bluuebunny/crossref_metadata_2025 huggingface dataset:
Variation of the Occurrence of Physical Restraint Use in the Long-Term Care: A Scoping Review
Authors: Ambrosi Elisa , Debiasi Martina , Longhini Jessica , Giori Lorenzo , Saiani Luisa , Mezzalira Elisabetta , Canzan Federica
Published: November 2021

Physical restraints in the long-term care setting are still commonly used in several countries with a prevalence ranging from 6% to 85%. Trying to have a broad and extensive overlook on the physical restraints use in long-term care is important to design interventions to prevent and/or reduce their use. Therefore, the aim of this scoping review was to analyze the range of occurrence of physical restraint in nursing homes, long-term care facilities, and psychogeriatric units. Pubmed, CINAHL, Ovid PsycINFO- databases were searched for studies with concepts about physical restraint use in the European long-term care setting published between 2009 and 2019, along with a hand search of the bibliographies of the included studies. Data on study design, data sources, clinical setting and sample characteristics were extracted. A total of 24 studies were included. The median occurrence of physical restraint in the European long-term care setting was still high (26.5%; IQR 16.5% to 38.5%) with a significant variability across the studies. The heterogeneity of data varied according to study design, data sources, clinical setting, physical restraint’s definition, and patient characteristics, such as ADLs dependence, presence of dementia and psychoactive drugs prescription.
Changes in Tobacco Use Patterns among Veterans in San Diego during the Recent Peak of the COVID-19 Pandemic
Authors: Fatollahi Javad J. , Bentley Sean , Doran Neal , Brody Arthur L.
Published: November 2021

The prevalence of tobacco use increases in times of stress; however, during the initial stage of the COVID-19 pandemic, tobacco use rates stayed the same in most populations. Previous work focused on the initial months of the pandemic, while this study examined the changes in tobacco use during a later peak period of the pandemic. We used data from 61,852 visits to the VA San Diego Healthcare System from November 2019 to February 2021, divided into pre-, early, and peak pandemic periods. Multinomial logistic regression was used to test whether the odds of being a daily or non-daily tobacco user varied over time, by demographic group, or with the presence of specific psychiatric diagnoses. Younger Veterans had a greater reduction in the prevalence of non-daily tobacco use between the early and peak periods, while older Veterans had a rise in daily use from pre- to the early pandemic, which returned to baseline during the peak. Individuals with substance use disorder and serious mental illness diagnoses were more likely to report tobacco use, but psychiatric diagnoses did not predict change over time. These findings demonstrate factors that potentially contribute to changes in tobacco use during a public health crisis and may help guide future targeted cessation efforts.
No Relationship between Lean Mass and Functional Asymmetry in High-Level Female Tennis Players
Authors: Chapelle Laurent , Bishop Chris , Clarys Peter , D’Hondt Eva
Published: November 2021

The relationship between lean mass and functional asymmetry in terms of their magnitude and direction was examined in 22 high-level female tennis players (20.9 ± 3.6 years). Lean mass of both upper and lower extremities was examined using Dual X-ray Absorptiometry. Functional asymmetry was assessed using a battery of field tests (handgrip strength, seated shot-put throw, plate tapping, single leg countermovement jump, single leg forward hop test, 6 m single leg hop test, and 505 change of direction (time and deficit)). Paired sample t-tests compared the dominant (overall highest/best (performance) value) against the non-dominant value (highest/best (performance) value of the opposing extremity). Linear regressions were used to explore the relationship between lean mass and functional asymmetry magnitudes. Kappa coefficients were used to examine the consistency in direction between the extremity displaying the highest lean mass value and the extremity performing dominantly across tests. Significant asymmetry magnitudes (p < 0.05) were found for all upper and lower extremity lean mass and functional values. No relationship was apparent between lean mass and functional asymmetry magnitudes (p-value range = 0.131–0.889). Despite finding perfect consistency in asymmetry direction (k-value = 1.00) for the upper extremity, poor to fair consistency (k-value range = −0.00–0.21) was found for the lower extremity. In conclusion, lean mass and functional asymmetries should be examined independently.
Night Shift and Decreased Brain Activity of ICU Nurses: A Near-Infrared Spectroscopy Study
Authors: Durán-Gómez Noelia , Guerrero-Martín Jorge , Pérez-Civantos Demetrio , López-Jurado Casimiro Fermín , Montanero-Fernández Jesús , Cáceres Macarena C.
Published: November 2021

Background: Shift working is associated with a profound desynchronization of circadian rhythm and in particular, night-shift work disrupts normal circadian physiology. Sleep deprivation affects the functioning of certain brain areas and thus impairs cognitive performance. The purpose of this study was to investigate the effects of the night shift on cognitive performance and cerebral oxygenation/haemodynamics. Methods: A prospective, observational, comparative, randomized and cross-over study was carried out. A total of 74 intensive care unit nurses in Spain were included in the study. The following variables were measured: sociodemographic, burnout, anxiety, baseline cerebral oxygenation levels on night and day shift using a near-infrared spectroscopy system and cognitive task performance during a verbal fluency task to evaluate the alterations in the prefrontal cortex, assessed as changes in regional saturation index. Results: The average regional saturation index decreased significantly in the night shift (r = 0.560, p < 0.001). The ICU nurses showed a significant decrease in the verbal fluency test on average (8.53 ± 8.49, p < 0.001) and, in general, there was also a significant increase in anxiety score (3.17 ± 7.56, p = 0.001). Conclusions: Sleep deprivation during the night shift was considered to be related to decreased dorsolateral PFC reactivity. After the night shift, the nurses showed a decrease in prefrontal cortex activity and in cognitive performance.
The Association between Physical Activity, Motor Skills and School Readiness in 4–5-Year-Old Children in the Northeast of England
Authors: Jones Dan , Innerd Alison , Giles Emma L. , Azevedo Liane B.
Published: November 2021

