bluuebunny/crossref_metadata_2025 huggingface dataset:
Urban Climate Policy and Action through a Health Lens—An Untapped Opportunity
Authors: de Nazelle Audrey , Roscoe Charlotte J. , Roca-Barcelό Aina , Sebag Giselle , Weinmayr Gudrun , Dora Carlos , Ebi Kristie L. , Nieuwenhuijsen Mark J. , Negev Maya
Published: November 2021

Motivated by a growing recognition of the climate emergency, reflected in the 26th Conference of the Parties (COP26), we outline untapped opportunities to improve health through ambitious climate actions in cities. Health is a primary reason for climate action yet is rarely integrated in urban climate plans as a policy goal. This is a missed opportunity to create sustainable alliances across sectors and groups, to engage a broad set of stakeholders, and to develop structural health promotion. In this statement, we first briefly review the literature on health co-benefits of urban climate change strategies and make the case for health-promoting climate action; we then describe barriers to integrating health in climate action. We found that the evidence-base is often insufficiently policy-relevant to be impactful. Research rarely integrates the complexity of real-world systems, including multiple and dynamic impacts of strategies, and consideration of how decision-making processes contend with competing interests and short-term electoral cycles. Due to siloed-thinking and restrictive funding opportunities, research often falls short of the type of evidence that would be most useful for decision-making, and research outputs can be cryptic to decision makers. As a way forward, we urge researchers and stakeholders to engage in co-production and systems thinking approaches. Partnering across sectors and disciplines is urgently needed so pathways to climate change mitigation and adaptation fully embrace their health-promoting potential and engage society towards the huge transformations needed. This commentary is endorsed by the International Society for Environmental Epidemiology (ISEE) and the International Society for Urban Health (ISUH) and accompanies a sister statement oriented towards stakeholders (published on the societies’ websites).
The Patient, the Physician, or the Relationship: Who or What Is “Difficult”, Exactly? an Approach for Managing Conflicts between Patients and Physicians
Authors: Tanoubi Issam , Cruz-Panesso Llian , Drolet Pierre
Published: November 2021

It is the patient who consults, often at the last minute, the one you sigh over when you see his or her name on your list, the one who makes you feel powerless, and whom you would like to refer to a colleague. Every practicing physician has experienced being involved in a dialog of the deaf, with a patient refusing physicians’ recommendations, in a therapeutic dead end. Faced with such patients, the physician tries to convey scientific evidence to untangle the situation. When it does not work, he looks for other arguments, raises his voice, and avoids looking the patient in the eyes. When he is out of resources, trying to sound professional, he uses a sentence such as “I understand and respect your beliefs, but I am telling you what I learned in medical school!”. At the same time, his non-verbal behavior betrays more than a hint of irritation. Far from being caricatures, such situations generally result in the physician diagnosing or labeling the patient as “difficult.” This label is affixed on more than one patient in ten, and for all sorts of reasons. How, then, do you re-establish a relationship of trust? Or, even better, how do you avoid such labeling?
Do People Trust in Robot-Assisted Surgery? Evidence from Europe
Authors: Torrent-Sellens Joan , Jiménez-Zarco Ana Isabel , Saigí-Rubió Francesc
Published: November 2021

(1) Background: The goal of the paper was to establish the factors that influence how people feel about having a medical operation performed on them by a robot. (2) Methods: Data were obtained from a 2017 Flash Eurobarometer (number 460) of the European Commission with 27,901 citizens aged 15 years and over in the 28 countries of the European Union. Logistic regression (odds ratios, OR) to model the predictors of trust in robot-assisted surgery was calculated through motivational factors, using experience and sociodemographic independent variables. (3) Results: The results obtained indicate that, as the experience of using robots increases, the predictive coefficients related to information, attitude, and perception of robots become more negative. Furthermore, sociodemographic variables played an important predictive role. The effect of experience on trust in robots for surgical interventions was greater among men, people between 40 and 54 years old, and those with higher educational levels. (4) Conclusions: The results show that trust in robots goes beyond rational decision-making, since the final decision about whether it should be a robot that performs a complex procedure like a surgical intervention depends almost exclusively on the patient’s wishes.
Developing Computational Thinking Teaching Strategies to Model Pandemics and Containment Measures
Authors: Araya Roberto , Isoda Masami , van der Molen Moris Johan
Published: November 2021

COVID-19 has been extremely difficult to control. The lack of understanding of key aspects of pandemics has affected virus transmission. On the other hand, there is a demand to incorporate computational thinking (CT) in the curricula with applications in STEM. However, there are still no exemplars in the curriculum that apply CT to real-world problems such as controlling a pandemic or other similar global crises. In this paper, we fill this gap by proposing exemplars of CT for modeling the pandemic. We designed exemplars following the three pillars of the framework for CT from the Inclusive Mathematics for Sustainability in a Digital Economy (InMside) project by Asia-Pacific Economic Cooperation (APEC): algorithmic thinking, computational modeling, and machine learning. For each pillar, we designed a progressive sequence of activities that covers from elementary to high school. In an experimental study with elementary and middle school students from 2 schools of high vulnerability, we found that the computational modeling exemplar can be implemented by teachers and correctly understood by students. We conclude that it is feasible to introduce the exemplars at all grade levels and that this is a powerful example of Science Technology, Engineering, and Mathematics (STEM) integration that helps reflect and tackle real-world and challenging public health problems of great impact for students and their families.
Obturator Prosthesis Rehabilitation after Maxillectomy: Functional and Aesthetical Analysis in 25 Patients
Authors: Corsalini Massimo , Barile Giuseppe , Catapano Santo , Ciocia Annamaria , Casorelli Assunta , Siciliani Rosaria , Di Venere Daniela , Capodiferro Saverio
Published: November 2021

