bluuebunny/crossref_metadata_2025 huggingface dataset:
Effects of Osteopathic T9–T10 Vertebral Manipulation in Tonsillitis: A Randomized Clinical Trial
Authors: Luceño-Mardones Agustín , Luceño-Rodríguez Irene , Rodríguez-López Elena Sonsoles , Oliva-Pascual-Vaca Jesús , Rosety Ignacio , Oliva-Pascual-Vaca Ángel
Published: April 2021

This study aimed to determine whether osteopathic manipulation of the T9–T10 vertebrae improves the evolution of tonsillitis. A randomized, stratified, controlled clinical trial with blinded patients, evaluator and data analyst was performed. The patients in the control group (CG) underwent a “sham” manipulation. A high-speed, low-amplitude technique was applied to the T9–T10 vertebrae in the osteopathic manipulative group (OMG) patients. The number of days needed to resolve the tonsillitis was significantly lower (p = 0.025) in the OMG (2.03 ± 0.95 days) than the CG (2.39 ± 0.82 days). Additionally, the number of episodes of tonsillitis after the treatment decreased significantly more in the OMG (0.8 ± 1.88 episodes/year in total) than the CG (2 ± 2.12) (p = 0.005). In the OMG, 60.8% had no recurrences of tonsillitis, compared to 22.5% of the CG, in the following year (χ2 (1) = 15.57, p < 0.001). No patients reported adverse effects. It has been concluded that during an episode of tonsillitis, the number of days to resolution was significantly lower after the application of an osteopathic manipulation of the T9–T10 vertebrae, compared to a sham manipulation. The number of subsequent year tonsillitis episodes was greatly reduced in both groups, significantly more in the OMG than in the CG patients.
The Association between Olfactory Function and Cognitive Impairment in Older Persons with Cognitive Impairments: A Cross-Sectional Study
Authors: Park Hyangjeong , Kim Heejeong , Kim Sisook , Cha Hyegyeong
Published: April 2021

Olfactory function is an emerging topic of research in the fields of cognitive impairment and neurodegenerative diseases. We aimed to confirm the association between olfactory function and cognitive impairment by assessing the olfactory function of older persons with cognitive impairment and identify whether olfactory function is associated with cognitive impairment. For this study, we recruited 117 older people aged ≥65 years with cognitive impairments from a public hospital in Korea. We used the Korean version of the expanded clinical dementia rating scale to evaluate participants’ cognitive impairments, and the University of Pennsylvania’s smell identification test to assess their olfactory function. Our results indicate a significant negative correlation between olfactory function and all domains of cognitive impairment (memory, orientation, judgement and problem-solving, community affairs, home and hobbies, and personal care). In addition, olfactory function was a factor associated with cognitive impairment in older persons. Therefore, we expect that our results to provide useful data for the development of interventions using olfactory stimulation to improve cognitive function in older persons with cognitive impairment.
Edible Flowers: Antioxidant Compounds and Their Functional Properties
Authors: B. Prabawati Nadhila B. , Oktavirina Viki , Palma Miguel , Setyaningsih Widiastuti
Published: April 2021

Edible flowers have been widely consumed for ages until now. The attractive colors and shapes, exotic aroma, and delightful taste make edible flowers very easy to attain. Moreover, they also provide health benefits for consumers due to the unique composition and concentration of antioxidant compounds in the matrices. Knowing the bioactive compounds and their functional properties from edible flowers is necessary to diversify the usage and reach broader consumers. Therefore, this reported review could be useful for functional product development, engaging the discussed edible flowers. We present a comprehensive review of edible flower composition and the functional properties of their antioxidant compounds, mainly phenolics.
COVID-19 Treatment Guidelines: Do They Really Reflect Best Medical Practices to Manage the Pandemic?
Authors: Jirjees Feras , Saad Ali K , Al Hano Zahraa , Hatahet Taher , Al Obaidi Hala , Dallal Bashi Yahya H
Published: April 2021

