green Alice , Gubrium Aline , Harrington Calla , Evans Elizabeth A.
Published: August 2022

Opioid-related fatalities increased exponentially during the COVID-19 pandemic and show little sign of abating. Despite decades of scientific evidence that sustained engagement with medications for opioid use disorders (MOUD) yields positive psychosocial outcomes, less than 30% of people with OUD engage in MOUD. Treatment rates are lowest for women. The aim of this project was to identify women-specific barriers and facilitators to treatment engagement, drawing from the lived experience of women in treatment. Data are provided from a parent study that used a community-partnered participatory research approach to adapt an evidence-based digital storytelling intervention for supporting continued MOUD treatment engagement. The parent study collected qualitative data between August and December 2018 from 20 women in Western Massachusetts who had received MOUD for at least 90 days. Using constructivist grounded theory, we identified major themes and selected illustrative quotations. Key barriers identified in this project include: (1) MOUD-specific discrimination encountered via social media, and in workplace and treatment/recovery settings; and (2) fear, perceptions, and experiences with MOUD, including mental health medication synergies, internalization of MOUD-related stigma, expectations of treatment duration, and opioid-specific mistrust of providers. Women identified two key facilitators to MOUD engagement: (1) feeling “safe” within treatment settings and (2) online communities as a source of positive reinforcement. We conclude with women-specific recommendations for research and interventions to improve MOUD engagement and provide human-centered care for this historically marginalized population.
Exploring the Relationship between COVID-19 Vaccine Refusal and Belief in Fake News and Conspiracy Theories: A Nationwide Cross-Sectional Study in Italy
Authors: Lo Moro Giuseppina , Scaioli Giacomo , Bert Fabrizio , Zacchero Andrea Lorenzo , Minutiello Ettore , Siliquini Roberta
Published: August 2022

The COVID-19 pandemic has been accompanied by an infodemic, which includes fake news (FNs) and conspiracy theories (CTs), and which may worsen vaccine refusal (VR), thus hindering the control of the transmission. This study primarily aimed to assess COVID-19 VR in Italy and its relationship with belief in FNs/CTs. Secondarily, it explored the conviction in FNs and CTs and associated variables. An online cross-sectional study was conducted in Italy (2021). The primary outcome was VR and secondary outcomes were FN misclassification score (0% to 100%: higher score means higher misclassification) and CT belief score (1 to 5: higher score means higher agreement). There were 1517 participants; 12.3% showed VR. The median FN and CT scores were: 46.7% (IQR = 40–56.7%) and 2.8 (IQR = 2.2–3.4). Age, education, FN, and CT scores had significant associations with VR. Education, economic situation, health and e-health literacy showed significant relationships with secondary outcomes. Study/work background had a significant association only with the FN score. FN and CT scores were associated. This work estimated a VR lower than before the first COVID-19 vaccine approval. The relationship between VR and FN/CT belief represents a new scenario, suggesting the need for planning effective strategies to tackle FNs and CTs to implement successful vaccination campaigns.
Media Coverage of Pedophilia and Its Impact on Help-Seeking Persons with Pedophilia in Germany—A Focus Group Study
Authors: Stelzmann Daniela , Jahnke Sara , Kuhle Laura F.
Published: August 2022

The public stigma associated with pedophilia, the sexual attraction to prepubescent children, is tremendous. Previous research indicates that undifferentiated media coverage plays an essential role in perpetuating the public stigma by falsely equating pedophilia and child sexual abuse (CSA) and thus may stop persons suffering from a pedophilic disorder from seeking professional help. Until now, a comprehensive examination of positive as well as negative media effects on affected individuals is missing. Therefore, the present study explores if and how media coverage impacts the lives of help-seeking persons with pedophilia by conducting four qualitative focus group discussions with a clinical sample (N = 20) from the German Prevention Network “Kein Täter werden”. Present results demonstrate that media coverage of pedophilia was perceived as mostly undifferentiated, even though participants observed an increase in fact-based reporting over the years. Moreover, it seems that media coverage has strong emotional and behavioral consequences for patients (e.g., negative reporting reduced self-esteem). In sum, our results highlight that differentiated media coverage could play a key role in supporting help-seeking persons with pedophilic disorder, while the impact of undifferentiated media coverage appears to be mostly negative. Therefore, our results point to the need to reframe pedophilia using differentiated media coverage to help affected persons receive treatment efficiently and thereby prevent CSA.
In Utero Exposure to Caffeine and Acetaminophen, the Gut Microbiome, and Neurodevelopmental Outcomes: A Prospective Birth Cohort Study
Authors: Laue Hannah E. , Shen Yike , Bloomquist Tessa R. , Wu Haotian , Brennan Kasey J. M. , Cassoulet Raphael , Wilkie Erin , Gillet Virginie , Desautels Anne-Sandrine , Abdelouahab Nadia , Bellenger Jean Philippe , Burris Heather H. , Coull Brent A. , Weisskopf Marc G. , Zhang Wei , Takser Larissa , Baccarelli Andrea A.
Published: August 2022