The number of patients undergoing a surgical resection of the maxilla for oncological reasons is constantly increasing, the most common complication of which remains the communication between oral and nasal cavities. On the basis of data arising from the literature regarding the treatment options of maxillary oncological post-surgical defects, obturator prosthesis remains the most used worldwide. We studied 25 patients (with at least 1-year follow up) rehabilitated by obturator prosthesis after maxillary resection leading to oro-nasal communication, providing data on the objective/subjective evaluation of such rehabilitation and mastication performance measured by a two-color chewing gum test. The type of defect was classified according to the classification system proposed by Aramany. Among the patients in our study, 72% rated a higher score for either stability and retention than for aesthetic appearance, as confirmed by the Kapur score rated by clinicians. The two-color chewing gum test shows similar results as only one patient had insufficient chewing function. Interestingly, we found no correlation between the masticatory function and residual denture, confirming that the maxillary obturator remains a predictable solution in such patients regardless of the anatomical alterations following surgery.
Psychological and Physical Distress in Italian People during COVID-19 Pandemic: One Year Later
Authors: Impellizzeri Alessandra , Dilucca Maddalena , Squillace Francesca , Guarnieri Rosanna , Polimeni Antonella , Galluccio Gabriella
Published: November 2021

The aim of this study was to evaluate the major life changes that Italian people experienced after one year of the COVID-19 pandemic. We assessed the psychological and physical impact of COVID-19 within one year of the pandemic situation, and its possible correlation with the positive COVID-19 trend in the Italian region. We invited Italian people to complete a cross-sectional, online survey within a three-week period from 14 March to 4 April 2021. The survey collected data on the participants’ stress and physical levels, attitude, perceived control, norms, personal and professional backgrounds, and place of stay in the last year. We used Student’s t-test and the software package GRETL for Windows to assess the association between the study outcome variables and the explanatory variables (stress, attitude, perceived control, and norms). All participants who declared a level of physical stress in their answer suffered from psychological stress, but not vice versa. The result to be highlighted is that this level of stress was found more in women and in the age range of 21–45 years.
Short Communication: Opportunities and Challenges for Early Person-Centered Care for Older Patients in Emergency Settings
Authors: Jensen Andrea N. , Andersen Ove , Gamst-Jensen Hejdi , Kristiansen Maria
Published: November 2021

The provision of person-centered care (PCC) for older adults in emergency settings is important. This short communication explores the complexity of providing comprehensive PCC for older adults in emergency settings, based on a synthesis of existing literature and empirical data from a small-scale case study on the potential of improving patient engagement in a Danish emergency department (ED). Our findings highlight overall positive attitudes towards PCC, as patient engagement is perceived as important and feasible during the waiting hours that older patients experience. However, the key challenges include barriers in organizational structures and cross-sectoral care coordination. We conclude that staff education, optimized care coordination across sectors, and increased involvement of geriatric nurses may enhance the provision of PCC for older, complex adults in EDs. We further conclude that future research into the feasibility and effects of structured approaches for providing PCC in EDs is needed, including exploration of organizational models for PCC.
Acute Effects of Air Pollution on Ischemic Heart Disease Hospitalizations: A Population-Based Time-Series Study in Wuhan, China, 2017–2018
Authors: Xu Wanglin , Liu Xingyuan , Huang Zenghui , Du Yating , Zhang Biao , Wang Qiaomai , Xiang Jing , Zou Yuliang , Ma Lu
Published: November 2021

Evidence of the acute effects of air pollutants on ischemic heart disease (IHD) hospitalizations based on the entire population of a megacity in central China is lacking. All IHD hospitalization records from 2017 to 2018 were obtained from the Wuhan Information Center of Health and Family Planning. Daily air pollutant concentrations and meteorological data were synchronously collected from the Wuhan Environmental Protection Bureau. A time-series study using generalized additive models was conducted to systematically examine the associations between air pollutants and IHD hospitalizations. Stratified analyses by gender, age, season, hypertension, diabetes, and hyperlipidemia were performed. In total, 139,616 IHD hospitalizations were included. Short-term exposure to air pollutants was positively associated with IHD hospitalizations. The age group ≥76 was at higher exposure risk, and the associations appeared to be more evident in cold seasons. PM2.5 and PM10 appeared to have greater effects on males and those without hypertension or diabetes, whereas NO2 and SO2 had greater effects on females and those with hypertension or diabetes. The risk of IHD hospitalization due to air pollutants was greater in people without hyperlipidemia. Our study provides new evidence of the effects of air pollution on the increased incidence of IHD in central China.
Electronic Health Literacy in Individuals with Chronic Pain and Its Association with Psychological Function
Authors: Castarlenas Elena , Sánchez-Rodríguez Elisabet , Roy Rubén , Tomé-Pires Catarina , Solé Ester , Jensen Mark P. , Miró Jordi
Published: November 2021

