bluuebunny/crossref_metadata_2025 huggingface dataset:
Effects of Brain Breaks Video Intervention of Decisional Balance among Malaysians with Type 2 Diabetes Mellitus: A Randomised Controlled Trial
Authors: Hidrus Aizuddin , Kueh Yee Cheng , Norsa’adah Bachok , Chang Yu-Kai , Kuan Garry
Published: August 2021

Brain Breaks® are structured physical activity (PA) web-based videos designed to promote an interest in learning and health promotion. The objective of this study was to examine its effects on decision balance (DB) which consists of the perceived benefits (Pros) and perceived barriers (Cons) of exercise in people with type 2 diabetes mellitus (T2DM). A randomised controlled trial was conducted among people with T2DM at Hospital Universiti Sains Malaysia. The intervention group received Brain Breaks videos for a period of four months. The intervention and control groups completed the validated Malay version of DB questionnaire for five times, at pre-intervention, the first month, the second month, the third month, and post-intervention. Multivariate Repeated Measures Analysis of Variance was performed for data analysis. A total of 70 participants were included (male = 39; female = 31) with a mean age of 57.6 years (SD = 8.5). The intervention group showed a significant change in the Pros and Cons factors of DB scores over time. The intervention group showed significantly higher scores for the Pros (p-value < 0.001) and lower scores for the Cons (p-value = 0.008) factors than the control group. In conclusion, the Brain Breaks video is an effective intervention to improve decisional balance in patients with T2DM to help them in deciding on behaviour change to be more physically active.
Long-Term Influences of Stunting, Being Underweight, and Thinness on the Academic Performance of Primary School Girls: The NW-CHILD Study
Authors: Haywood Xonné , Pienaar Anita Elizabeth
Published: August 2021

Poor socio-economic status contributes to undernutrition which, in turn, can increase the risk of academic underachievement. This study wants to determine if stunting, being underweight, and thinness show long term relations with academic performance in primary school girls aged 6 to 13 in the North West province of South Africa. A randomized and stratified longitudinal research design including a baseline and two time-point measurements over seven school years was used. The sample included girls aged 6 to 13 years (N = 198) in the North West province of South Africa. Academic performance in the June school assessments and national and provincial assessments in grades 1, 4, and 7 were used to determine academic performance. Independent t-testing was used to determine differences between thinness, underweight and stunted girls as opposed to a reference group with no undernutrition indices. A repeated measures ANOVA and post hoc Bonferroni adjustment analyzed relations over time. Normal weight girls significantly outperformed stunted girls academically (p < 0.05) over time. Stunting had prolonged and significant negative influences on language, mathematics, and grade point average (p < 0.05). Early identification of undernutrition, especially stunting, is important for intervention and the implementation of timely prevention strategies, especially during early childhood years.
Workplace Well-Being and Intent to Stay by Health Care Workers Reassigned during the First COVID-19 Wave: Results of a Swiss Survey
Authors: Gilles Ingrid , Mabire Cédric , Perriraz Margaux , Peytremann-Bridevaux Isabelle
Published: August 2021

Our study aimed at investigating the way not having the choice to be reassigned was associated to a poorer experience of reassignment among health care workers (HCWs) during the first wave of the coronavirus disease 2019 (COVID-19), and indirectly to a lower workplace well-being and reduced intent to stay at the hospital. We also investigated the moderating role of the perceived hospital management responsiveness on these associations. A cross sectional survey was sent to all professionals from 11 hospitals and clinics in the French-speaking part of Switzerland, in July 2020. Out of 2811 professionals who completed the survey, 436 were HCWs reassigned to COVID-19 units during the first wave of the pandemic and constituted our analysis sample. Results indicated that hospital management responsiveness moderated the association between lack of choice and reassignment experience, indicating that the more HCWs perceived responsiveness, the less the lack of choice affected their experience of reassignment and thus their intent to stay and workplace well-being. Lack of choice during reassignments can reduce intent to stay and workplace well-being, in particular if hospital management is not perceived to be responsive during the crisis. Attempts by hospital management to find solutions, such as flexibility in working hours or extraordinary leaves, can alleviate the perceived constraints of reassignment and be considered signs of responsiveness from hospital management.
Professionals’ Expectations and Preparedness to Implement Knowledge-Based Palliative Care at Nursing Homes before an Educational Intervention: A Focus Group Interview Study
Authors: Åvik Persson Helene , Ahlström Gerd , Ekwall Anna
Published: August 2021

The provision of knowledge-based palliative care is rare in nursing homes. There are obstacles to practically performing this because it can be difficult to identify when the final stage of life begins for older persons. Educational interventions in palliative care in nursing homes are a challenge, and joint efforts are needed in an organisation, including preparedness. The aim was to explore professionals’ expectations and preparedness to implement knowledge-based palliative care in nursing homes before an educational intervention. This study has a qualitative focus group design, and a total of 48 professionals working in nursing homes were interviewed with a semi-structured interview guide. Qualitative content analysis with an inductive approach was used for the analysis. One major theme was identified: professionals were hopeful yet doubtful about the organisation’s readiness. The main categories of increased knowledge, consensus in the team, and a vision for the future illustrate the hopefulness, while insufficient resources and prioritisation illustrate the doubts about the organisation’s readiness. This study contributes valuable knowledge about professionals’ expectations and preparedness, which are essential for researchers to consider in the planning phase of an implementation study. The successful implementation of changes needs to involve strategies that circumvent the identified obstacles to organisations’ readiness.
The Executive Skills Questionnaire-Revised: Adaptation and Psychometric Properties in the Working Context of Malaysia
Authors: Nasir Hira , Tan Chee-Seng , Pheh Kai-Shuen
Published: August 2021

