bluuebunny/crossref_metadata_2025 huggingface dataset:
Intraspecific Growth Response to Drought of Abies alba in the Southeastern Carpathians
Authors: Mihai Georgeta , Alexandru Alin Madalin , Stoica Emanuel , Birsan Marius Victor
Published: March 2021

The intensity and frequency of drought have increased considerably during the last decades in southeastern Europe, and projected scenarios suggest that southern and central Europe will be affected by more drought events by the end of the 21st century. In this context, assessing the intraspecific genetic variation of forest tree species and identifying populations expected to be best adapted to future climate conditions is essential for increasing forest productivity and adaptability. Using a tree-ring database from 60 populations of 38-year-old silver fir (Abies alba) in five trial sites established across Romania, we studied the variation of growth and wood characteristics, provenance-specific response to drought, and climate-growth relationships during the period 1997–2018. The drought response of provenances was determined by four drought parameters: resistance, recovery, resilience, and relative resilience. Based on the standardized precipitation index, ten years with extreme and severe drought were identified for all trial sites. Considerable differences in radial growth, wood characteristics, and drought response parameters among silver fir provenances have been found. The provenances’ ranking by resistance, recovery, and resilience revealed that a number of provenances from Bulgaria, Italy, Romania, and Czech Republic placed in the top ranks in almost all sites. Additionally, there are provenances that combine high productivity and drought tolerance. The correlations between drought parameters and wood characters are positive, the most significant correlations being obtained between radial growth and resilience. Correlations between drought parameters and wood density were non-significant, indicating that wood density cannot be used as indicator of drought sensitivity. The negative correlations between radial growth and temperature during the growing season and the positive correlations with precipitation suggest that warming and water deficit could have a negative impact on silver fir growth in climatic marginal sites. Silvicultural practices and adaptive management should rely on selection and planting of forest reproductive material with high drought resilience in current and future reforestation programs.
Assessment of Fennel Oil Microfluidized Nanoemulsions Stabilization by Advanced Performance Xanthan Gum
Authors: Llinares Rubén , Ramírez Pablo , Carmona José Antonio , Trujillo-Cayado Luis Alfonso , Muñoz José
Published: March 2021

In this work, nanoemulsion-based delivery system was developed by encapsulation of fennel essential oil. A response surface methodology was used to study the influence of the processing conditions in order to obtain monomodal nanoemulsions of fennel essential oil using the microchannel homogenization technique. Results showed that it was possible to obtain nanoemulsions with very narrow monomodal distributions that were homogeneous over the whole observation period (three months) when the appropriate mechanical energy was supplied by microfluidization at 14 MPa and 12 passes. Once the optimal processing condition was established, nanoemulsions were formulated with advanced performance xanthan gum, which was used as both viscosity modifier and emulsion stabilizer. As a result, more desirable results with enhanced physical stability and rheological properties were obtained. From the study of mechanical spectra as a function of aging time, the stability of the nanoemulsions weak gels was confirmed. The mechanical spectra as a function of hydrocolloid concentration revealed that the rheological properties are marked by the biopolymer network and could be modulated depending on the amount of added gum. Therefore, this research supports the role of advanced performance xanthan gum as a stabilizer of microfluidized fennel oil-in-water nanoemulsions. In addition, the results of this research could be useful to design and formulate functional oil-in-water nanoemulsions with potential application in the food industry for the delivery of nutraceuticals and antimicrobials.
Social and Neurocognitive Deficits in Remitted Patients with Schizophrenia, Schizoaffective and Bipolar Disorder
Authors: Dehelean Liana , Romosan Ana Maria , Bucatos Bianca Oana , Papava Ion , Balint Rita , Bortun Ana Maria Cristina , Toma Mirela Marioara , Bungau Simona , Romosan Radu Stefan
Published: March 2021

This study assesses the empathy level, cognitive performance and emotion recognition skills of remitted patients with schizophrenia, schizoaffective disorder and bipolar disorder, and also explores the relationship between impairments in the mentioned domains. The study was performed on 77 subjects divided into two groups: PAT sample (N = 37) included remitted patients with either schizophrenia, schizoaffective or bipolar disorder who were compared with healthy control subjects from the HC sample (N = 40). Along with sociodemographic and clinical data, empathy levels (using EQ (Empathy Quotient) scale), the ability to recognize another person’s emotional state (using RMET (Reading the Mind in the Eyes Test)), and cognitive performance (using MoCA (Montreal Cognitive Assessment) Scale) were investigated. The intensity of the psychiatric symptoms was measured with BPRS-E (Brief Psychiatric Rating Scale—Expanded). The remitted patients had lower EQ (p = 0.02) and RMET (p < 0.0001) scores than the healthy subjects. In the PAT group, RMET scores were positively correlated with MoCA total scores. Both EQ and RMET scores were negatively correlated with BPRS-E total scores. Psychiatric disorder was a significant predictor for deficits in emotion recognition. There were no significant differences in RMET, EQ and MoCA scores between patients with respect to diagnosis, the type of antipsychotic or the associated medication. In both samples, females had higher empathy levels (p = 0.04) and better emotion recognition abilities (p = 0.04) than males. Patients with schizophrenia, schizoaffective or bipolar disorder, currently in remission, displayed lower empathy levels and poorer emotion recognition skills than healthy subjects. Poor emotion recognition skills were associated with symptom severity and impairments in global cognition.
Efficacy of an Eco-Friendly Bloom Thinning Formulation on Mango Trees and Its Olfactory Effect on an Insect Pollinator, Apis mellifera
Authors: Son Tae-Kwon , Mostafiz Md Munir , Hwang Hwal-Su , Thạnh Nguyen Truong , Lee Kyeong-Yeoll
Published: March 2021