The benefits of being physically active, possessing good motor skills and being school-ready are well documented in early years. Nevertheless, the association between physical activity and motor skills with school readiness remains unknown. Therefore, the aim of this cross-sectional study was to explore the relationship between these variables. We collected data on 326 four to five-year-old children from the northeast of England. Children’s PA (ActiGraph GT1M accelerometers), motor skills (MABC-2 and the locomotor section of the TGMD-2) and school readiness (EYFSP) were measured, and associations between these variables were examined. This study found that, on average, children engaged in more MVPA (99.6 min/day) and less sedentary behaviour (261 min/day) than documented in previous research. Motor-skill scores were consistent with existing literature in early years. A higher percentage of children in the sample (79.6%) achieved school readiness than the average for England. Regression analyses found that motor-skill variables and sedentary behaviour were significantly predictive of school readiness, whereas physical activity was not. Motor skills and sedentary behaviour significantly predict school readiness. Therefore, promoting motor skills and developmentally appropriate sedentary behaviour activities may increase the number of children achieving school readiness.
Impact of COVID-19 Stay-at-Home Restrictions on Employment Status, Physical Activity, and Sedentary Behavior
Authors: Howe Cheryl A. , Corrigan Riley J. , de Faria Fernanda Rocha , Johanni Zoe , Chase Paul , Hillman Angela R.
Published: November 2021

Background. North Americans report insufficient moderate-to-vigorous physical activity (MVPA) and ample sedentary behaviors (SBs), suggesting possible barriers to an active lifestyle. This study compared self-reported MVPA and SB before and during COVID-19 “Stay-at-Home” restrictions as a potential barrier across North America. Methods: Questionnaires were distributed from 21 April to 9 May 2020. ANOVAs compared data overall and by group (age, sex, race, income, education, employment status). Results: During restrictions, 51.4% (n = 687) of the 1336 responses (991 female, 1187 Caucasian, 634 18–29 years) shifted to work from home and 12.1% (n = 162) lost their job. Overall, during restrictions, 8.3% (n = 110) fewer reported work-related MVPA (−178.6 ± 20.9 min/week). Similarly, 28.0% (n = 374) fewer reported travel-related MVPA, especially females and younger age groups. While the 7.3% (n = 98) fewer reporting recreational MVPA was not statistically significant (−30.4 ± 11.5 min/week), there was an increase in SB (+94.9 ± 4.1 min/week) in all groups, except the oldest age group (70+ years). Locomotive activities and fitness class remained the predominant MVPA mode. Of those reportedly using facilities (68%; n = 709) before COVID, 31.3% (n = 418) would not return due to it “being unsafe”. Conclusion: While barriers related to pandemic restrictions had a negative short-term impact on MVPA and SB in North America, the long-term impact is unknown.
Nutrient and Food Group Intakes among U.S. Children (2–5 Years) Differ by Family Income to Poverty Ratio, NHANES 2011–2018
Authors: Fadeyev Katia , Nagao-Sato Sayaka , Reicks Marla
Published: November 2021

Family income may influence nutrient and food group intakes among preschool children, thus increasing risk of nutrient deficiencies. This study compared nutrient and food group intakes and diet quality among a U.S. sample of children 2–5 years of age by family income to poverty ratio (PIR) based on National Health and Nutrition Examination Survey (2011–2018) data (n = 2249). Regression analyses were used to compare dietary intakes based on proxy-reported 24-h dietary recalls and Healthy Eating Index-2015 total scores by low PIR versus mid-high PIR levels adjusted for covariates. PIR levels varied by child race/ethnicity and household reference person’s sex, marital status, and education. More than half of the children in the low PIR group (56%) were reported to have received WIC benefits in the past year. Marginally lower calcium (p = 0.008) and lower fiber intakes, lower total HEI-2015 scores, and lower intakes of fruits and whole grain foods (all p < 0.007) were observed among children in low PIR households compared to mid-high PIR households. However, iron intakes were higher (p = 0.0003) among children in low PIR households compared to mid-high PIR households. Lack of other differences in nutrient and food group intakes may be attributable to WIC benefits.
Comparison of Whey Versus Almond Protein Powder on Nitrogen Balance in Female College Students; The California Almond Protein Powder Project (CAlmond-P3)
Authors: Maykish Adeline , Nishisaka Morgan M. , Talbott Courtney K. , Reaves Scott K. , Kristo Aleksandra S. , Sikalidis Angelos K.
Published: November 2021