Executive functions (EFs) are a set of high-level cognitive and behavioral monitoring skills that are important to employees’ work performance. The 25-item Executive Skills Questionnaire-Revised (ESQ-R) measures executive dysfunction in five dimensions (e.g., emotional regulation). Nevertheless, the usability of this newly developed scale for employees remains unclear. The present study evaluated the psychometric properties of the adopted ESQ-R for working adults in Malaysia. A total of 325 employees responded to an online survey consisted of the ESQ-R, Executive Function Index (EFI), self-rated creativity scale (SRCS), and 9-item Utretch Work Engagement Scale (UWES-9) and Employee Well-being Scale. Several CFAs were conducted to compare three competing models. While all models showed a good fit, the 5-factor second-order model that is in line with the theoretical structure is preferable. The ESQ-R showed excellent internal consistency. Moreover, the ESQ-R score was negatively correlated with EFI, creativity, and UWES-9 scores, supporting the convergent, discriminant, and concurrent validity. The ESQ-R score also explained incremental variance in well-being above and beyond scores of the UWES-9 and SRCS. Taken together, the ESQ-R is a useful tool for assessing employees’ executive dysfunction and suggesting intervention programs helping employees with deficits in EFs.
“One of My Basic Necessities of Life Is Work. That’s Just Broken Away.”—Explorative Triangulation of Personal and Work-Related Impacts for Supervisors and Disabled Employees in German Social Firms during the COVID-19 Pandemic
Authors: Kordsmeyer Ann-Christin , Efimov Ilona , Lengen Julia Christine , Harth Volker , Mache Stefanie
Published: August 2021

Social firms are located on the general labor market and employ 30–50% of severely disabled people. Findings on personal and work-related impacts for employees and supervisors during the COVID-19 pandemic are not yet available and will be investigated in the present study. Using the approach of a method triangulation, focus groups with employees and individual interviews with supervisors of several social firms from the North of Germany were combined and collected in parallel. Between July and November 2020, 16 semi-structured telephone interviews with supervisors and three focus groups with 3–6 employees each working within the same team (14 employees in total) were conducted. Both formats were recorded, transcribed, anonymized, and analyzed by using Mayring’s qualitative content analysis. Because a large proportion of the employees and supervisors interviewed worked in the gastronomy sector, they were particularly affected by the “restriction of social contacts” beginning in March 2020. Hygiene and distance regulations were implemented and personnel planning and distribution of work were adapted. Challenges were raised for employees with disabilities due to the implementation of hygiene and distance regulations, a sudden loss of work, lacking routines, additional work, a lack of movement, social contacts and financial challenges. Both employees and supervisors reported fears of infection, conflicts, additional work and fears of job loss. Additionally, supervisors dealt with less staffing, challenges in detaching from work and a strained economic situation. Overall, new insights were gained into the work-related impacts for employees and supervisors in inclusive workplaces during the current COVID-19 pandemic but further research on health-promoting structures is needed.
Self-Efficacy Mediates the Effect of Framing Eating Disorders Prevention Message on Intentions to Have a Sufficient Weight: A Pilot Study
Authors: Helme-Guizon Agnès , Gavard-Perret Marie-Laure , Shankland Rebecca , Flaudias Valentin
Published: August 2021

Background: In the context of social marketing, the effectiveness of prevention messages is a major issue. The main objective of the present study was to assess the effect of prevention messages framing on self-efficacy reinforcement in order to improve intentions to reach or maintain sufficient weight in a non-clinical sample. It thus focuses on testing the mediating role of self-efficacy. Methods: Two hundred and thirty-three university student women were randomly assigned to one of the two conditions (gain-framed versus loss-framed message). They were exposed to a short persuasive message and surveyed on self-efficacy and intention to maintain sufficient weight. Results: Loss-framed messages elicited higher levels of self-efficacy than gain-framed messages, which led to higher intentions to reach or maintain sufficient weight. This study sheds light on the mediating role of self-efficacy. Conclusions: The results suggest ways to improve the persuasiveness of prevention campaigns, thereby opening up further research avenues.
Soil Organic Matter Responses to Mangrove Restoration: A Replanting Experience in Northeast Brazil
Authors: Jimenez Laís Coutinho Zayas , Queiroz Hermano Melo , Otero Xosé Luis , Nóbrega Gabriel Nuto , Ferreira Tiago Osório
Published: August 2021

