bluuebunny/crossref_metadata_2025 huggingface dataset:
Eco-Efficiency Analysis for the Russian Cities along the Northern Sea Route: A Data Envelopment Analysis Approach Using an Epsilon-Based Measure Model
Authors: Yao Shuaiyu , Chen Mengmeng , Muravev Dmitri , Ouyang Wendi
Published: June 2021

In this paper, an eco-efficiency analysis is conducted using the epsilon-based measure data envelopment analysis (EBM-DEA) model for Russian cities along the Northern Sea Route (NSR). The EBM-DEA model includes five input variables: population, capital, public investment, water supply, and energy supply and four output variables: gross regional product (GRP), greenhouse gas (GHG) emissions, solid waste, and water pollution. The pattern of eco-efficiency of 28 Russian cities along the NSR is empirically analyzed based on the associated real data across the years from 2010 to 2019. The empirical results obtained from the analysis show that St. Petersburg, Provideniya, Nadym, N. Urengoy, and Noyabrsk are eco-efficient throughout the 10 years. The results also indicate that the cities along the central section of the NSR are generally more eco-efficient than those along other sections, and the cities with higher level of GRPs per capita have relatively higher eco-efficiency with a few exceptions. The study provides deeper insights into the causes of disparity in eco-efficiency, and gives further implications on eco-efficiency improvement strategies. The contributions of this study lie in the fact that new variables are taken into account and new modeling techniques are employed for the assessment of the eco-efficiency of the Russian cities.
Burnout in Intensive Care Unit Workers during the Second Wave of the COVID-19 Pandemic: A Single Center Cross-Sectional Italian Study
Authors: Stocchetti Nino , Segre Giulia , Zanier Elisa R. , Zanetti Michele , Campi Rita , Scarpellini Francesca , Clavenna Antonio , Bonati Maurizio
Published: June 2021

The COVID-19 pandemic had a massive impact on the Italian healthcare systems, which became overwhelmed, leading to an increased risk of psychological pressure on ICU workers. The present study aimed to investigate the prevalence of distress (anxiety, depression and insomnia symptoms), burnout syndrome and resilience in healthcare workers during the COVID-19 pandemic and to detect potential factors associated with their psychological response. This cross-sectional, survey-based study enrolled 136 healthcare workers assisting COVID-19 patients in the new COVID-19 ward (Intensive Care Unit), at Milano Fiera, Lombardy. Participants completed an online survey that comprised different validated and standardized questionnaires: Maslach Burnout Inventory (MBI), Resilience Scale for adults (RSA), Hospital Anxiety and Depression scale (HADS) and Insomnia Severity Index (ISI). Socio-demographic and work characteristics were also collected. Out of 136 ICU specialists, there were 84 nurses (62%) and 52 physicians (38%). Over half (60%) met the criteria for burnout, with nearly the same percentages among nurses and physicians. Nurses reported significantly higher scores of anxiety and insomnia levels. Forty-five percent of participants reported symptoms of depression (of whom 13.9% in the clinical range) and most of the staff showed moderate to high levels (82.4%) of resilience. The COVID-19 pandemic can have a significant impact on ICU staff. Effective interventions are needed to maintain healthcare professionals’ mental health and relieve burnout. Follow-up and tailored procedures should be provided to alleviate the psychological burden in the frontline staff at highest risk.
MCR: Open-Source Software to Automate Compilation of Health Study Report-Back
Authors: Polka Erin , Childs Ellen , Friedman Alexa , Tomsho Kathryn S. , Claus Henn Birgit , Scammell Madeleine K. , Milando Chad W.
Published: June 2021

Sharing individualized results with health study participants, a practice we and others refer to as “report-back,” ensures participant access to exposure and health information and may promote health equity. However, the practice of report-back and the content shared is often limited by the time-intensive process of personalizing reports. Software tools that automate creation of individualized reports have been built for specific studies, but are largely not open-source or broadly modifiable. We created an open-source and generalizable tool, called the Macro for the Compilation of Report-backs (MCR), to automate compilation of health study reports. We piloted MCR in two environmental exposure studies in Massachusetts, USA, and interviewed research team members (n = 7) about the impact of MCR on the report-back process. Researchers using MCR created more detailed reports than during manual report-back, including more individualized numerical, text, and graphical results. Using MCR, researchers saved time producing draft and final reports. Researchers also reported feeling more creative in the design process and more confident in report-back quality control. While MCR does not expedite the entire report-back process, we hope that this open-source tool reduces the barriers to personalizing health study reports, promotes more equitable access to individualized data, and advances self-determination among participants.
Longitudinal Associations between Intake of Fruit and Vegetables and Height Attainment from Preschool to School Entry
Authors: Rosário Rafaela , Händel Mina Nicole , Rohde Jeanett Friis , Olsen Nanna Julie , Heitmann Berit Lilienthal
Published: June 2021