Plant-based diets have become increasingly popular in the past decade, with approximately 11% of Americans self-identifying as vegan or vegetarian and many others trying to reduce meat consumption. Due to increasing interest, the plant-based food market has significantly expanded, with several innovative products serving as alternatives to animal-based products. One such example is almond protein powder, a new protein supplement created as an alternative to whey protein. Due to the novelty of almond protein products, little is known regarding how well the protein supplement supports nitrogen metabolism. The effects of both an almond-based protein beverage and a whey-based protein beverage on nitrogen balance are investigated in the work presented herein. Twenty female college students aged 20–25 years were randomly assigned to consume either an almond- or whey-based protein drink twice daily for one week; 24-h urine collection was performed at the baseline and endpoint of the 7-day treatment period and nitrogen balance was assessed. Body composition and hydration status were also assessed. Both protein sources (almond and whey) were able to notably improve nitrogen balance, thus indicating that almond protein powder may be a functional plant-based alternative to whey protein powder and may be of interest in future research regarding muscle mass and body composition improvement.
Anxiety and Depression during COVID-19 in Elite Rugby Players: The Role of Mindfulness Skills
Authors: Myall Kearnan , Montero-Marin Jesus , Kuyken Willem
Published: November 2021

The COVID-19 pandemic created stressors that raised the likelihood of elite athletes experiencing mental health problems. Understanding how individual traits promote resilience is key to offering treatments specific to this population. This prospective study explores the relationship between mindfulness skills, resilience, and athletic identity on anxiety and depression. The initial assessment was during the first UK lockdown April–May 2020 (T1), and the second during the return to competition July-August 2020 (T2). The sample was 160 elite rugby players. Measures included: Personal Health Questionnaire-9, General Anxiety Disorder-7, Cognitive Affective Mindfulness Scale, Connor-Davidson Resilience Scale, and Athletic Identity Measurement. The prevalence of anxiety and depression was profiled with descriptive statistics, and relationships between variables with bi-variate correlations and forward stepwise regression modelling. Depression decreased significantly between lock down (T1) and return to competition (T2) (MT1 = 4.20, MT2 = 3.24, p < 0.01), with no significant change in anxiety. Significant correlations were found between mindfulness, resilience, and anxiety and depression (≤0.001). Regression showed that mindfulness (T1) predicted lower anxiety and depression during the return to competition (T2) after controlling for baseline mental health symptoms. Returning to competition after lockdown was associated with a reduction in depression but not anxiety. Mindfulness skills potentially confer protection against anxiety and depression.
Redesigning the Process for Scheduling Elective Orthopaedic Surgery: A Combined Lean Six Sigma and Person-Centred Approach
Authors: Daly Ailish , Wolfe Nicola , Teeling Seán Paul , Ward Marie , McNamara Martin
Published: November 2021

The Health Service Executive Ireland model of care for elective surgery supports the delivery of elective surgical care in achieving both process and clinical outcomes. This project was conducted in the Orthopaedic Department. Following an outpatient consultation with an orthopaedic surgeon, patients who required surgical intervention were scheduled for their intervention by the administrative team. Prior to commencing this project, the average time from patient consultation to being scheduled for surgery on the hospital system was 62 h/2.58 days. A pre- and post-team-based intervention design employing Lean Six Sigma methodology was applied to redesign the process for scheduling elective orthopaedic surgery. The project was informed by collaborative, inclusive, and participatory stakeholder engagement. The goal was to streamline the scheduling process for elective orthopaedic surgery, with a target that 90% of surgeries are scheduled “right first time” within 48 h/two working days of the outpatient consultant appointment. The main outcome measures showed that 100% of orthopaedic surgeries were scheduled successfully within 2 days of outpatient appointment. Duplication in work between patient services and scheduling teams was eliminated and facilitated a reduction in unnecessary staff workload. This project highlights the importance of collaborative interdisciplinary stakeholder engagement in the redesigning of processes to achieve sustainable outcomes, and the findings have informed further improvements across the hospital’s surgical scheduling system.
Negative Association between Acrylamide Exposure and Metabolic Syndrome Markers in Adult Population
Authors: Hung Chun-Chi , Cheng Yung-Wen , Chen Wei-Liang , Fang Wen-Hui
Published: November 2021

Metabolic syndrome encompasses multiple conditions that increase the risk of cardiovascular disease, and exposure to environmental chemicals can cause metabolic syndrome. This cross-sectional study analyzed data from the US National Health and Nutrition Examination Survey (2003–2006) on 4318 adult participants to assess the association between acrylamide (AA) exposure and metabolic syndrome. Concentrations of hemoglobin-adducted AA (HbAA) and hemoglobin-adducted glycidamide (HbGA) were evaluated. Metabolic syndrome markers related to HbAA and HbGA and the effect of exposure to AA and GA on the prevalence of metabolic syndrome were studied by ANOVA and multivariate logistic regression analyses, respectively. HbAA concentration inversely correlated with the number of metabolic syndrome markers (p < 0.05). An increased HbAA concentration was noted with reduced high triglyceride and low high-density lipoprotein cholesterol levels in the adjusted model (p < 0.05). High fasting plasma glucose level significantly correlated with HbGA concentration in the adjusted model. In conclusion, AA exposure alters metabolic syndrome markers in adults. Additional clinical and animal studies will clarify the role of AA exposure at different stages in the progression of metabolic syndrome-related diseases.
Connectedness to Nature Does Not Explain the Variation in Physical Activity and Body Composition in Adults and Older People
Authors: Teixeira Andreia , Gabriel Ronaldo , Martinho José , Pinto Graça , Quaresma Luís , Faria Aurélio , Oliveira Irene , Moreira Helena
Published: November 2021