Electronic health literacy skills and competences are important for empowering people to have an active role in making appropriate health care decisions. The aims of this cross-sectional study were to (1) examine the frequency of use of the Internet for seeking online information about chronic pain, (2) determine the level of eHealth literacy skills in the study sample, (3) identify the factors most closely associated with higher levels of eHealth literacy, and (4) examine self-efficacy as a potential mediator of the association between eHealth literacy and measures of pain and function in a sample of adults with chronic pain. One-hundred and sixty-one adults with chronic pain completed measures assessing internet use, eHealth literacy, pain interference, anxiety, depression, and pain-related self-efficacy. Results indicated that 70% of the participants are active users of the Internet for seeking information related to their health. The level of eHealth literacy skills was not statistically significantly associated with participants’ age or pain interference but was significantly negatively associated with both anxiety and depression. In addition, the findings showed that self-efficacy fully explained the relationship between eHealth literacy and depression and partially explained the relationship between eHealth literacy and anxiety. Self-efficacy should be considered as a treatment target in eHealth literacy interventions, due to its role in explaining the potential benefits of eHealth literacy.
Development and Validation of the Depression Inventory for Type 1 Diabetes (DID-1)
Authors: Carreira Mónica , Ruiz de Adana María Soledad , Domínguez Marta , Valdés Sergio , Almaraz Maria Cruz , Olveira Gabriel , Anarte María Teresa
Published: November 2021

People with type 1 diabetes (T1D) are more likely to have depression than the general population and their prognosis is worse. Unfortunately, the characteristics of persons with T1D lead to inadequate screening for depression in this population. To aid in the detection of depression in this population, this study was undertaken to develop a depressive symptoms assessment instrument specific to patients with T1D and to examine its psychometric properties. A total of 207 people with T1D participated in this study. The reliability of the new scale was assessed using Cronbach’s alpha and the Spearman-Brown split-half coefficient. The Depression Inventory for type 1 Diabetes (DID-1), composed of 45 items on a Likert scale (1–7), shows high internal and temporal consistency, as well as adequate concurrent, convergent and discriminant validity. Factor analysis identified 7 factors (Symptoms of depression, Diminished interest, Hopelessness and dissatisfaction, Guilt, Fear, frustration and irritability, Defenselessness, and Interference in daily life) that explained 61.612% of the total variability. The cut-off score for diagnosis was set at 155 points. It was concluded that the DID-1 scale is a reliable, valid and useful tool for the assessment of depressive symptoms, eliminating the bias of other nonspecific diabetes scales.
The Mechanism and Mediating Effect of the “Perception–Emotion–Behaviour” Chain of Tourists at World Natural Heritage Sites—A Case Study from Bayanbulak, China
Authors: Ren Qingliu , He Baoshi , Chen Xiaodong , Han Jiali , Han Fang
Published: November 2021

The pro-environmental behaviour intentions (PEBIs) of tourists is a popular topic in tourism geography research. Visitors are important stakeholders in the development and conservation of World Natural Heritage sites (WNHs). Based on the perspective of the Mehrabian–Russell (M-R) theory, to advance our understanding of the transmission mechanism and mediation effect of the “perception–emotion–behaviour” chain of visitors at World Natural Heritage sites, we introduced two variables, namely heritage genes perception (HGP) and environmental knowledge perception (EKP), combined with place attachment (PA) and pro-environmental behaviour intentions (PEBIs), and scientifically constructed the conceptual model of the “EHPP model”, consisting of EKP, HGP, PA and PEBIs. Taking the Bayanbulak Heritage Site as an example, the EHPP model was fitted and tested using the structural equation model (SEM). The results show that: (1) the EHPP model is applied to fit the “cognitive–emotional–behaviour intentions” chain of visitors in WNHs and passed the empirical test; (2) there were positive and significant effects of EKP on HGP, and EKP indirectly affects PEBIs via HGP and PA; (3) place dependence (PD) had a significant and positive influence on place identity (PI); and (4) compliance with pro-environmental behaviour intentions (CPEBIs) had a direct positive influence on pro-environmental behaviour intentions (PPEBIs). The findings of this study provide empirical references for stimulating the pro-environmental behaviour intentions of tourists at World Natural Heritage sites.
Association between Handwashing Behavior and Infectious Diseases among Low-Income Community Children in Urban New Delhi, India: A Cross-Sectional Study
Authors: Khan Khalid M. , Chakraborty Rishika , Brown Stephen , Sultana Rasheda , Colon Alec , Toor Devinder , Upreti Pooja , Sen Banalata
Published: November 2021