Mangroves are among the most relevant ecosystems in providing ecosystem services because of their capacity to act as sinks for atmospheric carbon. Thus, restoring mangroves is a strategic pathway for mitigating global climate change. Therefore, this study aimed to examine the organic matter dynamics in mangrove soils during restoration processes. Four mangrove soils under different developmental stages along the northeastern Brazilian coast were studied, including a degraded mangrove (DM); recovering mangroves after 3 years (3Y) and 7 years (7Y) of planting; and a mature mangrove (MM). The soil total organic carbon (CT) and soil carbon stocks (SCSs) were determined for each area. Additionally, a demineralization procedure was conducted to assess the most complex humidified and recalcitrant fractions of soil organic matter and the fraction participating in organomineral interactions. The particle size distribution was also analyzed. Our results revealed significant differences in the SCS and CT values between the DM, 3Y and 7Y, and the MM, for which there was a tendency to increase in carbon content with increasing vegetative development. However, based on the metrics used to evaluate organic matter interactions with inorganic fractions, such as low rates of carbon enrichment, C recovery, and low C content after hydrofluoric acid (HF) treatment being similar for the DM and the 3Y and 7Y—this indicated that high carbon losses were coinciding with mineral dissolution. These results indicate that the organic carbon dynamics in degraded and newly planted sites depend more on organomineral interactions, both to maintain their previous SCS and increase it, than mature mangroves. Conversely, the MM appeared to have most of the soil organic carbon, as the stabilized organic matter had a complex structure with a high molecular weight and contributed less in the organomineral interactions to the SCS. These results demonstrate the role of initial mangrove vegetation development in trapping fine mineral particles and favoring organomineral interactions. These findings will help elucidate organic accumulation in different replanted mangrove restoration scenarios.
Efficacy of eHealth Interventions for Adults with Diabetes: A Systematic Review and Meta-Analysis
Authors: Bassi Giulia , Mancinelli Elisa , Dell’Arciprete Gaia , Rizzi Silvia , Gabrielli Silvia , Salcuni Silvia
Published: August 2021

The aim is to provide meta-analytical evidence on eHealth interventions’ efficacy in supporting the psychosocial and physical well-being of adults with type 1 or type 2 Diabetes Mellitus (DM), and to investigate differences in interventions primarily targeted at providing glycemic control vs. psychosocial support. A PRISMA-guided systematic search was conducted. Randomized Controlled Trials (RCTs) regarding eHealth interventions for adults (18–65 years) with DM were included. Data were pooled using Standard Mean Difference (SMD); sub-group analysis and meta-regressions were performed when appropriate. Outcomes were Hemoglobin A1c (HbA1c), diabetes distress, quality of life, anxiety, stress, and depression. Intervention acceptability was assessed performing the Odds Ratio (OR) of drop-out rates. Thirteen RCTs comprising 1315 participants were included (52.09% females; Mage = 46.18, SD = 9.98). Analyses showed intervention efficacy on HbA1c (SMD = −0.40; 95% CI = −0.70, −0.12; k = 13) and depressive symptoms (SMD = −0.18; 95% CI = −0.33, −0.02; k = 6) at RCTs endpoint and were well accepted (OR = 1.43; 95% CI = 0.72, 2.81; k = 10). However, efficacy on HbA1c was not maintained at follow-up (SMD = −0.13; 95% CI = −0.31, 0.05; k = 6). eHealth interventions providing medical support were acceptable and effective in fostering glycemic control and decreasing depressive symptoms in the short-term only. Digital solutions should be developed on multiple levels to fully support the psychophysical well-being of people with DM.
Bedtime Routine Characteristics and Activities in Families with Young Children in the North of England
Authors: Kitsaras George , Goodwin Michaela , Allan Julia , Kelly Michael P. , Pretty Iain A.
Published: August 2021

Bedtime routines have been shown to have significant associations with health, wellbeing and development outcomes for children and parents. Despite the importance of bedtime routines, most research has been carried out in the United States, with little information on bedtime routine characteristics and activities for families in other countries such as the United Kingdom and England in particular. Additionally, little is known about the possible effects of weekends vs. weekdays on the quality of bedtime routines. Finally, traditional, retrospective approaches have been most used in capturing data on bedtime routines, limiting our understanding of a dynamic and complex behaviour. The aim of this study was to explore bedtime routine characteristics and activities in families in the North of England with a real-time, dynamic data collection approach and to examine possible effects of weekend nights on the quality of bedtime routines. In total, 185 parents with children ages 3 to 7 years old provided data around their bedtime routine activities using an automated text-survey assessment over a 7-night period. Information on socio-economic and demographic characteristics were also gathered during recruitment. A small majority of parents managed to achieve all crucial elements of an optimal bedtime routine every night, with 53% reporting brushing their children’s teeth every night, 25% reading to their children every night and 30% consistently putting their children to bed at the same time each night. Results showed significant differences between weekend (especially Saturday) and weekday routines (F(1, 100) = 97.584, p < 0.001), with an additional effect for parental employment (F(1, 175) = 7.151, p < 0.05). Results highlight variability in bedtime routine activities and characteristics between families. Many families undertook, in a consistent manner, activities that are closely aligned with good practices and recommendations on what constitutes an optimal bedtime routine, while others struggled. Routines remained relatively stable during weekdays but showed signs of change over the weekend. Additional studies on mechanisms and elements affecting the formation, development and maintenance of bedtime routines are needed alongside studies on supporting and assisting families to achieve optimal routines.
Prevalence and Initial Diagnosis of Cerebral Palsy in Preterm and Term-Born Children in Taiwan: A Nationwide, Population-Based Cohort Study
Authors: Wang Hsin-Hua , Hwang Yea-Shwu , Ho Chung-Han , Lai Ming-Chi , Chen Yu-Chin , Tsai Wen-Hui
Published: August 2021