Connectedness to nature (CN) is a significant predictor of pro-environmental behaviours, human health and well-being. However, research on how this connection to the natural world might promote a more active lifestyle and improve body mass composition according to gender is lacking. This study investigated the influence of CN on physical activity (PA) and body composition in adults and older people. We recruited a sample of 219 individuals (77 men and 142 women), and a self-administered questionnaire was used to measure CN and obtain demographic data. Body composition was assessed by bioimpedance, and PA was assessed by accelerometry. Correlations and stepwise multiple regressions were used in data analysis. CN’s association with other variables was more pronounced in women than in men, and we only identified significant associations with steps/day and body composition. However, this variable would not be included in the regression models that we developed. Adiposity levels and muscle status were significant predictors of PA in women. In both genders, age, percentage of fat mass and fat-free mass were selected as regressors in the models developed for visceral fat area and muscle condition (R2 Adjusted ≥ 0.908).
Metabolic Syndrome and Psychological Effects of Exercise in Hemodialysis Patients
Authors: Hornik Beata , Duława Jan , Durmała Jacek
Published: November 2021

Metabolic syndrome (MS) and anxiety disorders are common problems among hemodialysis patients (HD). However, there have been no studies defining the role of physical activity in reducing anxiety in HD patients with MS. This study was aimed to determine the effects on the severity of anxiety of a four-week rehabilitation program for HD patients, with or without metabolic syndrome (MS), planned and adapted to their abilities. The study was single-center, interventional, non-randomized, and prospective. Fifty-eight individuals completed the project (28 HD patients and 30 controls (C) with normal kidney function). Each group was divided into two subgroups with respect to MS. The mean age of the subjects in the HD and C groups was 56.9 ± 13.3 years (x¯ ± SD) and 61.5 ± 8.3 years (x¯ ± SD), respectively. Planned and adapted to the patient’s abilities, the rehabilitation program based on physiotherapy was provided to each subject for 4 weeks. Baseline and post-intervention determined anxiety levels using the State-Trait Anxiety Inventory (STAI). The X1 scale tests state anxiety, and the X2 scale tests trait anxiety. Post-intervention, there was no significant difference in the intensity of state anxiety observed in HD patients compared to C with normal renal function, as observed before the program. After four weeks of regular physical activity planned and adapted to the patient’s abilities in an inpatient ward, the level of state anxiety (X1) and trait anxiety (X2) lowered considerably in all HD patients (respectively: 35.1 ± 8.0 vs. 29.2 ± 5.0, p = 0.001 for X1 and 41.8 ± 9.1 vs. 38.1 ± 5.9, p = 0.008 for X2). The rehabilitation program significantly reduced the intensity of state anxiety (X1) in HD patients with MS (35.8 ± 7.9 vs. 29.2 ± 5.1; p = 0.01). The rehabilitation program helped to significantly reduce the intensity of trait anxiety (X2) in HD patients without MS (41.9 ± 10.7 vs. 36.9 ± 5.9; p = 0.04). Four-week physical activity planned and adapted to the patient’s abilities reduces the intensity of anxiety in HD patients and controls with normal renal function. HD patients with MS benefit more in terms of reducing perceived state anxiety, and HD patients without MS in terms of reducing trait anxiety.
Evaluation of Stress Levels of Trainee Cardiac Surgery Residents during Training Interventions Using Physiological Stress Parameters
Authors: Awad George , Pohl Robert , Darius Sabine , Thielmann Beatrice , Kuzmin Boris , Slottosch Ingo , Wippermann Jens , Schmidt Hendrik , Scherner Maximilian Philipp , Böckelmann Irina
Published: November 2021

Background: This study analysed the psychological and psycho-emotional stress in cardiac surgery. Using heart rate variability (HRV) analysis, it is possible to record intraoperative objective stress responses in surgeons. The aim of the study was to assess with the help of HRV parameters the postulated increased stress levels of cardiac surgeons in training compared to experienced senior cardiothoracic surgeons in exactly the same work situation in order to make qualification-differentiated statements about physiological stress during surgical interventions. Methods: During surgical teaching procedures, long-term ECG data (n = 15 each) for two operating residents and their assisting senior physicians were recorded. Time and frequency domain HRV parameters were analysed. Results: The time-related parasympathetic-dominated HRV parameters RMSSD (19.5 ms vs. 28.1 ms), NN50 (297.67 vs. 693.40), and cardiac interval mean RR (692.8 ms vs. 737.3 ms) indicate a higher stress level in the operating residents compared to the experienced surgeons. The higher stress index (11.61 vs. 8.86) confirms this. Conclusion: Compared to experienced surgeons, operating residents showed lower parasympathetic activity and higher stress levels during cardiac surgery training procedures.
Down Syndrome in Brazil: Occurrence and Associated Factors
Authors: Laignier Mariana Rabello , Lopes-Júnior Luís Carlos , Santana Raquel Esperidon , Leite Franciéle Marabotti Costa , Brancato Carolina Laura
Published: November 2021