Diarrheal diseases and respiratory infections (RI) are two leading causes of childhood mortality in low and middle-income countries. Effective handwashing at critical time-points may mitigate these diseases. However, there is a lack of published data investigating this association in school-aged children in India. This study is part of a larger prospective handwashing intervention study in a low-income community in New Delhi, India examining the associations between handwashing behavior and diarrhea and RI in schoolchildren. This current study reports the findings of the baseline survey administered to 272 mother–child dyads. Children aged 8–12 years, and their mothers, were recruited from six schools. A baseline questionnaire was used to collect sociodemographic data, handwash behavior, and mother-reported recent diarrhea and RI incidence among the children. Handwashing before and after preparing food, after defecation, and after cleaning dishes significantly reduced the odds of diarrhea by over 70%, and of RI by over 56%. Using a clean cloth after handwashing lowered odds of diarrhea and RI by 72% and 63% respectively. Around 60% of the participants believed that handwashing could prevent diarrhea and RI in their children. There was a low prevalence of handwashing at critical time-points and a poor perception regarding handwashing benefits. To improve handwashing behavior, hygiene promotion programs need to understand what motivates and hinders handwashing in vulnerable populations.
Trans Adults Amidst the COVID-19 Pandemic: Quality of Life, Pandemic Impact, and Vaccine Preferences
Authors: Harner Vern , Munion Ascher K. , Shelton Jama
Published: November 2021

The ongoing COVID-19 pandemic is disproportionately impacting marginalized communities, such as Black, Indigenous, and people of color (BIPOC), disabled individuals, and transgender/nonbinary (i.e., trans) individuals. As trans individuals may be multiply marginalized, it is necessary to examine within group differences among trans individuals of different genders, races, socioeconomic statuses, and abilities. This study examines the following research questions: (1) What is the quality of life of trans adults during the COVID-19 pandemic? (2) How does the self-reported impact of the pandemic vary across groups within the trans community? (3) What preferences do trans adults have regarding receiving a COVID-19 vaccine? Survey data were collected in August/September of 2020. Among a sample of 449 trans adults, findings suggest that the profound impact of the pandemic was not consistent across all community members. Being a woman predicted a higher self-reported impact of the pandemic while being a masc(uline) white respondent tended to predict a lower impact of the pandemic. Higher income was associated with a higher quality of life and being a disabled white respondent predicted a lower quality of life. The majority (99%) of the sample reported wanting to receive a COVID-19 vaccine should one become available. Implications for practice include the importance of considering the holistic experiences of clients and community members, as opposed to having homogenized perspectives of even subsets of the trans community. Future research related to barriers faced when attempting to access a vaccine is needed to inform future public health responses to epidemics/pandemics impacting this community.
Go Green and Recycle: Analyzing the Usage of Plastic Bags for Shopping in China
Authors: Li Yong , Wang Bairong
Published: November 2021

The extensive usage of plastic bags has caused detrimental environmental damage, and an influx of research efforts have been undertaken to reduce people’s usage of plastic bags. However, studies regarding people’s reuse of plastic bags are still scarce. Therefore, this study is motivated to bridge this research gap by examining the determinants of old plastic bag usage and consumers’ maximum willingness to pay price for plastic carrier bags via a semi-structured online survey on a random sample of 777 Chinese consumers. Descriptive summary, KW test, and logistic regression were used to identify potential determinants and their influence on consumers’ usage of old plastic bags. The findings indicate that consumers’ age, altruistic values, and their perceived plastic ban effectiveness are positively associated with the usage of old plastic bags. Specifically, the elder and altruistic consumers who are positive for plastic ban effectiveness are more likely to reuse old plastic bags. Furthermore, when plastic carrier bags are priced at RMB 2.0, 81.2% of the surveyed consumers say they will stop buying them. Based on the pricing setting experience from the Irish plastic bag policy, we suggest that the optimal price of plastic carrier bags is RMB 12.0, which is also six times of the consumer’s maximum willingness to pay price.
Evaluation Method for Urban Public Service Carrying Capacity (UPSCC): A Qualitative–Quantitative Bi-Dimensional Perspective
Authors: Liao Shiju , Du Xiaoyun , Shen Liyin , Lv Minghe
Published: November 2021

Urban Public Service Carrying Capacity plays an essential role in urban social and economic development. However, existing study has been focused on the evaluation of UPSCC from a quantitative perspective. It is necessary to evaluate UPSCC from a qualitative–quantitative bi-dimensional perspective. This paper establishes an innovative evaluation method for UPSCC based on a qualitative–quantitative bi-dimensional (QQBD) perspective. The proposed QQBD-based UPSCC evaluation method can help identify the weak areas of public services. The conclusions of this study are as follows. Firstly, public services are people-oriented social resources, which should be evaluated from both quantitative and qualitative perspectives. Secondly, the quantitative measurement of public service carrying capacity needs to consider both UPSCC load and carrier, while the qualitative measurement needs to consider the satisfaction among stakeholders. Thirdly, the demonstration of the case study cities shows the effectiveness of the qualitative–quantitative bi-dimensional UPSCC evaluation method. By applying the QQBD-based UPSCC evaluation method introduced in this study, decision makers can identify the specific areas that affect the UPSCC performance, and thus tailor-made policy can be designed for improving UPSCC performance by adjusting UPSCC quantity and quality.
Attitudinal Barriers Hindering Adoption of Telepsychiatry among Mental Healthcare Professionals: Israel as a Case-Study
Authors: Magal Tamir , Negev Maya , Kaphzan Hanoch
Published: November 2021