The aim of this long-term longitudinal study in Taiwan was to estimate and compare the prevalence of cerebral palsy (CP) and to identify the age of CP diagnosis of term-born and preterm children with different birthweights. Records of 1494 extremely low birth weight (ELBW, <1000 g), 3961 very low birth weight (VLBW, 1000–1499 g), 19,612 low birth weight (LBW, 1500–2499 g) preterm, and 100,268 matched term-born children were retrieved from Taiwan′s National Health Insurance Research Database. According to a 12-year retrospective data review, the results showed the highest prevalence of CP in preterm ELBW children (147.3 cases per 1000 neonatal survivors), followed by preterm VLBW (97.2 cases), preterm LBW (27.7 cases), with the lowest prevalence in term-born children (2.5 cases). Regardless of the birthweight group, 90% of preterm children with CP were diagnosed by 4 years of age, but it was 7 years before 90% of term-born children with CP were diagnosed. After removing the children whose CP was caused by brain infections, injuries, or cerebrovascular accidents after 4 months of age, there were similar mean ages at the initial CP diagnosis (1.58–1.64 years of age) across birthweight groups born prematurely, but initial diagnosis occurred at an older age (2.41 years of age) in term-born children. The results indicate that birthweight is reversely correlated with the prevalence of CP in preterm children. Although the three preterm birthweight groups received different types of developmental follow-up programs after birth, it did not influence their age at the initial diagnosis of CP. Furthermore, we suggest that follow-up for at least 4 years after birth for preterm children, and 7 years for term-born children, is optimal for estimating CP prevalence. In order to identify and provide early intervention for term-born children with CP earlier, it is suggested that parents routinely fill out a self-reported motor developmental screening questionnaire and pediatricians conduct a motor developmental examination on term-born children at each time of scheduled vaccination injections.
Catalyzing Knowledge-Driven Discovery in Environmental Health Sciences through a Community-Driven Harmonized Language
Authors: Holmgren Stephanie D. , Boyles Rebecca R. , Cronk Ryan D. , Duncan Christopher G. , Kwok Richard K. , Lunn Ruth M. , Osborn Kimberly C. , Thessen Anne E. , Schmitt Charles P.
Published: August 2021

Harmonized language is critical for helping researchers to find data, collecting scientific data to facilitate comparison, and performing pooled and meta-analyses. Using standard terms to link data to knowledge systems facilitates knowledge-driven analysis, allows for the use of biomedical knowledge bases for scientific interpretation and hypothesis generation, and increasingly supports artificial intelligence (AI) and machine learning. Due to the breadth of environmental health sciences (EHS) research and the continuous evolution in scientific methods, the gaps in standard terminologies, vocabularies, ontologies, and related tools hamper the capabilities to address large-scale, complex EHS research questions that require the integration of disparate data and knowledge sources. The results of prior workshops to advance a harmonized environmental health language demonstrate that future efforts should be sustained and grounded in scientific need. We describe a community initiative whose mission was to advance integrative environmental health sciences research via the development and adoption of a harmonized language. The products, outcomes, and recommendations developed and endorsed by this community are expected to enhance data collection and management efforts for NIEHS and the EHS community, making data more findable and interoperable. This initiative will provide a community of practice space to exchange information and expertise, be a coordination hub for identifying and prioritizing activities, and a collaboration platform for the development and adoption of semantic solutions. We encourage anyone interested in advancing this mission to engage in this community.
Sea Buckthorn in Plant Based Diets. An Analytical Approach of Sea Buckthorn Fruits Composition: Nutritional Value, Applications, and Health Benefits
Authors: Gâtlan Anca-Mihaela , Gutt Gheorghe
Published: August 2021

Current nutritional trends include plant-based diets as nutritional behavior of consumers who are increasingly concerned about a healthy lifestyle. Sea buckthorn (Hippophaë rhamnoides L.) is a plant with great virtues, containing more than 100 types of compounds. It is a plant with versatile properties, multiple economic advantages and a rich history, which still continues in natural medicine, and it is hence included in the daily diet by more and more people for the prevention and treatment of diet-related diseases. Its uniqueness is due to its chemical composition and the health beneficial properties that rise from its composition. This review is a detailed analytical picture of the current state of knowledge currently available regarding the Hippophaë plant, providing an overview of the qualities of sea buckthorn. This article summarizes data on sea buckthorn’s nutritional value, health beneficial properties, and its applications.
COVID-19 Deaths in the United States: Shifts in Hot Spots over the Three Phases of the Pandemic and the Spatiotemporally Varying Impact of Pandemic Vulnerability
Authors: Park Yoo Min , Kearney Gregory D. , Wall Bennett , Jones Katherine , Howard Robert J. , Hylock Ray H.
Published: August 2021