In various orchard fruit trees, thinning of blossoms and fruits is important to increase fruit size and quality and to promote a new bloom in the following season. Several chemical thinning agents are currently commercially available, but they are inconsistent and produce side effects in crop plants and insect pollinators. Because of environmental concerns, developing alternative eco-friendly bloom thinning agents is necessary. We developed an eco-friendly bloom thinning formulation (BTF) using minerals and extracts of various medicinal plants. Our BTF spray (0.1%, w/v) decreased the number of fruits per tree (46.5%) and fruit yield per tree (81.5%) but increased the fruit weight (196.8%) compared with the control treatment; the spray induced a small number of larger mango fruits in the treated trees. We also investigated the effect of BTF on the olfactory behavior of Apis mellifera L. (Hymenoptera, Apidae), a major insect pollinator. We analyzed the behavioral changes of adult workers at two different concentrations (0.1% and 1%) of nine different BTF spray components using a Y-tube olfactometer. The behavioral responses of honey bees to nine BTF components showed significant differences. However, honey bees showed no clear attraction or repellent behavior towards the tested BTF components. Our results suggest that the newly developed eco-friendly BTF is practically applicable in mango orchards without interrupting honey bee behavior.
Hydrological Mapping in the Luquillo Experimental Forest: New Local Datum Improves Watershed Ecological Knowledge
Authors: Leon Miguel C. , Heartsill-Scalley Tamara , Santiago Iván , McDowell William H.
Published: March 2021

Streams and rivers of the Luquillo Experimental Forest, Puerto Rico, have been the subject of extensive watershed and aquatic research since the 1980s. This research includes understanding stream export of nutrients and coarse particulate organic matter, physicochemical constituents, aquatic fauna populations and community structure. However, many of the streams and watersheds studied do not appear in standard scale maps. We document recent collaborative and multi-institutional work to improve hydrological network information and identify knowledge gaps. The methods used to delimit and densify stream networks include establishment and incorporation of an updated new vertical datum for Puerto Rico, LIDAR derived elevation, and a combination of visual-manual and automated digitalization processes. The outcomes of this collaborative effort have resulted in improved watershed delineation, densification of hydrologic networks to reflect the scale of on-going studies, and the identification of constraining factors such as unmapped roadways, culverts, and other features of the built environment that interrupt water flow and alter runoff pathways. This work contributes to enhanced knowledge for watershed management, including attributes of riparian areas, effects of road and channel intersections and ridge to reef initiatives with broad application to other watersheds.
Exploring the Role of the Food Environment in Dietary Acculturation: A Study amongst Moroccan Immigrants in The Netherlands
Authors: O’Mara Jillian , Waterlander Wilma , Nicolaou Mary
Published: March 2021

Food environments play a role in immigrants’ dietary acculturation, but little is known about the directionality of the relationship. The objective was to explore the interaction between the food environment and food procurement behaviors in the process of dietary acculturation. A qualitative study design using in-depth interviews and a mapping exercise was conducted. The immigrant group studied used a variety of factors to select which foods to procure. Traditional foods were readily available, shifting the determining factors to a combination of affordability, acceptability and accessibility. The food environment is dynamic and responds to shifting market demands. Policies regarding food procurement behaviors should consider these upstream effects and be aware of the availability of traditional foods for immigrant groups.
Neurophysiological Approach by Self-Control of Your Stress-Related Autonomic Nervous System with Depression, Stress and Anxiety Patients
Authors: Blase Kees , Vermetten Eric , Lehrer Paul , Gevirtz Richard
Published: March 2021