Pregnant individuals are exposed to acetaminophen and caffeine, but it is unknown how these exposures interact with the developing gut microbiome. We aimed to determine whether acetaminophen and/or caffeine relate to the childhood gut microbiome and whether features of the gut microbiome alter the relationship between acetaminophen/caffeine and neurodevelopment. Forty-nine and 85 participants provided meconium and stool samples at 6–7, respectively, for exposure and microbiome assessment. Fecal acetaminophen and caffeine concentrations were quantified, and fecal DNA underwent metagenomic sequencing. Caregivers and study staff assessed the participants’ motor and cognitive development using standardized scales. Prenatal exposures had stronger associations with the childhood microbiome than concurrent exposures. Prenatal acetaminophen exposure was associated with a trend of lower gut bacterial diversity in childhood [β = −0.17 Shannon Index, 95% CI: (−0.31, −0.04)] and was marginally associated with differences in the relative abundances of features of the gut microbiome at the phylum (Firmicutes, Actinobacteria) and gene pathway levels. Among the participants with a higher relative abundance of Proteobacteria, prenatal exposure to acetaminophen and caffeine was associated with lower scores on WISC-IV subscales. Acetaminophen during bacterial colonization of the naïve gut is associated with lasting alterations in childhood microbiome composition. Future studies may inform our understanding of downstream health effects.
Clinical Efficacy of 1% CHX Gluconate Gel and 0.12% CHX Solution: A Randomized Controlled Trial
Authors: Lee Su-Young , Nam Eun-Joo
Published: August 2022

Chlorhexidine (CHX) is an effective antibacterial agent and is used in dental treatment in several formulations. The aim of this study was to compare the effectiveness of CHX solution and CHX gel on dental plaque inhibition and gingivitis relief by a randomized clinical trial. Thirty-eight participants were randomly divided into two groups: control group (0.12% CHX solution) and test group (1% CHX gel). Participants were provided with CHX products and were instructed to use each product in the morning and evening for 1 week. Clinical results were evaluated by analyzing the collected data of Turesky et al. the modified Quigley-Hein Plaque Index (TQHPI), gingival index (GI) and the BANA test. Measurements were conducted 4 weeks and 8 weeks after using chlorhexidine products. The results were analyzed using repeated measured ANOVA and paired t-test. TQHPI and GI were significantly different after treatments in both groups (p < 0.001). The GI decreased more in the test group compared to the control group 4 weeks and 8 weeks later. In both groups, the BANA score also significantly decreased (p < 0.001) after 8 weeks, though the BANA score decreased relatively more in the CHX gel group than the CHX solution group. These results suggest that 1% CHX gel is more effective in reducing gingivitis and bacteria of periodontal disease than the 0.12% CHX solution. Therefore, the 1% CHX gel is expected to be actively used for non-surgical treatment of periodontal disease patients.
Employees’ Entrepreneurial Dreams and Turnover Intention to Start-Up: The Moderating Role of Job Embeddedness
Authors: Li Mingze , Li Jiaze , Chen Xiaofang
Published: August 2022

Many people have entrepreneurial dreams in mind, yet existing research has neglected to focus on this phenomenon. This paper introduces the concept of entrepreneurial dreams, constructs a model of the relationship between entrepreneurial dreams and turnover intention to start-up, based on identity theory and prospect theory, and empirically analyses the mechanism of the effect of entrepreneurial dreams on turnover intention to start-up. Through the analysis of data from two multi-provincial and multi-wave employee studies (Study 1 N = 198, Study 2 N = 227), the findings show that: (1) employees’ entrepreneurial dreams positively influence turnover intention to start-up; (2) employees’ entrepreneurial dreams can stimulate employees’ sense of entrepreneurial self-efficacy, thus positively influencing turnover intention to start-up; (3) job embeddedness plays a moderating role in the relationship between entrepreneurial self-efficacy and turnover intention to start-up, specifically, the higher the degree of job embeddedness, the weaker the effect of entrepreneurial self-efficacy on turnover intention to start-up; (4) job embeddedness moderates the indirect effect of entrepreneurial dreams on turnover intention to start-up through entrepreneurial self-efficacy, specifically, the higher the degree of job embeddedness, the weaker the indirect effect of entrepreneurial dreams on turnover intention to start-up through entrepreneurial self-efficacy. This study reveals the mediating role of employees’ entrepreneurial self-efficacy and the moderating role of job embeddedness in the influence of entrepreneurial dreams on employees’ turnover intention to start-up, which provides theoretical and practical references for relevant organizations.