To examine associations between fruit and vegetable intake in young childhood and height attainment during preschool and at school entry. Data for this study was based on “The Healthy Start” primary intervention study, which included 635 obesity-prone children, (58% boys), from the greater Copenhagen area, with a mean (SD) age of 4.0 (1.1) years (age range 2–6 years) at baseline. In the current study, 553 children (57% boys) were included with information on dietary intake at baseline and height measured at baseline (preschool age), and 511 children (56.8% boys) with the height measured at school entry (~6 years old). Height was measured by trained health professionals during the intervention and by school nurses at school entry. Information on intakes of fruit and vegetables, separately and combined, was gathered with four-day dietary records reported by parents. Participants were grouped into tertiles for their intakes at baseline. Compared to boys with low consumption, those with a moderate and high intakes of fruit and vegetables (F&V) had a greater attained height at preschool of 1.3 cm (95% confidence interval (CI): 0.3; 2.3) and at school entry of 2.4 cm (95% CI: 0.8; 3.9) and 1.8 cm (95% CI: 0.2; 3.4), respectively, also after adjustment for differences in age, body mass index (BMI), and total energy intake. Additional adjustment for mid-parental height and parents’ education did not alter the significant associations between moderate consumption of F&V and attained height at preschool and school entry. There was no association among girls. Our results showed that a moderate consumption of F&V was directly associated with higher attainment in height at preschool and school entry in boys. From a public health perspective, it should be prioritized to continue developing intervention programs to improve fruit and vegetable intake.
Does Technological Innovation Promote Green Development? A Case Study of the Yangtze River Economic Belt in China
Authors: Hu Senlin , Zeng Gang , Cao Xianzhong , Yuan Huaxi , Chen Bing
Published: June 2021

The role of technological innovation (TI) in green development is controversial. Based on 2003–2017 panel data of 108 cities in the Yangtze River Economic Belt (YREB), this study constructed an index system to evaluate urban green development and analyzed the role of TI on urban green development with the help of a panel econometric model. The results show that: (1) From 2003 to 2017, the levels of TI and green development of cities in the YREB have gradually improved, but the core–periphery structure is obvious, and the levels of TI and green development in the lower reaches are significantly higher than those in the middle and upper reaches. (2) TI has a significant positive role in promoting green development, showing a U-shaped nonlinear relationship, and this relationship varies from region to region. (3) TI has a significant impact on green development with direct and indirect effects. In the economic and social dimensions, TI has a positive impact on green development, while in the ecological dimension, the direct effect and indirect effect have opposite relationships. (4) TI has a significant threshold effect on green development, and there are differences in threshold characteristics between the three dimensions. These findings provide a scientific basis for policymaking about innovation-driven regional green development, and it can enrich the related theories of environmental economic geography.
The Efficacy of Lingual Laser Frenectomy in Pediatric OSAS: A Randomized Double-Blinded and Controlled Clinical Study
Authors: Fioravanti Miriam , Zara Francesca , Vozza Iole , Polimeni Antonella , Sfasciotti Gian Luca
Published: June 2021

This randomized, double-blind and controlled clinical trial investigates how a diode laser lingual frenectomy can improve obstructive sleep apnea syndrome (OSAS) in pediatric patients. Background: Several authors have shown that a short lingual frenulum causes a reduction in incoming air flow and the relationship between OSAS and a short lingual frenulum. Methods: Thirty-two pediatric patients were equally randomly divided into a Study Group (SG) and a Control Group (CG). On each SG patient a polysomnography 1 (PSG1) and a lingual frenectomy were performed using a diode laser via Doctor Smile Wiser technology, power 7 W. After three months, a new polysomnography (PSG2) was performed to evaluate the lingual frenectomy efficacy in pediatric patients. The pain was assessed by a numerical rating scale (NRS) before and after surgery. The CG followed the same protocol without a lingual frenectomy but myofunctional and speech therapy were conducted to qualitatively and quantitatively improve the lingual functionality. In the SG, eight subjects (50%) had severe OSAS and eight had moderate (50%) while in the CG, three subjects had severe OSAS (18.8%) and thirteen had moderate (81.2%). Results: In the SG, 93.8% were classified as mild OSAS and 6.2% as moderate. In contrast, in the CG, 18.75% were classified as mild OSAS, 62.5% as moderate and 18.75% as severe. Conclusion: The study demonstrates how a lingual laser frenectomy can improve OSAS in pediatric patients.
Part II: Living Life: A Meta-Synthesis Exploring Recovery as Processual Experiences
Authors: Sommer Mona , Biong Stian , Borg Marit , Karlsson Bengt , Klevan Trude , Ness Ottar , Nesse Linda , Oute Jeppe , Sundet Rolf , Kim Hesook Suzie
Published: June 2021

