bluuebunny/crossref_metadata_2025 huggingface dataset:
How Can Cardiac Rehabilitation Promote Health Literacy? Results from a Qualitative Study in Cardiac Inpatients
Authors: Isselhard Anna , Lorenz Laura , Mayer-Berger Wolfgang , Redaélli Marcus , Stock Stephanie
Published: January 2022

After acute care of a cardiac event, cardiac rehabilitation helps future disease management. Patients with low health literacy have been shown to have fewer knowledge gains from rehabilitation and higher all-cause mortality after acute cardiac events. Cardiac rehabilitation may be the best channel to target population with low health literacy, yet research on this topic is limited. Consequently, the main aim of the current study was to identify patient perceptions about the health literacy domains that are needed for successful rehabilitation of patients attending German cardiac rehabilitation clinics after an acute cardiac event. Five focus group interviews with 25 inpatients (80% male, 20% female) were conducted at a cardiac rehabilitation clinic in Germany. Patients were eligible to participate if they had sufficient understanding of the German language and had no other debilitating diseases. Patients identified five domains of health literacy for rehabilitation success: knowledge about their health condition; being able to find and evaluate health-related information, being able to make plans and sticking to them, assumption of responsibility over one’s health and the ability to ask for and receive support. The results give an important insight into what patients perceive as important components of their cardiac rehabilitation, which can provide the basis for developing the health literacy of patients and how cardiac rehabilitation clinics respond to the recovery needs of their patients.
Reprotoxic Impact of Environment, Diet, and Behavior
Authors: Gallo Alessandra
Published: January 2022

Reproductive health is progressively declining due to multiples endogenous and exogenous factors, such as environmental contaminants, diet and behavior. Accumulated evidences confirm that fertility and reproductive function have been adversely affected by exposure to chemical contaminants released in the environment. Today, the impact of diet and behavior on reproductive processes is also receiving special attention from the scientific community. Indeed, a close relationship between diet and fertility has been proven. Furthermore, a combination of unhealthy behavior, such as exposure to hazardous compounds and stress factors, poses living organisms at higher risk of reprotoxic effects. In particular, it has been described that poor life behaviors are associated with reduced male and female fertility due to decreased gamete quality and function. Most of the erroneous behaviors are, furthermore, a source of oxidative stress that, leading to epigenetic alterations, results in an impaired reproductive fitness. This review reports the detrimental impact of the most common environmental chemical stressors, diet, and behavior on reproductive functionality and success. Although clear evidences are still scarce, reassuring data are provided that a healthy diet and reverting unhealthy lifestyles may be of help to recover physiological reproductive conditions.
Do Fitter Children Better Assess Their Physical Activity with Questionnaire Than Less Fit Children?
Authors: Premelč Jerneja , Meh Kaja , Vähä-Ypyä Henri , Sember Vedrana , Jurak Gregor
Published: January 2022

Most physical activity (PA) questionnaires assess moderate to vigorous PA (MVPA) describing the physical exertion of individuals that might be influenced by their physical fitness. Therefore, the aim of this study was to determine whether fitter children could better assess their PA with the questionnaire than less fit children. The cross-sectional validation study was conducted with 108 children (60 girls) aged 11 to 14 years, who were divided into three fitness groups based on the results of the 600 m running test. To answer the research question, the agreement between their assessment of PA using the SHAPES questionnaire and the UKK RM42 accelerometer data was analysed. One quarter of the participants achieved at least 60 min of MVPA each day, measured by accelerometer. The average MVPA obtained was 97.8 ± 35.6 min per day, with the high fitness group having a significantly higher value compared with the other groups. Moderate to high validity coefficients were found in the high fitness group (Spearman’s ρ range 0.34–0.70). In contrast, the lower fitness groups had poor to moderate validity for all variables (Spearman’s ρ range 0.03–0.42). These results suggest that the fittest children self-assess their PA with the questionnaire better than less fit children, which may advance new directions for the development and evaluation of PA questionnaires and their usability.
Match Physical and Physiological Response of Amateur Soccer Referees: A Comparison between Halves and Match Periods
Authors: Ozaeta Eñaut , Fernández-Lasa Uxue , Martínez-Aldama Inmaculada , Cayero Ruth , Castillo Daniel
Published: January 2022

The aim of this paper was to examine the differences in the external and internal load in amateur match officials between the 1st and 2nd half and among different 15 min periods. Twenty-three field referees (FRs) and 46 assistant referees (ARs) from the Spanish División de Honor participated in this study. Match external and internal loads were monitored showing that FRs recorded a lower Powermean, Speedmean, Cadencemean and Stiffnessmean (p < 0.05; d = 0.52 to 0.57) during the 2nd half and they also recorded a lower HRmean, and HRpeak, and spent less time in zone 5 (p < 0.05; d = 0.50 to 0.62). The FRs’ match load decreased during the match but they performed higher Powermean and covered more distance in the last 15 min of the match (p < 0.01; d = 0.87 to 4.28). The ARs external load did not show significant variations between halves, but ARs recorded a lower HRmean and spent less time in zone 5 (p < 0.01; d = 0.41 to 0.63), and the highest values of Powermean, Speedmean, Cadencemean and Vertical oscillationmean during the first 15 min of the match (p < 0.05; d = 0.45 to 0.75). The highest values of HRmean and distance covered were in the 0–15 min period. Results suggest that match load decreases as the match progresses because of the neuromuscular fatigue but increases in the last 15 min.
Screen Time and Body Image in Icelandic Adolescents: Sex-Specific Cross-Sectional and Longitudinal Associations
Authors: Hrafnkelsdottir Soffia M. , Brychta Robert J. , Rognvaldsdottir Vaka , Chen Kong Y. , Johannsson Erlingur , Guðmundsdottir Sigridur L. , Arngrimsson Sigurbjorn A.
Published: January 2022