Background: Down syndrome is the most frequent genetic cause of intellectual disability, with an estimated birth prevalence of 14 per 10,000 live births. In Brazil, statistical data on the occurrence of babies born with Down syndrome remain unclear. We aimed to estimate the occurrence of Down syndrome between 2012 and 2018, and to observe its association with maternal, gestational, paternal characteristics, and newborn vitality. Methods: A retrospective study was carried out using secondary data included in the Certificate of Live Birth in a state located in the southeastern region of Brazil. Data analysis was performed in the software Stata 14.1. Pearson’s chi-square test for bivariate analysis, and logistic regression for multivariate analysis were performed, with a 95% confidence interval (CI) and a significance of 5%. Results: We observed that 157 cases of Down syndrome were reported among 386,571 live births, representing an incidence of 4 in 10,000 live births. Down syndrome was associated with maternal age ≥ 35 years, paternal age ≥ 30 years, the performance of six or more prenatal consultations, prematurity, and low birth weight (p < 0.05). Conclusions: Women aged 35 and over were more likely to have children born with Down syndrome. In addition, there is an association of Down syndrome with premature birth, low birth weight, and the number of prenatal consultations (≥6).
Anthropometric Measurements, Metabolic Profile and Physical Fitness in a Sample of Spanish Women with Type 2 Diabetes
Authors: Lucha-López María Orosia , Vidal-Peracho Concepción , Hidalgo-García César , Rodríguez-Sanz Jacobo , Tricás-Vidal Héctor , Hernández-Secorún Mar , Monti-Ballano Sofía , Tricás-Moreno José Miguel , Lucha-López Ana Carmen
Published: November 2021

Background: Exercise training has proven to be effective for treatment of metabolic diseases, such as type 2 diabetes mellitus. The aims of this study were to compare anthropometric measurements, metabolic profile and physical fitness between active and sedentary women with type 2 diabetes, and to analyse relationships between anthropometry and metabolic profile and components of physical fitness (balance, flexibility, strength and endurance). Methods: Cross-sectional research on 28 women with type 2 diabetes. Amount of daily physical activity, BMI, waist circumference, HbA1c, fibrinogen, hs-CRP, tiptoe dynamic balance, static balance, finger floor distance, abdominal, upper and lower limb strength and walking cardiovascular endurance were recorded. Results: Age: 58.5 ± 7.8. Overall, 16 subjects were physically active and 12 were sedentary. Active subjects had lower BMI (p = 0.033) and better cardiovascular endurance (p = 0.025). BMI and waist circumference were not influenced by any physical fitness component. HbA1c, fibrinogen and hs-CRP were related with worse dynamic balance (p = 0.036, 0.006 and 0.031, respectively). Conclusions: Active women had lower BMI and showed a better performance in cardiovascular endurance. Tiptoe dynamic balance impairments were related to worse glycaemic control, hypercoagulation and inflammatory state.
Lower Extremity Flexibility Profile in Basketball Players: Gender Differences and Injury Risk Identification
Authors: Cejudo Antonio
Published: November 2021

Analysis of the flexibility profile of basketball players (BPs) can reveal differences in range of motion (ROM) by gender and also identify those players who are at higher risk for sports injuries. A descriptive observational study was conducted to determine the lower extremity flexibility profile of sixty-four basketball players and gender differences to identify players at higher risk of injury due to limited and asymmetric ROM in one or more movements. Participants: Sixty-four (33 male and 31 female) competitive athletes from the national leagues of the Spanish basketball league system participated in the present study (power of sample size ≥0.99). The eight passive ROM tests of the hip, knee and ankle were assessed using the ROM-SPORT battery. Each player completed a questionnaire on age, basic anthropometric data, dominant extremities, and training and sport-related variables. The lower extremity flexibility profile was established at 15° and 10° hip extension (HE), 39° and 38° ankle dorsiflexion with knee extended (ADF-KE), 40° and 39° ankle dorsiflexion with knee flexed (ADF-KF), 43° and 43° hip abduction (HAB), 75° and 61° hip abduction with the hip flexed (HAB-HF), 78° and 83° hip flexion with the knee extended (HF-KE), 134° and 120° knee flexion (KF), and 145° and 144° hip flexion (HF) by male and female basketball players, respectively. Sex differences in HE, HAB-HF, and KF were observed in BPs (p ≤ 0.01; Hedges’ g ≥ 1.04). Players reported limited ROM in ADF-KF, HE, HAB-HF, HF-KE, and KF; and asymmetric ROM mainly in HE, ADF-KE, KF, ADF-KF, and HF-KE. In conclusion, this study provides gender-specific lower extremity flexibility profile scores in BPs that can help athletic trainers and athletic and conditioning trainers to identify those players who are at higher risk of injury due to abnormal ROM scores.
Resilience: A Protective Factor from Depression and Anxiety in Mexican Dialysis Patients
Authors: González-Flores Cristina J. , García-García Guillermo , Lerma Abel , Pérez-Grovas Héctor , Meda-Lara Rosa M. , Guzmán-Saldaña Rebeca M. E. , Lerma Claudia
Published: November 2021