Background: Heart Rate Variability Biofeedback (HRVB) is a treatment in which patients learn self-regulation of a physiological dysregulated vagal nerve function. While the therapeutic approach of HRVB is promising for a variety of disorders, it has not yet been regularly offered in a mental health treatment setting. Aim: To provide a systematic review about the efficacy of HRV-Biofeedback in treatment of anxiety, depression, and stress related disorders. Method: Systematic review in PubMed and Web of Science in 2020 with terms HRV, biofeedback, Post-Traumatic Stress Disorder (PTSD), depression, panic disorder, and anxiety disorder. Selection, critical appraisal, and description of the Random Controlled Trials (RCT) studies. Combined with recent meta-analyses. Results: The search resulted in a total of 881 studies. After critical appraisal, nine RCTs have been selected as well as two other relevant studies. The RCTs with control groups treatment as usual, muscle relaxation training and a “placebo“-biofeedback instrument revealed significant clinical efficacy and better results compared with control conditions, mostly significant. In the depression studies average reduction at the Beck Depression Inventory (BDI) scale was 64% (HRVB plus Treatment as Usual (TAU) versus 25% (control group with TAU) and 30% reduction (HRVB) at the PSQ scale versus 7% (control group with TAU). In the PTSD studies average reduction at the BDI-scale was 53% (HRV plus TAU) versus 24% (control group with TAU) and 22% (HRVB) versus 10% (TAU) with the PTSD Checklist (PCL). In other systematic reviews significant effects have been shown for HRV-Biofeedback in treatment of asthma, coronary artery disease, sleeping disorders, postpartum depression and stress and anxiety. Conclusion: This systematic review shows significant improvement of the non-invasive HRVB training in stress related disorders like PTSD, depression, and panic disorder, in particular when combined with cognitive behavioral therapy or different TAU. Effects were visible after four weeks of training, but clinical practice in a longer daily self-treatment of eight weeks is more promising. More research to integrate HRVB in treatment of stress related disorders in psychiatry is warranted, as well as research focused on the neurophysiological mechanisms.
More Than Shelter: Housing for Urban Maternal and Infant Health
Authors: Reece Jason
Published: March 2021

Housing quality, stability, and affordability have a direct relationship to socioemotional and physical health. Both city planning and public health have long recognized the role of housing in health, but the complexity of this relationship in regard to infant and maternal health is less understood. Focusing on literature specifically relevant to U.S. metropolitan areas, I conduct a multidisciplinary literature review to understand the influence of housing factors and interventions that impact infant and maternal health. The paper seeks to achieve three primary goals. First, to identify the primary “pathways” by which housing influences infant and maternal health. Second, the review focuses on the role and influence of historical housing discrimination on maternal health outcomes. Third, the review identifies emergent practice-based housing interventions in planning and public health practice to support infant and maternal health. The literature suggests that the impact of housing on infant health is complex, multifaceted, and intergenerational. Historical housing discrimination also directly impacts contemporary infant and maternal health outcomes. Policy interventions to support infant health through housing are just emerging but demonstrate promising outcomes. Structural barriers to housing affordability in the United States will require new resources to foster greater collaboration between the housing and the health sectors.
Friendship and Consumption Networks in Adolescents and Their Relationship to Stress and Cannabis Use Intention
Authors: Martínez-Fernández María Cristina , Liébana-Presa Cristina , Fernández-Martínez Elena , Gomes Lisa , García-Rodríguez Isaías
Published: March 2021

Background: Cannabis is an illegal psychoactive substance that’s use is widespread among adolescents. During adolescence, many changes can cause stress. In this phase, the group of friends becomes increasingly important, being a situation of vulnerability for the beginning of cannabis use, either as an escape mechanism or due to peer’s influence. Therefore, the purpose of this study is to describe and analyze the structure of the consumption and friendship network, the intention to use cannabis, and the stress in a secondary school class. Methods: An online platform with validated self-reported questionnaires were used for data collection. Results: The sample consisted of adolescents (n = 20) aged 14–16 from a third-year class of compulsory secondary education in Ponferrada (León, Spain). Significant differences were obtained concerning consumption intention and the different network metrics in both the friendship and consumption networks. Subsequently, the representation of these networks was carried out. Conclusions: Social Network Analysis is a very useful tool that provides a picture of the context in which adolescents are located. In the consumption network, there are central actors who have not yet consumed cannabis; this is a crucial moment to implement prevention strategies.
Co-Production Performance Evaluation in Healthcare. A Systematic Review of Methods, Tools and Metrics
Authors: Marsilio Marta , Fusco Floriana , Gheduzzi Eleonora , Guglielmetti Chiara
Published: March 2021

Co-produced practices and publications in the healthcare sector are gaining momentum, since they can be a useful tool in addressing the sustainability and resilience challenges of health systems. However, the investigation of positive and, mainly, negative outcomes is still confused and fragmented, and above all, a comprehensive knowledge of the metrics used to assess these outcomes is lacking. To fill this gap, this study aims to systematically review the extant literature to map the methods, tools and metrics used to empirically evaluate co-production in health services. The search took place in six databases: Scopus, Web of Science, Psych INFO, PubMed, Cochrane and CINAHL. A total of 2311 articles were screened and 203 articles were included in the analysis, according to PRISMA guidelines. Findings show that outcomes are mainly investigated through qualitative methods and from the lay actor or provider perspective. Moreover, the detailed categorisation of the quantitative measures found offers a multidimensional performance measurement system and highlights the impact areas where research is needed to develop and test new measures. Findings should also promote improvements in empirical data collection on the multiple faceted co-produced activities and spur the consciousness of the adoption of sustainable co-productive initiatives.
Exploring the Associations between Early Childhood Development Outcomes and Ecological Country-Level Factors across Low- and Middle-Income Countries
Authors: Allel Kasim , Abou Jaoude Gerard , Poupakis Stavros , Batura Neha , Skordis Jolene , Haghparast-Bidgoli Hassan
Published: March 2021