Recovery, a prominent concern in mental health care worldwide, has been variously defined, requiring further clarification of the term as processual. Few studies have comprehensively addressed the nature of recovery processes. This study aims to explore the nature and characteristics of experiences of recovery as processual. The method used is a form of qualitative meta-synthesis that integrates the findings from 28 qualitative studies published during the past 15 years by one research group. Three meta-themes were developed: (a) recovery processes as step-wise, cyclical, and continuous, (b) recovery as everyday experiences, and (c) recovery as relational. These themes describe how recovery is intertwined with the way life in general unfolds in terms of human relationships, learning, coping, and ordinary everyday living. This meta-synthesis consolidates an understanding of recovery as fundamental processes of living in terms of being, doing, and accessing. These processes are contextualized in relation to mental health and/or substance abuse problems and highlight the need for support to facilitate the person’s access to necessary personal, social, and material resources to live an ordinary life in recovery.
The Effects of Martial Arts on Cancer-Related Fatigue and Quality of Life in Cancer Patients: An Up-to-Date Systematic Review and Meta-Analysis of Randomized Controlled Clinical Trials
Authors: Sur Daniel , Sabarimurugan Shanthi , Advani Shailesh
Published: June 2021

Background: To evaluate and synthesize the existing evidence of the effects of practicing martial arts by cancer patients and cancer survivors in relation to overall quality of life (QoL) and cancer-related fatigue (CRF). Methods: Randomized controlled trials (RCTs) from 1 January 2000 to 5 November 2020 investigating the impact of martial arts were compared with any control intervention for overall QoL and CRF among cancer patients and survivors. Publication quality and risk of bias were assessed using the Cochrane handbook of systematic reviews. Results: According to the electronic search, 17 RCTs were retrieved including 1103 cancer patients. Martial arts significantly improved social function, compared to that in the control group (SMD = −0.88, 95% CI: −1.36, −0.39; p = 0.0004). Moreover, martial arts significantly improved functioning, compared to the control group (SMD = 0.68, 95% CI: 0.39–0.96; p < 0.00001). Martial arts significantly reduced CRF, compared to that in the control group (SMD = −0.51, 95% CI: −0.80, −0.22; p = 0.0005, I2 > 95%). Conclusions: The results of our systematic review and meta-analysis reveal that the effects of practicing martial arts on CRF and QoL in cancer patients and survivors are inconclusive. Some potential effects were seen for social function and CRF, although the results were inconsistent across different measurement methods. There is a need for larger and more homogeneous clinical trials encompassing different cancer types and specific martial arts disciplines to make more extensive and definitive cancer- and symptom-specific recommendations.
Concerns in the Norwegian Population during the Initial Lockdown Due to the COVID-19 Pandemic
Authors: Schou-Bredal Inger , Skogstad Laila , Grimholt Tine K. , Bonsaksen Tore , Ekeberg Øivind , Heir Trond
Published: June 2021

Although concern affects one’s welfare or happiness, few studies to date have focused on peoples’ concerns during the initial COVID-19 lockdown. The aim of the study was to explore concerns in the Norwegian populations according to gender and age, and identify which concerns were most prominent during the lockdown. A population-based cross-sectional online survey using snowball-sampling strategies was conducted, to which 4527 adults (≥18 years) responded. Questions related to concerns had response alternatives yes or no. In addition, they were asked which concern was most prominent. Nearly all the 4527 respondents (92%) reported that they were concerned: 60.9% were generally concerned about the pandemic, 83.9% were concerned about family and friends, 21.8% had financial concerns, and 25.3% expected financial loss. More women were concerned about family and friends than males, (85.2% vs. 76.2%, p < 0.001), whereas more men expected financial loss (30.4% vs. 24.4%y, p = 0.001). Younger adults (<50 years) had more financial concerns than older adults (25.9% vs. 10.5%, p < 0.001). Being concerned about family and friends was the most prominent concern and was associated with; lower age (OR 0.79), female gender (OR 1.59), and being next of kin (2.42). The most prominent concern for adults 70 years or older was being infected by COVID-19. In conclusion, women and younger individuals were most concerned. While adults under 70 years of age were most concerned about family and friends and adults 70 years or older were most concerned about being infected by COVID-19.
Home Environment and Early Development of Rural Children: Evidence from Guizhou Province in China
Authors: Kuhn Lena , Liu Chengfang , Wang Tianyi , Luo Renfu
Published: June 2021

Delays in early child development are among the aspects underlying the persistent developmental gaps between regions and social strata. This study seeks to examine the relationship between the home environment and early child development in less-developed rural areas by drawing on data from 445 children from villages in Guizhou province in southwest China. A demographic questionnaire, the Home Observation Measurement of the Environment (HOME), and the Bayley Scales of Infant Development, version III (BSID-III), were used to measure the child’s demographic characteristics, home environment, and early development outcomes, respectively. Our data show that the sample children suffer a delay in various dimensions of child development and a deficit in the HOME scale. The results from a hierarchical regression model suggest that the availability of learning material at home, caregivers’ responsiveness and organization sub-scales are significantly positively correlated with the early development of sample children, after controlling for general socioeconomic status, health, and nutrition, and this correlation differs by gender. These results imply that the provision of learning material to households, promoting caregivers’ responsiveness and organization in less-developed rural areas could improve early child development among deprived children.
Family Medicine Education at a Rural Hospital in Japan: Impact on Institution and Trainees
Authors: Ohta Ryuichi , Ryu Yoshinori , Sano Chiaki
Published: June 2021