Depression and anxiety are highly prevalent psychological disorders in end-stage renal disease (ESRD) that have a negative clinical impact. The purpose of our study was to identify factors associated with the presence of depression and anxiety, in a sample of ESRD patients treated with hemodialysis. We included 187 patients from two dialysis facilities, age 18–65 years. Beck’s depression and anxiety inventories, KDQOL36 questionnaire, the cognitive distortion scale and the Mexican scale of resilience were used. Socio-demographic and clinical information was obtained from medical records. Depression was present in 143 (76.4%) patients. Patient with depression were older (33 (26–52) years vs. 30 (24.43) years, p = 0.025), had a lower education level (36% vs. 9%, p = 0.001), used more medications (67% vs. 36%, p = 0.001), had a comorbidity (75% vs. 41%, p = 0.001), and a higher proportion were waiting for a kidney transplant. Anxiety was present in 112 (59.8%) cases. By multivariate analysis, depression was independently associated with lower education, absence of previous kidney transplant, anxiety, higher cognitive distortion, lower psychological resilience, and lower quality of life scores. In conclusion, lower psychological resilience, lower education level, and higher cognitive distortions are factors associated with depression and anxiety in ESRD patients.
Sources of Stress among Saudi Arabian Nursing Students: A Cross-Sectional Study
Authors: Aljohani Wafaa , Banakhar Maram , Sharif Loujain , Alsaggaf Fatimah , Felemban Ohood , Wright Rebecca
Published: November 2021

Introduction: Nursing students experience higher levels of stress than those in other health-related disciplines; however, there are limited data exploring stress among these students in a Saudi context. Aim: This study examines sources of stress among nursing students at an academic institution in Jeddah, Saudi Arabia, using a descriptive quantitative cross-sectional research design. Methods: Data were collected from a convenience sample of 500 undergraduate nursing students, with a response rate of 71.8%, using an adapted Stress in Nursing Students (SINS) questionnaire. Results: Nursing student sources of stress fell into three categories: academic concerns, clinical practice, and social factors. Discussion: The results demonstrate commonality between other countries’ sources of stress for nursing students but highlight cultural factors unique to Saudi Arabia. This study shows opportunities for cross-cultural learning and areas needing cultural tailoring to reduce stress among nursing students.
Factors Associated with Free Medicine Use in Patients with Hypertension and Diabetes: A 4-Year Longitudinal Study on Full Coverage Policy for Essential Medicines in Taizhou, China
Authors: Guo Zhigang , Bai Lin , Luo Zhenhuan , Fu Mengyuan , Zheng Liguang , Guan Xiaodong , Shi Luwen
Published: November 2021

Full coverage policies for medicines have been implemented worldwide to alleviate medicine cost burden and promote access to medicines. However, few studies have explored the factors associated with free medicine use in patients with chronic diseases. This study aimed to analyze the utilization of free medicines by patients with hypertension and diabetes after the implementation of the full coverage policy for essential medicines (FCPEM) in Taizhou, China, and to explore the factors associated with free medicine use. We conducted a descriptive analysis of characteristics of patients with and without free medicine use and performed a panel logit model to examine factors associated with free medicine use, based on an electronic health record database in Taizhou from the baseline year (12 months in priori) to three years after FCPEM implementation. After FCPEM implementation, the proportion of patients without any free medicine use decreased from 31.1% in the baseline year to 28.9% in the third year, while that of patients taking free medicines rose from 11.0% to 22.8%. Patients with lower income or education level, those with agricultural hukou, patients aged 65 and above, married patients, and patients in the Huangyan district were more likely to take free medicines. In conclusion, FCPEM contributed to improved medicine access, especially in vulnerable populations. Local policy makers should consider expanding the coverage of FCPEM to other types of medicines and cultivate the potential of social supports for patients to enhance the effectiveness of FCPEM policies.
The Effects of Household Air Pollution (HAP) on Lung Function in Children: A Systematic Review
Authors: Aithal Sathya Swarup , Gill Shireen , Satia Imran , Tyagi Sudhir Kumar , Bolton Charlotte E. , Kurmi Om P.
Published: November 2021

The World Health Organization (WHO) estimates that around 3 billion people today are exposed to smoke from the household combustion of solid fuels. While the household use of solid fuels has decreased over the last few decades, it remains a leading modifiable risk factor for the global burden of disease. This systematic review analyzed the impact of Household Air Pollution (HAP) on lung function in children (under 18 years of age), as this is the time period of accelerated growth rate until full skeletal maturity. Data from 11 published studies demonstrated that exposure to smoke from solid fuel was associated with a lower growth rate of several lung function indices (FVC, FEV1, FEF25–75) in children. However, there was no observed association between HAP and the FEV1/FVC ratio over time. Although the evidence suggests an inverse association between high exposure to HAP and lung function indices, there is a lack of longitudinal data describing this association. Therefore, precaution is needed to reduce the smoke exposure from solid fuel burning.
Developing a Complex Understanding of Physical Activity in Cardiometabolic Disease from Low-to-Middle-Income Countries—A Qualitative Systematic Review with Meta-Synthesis
Authors: Heine Martin , Badenhorst Marelise , van Zyl Chanel , de Melo Ghisi Gabriela Lima , Babu Abraham Samuel , Buckley John , Serón Pamela , Turk-Adawi Karam , Derman Wayne
Published: November 2021