Studies of adolescent body image and screen use are mostly limited to girls, and longitudinal data are scarce. We examined cross-sectional and longitudinal associations between these variables in mid-adolescent boys and girls. Data was collected when participants were at age 15 and 17, by questionnaire and objective measurements (n = 152 had complete data). Sex-specific linear regression was used to explore cross-sectional and longitudinal associations of self-reported screen use (total use, and time spent in gaming, TV/DVD/internet-based watching and internet use for communication) and body image, adjusting for vigorous physical activity, symptoms of depression, and body composition. Screen time was negatively associated with body image at both time points, although more strongly at age 15, and for girls only. Gaming and TV/DVD/internet watching was more strongly associated with body image than internet use for communication. Girls with above median screen time at both ages had 14% lower body image score at age 17 than girls with below median screen time at both time points. Our results suggest that screen use is likely to play a role in the development of body dissatisfaction among adolescent females. Limiting screen time may, therefore, help to mitigate body dissatisfaction in adolescent girls.
Selection of the Most Scenic Viewpoints on an Island Based on Space–Time Perception: The Case of Nan’ao Island, China
Authors: Zhang Tongyan , Zhang Shengrui , Wang Yingjie , Yu Hu , Ju Hongrun , Xue Hanyun
Published: January 2022

Selecting the most scenic viewpoints in an island forest park can provide a scientific basis for island ecotourism planning. In this paper, considering the influence of climatic conditions on sightseeing, landscape factors, accessibility factors, and seasonal change factors are selected from the perspective of time and space to analyze the landscape spatiotemporal characteristics, and the construction of a landscape spatiotemporal perception evaluation model and the analysis of influencing factors are carried out. The results show that the evaluation model for landscape spatiotemporal perception factors can quantitatively describe tourists’ comprehensive perception of a landscape in different regions and time periods in ecotourism areas, and can identify the spatiotemporal characteristics of landscape perception. Case studies preliminarily prove the feasibility of the model and calculation process. This method provides a strong reference for the development and planning of island tourism, especially providing new ideas and methods for the design of sightseeing routes in the development and planning of small-scale scenic viewpoints, which can enrich island tourism planning.
A Blessing or a Curse? Exploring the Impact of Environmental Regulation on China’s Regional Green Development from the Perspective of Governance Transformation
Authors: Xu Xianpu , Li Xiawan , Zheng Lin
Published: January 2022

China’s rapid economic growth has caused serious problems, such as environmental pollution and resource exhaustion. Only by improving the green total factor productivity (GTFP) can China’s economic development get out of the dual dilemmas of environmental degradation and resources exhaustion. Although environmental regulation helps to improve China’s productivity, its impact on GTFP is still controversial and deserves careful investigation. In this context, this study adopts the global Malmquist-Luenberger productivity index to measure the GTFP change of China’s 30 provinces over the period of 2003 to 2017 and then it uses the fixed-effect dynamic panel model to investigate the impact of environmental regulation on GTFP from the perspective of governance transformation. The results show that: (1) there is a nonlinear U-shaped relationship between environmental regulation and GTFP, indicating that the Porter hypothesis is verified in China. More notably, the values of environmental regulation are still located on the left side of the U-shaped curve at present, which means that the promotional effect of environmental regulation on GTFP has not been realized fully. (2) The U-shaped relationship shows significant regional heterogeneity. The western region demonstrates the highest level of significance, followed by the eastern region. However, the U-shaped relationship is insignificant in the central region. (3) Governance transformation can not only significantly improve GTFP but it can also accelerate the realization of the Porter hypothesis by inspiring the innovative enthusiasm of enterprises, which means that governance transformation can contribute to the achievement of the improved effects of environmental regulation on GTFP. (4) R&D investment can significantly improve GTFP, where the impacts of trade openness and factor endowment were significantly negative and the influence of foreign direct investment was not significant. These conclusions provide a good reference point for optimizing the relationship between the government and the market, as well as promoting regional green and high-quality development in China.
Factors Associated with the Willingness to Become a Living Kidney Donor: A National Cross-Sectional Study
Authors: Kurleto Paulina , Tomaszek Lucyna , Milaniak Irena , Mędrzycka-Dąbrowska Wioletta
Published: January 2022