A poor start in life shapes children’s development over the life-course. Children from low- and middle-income countries (LMICs) are exposed to low levels of early stimulation, greater socioeconomic deprivation and persistent environmental and health challenges. Nevertheless, little is known about country-specific factors affecting early childhood development (ECD) in LMICs. Using data from 68 LMICs collected as part of the Multiple Indicator Cluster Surveys between 2010 and 2018, along with other publicly available data sources, we employed a multivariate linear regression analysis at a national level to assess the association between the average Early Childhood Development Index (ECDI) in children aged 3–5 and country-level ecological characteristics: early learning and nurturing care and socioeconomic and health indicators. Our results show that upper-middle-income country status, attendance at early childhood education (ECE) programs and the availability of books at home are positively associated with a higher ECDI. Conversely, the prevalence of low birthweight and high under-5 and maternal mortality are negatively associated with ECDI nationally. On average, LMICs with inadequate stimulation at home, higher mortality rates and without mandatory ECE programs are at greater risks of poorer ECDI. Investment in early-year interventions to improve nurturing care and ECD outcomes is essential for achieving Sustainable Development Goals.
Mucosal Melanoma of the Hard Palate: Surgical Treatment and Reconstruction
Authors: Bondi Stefano , Vinciguerra Alessandro , Lissoni Alessandra , Rizzo Nathalie , Barbieri Diego , Indelicato Pietro , Abati Silvio
Published: March 2021

Mucosal melanomas of the head and neck region are uncommon pathologies that can affect the oral cavity, and are characterized by a high rate of mortality. Considering the lack of knowledge regarding risk and prognostic factors, current best clinical practice is represented by a large surgical excision with disease-free margins, eventually associated with a reconstructive flap. Indeed, given the frequent necessity of postoperative radiotherapy and fast healing process, a reconstruction of the surgical gap is advisable. Even if several flaps have been most commonly used, the submental island flap represents a valid alternative thanks to local advantages and similar oncologic outcomes compared to free flaps.
Hypertensive Disorders during Pregnancy (HDP), Maternal Characteristics, and Birth Outcomes among Japanese Women: A Hokkaido Study
Authors: Poudel Kritika , Kobayashi Sumitaka , Miyashita Chihiro , Ikeda-Araki Atsuko , Tamura Naomi , Ait Bamai Yu , Itoh Sachiko , Yamazaki Keiko , Masuda Hideyuki , Itoh Mariko , Ito Kumiko , Kishi Reiko
Published: March 2021

Hypertension during pregnancy causes a greater risk of adverse birth outcomes worldwide; however, formal evidence of hypertensive disorders during pregnancy (HDP) in Japan is limited. We aimed to understand the association between maternal characteristics, HDP, and birth outcomes. In total, 18,833 mother-infant pairs were enrolled in the Hokkaido study on environment and children’s health, Japan, from 2002 to 2013. Medical records were used to identify hypertensive disorders and birth outcomes, namely, small for gestational age (SGA), SGA at full term (term-SGA), preterm birth (PTB), and low birth weight (LBW). The prevalence of HDP was 1.9%. Similarly, the prevalence of SGA, term-SGA, PTB, and LBW were 7.1%, 6.3%, 7.4%, and 10.3%, respectively. The mothers with HDP had increased odds of giving birth to babies with SGA (2.13; 95% Confidence Interval (CI): 1.57, 2.88), PTB (3.48; 95%CI: 2.68, 4.50), LBW (3.57; 95%CI: 2.83, 4.51) than normotensive pregnancy. Elderly pregnancy, low and high body mass index, active and passive smoking exposure, and alcohol consumption were risk factors for different birth outcomes. Therefore, it is crucial for women of reproductive age and their families to be made aware of these risk factors through physician visits, health education, and various community-based health interventions.
High Seroprevalence of SARS-CoV-2 among Healthcare Workers in a North Italy Hospital
Authors: Airoldi Chiara , Patrucco Filippo , Milano Fulvia , Alessi Daniela , Sarro Andrea , Rossi Maicol Andrea , Cena Tiziana , Borrè Silvio , Faggiano Fabrizio
Published: March 2021

Background: Healthcare workers (HCWs) have been the key players in the fight against the coronavirus disease 2019 (COVID-19) pandemic. The aim of our study was to evaluate the seroprevalence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) IgG anti-bodies. Methods: We conducted a cross-sectional study among workers of two hospitals and Territorial Medical and Administrative services in Northern Italy. From 8 May to 3 June 2020, 2252 subjects were tested. Seroprevalence and 95% confidence interval (CI) were calculated for all individuals who were stratified by job title, COVID-19 risk of exposure, direct contact with patients, unit ward, and intensity of care. Results: Median age was 50 years, and 72% of subjects were female. The overall seroprevalence was 17.11% [95% CI 15.55–18.67]. Around 20% of healthcare assistants were seropositive, followed by physicians and nurses (16.89% and 15.84%, respectively). HCWs with high risk of exposure to COVID-19 were more frequently seropositive (28.52%) with respect to those with medium and low risks (16.71% and 12.76%, respectively). Moreover, personnel in direct contact had higher prevalence (18.32%) compared to those who did not (10.66%). Furthermore, the IgG were more frequently detected among personnel of one hospital (19.43%). Conclusion: The high seroprevalence observed can be partially explained by the timing and the population seroprevalence; the study was conducted in an area with huge spread of the infection.
Evolution of Singlet Oxygen by Activating Peroxydisulfate and Peroxymonosulfate: A Review
Authors: Xiao Guangfeng , Xu Tiantian , Faheem Muhammad , Xi Yanxing , Zhou Ting , Moryani Haseeb Tufail , Bao Jianguo , Du Jiangkun
Published: March 2021