Despite proven advantages for the use of telemedicine in psychiatry, mental healthcare professionals have shown deep-seated mistrust and suspicion of telepsychiatry, which hinders its widespread application. The current study examines the attitudes of Israeli mental health professionals towards telepsychiatry and seeks to uncover the effects of experience and organizational affiliation on its adoption. The methodology included qualitative and thematic analysis of 27 in-depth interviews with Israeli mental health professionals, focusing on three major themes—clinical quality, economic efficiency, and the effects on the work–life balance of healthcare professionals. The attitudes of mental health professionals were found to be widely divergent and sharply dichotomized regarding different aspects of telepsychiatry and its suitability for mental healthcare services. However, there was a general consensus that telemedicine may not fulfil its promise of being a panacea to the problems of modern public medicine. In addition, attitudes were related to hierarchical position, organizational affiliation, and personal experience with telepsychiatry. Specifically, organizational affiliation influenced experience with and support for the assimilation of telepsychiatry. The study also revealed the role of organizational leadership and culture in promoting or inhibiting the proliferation and adoption of innovative technologies and services in modern medicine.
Lessons Learnt during the Implementation of WISN for Comprehensive Primary Health Care in India, South Africa and Peru
Authors: Mabunda Sikhumbuzo A. , Gupta Mona , Chitha Wezile W. , Mtshali Ntombifikile G. , Ugarte Claudia , Echegaray Ciro , Cuzco María , Loayza Javier , Peralta Felipe , Escobedo Seimer , Bustos Veronica , Mnyaka Onke R. , Swaartbooi Buyiswa , Williams Natasha , Joshi Rohina
Published: November 2021

Introduction: The World Health Organization introduced the workload indicators of staffing needs (WISN) in 1998 to improve country-level health workforce planning. This study presents the primary care health workforce planning experiences of India, South Africa and Peru. Methods: A case study approach was used to explore the lessons learnt in the implementation of WISN in India and South Africa. It also describes the methods developed and implemented to estimate health workforce in Peru. We identify the barriers and facilitators faced by countries during the implementation phase through the triangulation of literature, government reports and accounts of involved health planners in the three countries. Results: India implemented WISN in a referral pathway of three district health facilities, including a primary health centre, community health centre and district hospital. Implementation was impeded by limited technical support, poor stakeholder consultation and information systems challenges. South Africa implemented WISN for health workforce planning in primary care and found the skills mix and staff determinations to be unaffordable. The Peruvian Ministry of Health considered using WISN but decided to develop a context-specific tool to estimate the health workforce needed using its available resources such as the National Register of Health Personnel. The main challenge in using WISN was the insufficient information on its inputs. Conclusion: While India and South Africa had unique experiences with the integration of WISN in their health system, none of the countries has yet benefited from the implementation of WISN due to financial, infrastructure and technical challenges. Since the methodology developed by the Peruvian Ministry of Health is context-specific, its implementation has been promising for health workforce planning. The learnings from these countries’ experiences will prove useful in bringing future changes for the health workforce.
Exploring the Mediating Effects of Cognitive Function, Social Support, Activities of Daily Living and Depression in the Relationship between Age and Frailty among Community-Dwelling Elderly
Authors: Chen Lin-Yen , Fang Tzu-Jung , Lin Yu-Chih , Hsieh Hsiu-Fen
Published: November 2021

With 16.15% of its total population aged 65 or above, Taiwan is already an aging society. Frailty is a natural consequence of aging, which may decrease physical strength and deteriorate physiological functioning. We examined the mediating effects of cognitive function, social support, activities of daily living (ADL), and depression in the relationship between age and frailty in older people living in the community. This cross-sectional study used a structured questionnaire to collect data from a convenience sample of 200 pre-frail to mildly frail older adults in southern Taiwan. Structural equation modeling was used for data analysis, with data collected from July to November 2020. ADL mediated the relationship between age and frailty, while cognitive function also mediated the relationship between age and frailty, indicating that ADL and cognitive function were significant determinants of frailty. The path from age to frailty was significant, indicating that age was a significant determinant of frailty. The standardized total effect of age affected frailty through the mediating roles of ADL and cognitive function. Age, depression, ADL, and cognitive function explained 59% of the variance in frailty among older adults. ADL and cognitive function are significant mediators of frailty among older adults.
User-Centred Design of a Final Results Report for Participants in Multi-Sensor Personal Air Pollution Exposure Monitoring Campaigns
Authors: Robinson Johanna Amalia , Novak Rok , Kanduč Tjaša , Maggos Thomas , Pardali Demetra , Stamatelopoulou Asimina , Saraga Dikaia , Vienneau Danielle , Flückiger Benjamin , Mikeš Ondřej , Degrendele Céline , Sáňka Ondřej , García Dos Santos-Alves Saul , Visave Jaideep , Gotti Alberto , Persico Marco Giovanni , Chapizanis Dimitris , Petridis Ioannis , Karakitsios Spyros , Sarigiannis Dimosthenis A. , Kocman David
Published: November 2021