Family medicine is vital in Japan as its society ages, especially in rural areas. However, the implementation of family medicine educational systems has an impact on medical institutions and requires effective communication with stakeholders. This research—based on a mixed-method study—clarifies the changes in a rural hospital and its medical trainees achieved by implementing the family medicine educational curriculum. The quantitative aspect measured the scope of practice and the change in the clinical performance of family medicine trainees through their experience of cases—categorized according to the 10th revision of the International Statistical Classification of Disease and Related Health Problems. During the one-year training program, the trainees’ scope of practice expanded significantly in both outpatient and inpatient departments. The qualitative aspect used the grounded theory approach—observations, a focus group, and one-on-one interviews. Three themes emerged during the analysis—conflicts with the past, driving unlearning, and organizational change. Implementing family medicine education in rural community hospitals can improve trainees’ experiences as family physicians. To ensure the continuity of family medicine education, and to overcome conflicts caused by system and culture changes, methods for the moderation of conflicts and effective unlearning should be promoted in community hospitals.
Attitudes towards COVID-19-Related Medical Misinformation among Healthcare Workers and Non-Healthcare Workers in Saudi Arabia during the Pandemic: An Online Cross-Sectional Survey
Authors: Alotiby Amna Abdullah , Al-Harbi Laila Naif
Published: June 2021

Since the SARS-CoV-2 virus caused a global pandemic, the amount of misinformation in various media outlets has been on the rise. This has caused confusion among both healthcare workers and the general population about what the proper precautions against COVID-19 are. This study investigated attitudes towards misinformation related to protective measures that can be taken against COVID-19. The study was conducted in Saudi Arabia using an online survey questionnaire during the first three months of lockdown responding to the pandemic. The sample size of the study was N = 1294, of which 275 were healthcare workers and 974 were non-healthcare workers. The findings indicate that the Saudi Arabian population has a “Neutral” attitude towards COVID-19-related misinformation, meaning that, overall, they neither agree nor disagree with the most common COVID-19-related misinformation. Both healthcare workers and non-healthcare workers displayed a “Neutral” attitude towards herbal remedies for COVID-19. The level of agreement regarding the SARS-CoV-2 virus remaining in the throat for two days and the BCG vaccine protecting against COVID-19 was low. The findings of this research imply that knowledge dissemination is severely lacking in Saudi Arabia and that the Ministry of Health in Saudi Arabia should sincerely consider educating healthcare workers better about verified and true information regarding COVID-19. Conclusion: Future research should include larger sample sizes for each of the healthcare specialties surveyed in this study and analyse their attitudes towards COVID-19 misinformation.
Effects of Environmental Quality Perception on Depression: Subjective Social Class as a Mediator
Authors: Zhang Liqin , Wu Lin
Published: June 2021

Although the relationship between environment and public depression has aroused heated debate, the empirical research on the relationship between environmental quality perception and public depression is still relatively insufficient. This paper aims to explore the influence of environmental quality perception on public depression and the mediating role of subjective social class between environmental quality perception and public depression. Using the China Family Panel Studies data of 2016 for empirical analysis, this study’s results show that environmental quality perception has a significant effect on public depression and subjective social class also has a significant effect on public depression. In addition, we found that subjective social class can play a partial mediating role between environmental quality perception and public depression, and the intermediary effect only comes from the contribution of the perception of living environmental quality, not the perception of overall environmental quality. That is to say, the perception of living environment quality deeply affects the subjective social class, and then induces public depression. In order to alleviate the relationship between environmental quality and public depression, it is recommended that the state environmental protection department and civil affairs department strengthen the improvement of public living environment so as to promote individual subjective social class and reduce the risk of public depression. Moreover, it is suggested that research with longitudinal design and comprehensive indicators be undertaken in the future.
Quality of Life in Hidradenitis Suppurativa: An Update
Authors: Chernyshov Pavel V. , Finlay Andrew Y. , Tomas-Aragones Lucia , Poot Francoise , Sampogna Francesca , Marron Servando E. , Zemskov Sergey V. , Abeni Damiano , Tzellos Thrasyvoulos , Szepietowski Jacek C. , Zouboulis Christos C.
Published: June 2021

Knowledge on hidradenitis suppurativa/acne inversa (HS) is rapidly increasing. HS has a profound impact on patients and their family life. Several factors, such as comorbidities, unemployment and HS severity, make this impact even more severe. The most widely used instrument to measure this impact is the dermatology-specific DLQI. We also identified six HS-specific health-related quality of life (HRQoL) instruments. Of them, HIDRAdisk, HSIA, HiSQOL and HSQoL-24 are better validated but there is still lack of experience of its use. Several treatment methods showed positive effect on patients’ HRQoL. Surgery remains a method with a substantial positive effect on HRQoL. Several studies confirming a positive effect of adalimumab on the HRQoL of patients with HS were published during the last three years. Data on the influence of several other biologics on HRQoL of HS patients are controversial or based on studies with a small number of patients.
Enhance Access to Pulmonary Rehabilitation with a Structured and Personalized Home-Based Program—reabilitAR: Protocol for Real-World Setting
Authors: Bernard Sarah , Vilarinho Rui , Pinto Inês , Cantante Rosa , Coxo Ricardo , Fonseca Rosa , Mayoralas-Alises Sagrario , Diaz-Lobato Salvador , Carvalho João , Esteves Cátia , Caneiras Cátia
Published: June 2021