Introduction: Living donor kidney transplantation is the preferred method of treating kidney failure. The donor agrees to undergo an elective procedure for the benefit of the recipient. Aim: To assess the attitude toward living kidney donation and to investigate the factors that contribute to kidney donation willingness. Methods: A cross-sectional study was carried out between December 2020 and February 2021. The study covered a representative group of 953 Poles aged 18−77, living in all Polish voivodships. The relationship between sociodemographic factors, personal values (Personal Values List), the total score of life satisfaction (Satisfaction with Life Scale) and the willingness to donate a kidney to another human was assessed using a logistic regression model. Results: The most frequently chosen personal values were: good health; physical and mental fitness; love and friendship; knowledge and wisdom. The most frequently chosen symbols of happiness were: good health, successful family life, being needed by others. The median satisfaction with life for the entire group was 20 [16; 24]. Voluntary donation of a kidney to another human being i.e., family, friends, strangers were more often declared by women (OR = 1.21; Cl95%: 1.03−1.42), for whom the most important symbol of happiness was a life full of adventures, travels (OR = 1.39; Cl95%: 1.06−1.82) and the most important personal value was goodness and tenderness (OR = 1.21; Cl95%: 1.05−1.40). Total scores of The Satisfaction with Life Scale correlated positively with the willingness to voluntarily donate a kidney (OR = 1.03; Cl95%: 1.003−1.06), while age correlated negatively (OR = 0.99; Cl95%: 0.98−0.99). Conclusions: Respondents who declare their willingness to be a living kidney donor are mainly female, for which the most important symbol of happiness is a life full of adventures and travel, and the most important values are personal goodness and tenderness. The desire to donate a kidney to another person decreases with age and grows with life satisfaction. Trial registration: ClinicalTrials.gov (ID: NCT04789122).
Exposure–Response Functions for the Effects of Traffic Noise on Self-Reported Annoyance and Sleep Disturbance in Finland: Effect of Exposure Estimation Method
Authors: Yli-Tuomi Tarja , Turunen Anu W. , Tiittanen Pekka , Lanki Timo
Published: January 2022

Large variations in transportation noise tolerance have been reported between communities. In addition to population sensitivity, exposure–response functions (ERFs) for the effects of transportation noise depend on the exposure estimation method used. In the EU, the new CNOSSOS-EU method will change the estimations of exposure by changing the assignment of noise levels and populations to buildings. This method was officially used for the first time in the strategic noise mapping performed by Finnish authorities in 2017. Compared to the old method, the number of people exposed to traffic noise above 55 dB decreased by 50%. The main aim of this study, conducted in the Helsinki Capital Region, Finland, was to evaluate how the exposure estimation method affects ERFs for road traffic noise. As an example, with a façade road traffic noise level of 65 dB, the ERF based on the highest façade noise level of the residential building resulted in 5.1% being highly annoyed (HAV), while the ERF based on the exposure estimation method that is similar to the CNOSSOS-EU method resulted in 13.6%. Thus, the substantial increase in the health effect estimate compensates for the reduction in the number of highly exposed people. This demonstrates the need for purpose–fitted ERFs when the CNOSSOS-EU method is used to estimate exposure in the health impact assessment of transportation noise.
The Diagnosis and Management of Autism Spectrum Disorder (ASD) in Adult Females in the Presence or Absence of an Intellectual Disability
Authors: Rujeedawa Tanzil , Zaman Shahid H.
Published: January 2022

We review the reasons for the greater male predominance in the diagnosis of autism spectrum disorder in the non-intellectual disabled population and compare it to autism diagnosed in intellectually disabled individuals. Accurate and timely diagnosis is important, as it reduces health inequalities. Females often present later for the diagnosis. The differences are in core features, such as in social reciprocal interaction through ‘camouflaging’ and restricted repetitive behaviours, that are less noticeable in females and are potentially explained by the biological differences (female protective effect theory) and/or differences in presentation between the two sexes (female autism phenotype theory). Females more often present with internalising co-occurring conditions than males. We review these theories, highlighting the key differences and the impact of a diagnosis on females. We review methods to potentially improve diagnosis in females along with current and future management strategies.
Effects of Acute Yohimbine Hydrochloride Supplementation on Repeated Supramaximal Sprint Performance
Authors: Barnes Megan E. , Cowan Camryn R. , Boag Lauren E. , Hill Julianne G. , Jones Morgan L. , Nixon Kylie M. , Parker Mckenzie G. , Parker Shelby K. , Raymond Mary V. , Sternenberg Lillie H. , Tidwell Shelby L. , Yount Taylor M. , Williams Tyler D. , Rogers Rebecca R. , Ballmann Christopher G.
Published: January 2022