The geographic areas most impacted by COVID-19 may not remain static because public health measures/behaviors change dynamically, and the impacts of pandemic vulnerability also may vary geographically and temporally. The nature of the pandemic makes spatiotemporal methods essential to understanding the distribution of COVID-19 deaths and developing interventions. This study examines the spatiotemporal trends in COVID-19 death rates in the United States from March 2020 to May 2021 by performing an emerging hot spot analysis (EHSA). It then investigates the effects of the COVID-19 time-dependent and basic social vulnerability factors on COVID-19 death rates using geographically and temporally weighted regression (GTWR). The EHSA results demonstrate that over the three phases of the pandemic (first wave, second wave, and post-vaccine deployment), hot spots have shifted from densely populated cities and the states with a high percentage of socially vulnerable individuals to the states with relatively relaxed social distancing requirements, and then to the states with low vaccination rates. The GTWR results suggest that local infection and testing rates, social distancing interventions, and other social, environmental, and health risk factors show significant associations with COVID-19 death rates, but these associations vary over time and space. These findings can inform public health planning.
In Vitro and In Vivo Effects of Nobiletin on DRG Neurite Elongation and Axon Growth after Sciatic Nerve Injury
Authors: Seo Tae-Beom , Jeon Yoon-A , Kim Sang Suk , Lee Young Jae
Published: August 2021

Sciatic nerve injury (SNI) leads to sensory and motor dysfunctions. Nobiletin is a major component of polymethoxylated flavonoid extracted from citrus fruits. The role of nobiletin on sciatic nerve regeneration is still unclear. Thus, the purpose of this study was to investigate whether nobiletin increases DRG neurite elongation and regeneration-related protein expression after SNI. Cytotoxicity of nobiletin was measured in a concentration–dependent manner using the MTT assay. For an in vitro primary cell culture, the sciatic nerve on the middle thigh was crushed by holding twice with forceps. Dorsal root ganglion (DRG) and Schwann cells were cultured 3 days after SNI and harvested 36 h later and 3 days later, respectively. In order to evaluate specific regeneration-related markers and axon growth in the injured sciatic nerve, we applied immunofluorescence staining and Western blot techniques. Nobiletin increased cell viability in human neuroblastoma cells and inhibited cytotoxicity induced by exposure to H2O2. Mean neurite length of DRG neurons was significantly increased in the nobiletin group at a dose of 50 and 100 μM compared to those at other concentrations. GAP-43, a specific marker for axonal regeneration, was enhanced in injury preconditioned Schwann cells with nobiletin treatment and nobiletin significantly upregulated it in injured sciatic nerve at only 3 days post crush (dpc). In addition, nobiletin dramatically facilitated axonal regrowth via activation of the BDNF-ERK1/2 and AKT pathways. These results should provide evidence to distinguish more accurately the biochemical mechanisms regarding nobiletin-activated sciatic nerve regeneration.
Food Insecurity and Child Development: A State-of-the-Art Review
Authors: Gallegos Danielle , Eivers Areana , Sondergeld Peter , Pattinson Cassandra
Published: August 2021

Converging research indicates that household food insecurity impedes children from reaching their full physical, cognitive, and psychosocial potential. This state-of-the-art review examines the last decade of research to: (1) describe the impact of the severity and persistence of food insecurity on child development; (2) use a socio-ecological framework to examine significant proximal and distal factors which may interplay; and (3) outline directions for future research. We conducted a systematic review of six databases of published papers from 2011 to June 2021. The search was limited to high-income countries and children aged from birth to 12 years. From 17,457 papers, 17 studies were included in the final review. Transitioning between food security and food insecurity had a significant and lasting effect on academic/cognitive function and behavior (i.e., externalizing), however less clear relationships were seen for psychosocial outcomes and other behaviors examined (i.e., internalizing). There was significant variation in the measurement and thresholds used to define both food insecurity and child development outcomes. Subsequently, comparisons across studies are difficult. Several future recommendations, including incorporation of socio-ecological factors, is provided. In conclusion, this review supports the link between food insecurity and sub-optimal child development; however, there is an imperative to improve and extend current understanding to ameliorate the causes of food insecurity.
Impacts of the Goldmining and Chronic Methylmercury Exposure on the Good-Living and Mental Health of Munduruku Native Communities in the Amazon Basin
Authors: Achatz Rafaela Waddington , de Vasconcellos Ana Claudia Santiago , Pereira Lucia , Viana Paulo Victor de Sousa , Basta Paulo Cesar
Published: August 2021