Home-based models represent one of the solutions to respond to the poor accessibility of pulmonary rehabilitation (PR) services in patients with chronic respiratory disease (CRD). The main goal of this protocol is to present the implementation of the first nationwide home-based PR program—reabilitAR—in Portugal and the strategies to assess its benefits in patients with CRD. The program consists of 2 phases: a 12-week intensive phase and a 40-week maintenance phase (total: 52 weeks, 1 year). The intervention in both phases is composed of presential home visits and phone-call follow ups, including exercise training and the self-management educational program Living Well with COPD. Dyspnea, impact of the disease, emotional status, and level of dyspnea during activities of daily living are used as patient-reported outcomes measures. A one-minute sit-to-stand test is used as a functional outcome, and the number of steps as a measure of physical activity. To ensure safety, fall risk and the cognitive function are assessed. Data are collected at baseline, at 12 weeks, at 26 weeks and at 52 weeks. This is the first nationwide protocol on enhancing access to PR, providing appropriate responses to CRD patients’ needs through a structured and personalized home-based program in Portugal.
A Metagovernance Model of Innovation Networks in the Health and Social Services Using a Neo-Schumpeterian Framework
Authors: Peralta Alberto , Rubalcaba Luis
Published: June 2021

Health and social services (HSS) are now, more than ever, at the center of the debate of public policy. We are interested in studying the HSS services innovations from the networked-governance strategy standpoint. With this research, we contribute by analyzing the criteria leading to the formation of HSS public service innovation networks (HSS PSINs). These criteria are important because they may result in the much-needed empirical foundation of the metagovernance of public networks for sustainable innovation. Our analysis rests on neo-Schumpeterian interpretations of product, process, organizational, market, and input innovations, and their characteristics. By an empirical partial least squares structural equations model, we present here the relationships between those characteristics and HSS PSINs. Our intent is that these relationships become clearer, and help enhance HSS PSINs metagovernance—i.e., their control, democratic legitimacy, and accountability by public decision-makers. Hence, our research supports the voices for an extended use of networks for policy and service collaborative innovation for sustainability.
Humidifier Disinfectant Consumption and Humidifier Disinfectant-Associated Lung Injury in South Korea: A Nationwide Population-Based Study
Authors: Yoon Jeonggyo , Kang Minsun , Jung Jaehun , Ju Min Jae , Jeong Sung Hwan , Yang Wonho , Choi Yoon-Hyeong
Published: June 2021

Humidifier disinfectant (HD) is a household biocidal product used in humidifier water tanks to prevent the growth of microorganisms. In 2011, a series of lung injury cases of unknown causes emerged in children and pregnant women who had used HD in Korea. This study investigated changes in the nationwide number of cases of humidifier disinfectant-associated lung injury (HDLI) in concordance with nationwide HD consumption using data covering the entire Korean population. More than 25 kinds of HD products were sold between 1994 and 2011. The number of diagnosed HDLI, assessed by S27.3 (other injuries of lungs) of the Korea National Health Insurance Service (NHIS) data, sharply increased by 2005, subsequently decreased after 2005, and almost disappeared after 2011 in concordance with the annual number of HD sales. The number of self-reported HDLIs, assessed using data from all suspected HDLI cases registered in the Korea Ministry of Environment, changed with the annual number of HD sales, with a delay pattern, potentially induced by the late awareness of lung injury diseases. The present study suggests that changes in the nationwide annual consumption of HD products were consistent with changes in the annual number of HDLI cases in Korea.
Entomovirological Surveillance in Schools: Are They a Source for Arboviral Diseases Transmission?
Authors: Pérez-Pérez Juliana , Peña-García Víctor Hugo , Calle-Tobón Arley , Quimbayo-Forero Marcela , Rojo Raúl , Henao Enrique , Shragai Talya , Rúa-Uribe Guillermo
Published: June 2021

Surveillance and control activities for virus-transmitting mosquitoes have primarily focused on dwellings. There is little information about viral circulation in heavily trafficked places such as schools. We collected and analyzed data to assess the presence and prevalence of dengue, chikungunya, and Zika viruses in mosquitoes, and measured Aedes indices in schools in Medellín (Colombia) between 2016–2018. In 43.27% of 2632 visits we collected Aedes adults, creating 883 pools analyzed by RT-PCR. 14.27% of pools yielded positive for dengue or Zika (infection rates of 1.75–296.29 for Aedes aegypti). Ae. aegypti was more abundant and had a higher infection rate for all studied diseases. Aedes indices varied over time. There was no association between Aedes abundance and mosquito infection rates, but the latter did correlate with cases of arboviral disease and climate. Results suggest schools are important sources of arbovirus and health agencies should include these sites in surveillance programs; it is essential to know the source for arboviral diseases transmission and the identification of the most population groups exposed to these diseases to research and developing new strategies.
Influence of Thermal Environment on Attendance and Adaptive Behaviors in Outdoor Spaces: A Study in a Cold-Climate University Campus
Authors: Xue Jiao , Liu Wei , Liu Kuixing
Published: June 2021