Advanced oxidation processes (AOPs) based on peroxydisulfate (PDS) or peroxymonosulfate (PMS) activation have attracted much research attention in the last decade for the degradation of recalcitrant organic contaminants. Sulfate (SO4•−) and hydroxyl (•OH) radicals are most frequently generated from catalytic PDS/PMS decomposition by thermal, base, irradiation, transition metals and carbon materials. In addition, increasingly more recent studies have reported the involvement of singlet oxygen (1O2) during PDS/PMS-based AOPs. Typically, 1O2 can be produced either along with SO4•− and •OH or discovered as the dominant reactive oxygen species (ROSs) for pollutants degradation. This paper reviews recent advances in 1O2 generation during PDS/PMS activation. First, it introduces the basic chemistry of 1O2, its oxidation properties and detection methodologies. Furthermore, it elaborates different activation strategies/techniques, including homogeneous and heterogeneous systems, and discusses the possible reaction mechanisms to give an overview of the principle of 1O2 production by activating PDS/PMS. Moreover, although 1O2 has shown promising features such as high degradation selectivity and anti-interference capability, its production pathways and mechanisms remain controversial in the present literatures. Therefore, this study identifies the research gaps and proposes future perspectives in the aspects of novel catalysts and related mechanisms.
The Effects of Insole-Based Visual Feedback on Weight-Bearing in Patients Undergoing Total Hip Replacement
Authors: Marin Luca , Vandoni Matteo , Zaza Giancarlo , Febbi Massimiliano , Pedrotti Luisella , Chiodaroli Matteo , Lovecchio Nicola , Manzoni Federica
Published: March 2021

This study aimed to investigate the visual biofeedback effect of a sensorized system for plantar pressure dynamic evaluation of in patients with a total hip replacement. Experimental group followed the rehabilitation training wearing sensorized insoles that provided images on three monitors. The control group followed the verbal instructions of physiotherapists during training. Weight bearing percentage healthy limb (WBPH), weight bearing percentage surgical limb (WBPS), swing healthy limb (SWH) and swing surgical limb (SWS) improved significantly more in the experimental group. The results underline the effectiveness of visual biofeedback based on sensorized system with dynamic evaluation of the plantar pressure.
Controlled Irrigation and Drainage Reduce Rainfall Runoff and Nitrogen Loss in Paddy Fields
Authors: Yu Yanmei , Xu Junzeng , Zhang Pingcang , Meng Yan , Xiong Yujiang
Published: March 2021

In southern China, the growing period of rice is synchronized with the rainy period, and the loss of nutrients (such as nitrogen) due to unreasonable irrigation and drainage, along with rainfall and runoff, has become the main source of agricultural nonpoint source pollution. The laws of runoff and nitrogen loss in paddy fields under different irrigation and drainage modes are not clear. In this study, field experiments were adopted to observe the runoff and nitrogen loss under typical rainfall and throughout the whole growth period. The results showed that, compared with the traditional irrigation and drainage mode, the controlled irrigation and drainage mode reduced the drainage of two typical rainfall processes by 47.5% and 31.3% and the peak drainage by 38.9% and 14.4%. Compared with those under the traditional irrigation and drainage mode, the average concentrations of total nitrogen, nitrate nitrogen, and ammonium nitrogen under the controlled irrigation and drainage mode were reduced by 22.2%, 22.7%, and 27.8%, respectively, during the whole rainfall process on July 21 and were decreased by 27.1%, 11.4%, and 25.6%, respectively, on August 25. In irrigated rice areas, under the controlled irrigation and drainage mode, drainage was reduced after two intercepts through paddy fields and drainage ditches. The nitrogen concentration in the drainage ditch decreased due to the increase in retention time and the effect of the ditch and field wetland. Compared with the traditional irrigation and drainage mode, the total nitrogen, nitrate nitrogen, and ammonium nitrogen loads of the controlled irrigation and drainage mode were reduced by 69.8%, 65.3%, and 69.7%, respectively.
Chronic Illness and Income Diversification in Rural China
Authors: Liao Wenmei , Wang Jiawei , Lin Ying , Wang Yao
Published: March 2021