The purpose of this study was to examine the effects of a single acute dose of yohimbine hydrochloride on repeated anaerobic sprint ability. Physically active females (n = 18) completed two separate repeated supramaximal sprint trials each with a different single-dose treatment: placebo (PL; gluten-free corn starch) or yohimbine hydrochloride (YHM; 2.5 mg). For each trial, participants consumed their respective treatment 20 min before exercise. Following a warm-up, participants completed 3 × 15 s Wingate anaerobic tests (WAnTs) separated by 2 min of active recovery. A capillary blood sample was obtained pre- and immediately post-exercise to measure blood concentrations of lactate (LA), epinephrine (EPI), and norepinephrine (NE). Heart rate (HR) and rate of perceived exertion (RPE) were measured following each WAnT. Findings showed that mean power (p < 0.001; η2 = 0.024), total work (p < 0.001; η2 = 0.061), and HR (p < 0.001; η2 = 0.046), were significantly higher with YHM supplementation versus PL. Fatigue index (p < 0.001; η2 = 0.054) and post-exercise LA (p < 0.001; d = 1.26) were significantly lower with YHM compared to PL. YHM resulted in significantly higher EPI concentrations versus PL (p < 0.001; η2 = 0.225) pre- and post-exercise while NE only increased as a function of time (p < 0.001; η2 = 0.227) and was unaffected by treatment. While RPE increased after each WAnT, no differences between treatments were observed (p = 0.539; η2 < 0.001). Together, these results suggest that acute YHM ingestion imparts ergogenic benefits which may be mediated by lower blood LA and fatigue concomitantly occurring with blood EPI increases. Thus, YHM may improve sprint performance although more mechanistic study is warranted to accentuate underlying processes mediating performance enhancement.
Polish Nurses’ Knowledge of Heart Failure Self-Management Principles
Authors: Krówczyńska Dorota , Jankowska-Polańska Beata
Published: January 2022

Background: Only comprehensive care and structured education can have a significant impact on the effectiveness of treatment and prepare patients for self-care. Unfortunately, Polish nurses are not ready to perform comprehensive heart failure (HF) care tasks without careful preparation.The purpose of the study was to evaluate nurses’ knowledge of patient education in general and topic-specific perceptions of basic information important for HF self-care, and also to determine the variables (workplace, education, internship) that may affect the implementation of educational tasks in the care of patients with HF. Methods: The study involved 304 nurses who were surveyed using the Nurses’ Knowledge of Heart Failure Education Principles. Results: Cardiology nurses’ knowledge regarding patient education for self-care is insufficient. The overall knowledge score was the highest among nurses in provincial specialist hospitals and university hospitals and the lowest in regional hospitals in small towns (14.98 vs. 14.35 vs. 12.83 vs. 11.89, respectively). Nurses who completed a cardiological specialty demonstrated significantly more extensive knowledge than those who had completed other specialties (15.52 vs. 13.71). Conclusions: Cardiology nurses’ knowledge of HF self-care principles regarding patient education is satisfactory, but not with all mandatory issues, especially in the recognition of disease symptoms, exacerbations, and pharmacotherapy.
“I’m a Winner, Not a Victim”: The Facilitating Factors of Post-Traumatic Growth among Women Who Have Suffered Intimate Partner Violence
Authors: Bryngeirsdottir Hulda S. , Halldorsdottir Sigridur
Published: January 2022

Post-traumatic growth (PTG) is a positive psychological change following trauma. Intimate partner violence (IPV) is one such trauma. The aim of this phenomenological study was to explore PTG from the perspective of women who have survived IPV as well as their perceptions of PTG. Twenty-two female IPV survivors aged 23–56 who reached PTG, according to the working definition used, were interviewed. The overriding theme of the study was “I’m a winner, not a victim”, which describes the essence of the women’s experience of PTG. They described their experience as a shift from being suffering victims of IPV to becoming winners who enjoyed PTG. They felt that their positive attitude and personal strengths had helped them to reach PTG as well as to face the fact that they had been in an abusive relationship, thus forgiving and believing in themselves and taking responsibility for their own health and well-being. They sought knowledge about violence, how to process it, and how to respond to triggers. They set boundaries for their perpetrators and were in as little contact with them as possible. They chose the company of positive, supportive, and constructive people and situations where they were not being controlled. It was concluded that, even though suffering IPV is a terrible experience that no one should endure, the participants’ experiences had resulted in PTG that they treasured.
Environmental and Occupational Health Exposures and Outcomes of Informal Street Food Vendors in South Africa: A Quasi-Systematic Review
Authors: Sepadi Maasago Mercy , Nkosi Vusumuzi
Published: January 2022

Introduction: Informal street vending is a form of informal employment, and occupational conditions for people within this group have been proven to be detrimental to their health. Two independent reviewers carried out a systematic evaluation of the existing literature in South Africa on environmental and occupational exposures, as well as the health effects faced by informal street food vendors. Methods: 354 published publications were reviewed and 9 were included, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Results: The evidence showed that informal street vendors are exposed to workplace risks that affect their health and wellbeing. Non-enclosed vendor stalls and frequent use of open fires were among the risk concerns. Vendors are vulnerable to gastrointestinal diseases such as salmonellosis and respiratory infections such as influenza and COVID-19 due to inadequate access to water, waste disposal facilities, and basic hygiene awareness and practices. Exposure to air pollutants increased the risk of respiratory and urinary illnesses and an impact on the reproductive health of female street vendors. Conclusions: This investigation demonstrated the difficulties in complying with the requirements of the Regulations Governing General Hygiene Requirements for Food Premises, the Transport of Food, and Related Matters (no. R638 of 22 June 2018) and the Occupational Health and Safety (OHS) Act (no. 85 of 1993). Within South African borders, there is a scarcity of research on occupational exposures and health effects in this occupation. As a result, eliminating or preventing these occupational exposures should be at the top of government and stakeholder agendas. The majority of the research was carried out in KwaZulu Natal and used a quantitative, cross-sectional technique. Other designs, including cohorts, time series, and randomized intervention trials, were underutilized.
A Game-Based Approach to Lower Blood Pressure? Comparing Acute Hemodynamic Responses to Endurance Exercise and Exergaming: A Randomized Crossover Trial
Authors: Kircher Eva , Ketelhut Sascha , Ketelhut Kerstin , Röglin Lisa , Hottenrott Kuno , Martin-Niedecken Anna Lisa , Ketelhut Reinhard G.
Published: January 2022