Physical activity behaviour is complex, particularly in low-resource settings, while existing behavioural models of physical activity behaviour are often linear and deterministic. The objective of this review was to (i) synthesise the wide scope of factors that affect physical activity and thereby (ii) underpin the complexity of physical activity in low-resource settings through a qualitative meta-synthesis of studies conducted among patients with cardiometabolic disease living in low-to-middle income countries (LMIC). A total of 41 studies were included from 1200 unique citations (up to 15 March 2021). Using a hybrid form of content analysis, unique factors (n = 208) that inform physical activity were identified, and, through qualitative meta-synthesis, these codes were aggregated into categories (n = 61) and synthesised findings (n = 26). An additional five findings were added through deliberation within the review team. Collectively, the 31 synthesised findings highlight the complexity of physical activity behaviour, and the connectedness between person, social context, healthcare system, and built and natural environment. Existing behavioural and ecological models are inadequate in fully understanding physical activity participation in patients with cardiometabolic disease living in LMIC. Future research, building on complexity science and systems thinking, is needed to identify key mechanisms of action applicable to the local context.
Satisfaction of Township Hospitals Health Workers on How They Are Paid in China
Authors: Yuan Beibei , Yu Yahang , Zhang Hongni , Li Huiwen , Kong Chen , Zhang Wei
Published: November 2021

Background: Township Hospitals (THs) are crucial providers in China’s primary health delivery system. Low job satisfaction of THs health workers has been one of biggest challenges to strengthening the health system in China. Even huge amounts of studies confirmed low remuneration level as a key demotivating factor though few studies have explored the feelings of health workers on how they were paid. Objective: To analyze how the key design of Performance-based Salary System (PBS) influences the satisfaction of health workers on the payment system in China’s THs. Method: A cross-sectional study was conducted in 47 THs in Shandong China, and a total of 1136 participants were recruited. Expectancy theory was applied to design the measurements on designs of PBS. The associations between PBS design and satisfaction of health workers were analyzed by logistic regression. Results: Three key components of PBS design were all related to the satisfaction of health workers. Those health workers who were aware of assessment methods were more likely to be satisfied with how they were paid (OR = 2.44, p < 0.001) compared with those being not aware of the methods. The knowledge on personal performance was also associated with being satisfied (OR = 3.34, p < 0.001). The percentage of floating income in total income was negatively associated with the satisfaction, and one percentage point increase in floating income proportion could result in the possibility of being satisfied decreasing by 2.82% (95%CI −4.9 to −0.7, p = 0.01). Subgroup analysis found that only in those with lower value on monetary income, the negative influence of more floating income was significant. Conclusions: When policymakers or managers apply performance-related payment to incentivize certain work behavior, they should pay attention to the design details, including keeping transparency in the performance assessment criteria, clear performance feedback, and setting the proportion of the performance-related part based on the preference of health workers in certain cultural settings.
Relations of Conspicuous Consumption Tendency, Self-Expression Satisfaction, and SNS Use Satisfaction of Gen Z through SNS Activities
Authors: Shin Seung-A. , Jang Jong-Oh , Kim Jong-Kul , Cho Eun-Hyung
Published: November 2021

The purpose of this study was to analyze the relations of conspicuous consumption tendency, self-expression satisfaction, and SNS use satisfaction of Gen Z through SNS activities. For a week from 17–23 March 2021, an online survey was conducted targeting the enrolled students of university in Chungcheongnam-do. Out of a total of 398 questionnaires, a total of 394 questionnaires (98.9%) were used for the final analysis after excluding four questionnaires with low reliability. This study was analyzed using SPSS by IBM 23.0(New York, NY, USA) and AMOS 21.0 (New York, NY, USA). In the results of this study, first, the factors such as imported goods/famous brands, high-priced articles, and status symbol except for pursuit of trend of conspicuous consumption tendency had significant effects on the self-expression satisfaction. Second, the factors such as imported goods/famous brands, high-priced articles, and status symbol except for pursuit of trend of conspicuous consumption tendency of Gen Z through SNS activities had significant effects on the SNS use satisfaction. Third, the self-expression satisfaction of Gen Z through SNS had significant effects on the SNS use satisfaction.
An Evaluation of the Impact of a Multicomponent Stop Smoking Intervention in an Irish Prison
Authors: Bowe Andrea , Marron Louise , Devlin John , Kavanagh Paul
Published: November 2021

The disproportionately high prevalence of tobacco use among prisoners remains an important public health issue. While Ireland has well-established legislative bans on smoking in public places, these do not apply in prisons. This study evaluates a multi-component tobacco control intervention in a medium security prison for adult males in Ireland. A stop-smoking intervention, targeting staff and prisoners, was designed, implemented, and evaluated with a before-and-after study. Analysis was conducted using McNemar’s test for paired binary data, Wilcoxon signed rank test for ordinal data, and paired T-tests for continuous normal data. Pre-intervention, 44.3% (n = 58) of the study population were current smokers, consisting of 60.7% of prisoners (n = 51) and 15.9% of staff (n = 7). Post-intervention, 45.1% of prisoners (n = 23/51) and 100% of staff (n = 7/7) who identified as current smokers pre-intervention reported abstinence from smoking. Among non-smokers, the proportion reporting being exposed to someone else’s cigarette smoke while being a resident or working in the unit decreased from 69.4% (n = 50/72) pre-intervention to 27.8% (n = 20/72) post-intervention (p < 0.001). This multicomponent intervention resulted in high abstinence rates, had high acceptability among both staff and prisoners, and was associated with wider health benefits across the prison setting.
Integration of Vulnerability and Hazard Factors for Landslide Risk Assessment
Authors: Arrogante-Funes Patricia , Bruzón Adrián G. , Arrogante-Funes Fátima , Ramos-Bernal Rocío N. , Vázquez-Jiménez René
Published: November 2021