This paper is an exploratory study that examines the illegal goldmining impacts on Munduruku communities’ “Good-Living” (Xipan Jewewekukap) and explores the possible relationship between chronic methylmercury (MeHg) exposure and the worsening mental health conditions in three villages in the Middle-Tapajós River, Brazilian Amazon. The region has been experiencing a long-lasting threat of goldminers’ invasions. A total of 109 people were interviewed and evaluated. Total mercury (THg) exposure levels were evaluated through hair samples analysis, from which MeHg exposure levels were calculated. The Geriatric Depression Scale—Short Form (GDS-SF) was used as a screening tool in order to assess mental health indicators. Brief non-structured interviews were carried out to investigate how goldmining is impacting the communities Good-Living. A Poisson regression model was used to estimate the possible association between mental health indicators (assessed through the GDS-SF) and the following independent variables: (i) mercury exposure level (<10.0 μg/g vs. ≥10.0 μg/g), (ii) self-reported nervousness, (iii) self-reported irritability, (iv) age group, and (v) monthly income. The analysis revealed high levels of mercury in hair samples (median: 7.4 µg/g, range 2.0–22.8; 70% and 28% of the participants had THg levels ≥6.0 and ≥10.0 µg/g, respectively) and pointed to a tendency in which higher levels of methylmercury exposure (Hg ≥ 10.0 µg/g) could be linked to worse mental health indicators. Although the GDS-SF has presented limitations due to the Munduruku sociocultural context, our findings suggest a tendency of worse mental health indicators in participants presenting high levels of MeHg exposure. Despite this limitation, the qualitative approach indicates an evident association between the impacts of goldmining and the Munduruku people’s decreasing autonomy to maintain a Good-Living on their own terms, pointing to the importance of carrying out new investigations, especially considering longitudinal studies with qualitative methodologies and ethnographic approaches.
COVID-19 Screening by Anti-SARS-CoV-2 Antibody Seropositivity: Clinical and Epidemiological Characteristics, Comorbidities, and Food Intake Quality
Authors: Macedo-Ojeda Gabriela , Muñoz-Valle José Francisco , Yokogawa-Teraoka Patricia , Machado-Sulbarán Andrea Carolina , Loza-Rojas María Guadalupe , García-Arredondo Atziri Citlally , Tejeda-Constantini Rafael , Vega-Magaña Alejandra Natali , González-Estevez Guillermo , García-Chagollán Mariel , Zepeda-Nuño José Sergio , Hernández-Bello Jorge
Published: August 2021

Developing countries have reported lower molecular diagnostic testing levels due to a lack of resources. Therefore, antibody tests represent an alternative to detect exposure to SARS-CoV-2 and analyze possible risk factors. We aimed to describe and compare the clinical-epidemiological characteristics and the quality of food intake in Mexican individuals with a positive or negative test to antibodies against SARS-CoV-2. We carried out antibody tests and applied a survey to 1799 individuals; 42% were positive, and diabetes was more prevalent in these cases (p < 0.01). No differences were identified in the blood type nor influenza vaccination between groups. Coughing, respiratory distress, muscle pain, joint pain, and anosmia were the most prevalent symptoms among seropositive cases (p < 0.0001). Food intake quality was similar in both groups, except for the most consumed type of fat (p = 0.006). In conclusion, this study supports the association of diabetes as a principal risk factor for SARS-CoV-2 infection in the Mexican population. The results do not support previous associations between blood group or influenza vaccination as protective factors against SARS-CoV-2 infection. However, frequent consumption of polyunsaturated fats is highlighted as a new possible associated factor with COVID-19, which more studies should corroborate as with all novel findings.
Effects of Resistance Training in Muscle Mass and Markers of Muscle Damage in Adults with Down Syndrome
Authors: Diaz Antonio J. , Rosety Ignacio , Ordonez Francisco J. , Brenes Francisco , Garcia-Gomez Natalia , Castejon-Riber Cristina , Rosety-Rodriguez Manuel , Bernardi Marco , Alvero-Cruz Jose Ramon , Rosety Miguel A.
Published: August 2021

Recent studies have emphasized that regular exercise should be encouraged as a key part of care and support for people with Down syndrome (DS). However, muscle hypotonia has traditionally been considered a major barrier to resistance training (RT) in people with DS. The main objective of this study was to analyze the impact of circuit RT on markers of muscle damage. The secondary objective was to assess the influence of a RT program on body composition and work task performance. Thirty-six men with DS were recruited and randomly assigned to perform a circuit RT program with six stations 3 days/week for 12 weeks (n = 18) or to a control group (n = 18). Body composition was assessed by bioelectrical impedance analysis. Serum markers of muscle damage (creatine kinase, myoglobin, and lactate dehydrogenase) were determined at baseline and at the end of training weeks 1, 6, and 12. Work task performance was assessed using the weighted pail-carry test. RT did not induce significant changes in markers of muscle damage during the intervention. Furthermore, muscle mass and work task performance were significantly improved in the exercise group. These findings suggest that circuit RT can be used safely to increase muscle mass and work task performance in young adults with DS. Muscle hypotonia should not be considered a major barrier to exercise in people with DS, provided that qualified staff design and supervise all training sessions.
Tobacco Craving, Nicotine Dependence, and Quit Intentions among LGB and Non-LGB High School Students: A Quasi-Experimental Analysis
Authors: Azagba Sunday , Shan Lingpeng
Published: August 2021