Creating a favorable thermal environment in an outdoor space is essential for attracting more occupants to outdoor areas and vitalizing a city. It is possible to study occupants’ needs in an outdoor thermal environment by observing their attendance and behaviors, since people may exhibit certain adaptive measures, such as seeking shade, using parasols, etc., “vote with their feet”, or even leave the space, if they feel uncomfortable. In order to investigate the influence of thermal environment on attendance and adaptive behaviors in outdoor spaces, in this study we carried out field campaigns in a university campus in a cold-climate city. The thermal environment was monitored, while surveys of thermal perceptions and observations of attendance and adaptive behaviors were conducted. Through the data analyses, it was found that the thermal environment had a great impact on the attendance of optional activities, but necessary activities were not influenced. The greatest influence on attendance came from air temperature. The influences of wind and humidity on attendance were found to be coupled with that of air temperature. Adaptive behaviors, such as seeking shade, using parasols, changing clothes, and changing the lengths of stay, were also greatly influenced by air temperature.
Perceived Opportunities for Physical Activity and Willingness to Be More Active in Older Adults with Different Physical Activity Levels
Authors: Aartolahti Eeva , Eronen Johanna , Törmäkangas Timo , Rantanen Taina , Hirvensalo Mirja , Palmberg Lotta , Skantz Heidi , Viljanen Anne , Portegijs Erja , Iwarsson Susanne , Rantakokko Merja
Published: June 2021

This study examined equity in physical activity (PA) by investigating whether perceived opportunity for PA was associated with willingness to be more active. Among community residents (75, 80, or 85 years old, n = 962) perceived opportunity for PA (poor and good), willingness to be more active (not at all, a bit, and a lot), and level of PA (low, moderate, and high) were assessed via questionnaires. Multinomial logistic regression showed that physical activity moderated the association between poor opportunity and willingness to increase PA. Among those with moderate PA, poor opportunity for PA increased the odds of willingness to be a lot more active (multinomial odds ratio, mOR 3.90, 95% confidence interval 2.21–6.87) than not wanting to be more active compared to those perceiving good opportunities. Associations were similar at high PA levels (p < 0.001), but were not found at low PA levels. Those with moderate or high PA wish to increase their activity particularly when the perceived opportunities for activity are not optimal. Among those with low PA, perceived opportunities are not associated with a perceived need to increase physical activity. Increasing equity in physical activity in old age requires provision of support and opportunities at every level of physical activity.
Comparison of Access Site-Related Complications and Quality of Life in Patients after Invasive Cardiology Procedures According to the Use of Radial, Femoral, or Brachial Approach
Authors: Roczniak Jan , Koziołek Wojciech , Piechocki Marcin , Tokarek Tomasz , Surdacki Andrzej , Bartuś Stanisław , Chyrchel Michał
Published: June 2021

The radial approach (RA) is the most common in invasive cardiology, but depending on the clinical situation, the femoral approach (FA) and brachial approach (BA) are also used. The BA is associated with the highest odds of complications so it is used mainly if a first-choice approach fails. The aim of the study was to assess clinical outcomes after invasive cardiology procedures stratified by the use of the RA, FA, and BA, with a focus on access site-related complications, quality of life (QoL), and patients’ perspective. A total of 250 procedures (RA: 98; FA: 99; BA: 53) performed between 2013 and 2020 were retrospectively analyzed. Puncture site-related complications, vascular events, patient preferences, and QoL were assessed by the analysis of medical records and telephone follow-up using a proprietary questionnaire and the modified EQ-5D-3L questionnaire. Patients from the RA group received the smallest volume of contrast during a percutaneous coronary interventions (PCI) procedure (RA vs. FA vs. BA: 180 (150–240) mL vs. 200 (180–270) mL vs. 190 (100–200) mL, p = 0.045). The access site was changed most frequently in the procedures initiated from the RA (p < 0.04). Overall puncture site-related complications, especially local hematomas, occurred most commonly in the BA group (7.1, 14.1, and 24.5% for RA, FA, and BA, respectively, p = 0.01). During the index procedure, the access site was changed most frequently in procedures initiated from the RA (19.7, 8.5 and 0%, p = 0.04). The RA was indicated as an approach preferred by the patient for a hypothetical next procedure (87.9, 55.4, and 70.0% for subjects preferring the same approach out of patients who underwent a procedure by the RA, FA, and BA, respectively, p < 0.001). For the RA and FA, the prevalence of moderate or extreme access site-related problems in self-care decreased significantly (RA: p < 0.01, FA: p < 0.05) within 1 month after the index procedure (RA: 18.1, 4.2, and 1.4%; FA: 20.7, 11.1, and 9.6% periprocedurally, after 1 and 6 months, respectively). In contrast, for the BA these percentages were higher and a significant improvement (p < 0.05) was delayed until 6 months (54.6, 36.4, and 18.2% periprocedurally, after 1 and 6 months, respectively). In conclusion, compared to the BA and FA, the RA appears to be not only the safest, mainly due to the lowest risk of puncture site-related complications after coronary procedures but also represents a preferable approach from the patient’s perspective. Although overall post-procedural QoL outcomes did not differ significantly according to the access site, nevertheless, the BA was associated with more frequent self-care problems whose improvement was delayed until more than one month after the index procedure.
Tipsters and Addiction in Spain. Young People’s Perception of Influencers on Online Sports Gambling
Authors: Gonzálvez-Vallés Juan Enrique , Barquero-Cabrero José Daniel , Caldevilla-Domínguez David , Barrientos-Báez Almudena
Published: June 2021