Using low-cost portable air quality (AQ) monitoring devices is a growing trend in personal exposure studies, enabling a higher spatio-temporal resolution and identifying acute exposure to high concentrations. Comprehension of the results by participants is not guaranteed in exposure studies. However, information on personal exposure is multiplex, which calls for participant involvement in information design to maximise communication output and comprehension. This study describes and proposes a model of a user-centred design (UCD) approach for preparing a final report for participants involved in a multi-sensor personal exposure monitoring study performed in seven cities within the EU Horizon 2020 ICARUS project. Using a combination of human-centred design (HCD), human–information interaction (HII) and design thinking approaches, we iteratively included participants in the framing and design of the final report. User needs were mapped using a survey (n = 82), and feedback on the draft report was obtained from a focus group (n = 5). User requirements were assessed and validated using a post-campaign survey (n = 31). The UCD research was conducted amongst participants in Ljubljana, Slovenia, and the results report was distributed among the participating cities across Europe. The feedback made it clear that the final report was well-received and helped participants better understand the influence of individual behaviours on personal exposure to air pollution.
Seroprevalence of Anti-SARS-CoV-2 Antibodies among Municipal Staff in the Municipality of Prishtina
Authors: Gashi Bujar , Osmani Vesa , Halili Rrezart , Hoxha Teuta , Kamberi Agron , Hoti Nexhmedin , Agahi Riaz , Basha Vlora , Berisha Visar , Hoxha Ilir
Published: November 2021

Background: Some studies have assessed the seroprevalence of anti-SARS-CoV-2 antibodies in different populations. Very few studies have explored seroprevalence in municipal workers, an important and potentially high-risk population. This study aims to determine the prevalence of anti-SARS-CoV-2 antibodies in municipal workers, with the additional examination of the association of prevalence with various demographic, health-related, and epidemiological factors. Methods: We surveyed and tested for seroprevalence 418 public servants from the municipality of Prishtina, the capital of Kosovo. The primary prespecified outcome was the seroprevalence of anti-SARS-CoV-2 antibodies, IgG, and IgM. Additional outcomes were crude and adjusted odds ratios of seroprevalence by different factors. Results: 21.1% of municipal workers tested positive for either IgM or IgG. Of these, 9.6% were positive for IgM and 19.4% for IgG. Data showed high levels of adherence to protective measures, e.g., social distancing in the office, but calculation of ORs did not show a significant difference between those reporting adherence to such measures and those reporting nonadherence. Of other examined factors, significantly lower odds were observed for smokers (0.52, 95% CI 0.28, 0.97), while municipal workers with infected family members had elevated odds of seropositivity according to both crude (2.19, 95% CI 1.34, 3.59) and adjusted (2.00, 95% CI 1.17, 3.41) ORs. Conclusions: Most answers from public servants demonstrated compliance to social-distancing policies in the workplace, but analysis of crude and adjusted odds ratios did not suggest a significant effect between municipal workers who followed these guidelines and those who did not. Results from this study help Kosovo policy makers in understanding the level of prevalence of COVID-19 in municipal workers and the effect of different factors on such prevalence. Results from the study could inform future decisions on the design and application of protective measures for municipal workers. Our findings should encourage further research to assess the extent of the spread of COVID-19 to other essential workers in Kosovo, including retail workers.
Insecure Employment Contracts during the COVID-19 Pandemic and the Need for Participation in Policy Making
Authors: Maleki Maryam , Mardani Abbas , Vaismoradi Mojtaba
Published: November 2021

Job security influences the ability of nurses to provide high-quality nursing care. The Iranian health system has always faced nursing shortages, and the COVID-19 pandemic has worsened this situation. Although nurses have been labelled ‘heroes’ across the globe, many of them have been hired using insecure employment contracts. This commentary aims to describe issues surrounding job contracts for Iranian nurses during the COVID-19 pandemic and discusses how the current situation can be improved. Iranian nurses are at the frontline of the fight against COVID-19 and need to receive better support in terms of job security and dignity. They should participate more in policymaking activities to improve their job condition and prevent the development and implementation of the short-term and insecure job contracts that lead to job insecurity.
Per- and Polyfluoroalkyl Substances (PFAS) in Integrated Crop–Livestock Systems: Environmental Exposure and Human Health Risks
Authors: Jha Gaurav , Kankarla Vanaja , McLennon Everald , Pal Suman , Sihi Debjani , Dari Biswanath , Diaz Dawson , Nocco Mallika
Published: November 2021