Off-farm diversification offers an important pathway out of poverty while health-impaired rural farmers can hardly seize the opportunity in developing countries. This paper investigates how chronic illness shapes livelihood structure and income generation in rural China. Our sample consists of 3850 rural households in Southern China and we rely on instrumental variable regressions to identify causal effects. We find that farmers with chronic illness tend to diversify towards local off-farm employments, rather than migrants, since local off-farm employments are more likely to act in a strategically complementary way to farming. Further analysis shows that income returns of diversification tend to be substantially higher for the health-impaired. While the relationship between diversification and income presents a conventional inverted U shape for the healthy, it is best categorized as upward sloping with diminishing marginal effects for farmers with chronic illness.
Associations between Children’s Risky Play and ECEC Outdoor Play Spaces and Materials
Authors: Sandseter Ellen Beate Hansen , Sando Ole Johan , Kleppe Rasmus
Published: March 2021

Children spend a large amount of time each day in early childhood education and care (ECEC) institutions, and the ECEC play environments are important for children’s play opportunities. This includes children’s opportunities to engage in risky play. This study examined the relationship between the outdoor play environment and the occurrence of children’s risky play in ECEC institutions. Children (n = 80) were observed in two-minute sequences during periods of the day when they were free to choose what to do. The data consists of 935 randomly recorded two-minute videos, which were coded second by second for several categories of risky play as well as where and with what materials the play occurred. Results revealed that risky play (all categories in total) was positively associated with fixed equipment for functional play, nature and other fixed structures, while analysis of play materials showed that risky play was positively associated with wheeled toys. The results can support practitioners in developing their outdoor areas to provide varied and exciting play opportunities.
The Impact of the COVID-19 Pandemic on the Brazilian Immigrant Community in the U.S: Results from a Qualitative Study
Authors: Priebe Rocha Leticia , Rose Raviv , Hoch Annmarie , Soares Cristiane , Fernandes Adriana , Galvão Heloisa , Allen Jennifer
Published: March 2021

While an increasing body of data suggests that marginalized groups have been disproportionately impacted by COVID-19, little has been published about the specific impact on Brazilian immigrants in the U.S. We conducted 15 key informant interviews, one of which included two participants (n = 16), with representatives from social service agencies, healthcare, and faith-based organizations serving Brazilian immigrants. Key informants were asked about the community’s experiences with COVID-19 testing and treatment, responses to CDC (Centers for Disease Control) guidelines, perceptions about the virus, and the pandemic’s impact on physical and mental health. Results suggest that COVID-19 has profoundly impacted Brazilian immigrants’ mental and physical health. Key informants perceived that community members faced higher risk of COVID-19 infection due to overcrowded living conditions and over-representation in public-facing and informal (e.g., housecleaning) jobs. They reported barriers to COVID-19-related healthcare services including language, immigration status, and fear of deportation. Brazilian cultural norms surrounding hygiene practices, social distancing, and information distribution have shaped the community’s pandemic response. The Brazilian community has faced extensive social, economic, and health ramifications due to the pandemic. While not unique to this community, pre-existing concerns about social disadvantage suggest a particular vulnerability of this population to the virus.
Knowledge, Attitudes, and Sources of Information on Vaccines in Spanish Nursing Students: A Cross-Sectional Study
Authors: Tuells José , Egoavil Cecilia M. , Morales-Moreno Isabel , Fortes-Montoya Elena , Salazar-García Carlos , Rodríguez-Blanco Noelia
Published: March 2021

Health professionals are the most influential and main sources of information about vaccines for the general population, as they are regarded as role models by patients and society. The objective of the present study was to determine the knowledge and attitudes of a group of university Nursing students about vaccines, as well as their sources of information and their education needs. A cross-sectional study was performed through a questionnaire (55 items) provided to Nursing students at two Spanish universities. A total of 1122 students participated in the study. The mean score obtained for knowledge about vaccines was 44.6 ± 4.3, and for attitudes towards vaccines, it was 37.2 ± 3.9. Hepatitis B (94.7%) and the Flu (89%) are the two main vaccines they should receive as health workers. The main source of information was the family environment (65.6%). Most of them considered that post-graduate education about vaccines should be provided by academic entities (universities, 62.7%). Among the health professionals, Nurses (85.5%) must be better educated and trained on the subject of vaccines. It is therefore necessary to delve into and complete the nurses’ training on vaccines, to educate them about the risks at the individual level, and their decisive role as promoters of the vaccination strategy for the general population. Universities must become the leaders in vaccine education and training.
Experimental Evaluation of Aerosol Production after Dental Ultrasonic Instrumentation: An Analysis on Fine Particulate Matter Perturbation
Authors: Graziani Filippo , Izzetti Rossana , Lardani Lisa , Totaro Michele , Baggiani Angelo
Published: March 2021