This research analyzes young people’s perception of the presence of tipsters as influencers on online sports gambling and whether their presence can promote addiction to this activity. To achieve this goal, we designed a questionnaire that was administered to young people in public universities in Madrid, being answered by 1032 individuals, out of whom 613 claimed to be regular bettors. We proceeded to the factor analysis of the variables with a high or very high correlation, and results showed that young people perceive a clear relationship between gambling and addiction. An even more enlightening aspect is the result that links tipsters with addiction to online sports gambling; young people’s perception correlates both concepts with extraordinary strength. This study’s main conclusion makes it clear that there is a huge amount of influence of tipsters on the world of online sports betting, as well as the risk of marrying these two concepts, since young people perceive that either they or others could be initiated into the world of problem gambling.
Prenatal Exposure to Favorable Social and Environmental Neighborhood Conditions Is Associated with Healthy Pregnancy and Infant Outcomes
Authors: Appleton Allison A. , Lin Betty , Holdsworth Elizabeth A. , Feingold Beth J. , Schell Lawrence M.
Published: June 2021

Neighborhood and individual level risks commonly co-occur for pregnant women and may cumulatively contribute to birth outcomes. Moreover, the relationship between favorable social and environmental neighborhood conditions and perinatal outcomes has been understudied. This study considered the accumulated impact of prenatal exposure to positive neighborhood social, environmental, and educational conditions in relation to maternal health during pregnancy and birth size outcomes. In a prospective study of a multi-ethnic and socioeconomically diverse cohort (n = 239) of pregnant women and their infants, neighborhoods were characterized by the Child Opportunity Index (COI), a census-tract composite indicator representing favorable social, environmental, and educational community conditions. Adjusted generalized estimating equations showed that favorable neighborhood conditions promoted the growth of longer and heavier infant bodies, and reduced the risk of intrauterine growth restriction. The associations were stronger for female versus male infants, though not significantly different. Moreover, COI was associated with better maternal mental health and diet during pregnancy; diet significantly mediated the association between COI and birth size outcomes. This study underscores the importance of considering the accumulated benefit of neighborhood assets for maternal and infant health. Interventions that capitalizes on the full range of contextual assets in which mothers live may promote pregnancy health and fetal growth.
Medication for Opioid Use Disorder Service Provision and Telephone Counseling: A Concurrent Mixed-Methods Approach
Authors: Martin Rosemarie , Kang Augustine W. , DeBritz Audrey A. , Walton Mary R. , Hoadley Ariel , DelaCuesta Courtney , Hurley Linda
Published: June 2021

Using quantitative and qualitative evidence, this study triangulates counselors’ perspectives on the use of telemedicine in the context of Opioid Use Disorder (OUD) treatment. A concurrent mixed-methods design examined counselors’ experiences with telephone counseling during the COVID-19 pandemic. N = 42 counselors who provided OUD counseling services completed a close-ended, quantitative survey examining their experiences in addressing clients’ anxiety, depression, anger, substance use, therapeutic relationship, and substance use recovery using telephone counseling. The survey also assessed comfort, convenience, and satisfaction with telephone counseling. Counselors also completed open-ended responses examining satisfaction, convenience, relationship with patients, substance use, and general feedback with telephone counseling. The synthesis of quantitative and qualitative evidence indicated that a majority of counselors had positive experiences with using telephone counseling to provide services to clients undergoing OUD treatment. Convenience, greater access to clients, and flexibility were among the reasons cited for their positive experience. However, counselors also expressed that the telephone counseling was impersonal, and that some clients may have difficulties accessing appropriate technology for telehealth adoption. Findings suggest that further research with counselors is needed to identify the key elements of an effective integration of telephone counseling with traditional in-person treatment approaches in the post-pandemic era.
Systematic Review to Update ‘Value of a Statistical Life’ Estimates for Australia
Authors: Ananthapavan Jaithri , Moodie Marj , Milat Andrew J. , Carter Rob
Published: June 2021