Per- and polyfluoroalkyl substances (PFAS) are highly persistent synthetic organic contaminants that can cause serious human health concerns such as obesity, liver damage, kidney cancer, hypertension, immunotoxicity and other human health issues. Integrated crop–livestock systems combine agricultural crop production with milk and/or meat production and processing. Key sources of PFAS in these systems include firefighting foams near military bases, wastewater sludge and industrial discharge. Per- and polyfluoroalkyl substances regularly move from soils to nearby surface water and/or groundwater because of their high mobility and persistence. Irrigating crops or managing livestock for milk and meat production using adjacent waters can be detrimental to human health. The presence of PFAS in both groundwater and milk have been reported in dairy production states (e.g., Wisconsin and New Mexico) across the United States. Although there is a limit of 70 parts per trillion of PFAS in drinking water by the U.S. EPA, there are not yet regional screening guidelines for conducting risk assessments of livestock watering as well as the soil and plant matrix. This systematic review includes (i) the sources, impacts and challenges of PFAS in integrated crop–livestock systems, (ii) safety measures and protocols for sampling soil, water and plants for determining PFAS concentration in exposed integrated crop–livestock systems and (iii) the assessment, measurement and evaluation of human health risks related to PFAS exposure.
Security Providing Leadership: A Job Resource to Prevent Employees’ Burnout
Authors: Moriano Juan A. , Molero Fernando , Laguía Ana , Mikulincer Mario , Shaver Phillip R.
Published: November 2021

Leadership styles in work contexts play a role in employees’ well-being, contributing to better health or, on the contrary, being a source of stress. In this study we propose that security providing leadership may be considered as a resource to prevent employees’ job burnout. First, we examine the relationship between employees’ perception of their leader’s degree of security in providing leadership and the employees’ degree of job-related burnout. Second, the underlying processes by which leaders as security providers exert their influence on burnout are analyzed with a focus on the mediating role of two variables: an organizational climate oriented to psychological safety and organizational dehumanization. A total of 655 Spanish employees (53.7% women) completed a paper-and-pencil self-report questionnaire. To recruit participants, we employed an exponential non-discriminative snowball sampling. Results, using Partial Least Squares Structural Equation Modeling (PLS-SEM) to test hypotheses, show that security providing leadership was related negatively to burnout. Furthermore, psychological safety climate and organizational dehumanization mediated the relationship between security providing leadership and burnout. These findings support the attachment approach to leadership and open new avenues for creating better organizational environments. Security-providing leaders, by supporting employees and treating them in a personalized way, can enhance the psychological safety climate and prevent organizational dehumanization and consequent job burnout.
Lessons Learnt during COVID-19 Lockdown: A Qualitative Study of South African Families
Authors: Donga Gift T. , Roman Nicolette V. , Adebiyi Babatope O. , Omukunyi Bernard , Chinyakata Rachel
Published: November 2021

In a pandemic, such as COVID-19, with every single person struggling to deal with the unknown, it is often within the family that support is found but it is also within the family that circumstances, contexts and behaviours could further drive the pandemic and where they struggle to cope. This is novel research in the South African context with no known information regarding family life during and post the pandemic. This study, therefore, explores the lessons learnt during COVID-19 by South African families. A qualitative approach was employed to guide the gathering and analysis of the data. Data were collected from a sample of 31 family members above the age of 18 years from communities of the Western Cape Province and analysed through thematic analysis. According to the participants interviewed some of the significant lessons learnt from the lockdown include hygiene and health consciousness, appreciation for family, valuing life, self-introspection, less dependency, remote working, and financial savings. The realisation of such lessons even post-pandemic has the potential of strengthening families to be a resource of coping and resilience during very difficult times at the same time, contributing to greater physical, social, and economic functioning of families across South Africa.
Obstetric Violence as an Infringement on Basic Bioethical Principles. Reflections Inspired by Focus Groups with Midwives
Authors: Martín-Badia Júlia , Obregón-Gutiérrez Noemí , Goberna-Tricas Josefina
Published: November 2021

Background: obstetric violence is still far too invisible; the word “violence” generates rejection and obstetric violence is complex to define and typify, as it is a subjective experience. It has been widely analyzed from legal, sociological, and clinical perspectives, but not equally so from the bioethical point of view. This article sets out to take a more in-depth look at the experiences of midwives in order to describe the ethical perspectives of obstetric violence. We intend to describe the effects that malpractice and violence within obstetric care have on American and European bioethical principles. Methodology: A qualitative methodology of the phenomenological tradition was used: 24 midwives participated in three focus groups. Results and Discussion: four categories were arrived at; they are “the maleficence of forgetting my vulnerability”, “beneficence requires respect for my integrity and dignity”, “my autonomy is being removed from me” and “a problem of social justice towards us, women”. Conclusion: obstetric violence infringes on the main bioethical principles (non-maleficence, beneficence, autonomy, justice, vulnerability, dignity, and integrity). Beyond whether it is called violence or not, what matters from an ethical perspective is that, as long as women have such negative experiences during pregnancy and childbirth, obstetric care needs better humanizing.
How Do Serum Zonulin Levels Change in Gestational Diabetes Mellitus, Pregnancy Cholestasis, and the Coexistence of Both Diseases?
Authors: Güvey Huri , Çelik Samettin , Çalışkan Canan Soyer , Yılmaz Zehra , Yılmaz Merve , Erten Özlem , Tinelli Andrea
Published: November 2021