SARS-CoV-2 (COVID-19) has been changing the world since December 2019. A comprehensive search into many COVID-19 treatment guidelines was conducted and reported in this article. This is a review paper to probe differences in COVID-19 managing strategies and explore the most common treatment plans among countries. Published guidelines from 23 countries and three references guidelines—until the end of 2020—were included in this article. The majority of COVID-19 treatment options were reported in this review and it includes antiviral drugs, antimalarial drugs, antibiotics, corticosteroids, immunotherapy, anticoagulants, and other pharmacological treatment. The presence of such information from different countries in a single comprehensive review article could help in understanding and speculation of variation in the recommended treatment in each country. This might be related to the cost of medications, the access to the medications, availability of medication that could potentially be useful in managing COVID-19 cases, and the availability/capacity of healthcare facilities. Finally, although there are various treatment groups listed in the published therapeutic guidelines worldwide, unfortunately, there is no evidence for effectiveness of most of these medications in reducing the COVID-19 mortality curve over more than one year of this global pandemic.
Premenstrual Symptoms and Work: Exploring Female Staff Experiences and Recommendations for Workplaces
Authors: Hardy Claire , Hunter Myra S.
Published: April 2021

Most women experience some premenstrual symptoms during their reproductive years. Yet, this is an under-researched health issue, particularly in the context of work. This study aimed to: (i) understand the prevalence and severity of premenstrual symptoms experienced by working females, and their association with key work outcomes; (ii) explore factors that may be influencing these symptoms and their severity; and (iii) examine how organizations might help staff with premenstrual symptoms that may be impacting their working lives. An online, anonymous survey collected quantitative and qualitative data from 125 working women in the UK. Over 90% of the sample reported some premenstrual symptoms; 40% experienced premenstrual symptoms moderately or severely. Higher symptom severity was significantly (p < 0.05) associated with poor presenteeism, intention to reduce working hours, and higher work absence (time off work, being late, leaving early). Moderate/severe symptoms were significantly associated with several individual-related variables: lower perceived general health, higher alcohol consumption, poorer sleep quality, anxiety, depression, hormonal contraception, and using fewer coping approaches towards premenstrual symptoms (avoiding harm, adjusting energy levels); and work-related variables: poorer work–life balance, lower levels of psychological resilience, higher perceived work demands, less control over work. Disclosure of premenstrual symptoms and sickness absence because of premenstrual symptoms was very low, typically because of perceptions of appropriateness as a reason for work absence, gender of line managers (male), and it being a personal or embarrassing topic. Staff with moderate to severe premenstrual symptoms were statistically more likely to disclose reason for absence than those with milder symptoms. Recommendations and suggestions for employers and line managers include the need to train staff to improve knowledge about women’s experience of premenstrual symptoms, to be able to communicate effectively with women and to provide tailored support and resources for those who need it. Implications for future research, policy and practice are discussed.
Palestinian Refugee Youth in Jordan: Parental Practices, Neighborhood Cohesion and Assistance, and Adolescent Wellbeing
Authors: Ahmad Ikhlas , Smetana Judith
Published: April 2021

In this study, a total of 335 Palestinian refugees (M = 15.5 years, SD = 1.05, 49% males), recruited from four United Nations Relief and Work Agency (UNRWA) schools at the Al-Baqa’a and Jabal Al-Hussein refugee camps in Jordan, rated their neighborhood physical environment and neighborhood support and cohesion, separately rated their mothers’ and fathers’ parenting on several dimensions, and reported on their adjustment to these circumstances (internalizing symptoms, self-concept clarity, and norm breaking). Living in more dangerous physical environments was associated with higher levels of refugee youths’ internalizing symptoms and norm breaking, but effects were not significant when parenting was considered. Our study showed that higher levels of psychological control–disrespect (significantly for fathers and marginally for mothers) and marginally, higher levels of maternal harsh punishment were associated with more teen internalizing symptoms. In addition, fathers’ greater psychological control and lower levels of support had a marginally significant effect on teens’ greater norm breaking. For behavioral control, only mothers’ greater behavioral control was associated with refugee youths’ greater self-concept clarity but not with paternal behavioral control. Thus, fathers’ psychological control and mothers’ behavioral control had the biggest association with adolescent outcomes.
A Novel Approach to Derive the Predicted No-Effect Concentration (PNEC) of Benzophenone-3 (BP-3) Using the Species Sensitivity Distribution (SSD) Method: Suggestion of a New PNEC Value for BP-3
Authors: Jung Jae-Woong , Kang Jae Soon , Choi Jinsoo , Park June-Woo
Published: April 2021