The value of a statistical life (VSL) estimates individuals’ willingness to trade wealth for mortality risk reduction. This economic parameter is often a major component of the quantified benefits estimated in the evaluation of government policies related to health and safety. This study reviewed the literature to update the VSL recommended for Australian policy appraisals. A systematic literature review was conducted to capture Australian primary studies and international review papers reporting VSL estimates published from 2007 to January 2019. International estimates were adjusted for income differences and the median VSL estimate was extracted from each review study. VSL estimates were used to calculate the value of a statistical life year. Of the 18 studies that met the inclusion criteria, two studies were primary Australian studies with a weighted mean VSL of A$7.0 million in 2017 values. The median VSL in the review studies was A$7.3 million. For Australian public policy appraisals, we recommend the consideration of a base case VSL for people of all ages and across all risk contexts of A$7.0 million. Sensitivity analyses could use a high value of A$7.3 million and a low value that reflects the value (A$4.3 million) currently recommended by the Australian government.
The Perceived Impact of The First UK COVID-19 Lockdown on Companion Animal Welfare and Behaviour: A Mixed-Method Study of Associations with Owner Mental Health
Authors: Shoesmith Emily , Santos de Assis Luciana , Shahab Lion , Ratschen Elena , Toner Paul , Kale Dimitra , Reeve Catherine , Mills Daniel S.
Published: June 2021

Background: Companion animals may be a positive presence for their owners during the COVID-19 pandemic. However, the welfare of a companion animal is strongly influenced by the behaviour of their owners, as well as their physical and social environment. We aimed to investigate the reported changes in companion animal welfare and behaviour and to examine the association between these changes and companion animal owners’ mental health. Methods: A cross-sectional online survey of UK residents over 18 years of age was conducted between April and June 2020 (n = 5926). The questionnaire included validated, bespoke items measuring outcomes related to mental health, human-animal bonds and reported changes in animal welfare and behaviour. The final item of the survey invited open-ended free-text responses, allowing participants to describe experiences associated with human-animal relationships during the first UK lockdown phase. Results: Animal owners made up 89.8% of the sample (n = 5323), of whom 67.3% reported changes in their animal’s welfare and behaviour during the first lockdown phase (n = 3583). These reported changes were reduced to a positive (0–7) and negative (0–5) welfare scale, following principal component analysis (PCA) of 17 items. Participants reported more positive changes for cats, whereas more negative changes were reported for dogs. Thematic analysis identified three main themes relating to the positive and negative impact on companion animals of the COVID-19 pandemic. Generalised linear models indicated that companion animal owners with poorer mental health scores pre-lockdown reported fewer negative changes in animal welfare and behaviour. However, companion animal owners with poorer mental health scores since lockdown reported more changes, both positive and negative, in animal welfare and behaviour. Conclusion: Our findings extend previous insights into perceived welfare and behaviour changes on a very limited range of species to a wider range of companion animals. Owner mental health status has a clear, albeit small, effect on companion animal welfare and behaviour.
Exploring the Spatiotemporal Patterns of Residents’ Daily Activities Using Text-Based Social Media Data: A Case Study of Beijing, China
Authors: Liu Jian , Meng Bin , Wang Juan , Chen Siyu , Tian Bin , Zhi Guoqing
Published: June 2021

The use of social media data provided powerful data support to reveal the spatiotemporal characteristics and mechanisms of human activity, as it integrated rich spatiotemporal and textual semantic information. However, previous research has not fully utilized its semantic and spatiotemporal information, due to its technical and algorithmic limitations. The efficiency of the deep mining of textual semantic resources was also low. In this research, a multi-classification of text model, based on natural language processing technology and the Bidirectional Encoder Representations from Transformers (BERT) framework is constructed. The residents’ activities in Beijing were then classified using the Sina Weibo data in 2019. The results showed that the accuracy of the classifications was more than 90%. The types and distribution of residents’ activities were closely related to the characteristics of the activities and holiday arrangements. From the perspective of a short timescale, the activity rhythm on weekends was delayed by one hour as compared to that on weekdays. There was a significant agglomeration of residents’ activities that presented a spatial co-location cluster pattern, but the proportion of balanced co-location cluster areas was small. The research demonstrated that location conditions, especially the microlocation condition (the distance to the nearest subway station), were the driving factors that affected the resident activity cluster patterns. In this research, the proposed framework integrates textual semantic analysis, statistical method, and spatial techniques, broadens the application areas of social media data, especially text data, and provides a new paradigm for the research of residents’ activities and spatiotemporal behavior.
MDST-DBSCAN: A Density-Based Clustering Method for Multidimensional Spatiotemporal Data
Authors: Choi Changlock , Hong Seong-Yun
Published: June 2021

The increasing use of mobile devices and the growing popularity of location-based ser-vices have generated massive spatiotemporal data over the last several years. While it provides new opportunities to enhance our understanding of various urban dynamics, it poses challenges at the same time due to the complex structure and large-volume characteristic of the spatiotemporal data. To facilitate the process and analysis of such spatiotemporal data, various data mining and clustering methods have been proposed, but there still needs to develop a more flexible and computationally efficient method. The purpose of this paper is to present a clustering method that can work with large-scale, multidimensional spatiotemporal data in a reliable and efficient manner. The proposed method, called MDST-DBSCAN, is applied to idealized patterns and a real data set, and the results from both examples demonstrate that it can identify clusters accurately within a reasonable amount of time. MDST-DBSCAN performs well on both spatial and spatiotemporal data, and it can be particularly useful for exploring massive spatiotemporal data, such as detailed real estate transactions data in Seoul, Korea.