The present randomized crossover study aimed to determine whether an exergaming session in an innovative, functional fitness game could be an effective exercise approach that elicits favorable blood pressure (BP) responses, such as a typical moderate endurance exercise (ET). Therefore, acute hemodynamic responses after a training session in the ExerCube and an ET on a treadmill were assessed and compared. Twenty-eight healthy recreational active participants (13 women; aged 24.8 ± 3.9 years) completed an exergaming session (EX) and an ET in a randomized and counterbalanced order. Before and throughout the 45 min after the training, the peripheral and central BP were measured. After the ET, there was a moderate decrease in both peripheral systolic (−1.8 mmHg; p = 0.14) and diastolic (−0.8 mmHg; p = 0.003), as well as central diastolic (−1.5 mmHg; p = 0.006) pressure compared to the resting value before the exercise. After the EX, there was a significant decrease in peripheral systolic (−6.3 mmHg; p < 0.001) and diastolic (−4.8 mmHg; p < 0.001), as well as central systolic (−5.8 mmHg; p < 0.001) and diastolic (−5.3 mmHg; p < 0.001) pressure compared to baseline. The interaction effects showed significant differences in peripheral and central systolic BP as well as in peripheral diastolic BP (p = 0.05). The EX seems to be an effective training approach that triggers relevant peripheral and central BP-responses, which are more pronounced than after a typical ET. Therefore, the ExerCube can be a time-efficient training tool to improve cardiovascular health.
Co-Designing a Program to Lower Cardiovascular Disease Risk in Midlife Black Women
Authors: Jones Holly J. , Bakas Tamilyn , Nared Sheila , Humphries Jacqueline , Wijesooriya Julie , Butsch Kovacic Melinda
Published: January 2022

Midlife Black women suffer disproportionately from heart disease and stroke in comparison to White women of similar age and demographic. Risk for cardiovascular disease (CVD) and stroke is largely considered to be modifiable yet CVD prevention and awareness campaigns have been less effective among Black women. Decreased awareness of personal CVD risk is associated with delays in the presentation of women to the emergency room or health care providers for symptoms of myocardial infarction. The Midlife Black Women’s Stress and Wellness (B-SWELL) program was designed to increase awareness about CVD risk factors, stress, and healthy lifestyle behaviors among midlife Black women. In partnership with an existing Community Research Advisory Board (C-RAB), materials were developed and culturally adapted for the B-SWELL program. Following successful development of the B-SWELL materials, a trial of the B-SWELL program was conducted with a sample of midlife Black women recruited from the community. The program was co-facilitated by members of the C-RAB. We outline the strategies used to successfully co-create and trial the B-SWELL program materials and reflect on the strengths and challenges associated with the development of a culturally tailored heart disease prevention program using community participatory methods.
The Promise of Digital Self-Management: A Reflection about the Effects of Patient-Targeted e-Health Tools on Self-Management and Wellbeing
Authors: van Olmen Josefien
Published: January 2022

Increasingly, people have direct access to e-Health resources such as health information on the Internet, personal health portals, and wearable self-management applications, which have the potential to reinforce the simultaneously growing focus on self-management and wellbeing. To examine these relationships, we searched using keywords self-management, patient-targeting e-Health tools, and health as wellbeing. Direct access to the health information on the Internet or diagnostic apps on a smartphone can help people to self-manage health issues, but also leads to uncertainty, stress, and avoidance. Uncertainties relate to the quality of information and to use and misuse of information. Most self-management support programs focus on medical management. The relationship between self-management and wellbeing is not straightforward. While the influence of stress and negative social emotions on self-management is recognized as an important cause of the negative spiral, empirical research on this topic is limited to health literacy studies. Evidence on health apps showed positive effects on specific actions and symptoms and potential for increasing awareness and ownership by people. Effects on more complex behaviors such as participation cannot be established. This review discovers relatively unknown and understudied angles and perspectives about the relationship between e-Health, self-management, and wellbeing.
Behavioral Changes, Adaptation, and Supports among Indonesian Female Sex Workers Facing Dual Risk of COVID-19 and HIV in a Pandemic
Authors: Wirawan Gede Benny Setia , Wardhani Brigitta Dhyah K. , Pradnyani Putu Erma , Nurhalina Afriana , Sulaiman Nurjannah , Sukmaningrum Evi , Wulandari Luh Putu Lila , Januraga Pande Putu
Published: January 2022