The necessity for the aquatic ecological risk assessment for benzophenone-3 (BP-3) is increasing due to its high toxic potential and high detection frequency in freshwater. The initial step in the ecological risk assessment is to determine predicted no-effect concentration (PNEC). This study derived PNEC of BP-3 in freshwater using a species sensitivity distribution (SSD) approach, whilst existing PNECs are derived using assessment factor (AF) approaches. A total of eight chronic toxicity values, obtained by toxicity testing and a literature survey, covering four taxonomic classes (fish, crustaceans, algae, and cyanobacteria) were used for PNEC derivation. Therefore, the quantity and quality of the toxicity data met the minimum requirements for PNEC derivation using an SSD approach. The PNEC derived in this study (73.3 μg/L) was far higher than the environmental concentration detected in freshwater (up to 10.4 μg/L) as well as existing PNECs (0.67~1.8 μg/L), mainly due to the difference in the PNEC derivation methodology (i.e., AF vs. SSD approach). Since the SSD approach is regarded as more reliable than the AF approach, we recommend applying the PNEC value derived in this study for the aquatic ecological risk assessment of BP-3, as the use of the existing PNEC values seems to unnecessarily overestimate the potential ecological risk of BP-3 in freshwater.
Co-Use of Alcohol and Cannabis: Longitudinal Associations with Mental Health Outcomes in Young Adulthood
Authors: Thompson Kara , Holley Maria , Sturgess Clea , Leadbeater Bonnie
Published: April 2021

Increases in cannabis use among young people has heightened concern about the potential interactive health effects of cannabis with other drugs. We examined the longitudinal association between concurrent and simultaneous (SAM) co-use of alcohol and cannabis in young adulthood on mental health symptoms, substance use behaviors, and substance-related harms two years later. Data were drawn from Time 5 (T5; n = 464; 46% male) and 6 (T6; n = 478; 45% male) of the Victoria Healthy Youth Survey. At T5, 42% of participants used alcohol-only, 13% used concurrently, 41% used SAM, 1% were cannabis only users, and 3% abstained from cannabis and alcohol. Boys were more likely to use SAM. Higher T5 SAM use frequency was associated with heavier use of substances, more substance-related harms, and symptoms of psychosis and externalizing problems at T6. T5 Concurrent use was associated with conduct symptoms, illicit drug use, and alcohol use disorders at T6 relative to alcohol-only use. Cannabis is commonly used with alcohol and the findings suggest that any co-use (concurrent or simultaneous) may be problematic in young adulthood. Public health messages need to explicitly inform consumers about the possible consequences of using both alcohol and marijuana and the addictive pharmacological impact of using them together.
Examining the Exercise and Self-Esteem Model Revised with Self-Compassion among Hong Kong Secondary School Students Using Structural Equation Modeling
Authors: Wong Ming-Yu Claudia , Chung Pak-Kwong , Leung Ka-Man
Published: April 2021