Aerosol production represents a major concern during the majority of dental procedures. The aim of the present study is to investigate the dynamics of aerosol particles after 15 min of continuous supragingival ultrasonic instrumentation with no attempt of containment through particle count analysis. Eight volunteers were treated with supragingival ultrasonic instrumentation of the anterior buccal region. A gravimetric impactor was positioned 1 m away and at the same height of the head of the patient. Particles of different sizes (0.3–10 µm) were measured at the beginning of instrumentation, at the end of instrumentation (EI), and then every 15 min up to 105 min. The 0.3-µm particles showed non-significant increases at 15/30 min. The 0.5–1-µm particles increased at EI (p < 0.05), and 0.5 µm remained high for another 15 min. Overall, all submicron aerosol particles showed a slow decrease to normal values. Particles measuring 3–5 µm showed non-significant increases at EI. Particles measuring 10 µm did not show any increases but a continuous reduction (p < 0.001 versus 0.3 µm, p < 0.01 versus 0.5 µm, and p < 0.05 versus 1–3 µm). Aerosol particles behaved differently according to their dimensions. Submicron aerosols peaked after instrumentation and slowly decreased after the end of instrumentation, whilst larger particles did not show any significant increases. This experimental study produces a benchmark for the measurement of aerosol particles during dental procedures and raises some relevant concerns about indoor air quality after instrumentation.
Obstetric Violence in Spain (Part III): Healthcare Professionals, Times, and Areas
Authors: Mena-Tudela Desirée , Iglesias-Casás Susana , González-Chordá Víctor Manuel , Valero-Chillerón María Jesús , Andreu-Pejó Laura , Cervera-Gasch Águeda
Published: March 2021

Background: Obstetric violence is a worldwide public health problem, which seems greater in Spain. As no studies were found that identify the most representative healthcare professionals, times, and areas involved in obstetric violence, the objective of this work was to study at what time of maternity, with which professionals, and in what areas women identified obstetric violence. Methods: This descriptive, retrospective, and cross-sectional study was performed from January 2018 to June 2019. The main variables were the area (hospital, primary care, both), the time (pregnancy, birth, puerperium), and the professionals attending to women. Results: Our sample comprised 17,541 participants. The area identified with the most obstetric violence for the different studied variables was hospitals. Women identified more obstetric violence at time of birth. Findings such as lack of information and informed consent (74.2%), and criticism of infantile behavior and treatment (87.6%), stood out. The main identified healthcare professionals were midwives and gynecologists, and “other” professionals repeatedly appeared. Conclusions: Having identified the professionals, times, and areas of most obstetric violence in Spain, it seems necessary to reflect on not only the Spanish National Health System’s structure and management but also on healthcare professionals’ training.
A Qualitative Study of Understanding Reasons for Self-Harm in Adolescent Girls
Authors: Miller Michelle , Redley Marcus , Wilkinson Paul O.
Published: March 2021

Objective: Self-harm is an important public health issue in the UK. Young people who self-harm frequently feel misunderstood, and unable to access help. Improving understanding is key to informing the development and delivery of effective treatments and services. Methods: In this qualitative study, we interviewed nine adolescent girls (13–17 years old) with recurrent self-harm, recruited from NHS specialist child and adolescent mental health services. Data were analysed using Interpretative Phenomenological Analysis (IPA). Results: Findings revealed that self-harm is experienced as powerful mental and physical urges, sated only by self-harming, suggesting that self-harm could be considered a compulsive rather than impulsive disorder, representing a new perspective on the behaviour. Five themes emerged: emotion regulation; an addictive urge; self-harm to survive; interpersonal triggers; interpersonal relationships, not mechanical distractors, reduce self-harm. Conclusions: This study provides further evidence that non-suicidal self-injury may be engaged in to reduce suicidal risk. Seeking the company of helpful friends or family members may reduce the urge to self-harm. Repetitive self-harm may be a compulsive behaviour.
Physical Activity and the Home Environment of Pre-School-Aged Children in Urban Bangladesh
Authors: Watterworth Jessica C. , Korsiak Jill , Keya Farhana K. , Arbour-Nicitopoulos Kelly P. , Al Mahmud Abdullah , Tam Vivian , Roth Daniel E.
Published: March 2021

Physical activity (PA) is a key determinant of health and development, yet few studies have examined PA levels and risk factors for low PA among young children in low- and middle-income countries. This study aimed to describe the PA and sedentary (SED) behavior levels of preschool-aged children in Dhaka, Bangladesh, and to estimate the associations between potential risk factors in the home built environment and moderate to vigorous PA (MVPA). In a sample of preschool-aged children (n = 65) in Dhaka, PA and SED behavior were measured for 7 days using ActiGraph GT3X-BT accelerometers. Characteristics of the home built environment, socioeconomic factors, and anthropometry were also measured. Linear mixed-effects models were used to estimate multivariable-adjusted associations between characteristics of the home environment and MVPA. Preschool-aged children spent a mean (±standard deviation) 421 ± 48 and 82 ± 23 min per day sedentary and in MVPA, respectively. There were no statistically significant associations between factors in the home built environment (indoor area, presence of an open stairwell, and presence of gross motor activity facilitating items) and MVPA. These findings suggest that the studied characteristics of the home built environment may not significantly influence the MVPA observed among preschool-aged children in Dhaka. Future research should focus on other structural and behavioral factors that facilitate PA among young children in dense urban settings.
Older Adults Who Spend More Time Outdoors in Summer and Have Higher Dietary Vitamin D Than Younger Adults Can Present at Least as High Vitamin D Status: A Pilot Study
Authors: Borecka Oktawia , Farrar Mark D. , Osman Joanne E. , Rhodes Lesley E. , Webb Ann R.
Published: March 2021