The objective of this study is to explore the impacts of COVID-19 and changes taking place among the Indonesian female sex worker (FSW) community during the COVID-19 pandemic and the predictors of these changes. We conducted a cross-sectional online survey and selected the participants using a purposive snowball sampling technique. Incentives were provided to participants in the form of a 5 USD e-wallet balance. Variables of interest included adaptation to online sex work, adherence to COVID-19 prevention measures during sex work, number of clients, income reduction, social support, condom access, and condom use frequency. Sociodemographic data and COVID-19 fear index values were also collected. Final analysis included 951 FSWs, of whom 36.4% of had adapted to online sex work and 48.6% had practiced COVID-19 prevention measures. Major reductions in client frequency and income were reported by 67.8% and 71.1% of respondents, respectively. However, only 36.3% of FSWs reported they had ever received any form of social support from any parties, public or private. Meanwhile, 16.7% encountered difficulties in accessing condoms and 12.5% reported less frequent condom use during the pandemic. Easy access to condoms was the main factor influencing the frequency of condom use. As expected, staying in employment protected FSWs from major income loss, while education and younger age predicted adaptive behavioral changes, such as taking up online sex work. The COVID-19 pandemic has disrupted access to socioeconomic support systems and HIV prevention services among FSWs and has further exposed them to the dual jeopardy of HIV and COVID-19 infections.
The Impact of Internet Development on Urban Eco-Efficiency—A Quasi-Natural Experiment of “Broadband China” Pilot Policy
Authors: Zhong Xiaoying , Liu Guanghai , Chen Peng , Ke Kaili , Xie Ruhe
Published: January 2022

Based on the panel data of 285 prefecture-level cities and above in China from 2005 to 2019, this paper takes the “Broadband China” pilot policy as a quasi-natural experiment and evaluates the impact of Internet development on urban eco-efficiency (symbolized by the “Broadband China” policy) by constructing multi-period difference-in-difference (DID) and spatial DID models. Results show that: the “Broadband China” pilot policy significantly improves the urban eco-efficiency: the eco-efficiency in pilot cities is about 16.8% higher than that in other cities. The results remain consistent after testing for robustness, including using estimation methods, excluding the sample of key cities, changing core explanatory variables, and introducing instrumental variables. Next, the influence of the “Broadband China” pilot policy on eco-efficiency is characterized by significant regional heterogeneity: Internet development significantly improves the eco-efficiency in the central, eastern and northeastern regions that are economically more developed and not resource-dependent. In contrast, this effect is not obvious in the western region that is economically less developed and resource-dependent. Moreover, the influencing mechanism of Internet development on eco-efficiency suggests that the “Broadband China” strategy boosts urban eco-efficiency by increasing the Internet penetration rate, improving technological innovation capacity, and upgrading the industrial structure. In addition, results from the spatial DID models indicate that the “Broadband China” pilot policy improves the eco-efficiency in local cities and significantly enhances that in neighboring cities. Based on this, this paper puts forward some suggestions regarding promoting new network infrastructure construction and differentiating development policies to fit local conditions.
Enhanced Biodegradation of Phenylurea Herbicides by Ochrobactrum anthrophi CD3 Assessment of Its Feasibility in Diuron-Contaminated Soils
Authors: Alba Lara-Moreno , Esmeralda Morillo , Jaime Villaverde
Published: January 2022

The phenylurea herbicides are persistent in soil and water, making necessary the de-velopment of techniques for their removal from the environment. To identify new options in this regard, bacterial strains were isolated from a soil historically managed with pesticides. Ochrobactrum anthropi CD3 showed the ability to remove completely herbicides such as diuron, linuron, chlorotoluron and fluometuron from aqueous solution, and up to 89% of isoproturon. In the case of diuron and linuron, their main metabolite, 3,4-dichloroaniline (3,4-DCA), which has a higher toxicity than the parent compounds, was formed, but remained in solution without further degradation. O. anthropi CD3 was also tested for bioremediation of two different agricultural soils artificially contaminated with diuron, employing bioremediation techniques: (i) biostimulation, using a nutrient solution (NS), (ii) bioaugmentation, using O. anthropi CD3, and iii) bioavailability enhancement using 2-hydroxypropyl-β-cyclodextrin (HPBCD). When bioaugmentation and HPBCD were jointly applied, 50% of the diuron initially added to the soil was biodegraded in a range from 4.7 to 0.7 d. Also, 3,4-DCA was degraded in soil after the strain was inoculated. At the end of the soil biodegradation assay an ecotoxicity test confirmed that after inoculating O. anthropi CD3 the toxicity was drastically reduced.
Impact of Contaminants on Microbiota: Linking the Gut–Brain Axis with Neurotoxicity
Authors: Balaguer-Trias Jordina , Deepika Deepika , Schuhmacher Marta , Kumar Vikas
Published: January 2022