The association between physical activity in achieving mental health benefits and subjective well-being is consistently identified by empirical research. The causation of a positive self-concept created by physical exercise is empirically supported by Sonstroem and Morgan’s (1988) exercise and self-esteem model (EXSEM). However, various drawbacks of maintaining high self-esteem have been identified; thus, the concept of self-compassion was conjectured to be a form of “true self-esteem.” Hence, the current study aimed to investigate the relationship between physical activity and self-compassion by examining the exercise and self-esteem model revised with self-compassion (EXSEM-SC). This study recruited secondary school students from Hong Kong using convenience sampling. The structural equation modeling (SEM) approach, including path analysis and multiple indicators, multiple causes (MIMIC) modeling, were used to reveal the results of the study. The results (n = 1097) indicated that the relationship between physical activity and self-compassion could be demonstrated by the EXSEM-SC, with a satisfactory goodness-of-fit index in the SEMs. The SEM also demonstrated the direct paths from physical activity to self-compassion and mental well-being, indicating the significant effect of physical activity on self-compassion.
Effect of Three Months Pilates Training on Balance and Fall Risk in Older Women
Authors: Długosz-Boś Małgorzata , Filar-Mierzwa Katarzyna , Stawarz Robert , Ścisłowska-Czarnecka Anna , Jankowicz-Szymańska Agnieszka , Bac Aneta
Published: April 2021

This study assessed the effect of Pilates exercises on balance and fall risk in older women. Participants comprised 50 older women aged over 60 years, divided randomly into two groups: the experimental group (n = 30), which took part in Pilates sessions two times per week for three months, and the control group (n = 20). The control group did not participate in such sessions but also did not participate in any other rehabilitation programs or additional physical activity except everyday activities. Before and after the training cycle, all women underwent an assessment using Timed Up and Go (TUG), the One Leg Stance Test (OLST), a test performed on a Freestep baropodometric platform, and the tests performed on a Biosway platform. After the training, significantly decreased values of the surface of the ellipse (p = 0.0037) and mean values of velocity (p = 0.0262) for the right foot in the experimental group were observed. The Limits of Stability (LoS) test (p = 0.005) and the Modified Clinical Test of Sensory Interaction on Balance (m-CTSIB) performed on an unstable surface with eyes closed (p = 0.0409) indicated statistically significant changes in the experimental group. None of the above changes were statistically significant in relation to the control group. Pilates training affected the participants’ balance by improving LOS and reducing fall risk.
Effectiveness of Face Coverings in Mitigating the COVID-19 Pandemic in the United States
Authors: Ayodeji Olukayode James , Ramkumar Seshadri
Published: April 2021

The COVID-19 pandemic has been one of the biggest public health challenges of the 21st century. Many prevalent measures have been taken to prevent its spread and protect the public. However, the use of face coverings as an effective preventive measure remains contentious. The goal of the current study is to evaluate the effectiveness of face coverings as a protective measure. We examined the effectiveness of face coverings between 1 April and 31 December 2020. This was accomplished by analyzing trends of daily new COVID-19 cases, cumulative confirmed cases, and cases per 100,000 people in different U.S. states, including the District of Columbia. The results indicated a sharp change in trends after face covering mandates. For the 32 states with face covering mandates, 63% and 66% exhibited a downward trend in confirmed cases within 21 and 28 days of implementation, respectively. We estimated that face covering mandates in the 32 states prevented approximately 78,571 and 109,703 cases within 21- and 28-day periods post face covering mandate, respectively. A statistically significant (p = 0.001) negative correlation (−0.54) was observed between the rate of cases and days since the adoption of a face covering mandate. We concluded that the use of face coverings can provide necessary protection if they are properly used.
Quality of Life Changes during the COVID-19 Pandemic for Caregivers of Children with ADHD and/or ASD
Authors: Pecor Keith , Barbayannis Georgia , Yang Max , Johnson Jacklyn , Materasso Sarah , Borda Mauricio , Garcia Disleidy , Garla Varsha , Ming Xue
Published: April 2021