Among the numerous natural hazards, landslides are one of the greatest, as they can cause enormous loss of life and property, and affect the natural ecosystem and their services. Landslides are disasters that cause damage to anthropic activities and innumerable loss of human life, globally. The landslide risk assessed by the integration of susceptibility and vulnerability maps has recently become a manner of studying sites prone to landslide events and managing these regions well. Developing countries, where the impact of landslides is frequent, need risk assessment tools that enable them to address these disasters, starting with their prevention, with free spatial data and appropriate models. Our study shows a heuristic risk model by integrating a susceptibility map made by AutoML and a vulnerability one that is made considering ecological vulnerability and socio-economic vulnerability. The input data used in the State of Guerrero (México) approach uses spatial data, such as remote sensing, or official Mexican databases. This aspect makes this work adaptable to other parts of the world because the cost is low, and the frequency adaptation is high. Our results show a great difference between the distribution of vulnerability and susceptibility zones in the study area, and even between the socio-economic and ecological vulnerabilities. For instance, the highest ecological vulnerability is in the mountainous zone in Guerrero, and the highest socio-economic vulnerability values are found around settlements and roads. Therefore, the final risk assessment map is an integrated index that considers susceptibility and vulnerability and would be a good first attempt to challenge landslide disasters.
The Role of Centrosome Distal Appendage Proteins (DAPs) in Nephronophthisis and Ciliogenesis
Authors: Mansour Fatma , Boivin Felix J. , Shaheed Iman B. , Schueler Markus , Schmidt-Ott Kai M.
Published: November 2021

The primary cilium is found in most mammalian cells and plays a functional role in tissue homeostasis and organ development by modulating key signaling pathways. Ciliopathies are a group of genetically heterogeneous disorders resulting from defects in cilia development and function. Patients with ciliopathic disorders exhibit a range of phenotypes that include nephronophthisis (NPHP), a progressive tubulointerstitial kidney disease that commonly results in end-stage renal disease (ESRD). In recent years, distal appendages (DAPs), which radially project from the distal end of the mother centriole, have been shown to play a vital role in primary ciliary vesicle docking and the initiation of ciliogenesis. Mutations in the genes encoding these proteins can result in either a complete loss of the primary cilium, abnormal ciliary formation, or defective ciliary signaling. DAPs deficiency in humans or mice commonly results in NPHP. In this review, we outline recent advances in our understanding of the molecular functions of DAPs and how they participate in nephronophthisis development.
Phytosterols: Potential Metabolic Modulators in Neurodegenerative Diseases
Authors: Sharma Niti , Tan Mario A. , An Seong Soo A.
Published: November 2021

Phytosterols constitute a class of natural products that are an important component of diet and have vast applications in foods, cosmetics, and herbal medicines. With many and diverse isolated structures in nature, they exhibit a broad range of biological and pharmacological activities. Among over 200 types of phytosterols, stigmasterol and β-sitosterol were ubiquitous in many plant species, exhibiting important aspects of activities related to neurodegenerative diseases. Hence, this mini-review presented an overview of the reported studies on selected phytosterols related to neurodegenerative diseases. It covered the major phytosterols based on biosynthetic considerations, including other phytosterols with significant in vitro and in vivo biological activities.
Mixed Transcriptome Analysis Revealed the Possible Interaction Mechanisms between Zizania latifolia and Ustilago esculenta Inducing Jiaobai Stem-Gall Formation
Authors: Zhang Zhi-Ping , Song Si-Xiao , Liu Yan-Cheng , Zhu Xin-Rui , Jiang Yi-Feng , Shi Ling-Tong , Jiang Jie-Zeng , Miao Min-Min
Published: November 2021

The smut fungus Ustilago esculenta infects Zizania latifolia and induces stem expansion to form a unique vegetable named Jiaobai. Although previous studies have demonstrated that hormonal control is essential for triggering stem swelling, the role of hormones synthesized by Z. latifolia and U. esculenta and the underlying molecular mechanism are not yet clear. To study the mechanism that triggers swollen stem formation, we analyzed the gene expression pattern of both interacting organisms during the initial trigger of culm gall formation, at which time the infective hyphae also propagated extensively and penetrated host stem cells. Transcriptional analysis indicated that abundant genes involving fungal pathogenicity and plant resistance were reprogrammed to maintain the subtle balance between the parasite and host. In addition, the expression of genes involved in auxin biosynthesis of U. esculenta obviously decreased during stem swelling, while a large number of genes related to the synthesis, metabolism and signal transduction of hormones of the host plant were stimulated and showed specific expression patterns, particularly, the expression of ZlYUCCA9 (a flavin monooxygenase, the key enzyme in indole-3-acetic acid (IAA) biosynthesis pathway) increased significantly. Simultaneously, the content of IAA increased significantly, while the contents of cytokinin and gibberellin showed the opposite trend. We speculated that auxin produced by the host plant, rather than the fungus, triggers stem swelling. Furthermore, from the differently expressed genes, two candidate Cys2-His2 (C2H2) zinc finger proteins, GME3058_g and GME5963_g, were identified from U. esculenta, which may conduct fungus growth and infection at the initial stage of stem-gall formation.