Over the last years, research has focused on microbiota to establish a missing link between neuronal health and intestine imbalance. Many studies have considered microbiota as critical regulators of the gut–brain axis. The crosstalk between microbiota and the central nervous system is mainly explained through three different pathways: the neural, endocrine, and immune pathways, intricately interconnected with each other. In day-to-day life, human beings are exposed to a wide variety of contaminants that affect our intestinal microbiota and alter the bidirectional communication between the gut and brain, causing neuronal disorders. The interplay between xenobiotics, microbiota and neurotoxicity is still not fully explored, especially for susceptible populations such as pregnant women, neonates, and developing children. Precisely, early exposure to contaminants can trigger neurodevelopmental toxicity and long-term diseases. There is growing but limited research on the specific mechanisms of the microbiota–gut–brain axis (MGBA), making it challenging to understand the effect of environmental pollutants. In this review, we discuss the biological interplay between microbiota–gut–brain and analyse the role of endocrine-disrupting chemicals: Bisphenol A (BPA), Chlorpyrifos (CPF), Diethylhexyl phthalate (DEHP), and Per- and polyfluoroalkyl substances (PFAS) in MGBA perturbations and subsequent neurotoxicity. The complexity of the MGBA and the changing nature of the gut microbiota pose significant challenges for future research. However, emerging in-silico models able to analyse and interpret meta-omics data are a promising option for understanding the processes in this axis and can help prevent neurotoxicity.
Imputation of Below Detection Limit Missing Data in Chemical Mixture Analysis with Bayesian Group Index Regression
Authors: Carli Matthew , Ward Mary H. , Metayer Catherine , Wheeler David C.
Published: January 2022

There is growing scientific interest in identifying the multitude of chemical exposures related to human diseases through mixture analysis. In this paper, we address the issue of below detection limit (BDL) missing data in mixture analysis using Bayesian group index regression by treating both regression effects and missing BDL observations as parameters in a model estimated through a Markov chain Monte Carlo algorithm that we refer to as pseudo-Gibbs imputation. We compare this with other Bayesian imputation methods found in the literature (Multiple Imputation by Chained Equations and Sequential Full Bayes imputation) as well as with a non-Bayesian single-imputation method. To evaluate our proposed method, we conduct simulation studies with varying percentages of BDL missingness and strengths of association. We apply our method to the California Childhood Leukemia Study (CCLS) to estimate concentrations of chemicals in house dust in a mixture analysis of potential environmental risk factors for childhood leukemia. Our results indicate that pseudo-Gibbs imputation has superior power for exposure effects and sensitivity for identifying individual chemicals at high percentages of BDL missing data. In the CCLS, we found a significant positive association between concentrations of polycyclic aromatic hydrocarbons (PAHs) in homes and childhood leukemia as well as significant positive associations for polychlorinated biphenyls (PCBs) and herbicides among children from the highest quartile of household income. In conclusion, pseudo-Gibbs imputation addresses a commonly encountered problem in environmental epidemiology, providing practitioners the ability to jointly estimate the effects of multiple chemical exposures with high levels of BDL missingness.
Use of Statins in Kidney Transplant Recipients in Norway
Authors: Rønning Marit , Hjellvik Vidar , Sakshaug Solveig , Blix Hege Salvesen , Midtvedt Karsten , Reisæter Anna Varberg , Holdaas Hallvard , Åsberg Anders
Published: January 2022

Kidney transplant recipients (KTRs) experience increased risk of cardiovascular disease. Guidelines recommend HMG-CoA reductase inhibitor (statin) therapy when tolerated. We aimed to study changes in the prescription of statins and patients’ adherence to treatment over time. A population-based observational study utilizing linked data from the Norwegian Renal Registry (national coverage of 99.9%) and the Norwegian Prescription Database was performed. Data from a total of 2250 first KTRs were included (mean age—54 years, 69% men). Dispensed prescriptions of statins and immunosuppressants for the period 2004–2016 for all first KTRs engrafted in the period 2005–2015 were analyzed. Seventy-two percent received statins the first year after kidney transplantation and the proportion increased with age. The proportion receiving a statin varied according to the time frame of transplantation (77% in 2005–2010 vs. 66% in 2012–2015). Among new users of statins, 82% of the patients were adherent both the second and third year after kidney transplantation, while the corresponding figure for those already receiving statins before transplantation was 97%. Statin continuation rates in KTRs were high. In conclusion, our findings show a slightly lower overall proportion of patients receiving statins after kidney transplants than the national target level of 80%. The proportion of statin users increased with the age of the KTRs but showed a decreasing trend as time progressed.
The Diagnostic Accuracy and Clinimetric Properties of Screening Instruments to Identify Frail Older Adults Attending Emergency Departments: A Protocol for a Mixed Methods Systematic Review and Meta-Analysis
Authors: Moloney Elizabeth , Sezgin Duygu , O’Donovan Mark , Adja Kadjo Yves Cedric , McGrath Keith , Liew Aaron , Lenzi Jacopo , Gori Davide , O’Connor Kieran , Molloy David William , Flanagan Evelyn , McLoughlin Darren , Fantini Maria Pia , Timmons Suzanne , O’Caoimh Rónán
Published: January 2022

Background: Prompt and efficient identification and stratification of patients who are frail is important, as this cohort are at high risk of adverse healthcare outcomes. Numerous frailty screening tools have been developed to support their identification across different settings, yet relatively few have emerged for use in emergency departments (EDs). This protocol provides details for a systematic review aiming to synthesize the accumulated evidence regarding the diagnostic accuracy and clinimetric properties of frailty screening instruments to identify frail older adults in EDs. Methods: Six electronic databases will be searched from January 2000 to March 2021. Eligible studies will include adults aged ≥60 years screened in EDs with any available screening instrument to identify frailty (even if not originally designed for this purpose). Studies, including case-control, longitudinal, and cohort studies, will be included, where instruments are compared to a reference standard to explore diagnostic accuracy. Predictive accuracy for a selection of outcomes, including mortality, institutionalization, and readmission, will be assessed. Clinical and methodological heterogeneity will be examined, and a random effects meta-analysis performed if appropriate. Conclusion: Understanding whether frailty screening on presentation to EDs is accurate in identifying frailty, and predicting these outcomes is important for decision-making and targeting appropriate management.
Medical Waste from COVID-19 Pandemic—A Systematic Review of Management and Environmental Impacts in Australia
Authors: Andeobu Lynda , Wibowo Santoso , Grandhi Srimannarayana
Published: January 2022