There is evidence of higher tobacco use among lesbian or gay and bisexual (LGB) populations. However, a limited number of studies have examined whether there are differences in potential indicators of future tobacco cessation behaviors between LGB and non-LGB populations. This study examined whether sexual identity is associated with craving, nicotine dependence, and quit intentions among high school students. Data were drawn from the 2020 National Youth Tobacco Survey (n = 1642). A propensity score matching (PSM) technique was used to address covariate imbalance among sexual identity groups. Additionally, subgroup analyses were performed for both males and females. The PSM results showed higher odds of craving among students who were gay or lesbian (aOR, 1.70; 95% CI = 1.13–2.55) and bisexual (aOR, 1.89; 95% CI = 1.23–2.92) compared to heterosexual (straight) students. In the sex-based subgroup analyses, we found that gay or lesbian (aOR, 1.92; 95% CI = 1.10–3.34) and bisexual (aOR, 3.12; 95% CI, 1.46–6.66) male students had significantly higher odds of craving when compared to heterosexual/straight male adolescents. However, the association was not significant in female students. Additionally, female bisexuals had significantly lower odds for quit intention (aOR, 0.48; 95% CI = 0.29–0.81) when compared to heterosexual/straight female adolescents. Results also showed no significant differences between LGB and non-LGB students for nicotine dependence. Sexual minority adolescents, especially male adolescents, were more likely to have tobacco cravings and bisexual females had lower odds of quit intention than heterosexual peers. Prevention efforts targeting this subpopulation may be beneficial.
Effectiveness of a Three-Week Inpatient Pulmonary Rehabilitation Program for Patients after COVID-19: A Prospective Observational Study
Authors: Hayden Markus C. , Limbach Matthias , Schuler Michael , Merkl Steffen , Schwarzl Gabriele , Jakab Katalin , Nowak Dennis , Schultz Konrad
Published: August 2021

For COVID-19 patients who remain symptomatic after the acute phase, pulmonary rehabilitation (PR) is recommended. However, only a few studies have investigated the effectiveness of PR, especially considering the duration between the acute phase of COVID-19 and the onset of rehabilitation, as well as the initial severity. This prospective observational study evaluated the efficacy of PR in patients after COVID-19. A total of 120 still-symptomatic patients referred for PR after overcoming acute COVID-19 were asked to participate, of whom 108 (mean age 55.6 ± 10.1 years, 45.4% female) consented. The patients were assigned to three groups according to the time of referral and initial disease severity (severe acute; severe after interval; mild after interval). The primary outcome was dyspnea. Secondary outcomes included other respiratory disease symptoms, physical capacity, lung function, fatigue, quality of life (QoL), depression, and anxiety. Furthermore, patients rated the overall effectiveness of PR and their subjective change in health status. At the end of PR, we detected improvements with large effect sizes in exertional dyspnea, physical capacity, QoL, fatigue, and depression in the overall group. Other parameters changed with small to medium effect sizes. PR was effective after acute COVID-19 in all three groups analyzed.
The Experiences of Nurses and Physicians Caring for COVID-19 Patients: Findings from an Exploratory Phenomenological Study in a High Case-Load Country
Authors: Khatatbeh Moawiah , Alhalaiqa Fadwa , Khasawneh Aws , Al-Tammemi Ala’a B. , Khatatbeh Haitham , Alhassoun Sameera , Al Omari Omar
Published: August 2021

Various changes have affected health services delivery in response to the repercussions of the COVID-19 pandemic, and this may exhibit unprecedented effects on healthcare workers (HCWs). This study aimed to explore the lived experience of physicians and nurses caring for patients with COVID-19 in Jordan. An interpretative phenomenology approach was used, and sampling was purposively performed. Data were collected through semi-structured interviews using an online meeting platform (Zoom®). Interviews were audio-recorded, transcribed verbatim, and analyzed. The data were obtained from 26 physicians and nurses caring for patients with COVID-19. The mean age of the participants was 29.41 years (SD = 2.72). Six main themes and 17 subthemes were identified: (i) emotional reactions; (ii) preparation; (iii) source of support; (iv) extreme workload; (v) occupational challenges, and (vi) work-related concerns. The results showed that nurses and physicians caring for COVID-19 patients in Jordan were experiencing mental and emotional distress and were practicing under inadequate work conditions. This distress could be multifactorial with personal, organizational, or cultural origins. Our findings may guide policymakers to consider the potential factors that significantly affect working environment in healthcare settings, the physical and mental wellbeing of HCWs, and the required professional training that can help in enhancing resilience and coping strategies amidst crises.
Perceived Risk in the Population Living near the Turin Incinerator: Comparison between before and at Three Years of Operation
Authors: Bena Antonella , Gandini Martina , Crosetto Laura , Ivaldi Cristiana , Procopio Enrico , Salamina Giuseppe , Orengia Manuela , Farina Elena
Published: August 2021