The COVID-19 pandemic has presented many challenges to caregivers of children. Families with children with attention-deficit/hyperactivity disorder (ADHD) and/or autism spectrum disorder (ASD) are an understudied but potentially vulnerable population to changes during the outbreak. As such, the aim of this study was to contrast quality of life for caregivers of children with ADHD and/or ASD, before and during the pandemic, compared to caregivers of neurotypical (NT) children. Total, Parent Health-Related Quality of Life, and Family Functioning Summary Scores from the Family Impact Module of the Pediatric Quality of Life InventoryTM were contrasted among caregivers of children with ADHD, ASD, comorbid ADHD and ASD, and NT development. For all scores, caregivers of ADHD and/or ASD children reported lower quality of life, both before and during the pandemic, in comparison to caregivers of NT children. For all diagnoses, quality of life decreased during the pandemic, but caregivers of children with ADHD and/or ASD reported a greater decrease in quality of life than caregivers for NT children. There are limitations to this study in terms of the composition of the sample and the survey methodology, but we are able to conclude that caregivers of children with ADHD and/or ASD have been disproportionately affected by the pandemic, and it is imperative that these families receive additional resources and support to improve their quality of life.
Effects of the Educational Use of Music on 3- to 12-Year-Old Children’s Emotional Development: A Systematic Review
Authors: Blasco-Magraner José Salvador , Bernabe-Valero Gloria , Marín-Liébana Pablo , Moret-Tatay Carmen
Published: April 2021

Interest in the study of emotions in education has grown in recent years. Some of our modern challenges, such as constantly adapting to new scenarios or the need for team work have justified the introduction of emotional competence into educational systems, while diverse studies confirm the relationship between music and emotional intelligence, so that the former could be used as a tool to develop the latter. The aim of this work was to examine the evidence for positive effects of music on the emotions of 3- to 12-year-old children, to which end a systematic review was carried out. Two reviewers independently evaluated 424 studies that were identified in MEDLINE, Psycinfo, and CINAHL databases, in order to determine whether they met the stated inclusion criteria. A total of 26 articles were selected for review. The results suggest several beneficial effects of music on children’s development, such as greater emotional intelligence, academic performance, and prosocial skills. It can therefore be concluded that music should be used in school settings, not only as an important subject in itself, but also as an educational tool within other subjects.
The Influence of Internal Marketing and Job Satisfaction on Task Performance and Counterproductive Work Behavior in an Emerging Market during the COVID-19 Pandemic
Authors: Nemteanu Marcela-Sefora , Dabija Dan-Cristian
Published: April 2021

To reduce the spread of the virus, authorities have imposed restrictive measures, such as limiting movement of individuals, shutting down non-essential stores, imposing a general or local quarantine, along with physical distancing and isolation of vulnerable people. Remote working has become the ‘new normal’ for many organizations, engendering further challenges for employees, who have started experiencing anxiety, technostress caused by digitalization and lack of social interaction, frustration, occupational burden, counterproductive work behavior, exhaustion, burnout, depersonalization, and increased turnover intention. All these factors, corroborated by prolonged restrictions, have contributed to a decrease in employee satisfaction, diminishing performance and generating a counterproductive behavior. Based on Social Exchange Theory, this research plans to investigate the influence of internal marketing on job satisfaction, task performance, and counterproductive work behavior in the context of the COVID-19 pandemic in an emerging market, namely Romania. Based on a quantitative research study among 850 employees, we show that internal marketing strongly and significantly impacts job satisfaction, while insignificantly impacting task performance and counterproductive work behavior. Job satisfaction actuates task performance in a significant and positive manner, contributing to a reduction in counterproductive work behaviors. This paper highlights the effects of internal marketing orientation on job satisfaction, and the effects of job satisfaction on job performance and counterproductive work behaviors.
Mild to Severe Neurological Manifestations of COVID-19: Cases Reports
Authors: Melegari Gabriele , Rivi Veronica , Zelent Gabriele , Nasillo Vincenzo , De Santis Elena , Melegari Alessandra , Bevilacqua Claudia , Zoli Michele , Meletti Stefano , Barbieri Alberto
Published: April 2021

The main focus of Coronavirus disease 2019 (COVID-19) infection is pulmonary complications through virus-related neurological manifestations, ranging from mild to severe, such as encephalitis, cerebral thrombosis, neurocognitive (dementia-like) syndrome, and delirium. The hospital screening procedures for quickly recognizing neurological manifestations of COVID-19 are often complicated by other coexisting symptoms and can be obscured by the deep sedation procedures required for critically ill patients. Here, we present two different case-reports of COVID-19 patients, describing neurological complications, diagnostic imaging such as olfactory bulb damage (a mild and unclear underestimated complication) and a severe and sudden thrombotic stroke complicated with hemorrhage with a low-level cytokine storm and respiratory symptom resolution. We discuss the possible mechanisms of virus entrance, together with the causes of COVID-19-related encephalitis, olfactory bulb damage, ischemic stroke, and intracranial hemorrhage.
A Scientometric Review of Urban Disaster Resilience Research
Authors: Xu Hui , Li Yang , Tan Yongtao , Deng Ninghui
Published: April 2021