The coronavirus (COVID-19) pandemic has created a global medical emergency. The unforeseen occurrence of a pandemic of this magnitude has resulted in overwhelming levels of medical waste and raises questions about management and disposal practices, and environmental impacts. The amount of medical waste generated from COVID-19 since the outbreak is estimated to be 2.6 million tons/day worldwide. In Australia, heaps of single-use gowns, facemasks/face shields, aprons, gloves, goggles, sanitizers, sharps, and syringes are disposed everyday as a result of the pandemic. Moreover, the establishment of new home/hotel quarantine facilities and isolation/quarantine centres in various Australian states and territories have increased the risks of transmission among people in these facilities and the likelihoods of general waste becoming contaminated with medical waste. This warrants the need to examine management and disposal practices implemented to reduce the transmission and spread of the virus. This study reviews the various management and disposal practices adopted in Australia for dealing with medical waste from the COVID-19 pandemic and their impacts on public health and the environment. To achieve the aims of this study, prior studies from 2019–2021 from various databases are collected and analysed. The study focuses on generation of medical waste from COVID-19, management and disposal methods, current problems/challenges and environmental and public health impacts. Considering the enormous risks involved and the significance of appropriate handling and disposal of medical waste from COVID-19, this study provides insights on short and long term responses towards managing COVID-19 waste in Australia. The study contributes to Australia’s efforts against the transmission and spread of COVID-19 and provides recommendations for the development of workable and sustainable strategies for mitigating similar pandemics in the future.
Air Pollution, Health Shocks and Labor Mobility
Authors: Zhang Yi , Shi Tao , Wang Ai-Jun , Huang Qi
Published: January 2022

The health shocks caused by air pollution seriously interfere with people’s economic life. Based on the air pollution index and health shock index calculated by the principal component entropy weight method, this article analyzes the impact of air pollution on labor mobility, and adopts the mediation effect model to test the mediation effect of health shocks, using the threshold model to analyze the time and the health shocks threshold effect of air pollution on labor mobility. Its conclusions are as follows: (1) Air pollution has a negative impact on the net inflow of labor mobility, and the net inflow of labor mobility decreases between 24.9% and 44.7% on average for each unit increase in the health shocks of air pollution. (2) The impact of air pollution on labor mobility is all caused by health shocks; the health shocks are also an important factor influencing the decrease in the labor mobility supply across provinces, and the different health levels of the migrating individuals due to air pollution. (3) The health shocks of air pollution have a single-time threshold effect on labor mobility, and the health shocks of air pollution in China have intensified after 2010, confirming that China’s Lewis turning point was 2010. (4) The attraction effect of stable and higher regional real income will partially offset the repulsion effect of health shocks of air pollution on labor mobility, when the health-shocks index of air pollution exceeds the threshold value of 1.9873. Finally, the policy implications of the health shocks of air pollution on labor mobility are also formulated.
Inequalities in Birth Weight in Relation to Maternal Factors: A Population-Based Study of 3,813,757 Live Births
Authors: Genowska Agnieszka , Motkowski Radosław , Strukcinskaite Vaiva , Abramowicz Paweł , Konstantynowicz Jerzy
Published: January 2022

Background: Despite numerous studies of women having children later in life, evidence of the relationship between maternal factors and newborn outcomes in Central and Eastern European countries is limited. This study aimed to examine the association between maternal age, biological determinants, including parity and sex of the newborn, demographic and social background, and birth weight in 3.8 million singleton live births in Poland. Methods: The effect of maternal age on birth weight (in grams and Z-scores) adjusted for confounders was assessed using Generalized Linear Models. Results: The mean (±SD) birth weights of neonates born to primiparous women and multiparous women were 3356.3 ± 524.9 g and 3422.7 ± 538.6 g, respectively, which corresponded to a Z-score of −0.07 ± 0.96 and 0.14 ± 1.00, respectively (p ≤ 0.001). After controlling for biological, demographic, and social factors, a significant decrease in birth weight was found for primiparous women of the age group ≥30 years and multiparous women aged ≥35 years compared to the age group of 25–29 years. The lowest neonatal birth weight was observed in the case of women aged ≥45 years. Confounders did not affect birth weight Z-scores among primiparous women, whereas among multiparous women, together with educational factors, they reversed Z-scores from positive to negative values. The lower birth weight of neonates was overall associated with lower maternal education. Conclusions: Regardless of parity, advanced maternal age is strongly associated with a decreased neonatal birth weight, implying complications in early pregnancy and the antenatal period as well as obstetric complications. Counseling to support women’s family planning decisions and improving women’s education during their reproductive age may help to alleviate unfavorable newborn outcomes.