When the Turin incinerator went into operation in 2013, it was accompanied by surveillance of health effects that included a human biomonitoring survey of 394 residents. They responded to items investigating their awareness of environmental and health issues and perception of environmental health risks. In this study, we compared the questionnaire responses before plant startup and at 3 years of operation. To accomplish this, we investigated changes in perceived risk and evaluated the efficacy of communication strategies. A total of 344 participants equally distributed in an exposed and an unexposed group responded to the follow-up questionnaire. Survey items investigated the perception of a relationship between illness and exposure to environmental pollution, feeling at risk of developing an illness, and concern about natural and anthropogenic hazards. The proportion of ‘certain’ and ‘very probable’ responses was compared to the total using the difference-in-differences method. Analyses showed an overall decrease in the differences between the two groups, which suggests that the communication actions undertaken for the exposed group were effective. Future communication plans should also include initiatives targeting the unexposed group.
Affiliate Stigma in Caregivers of Children with Attention-Deficit/Hyperactivity Disorder: The Roles of Stress-Coping Orientations and Parental Child-Rearing Styles
Authors: Chang Chih-Cheng , Chen Yu-Min , Hsiao Ray C. , Chou Wen-Jiun , Yen Cheng-Fang
Published: August 2021

Affiliate stigma may increase the risks of negative parenting and psychological and depressive problems in caregivers of children with attention-deficit/hyperactivity disorder (ADHD). Evaluating affiliate stigma and determining how to reduce it are crucial to promoting mental health in caregivers and their children with ADHD. The aim of this study was to examine the associations of stress-coping orientations and parental child-rearing styles with the risk of high affiliate stigma in caregivers of children with ADHD in Taiwan. Affiliate stigma, stress-coping orientations, and parental child-rearing styles were assessed. The results of univariate logistic regression analysis indicated that caregivers’ gender, depressive symptoms, four orientations of stress coping, and two parenting styles, and children’s high severities of internalizing, externalizing, and ADHD symptoms were significantly associated with high affiliate stigma. The results of multivariate logistic regression analysis indicated that after controlling for caregivers’ gender, depressive symptoms, and children’s severity of internalizing, externalizing, and ADHD symptoms, caregivers with high orientation of seeking social support were less likely to have high affiliate stigma than those with low orientation of seeking social support; the caregivers with high care and affection parenting were less likely to have high affiliate stigma than those with low care and affection parenting, whereas the caregivers with high overprotection parenting were more likely to have high affiliate stigma than those with low overprotection parenting. Intervention programs targeting caregiver affiliate stigma must consider various coping orientations and parental child-rearing styles in their approach.
An Analysis of the Social and Economic Costs of Breast Cancer in Italy
Authors: Mennini Francesco Saverio , Trabucco Aurilio Marco , Gazzillo Simone , Nardone Claudia , Sciattella Paolo , Marcellusi Andrea , Migliorini Raffaele , Sciannamea Valerio , Piccioni Andrea , Bolcato Matteo , Barni Sandro
Published: August 2021

Background: Breast cancer is the most prevalent cancer affecting women and it represents an important economic burden. The aim of this study was to estimate the socio-economic burden of breast cancer (BC) in Italy both from the National Health Service (NHS) and the government perspectives (costs borne by the social security system). Methods: The economic analysis was based on the costs incurred by the NHS from 2008 to 2016 (direct costs related to hospitalizations) and by the National Social Security Institute (INPS) from 2009 to 2015 (costs of social security benefits) for patients with breast cancer. The analysis was based on the Hospital Information System (HIS) and Disability Insurance Awards databases. For both databases, patients affected by a malignant neoplasm of the female breast, carcinoma in situ, or secondary malignant neoplasm of the breast were considered. Results: Results show that more than 75,000 women were hospitalized for breast cancer every year, with an overall cost for hospitalization of about €300 million per year. From the Social Security analysis, a number of 29,000 beneficiaries each year was estimated. Considering per patient social costs, breast cancer at the primary stage cost €8828 per year, while secondary neoplasms cost €9780, with an average total economic burden of €257 million per year. Conclusions: This analysis focused on the economic impact of breast cancer in Italy, showing that an advanced stage of the disease was associated with a higher cost.
Evaluation of the Policy Effect of China’s Environmental Interview System for Effective Air Quality Governance
Authors: Jin Xue , Sumaila Ussif Rashid , Yin Kedong , Qi Zhichao
Published: August 2021

The Ministry of Ecology and Environment of the People’s Republic of China formally proposed an environmental interview system in May 2014, which applies pressure on local governments to fulfill their responsibility toward environmental protection by conducting face-to-face public interviews with their officials. In this paper, 48 cities that were publicly interviewed from 2014–2020 were considered the experimental group and 48 cities surrounding them were the control group. First, the dynamic panel model is applied to initially determine the effect of the policy. Then, a regression discontinuity method (Sharp RD) is used to analyze the short-term and long-term effects and compare the reasons for the differences observed among the estimates of various types of samples. Finally, a series of robustness tests were also conducted. The results show that the environmental interview system can improve air quality. However, because an emergency short-term local governance system exists at present, the governance effect is not long-term and, therefore, not sustainable. Therefore, it suggests that the government should continue to improve the environmental interview system, establish an optimal environmental protection incentive mechanism, and encourage local governments to implement environmental protection policies effectively in the long term. The results of the research are of great significance to the environmental impact assessment system of the world, especially in countries with similar economic systems, which are facing a trade-off between economic growth and environmental sustainability.