We investigated the question of how serum zonulin levels change in intrahepatic cholestasis of pregnancy (ICP) and gestational diabetes mellitus (GDM) and, in the case of the coexistence of ICP and GDM, evaluated the eventual increase in zonulin plasmatic levels. Participants were enrolled for the study between 25 February 2021 and 20 August 2021. The prospective case-control study included: group 1 of 95 pregnant women diagnosed with ICP; group 2 of 110 pregnant women diagnosed with GDM; group 3 of 16 women diagnosed with both GDM and ICP; group 4 of 136 healthy pregnant women as the control group. The groups were compared in terms of age, body mass index (BMI), gravidity, parity, gestational week of delivery, plasma zonulin levels, delivery type, birth weight, first- and fifth-minute APGAR scores, newborn intensive care unit (NICU) admission, and meconium staining of amniotic fluid parameters. The results suggested that the plasma zonulin levels of ICP (group 1), GDM (group 2), and GDM with ICP (group 3) patients were higher than those of the healthy pregnant women of group 4 (p < 0.001). Among the patient groups, the highest median plasma zonulin levels were found in group 3 (110.33 ng/mL). Zonulin levels were also associated with the severity of ICP and adverse pregnancy outcomes. High serum zonulin levels were related to GDM, ICP, and adverse perinatal outcomes. The coexistence of GDM and ICP led to higher serum zonulin concentrations.
Why Do People with Severe Mental Illness Have Poor Cardiovascular Health?—The Need for Implementing a Recovery-Based Self-Management Approach
Authors: Zabeen Sara , Lawn Sharon , Venning Anthony , Fairweather Kate
Published: November 2021

People with severe mental illness (SMI) die significantly earlier than their well counterparts, mainly due to preventable chronic conditions such as cardiovascular disease (CVD). Based on the existing research, this perspective paper summarises the key contributors to CVD in people with SMI to better target the areas that require more attention to reduce, and ultimately resolve this health inequity. We discuss five broad factors that, according to current international evidence, are believed to be implicated in the development and maintenance of CVD in people with SMI: (1) bio-psychological and lifestyle-related factors; (2) socio-environmental factors; (3) health system-related factors; (4) service culture and practice-related factors; and (5) research-related gaps on how to improve the cardiovascular health of those with SMI. This perspective paper identifies that CVD in people with SMI is a multi-faceted problem involving a range of risk factors. Furthermore, existing chronic care or clinical recovery models alone are insufficient to address this complex problem, and none of these models have identified the significant roles that family caregivers play in improving a person’s self-management behaviours. A new framework is proposed to resolve this complex health issue that warrants a collaborative approach within and between different health and social care sectors.
Menopause and Sustainable Career Outcomes: A Science Mapping Approach
Authors: Van der Heijden Beatrice I. J. M. , Pak Karen , Santana Mónica
Published: November 2021

This paper provides a systematic review of the phenomenon of menopause at the workplace from a sustainable career perspective, by highlighting its major themes along with the evolution and tendencies observed in this field. A conceptual science mapping analysis based on co-word bibliographic networks was developed, using the SciMAT tool. From 1992 to 2020, 185 documents were retrieved from the Web of Science. In the first analyzed time span (1992–2002), postmenopausal women, health, and risk factors appeared to be the motor themes (well-developed and important for the structure of the discipline under focus), and disorder was an emerging or disappearing theme in the phenomenon under research. In the second studied period (2003–2013), risk and health were motor themes, menopausal symptoms was a basic or transversal theme (important for the discipline but not well-developed), coronary heart disease was a specialized theme (well-developed but less important for the structure of the research field), and postmenopausal women was an emerging or disappearing theme (both weakly developed and marginal to the field). In the third studied period (2014–2020), menopause, breast cancer, and menopausal symptoms were motor themes, Anxiety was a specialized theme and risk and body mass index were emerging or disappearing themes. Sustainability of women’s careers in the second half of life is of increasing importance given the increasing equal representation of men and women in working organizations, and the impact of the changing nature of work in the 21st century on older workers.
The Effect of Exercise Intervention on Reducing the Fall Risk in Older Adults: A Meta-Analysis of Randomized Controlled Trials
Authors: Sun Mingyu , Min Leizi , Xu Na , Huang Lei , Li Xuemei
Published: November 2021

Exercise intervention has a positive effect on reducing the fall risk in older adults. To investigate the effect of different factors of exercise intervention (type, duration, and frequency) on reducing the fall risk in older adults, a meta-analysis was performed in this study. According to the PRISMA®, two researchers independently searched PubMed, Web of Science, and the China National Knowledge Infrastructure databases to assess the quality of the studies using the PEDro scale. A total of 648 subjects in 10 randomized controlled trials were included in this study, and the exercise interventions included integrated training (resistance training, core training, and balance training), balance training, core training, Pilates, Ba Duan Jin, and Tai Chi. These studies show that exercise intervention has a huge and significant impact on reducing the risk of falls of the elderly. In conclusion, an integrated intervention with a frequency of more than five times a week and a duration of more than 32 weeks are more effective in reducing the fall risk.