Vitamin D3 can be produced by exposing skin to UVB radiation or sourced through dietary products. It is often stated that vitamin D status declines in older adults, yet little is known about differences in current-day lifestyle and dietary behaviours influencing vitamin D outcomes in younger (18–40 years old) and older adults (65–89 years old). Our objectives were to perform a pilot study to compare sun exposure behaviours, i.e., time spent outdoors, holiday behaviour and use of sunscreen/clothing, and dietary vitamin D intake, in young and older adults in the UK, together with assessment of their vitamin D status. A total of 13 young and 11 older volunteers completed a four-page questionnaire to assess sun exposure and photoprotective behaviour and an eleven-page one-week vitamin D diet diary, alongside their plasma 25(OH)D measurement. It was found that the older group tended to spend more time outdoors during the working week in summer, to take more summer and winter holidays each year, take longer winter holidays and have similar sunscreen use when compared to younger adults. Older adults had a significantly higher daily dietary intake of vitamin D (4.0 μg) than young adults (2.4 μg). Mean winter 25(OH)D concentration was higher in older (56.9 nmol/L) than in young adults (43.2 nmol/L), but there was no statistical difference between the groups. Contrary to common assumptions, in this study, older adults had sun exposure and dietary behaviours conferring a vitamin D status at least as good as that of younger adults.
Morphometric Analysis of the Mandibular Canal, Anterior Loop, and Mental Foramen: A Cone-Beam Computed Tomography Evaluation
Authors: Ahmed Altayeb Abdalla , Ahmed Rawia Mohamed , Jamleh Ahmed , Spagnuolo Gianrico
Published: March 2021

This study investigated the cone-beam computed tomography (CBCT)-based features of the mandibular canal, mental foramen, anterior loop, and accessory mental foramina with respect to age and sex. A total of 306 CBCT mandibular images were included in this retrospective study to measure the mandibular canal location and extension, the mental foramen position, the presence of the anterior loop, and the accessory mental foramina. The measurements were obtained in sagittal, coronal, and axial views. Descriptive statistics are presented. Sex-related differences, correlations, and comparisons were calculated using SPSS at 5% significance level. The mandibular canal was located more coronal and medial in male patients. The majority of cases had the mental foramen located just apical to the mandibular second premolar with a mean height of 2.94 mm and a mean length of 3.28 mm. Age affected the size of the mental foramen. The mental canal in all cases tended to show a coronal direction. Mesial extension of the anterior loop was found in 66.01% of the images while accessory mental foramina were detected in 2.6%. The complexity of the mandibular canal, mental foramen, anterior loop, and accessory mental foramina among Sudanese patients with respect to age and sex was confirmed.
People’s Response to Potential Natural Hazard-Triggered Technological Threats after a Sudden-Onset Earthquake in Indonesia
Authors: Lestari Fatma , Jibiki Yasuhito , Sasaki Daisuke , Pelupessy Dicky , Zulys Agustino , Imamura Fumihiko
Published: March 2021

(1) Background: We aim to examine whether people activate initial protection behavior, adopt evacuation behavior, worry about the possibility of a tsunami, and consider natural hazard-triggered technological (Natech) situations in a sudden-onset earthquake. The literature suggests that risk perception is a significant predictor of people’s response to potential Natech threats. We aim to empirically verify the variables relating to people’s responses. (2) Methods: We conducted a household survey following a January 2018 earthquake in Indonesia. (3) Results: Immediately after the earthquake, almost 30% of the respondents assembled at the evacuation point. However, sequential steps of people’s response were not observed: evacuation immediately after the earthquake was due to worry about the possibility of a tsunami, but this worry was not related to Natech damage estimation. The relevant factors for evacuation behavior were information access, worry about the possibility of a tsunami, and knowledge of groups and programs related to disaster risk reduction (DRR). The survey location (two villages), perceived earthquake risk, and DRR activity participation are less relevant to the behavior of assembling at the evacuation point. (4) Conclusions: Contrary to the existing literature, our results do not support that higher risk perception is associated with evacuation behavior, or that immediate evacuation is related to foreseeing cascading sequential consequences.
The Academic Landscapes of Manufacturing Enterprise Performance and Environmental Sustainability: A Study of Commonalities and Differences
Authors: Mejia Cristian , Kajikawa Yuya
Published: March 2021

This article reviews literature on manufacturing enterprise performance (MEP) and environmental sustainability (ES) to identify their commonalities and distinguishing factors; it is expected to help determine gaps and paths for future research. Topics are classified based on patterns in the citation networks of 7308 and 6275 MEP and ES articles, respectively. Additionally, a semantic linkage was computed to reveal overlap in vocabulary between the two topics. A total of 17 and 21 topics were found in MEP and ES, respectively, where the main shared theme was the green supply chain. However, research on biofuels is unique to ES, and privatization is unique to MEP, among others. The concept of “performance” has also been covered by MEP and ES researchers. This article provides an objective snapshot of current research trends based on quantitative data, and the findings may be used to guide future research directions at the intersection of MEP and ES.