Natural disasters and human-made disasters are threatening urban areas globally. The resilience capacity of the urban system plays an important role in disaster risk response and recovery. Strengthening urban disaster resilience is also fundamental to ensuring sustainable development. Various practices and research for enhancing urban disaster resilience have been carried out worldwide but are yet to be reviewed. Accordingly, this paper gives a scientometric review of urban disaster resilience research by using CiteSpace. The time span (January 2001–January 2021) was selected and divided into three phases based on the number of publications. In addition, according to keyword statistics and clustering results, the collected articles are grouped into four hotspot topics: disaster risk reduction, specific disaster resilience research, resilience assessment, and combination research. The results show that most of the existing research is in the first two categories, and articles in the second and fourth categories both show a high growth rate and could be further research directions. The review indicates that urban disaster resilience is essential for a city’s sustainable development. Moreover, the findings provide scholars a full picture of the existing urban disaster resilience research which can help them identify promising research directions. The findings can also help urban government officials and policymakers review current urban disaster management strategies and make further improvements.
Broccoli-Soybean-Mangrove Food Bar as an Emergency Food for Older People during Natural Disaster
Authors: Fatmah Fatmah , Utomo Suyud Warno , Lestari Fatma
Published: April 2021

Older people risk poor nutritional status during natural disasters due to low intakes of energy, carbohydrates, protein, and fat. A food bar is a form of emergency food product that contains carbohydrate and protein, and is practical for disaster situations. The study aimed to investigate the effect of a broccoli-soybean-mangrove food bar on older people’s weight following natural disasters. A quasi-experimental pre-post intervention study was designed using 33 subjects at the treatment group of various nutritional status types of older people during two weeks with balanced nutrition education over two weeks. Bivariate analysis with a paired t-test used to test whether weight, macronutrient intakes, and balanced nutrition knowledge were significantly different before and after the study. The study showed broccoli-soybean-mangrove food bar consumption resulted in a significantly increased weight of 0.2 kg, energy (291.9 kcal), protein (6.1 g), carbohydrate (31.1 g), dan fat (15.6 g) intakes. Balanced nutrition education of older people could also substantially increase knowledge of older people regarding nutrition (11.8 points). The proportion of malnourished subjects who gained weight was more remarkable than normal subjects in the first and second weeks of the intervention. However, the proportion of normal nutritional status subjects having increased macronutrients intakes was higher than the malnourished subjects. These findings recommend broccoli-soybean-mangrove food bar consumption to significantly improve weight and macronutrients intakes in older people following a natural disaster. It is necessary to make the broccoli-soybean-mangrove food bar more available, accessible, and affordable to all people in emergencies, mainly for older people.
Proposing a TAM-SDT-Based Model to Examine the User Acceptance of Massively Multiplayer Online Games
Authors: Linares Manuela , Gallego M. Dolores , Bueno Salvador
Published: April 2021

This study is focused on the massively multiplayer online games’ acceptance. In general, while specialized literature reveals that the online gaming industry has grown strongly in recent years, little evidence is identified on its user acceptance. In this manner, the present study is an attempt to fill this gap. Concretely, two aims are defined: (1) proposing an acceptance model to predict the continuance usage of massively multiplayer online games, and (2) knowing how this continuance usage encourages social well-being. The model proposed employing the structural equation modeling with partial least squares (PLS-SEM) methodology. This PLS-SEM model has been defined using a combination of the technology acceptance model (TAM) and the self-determination theory (SDT), comprising eight constructs: (1) autonomy and competence, (2) relatedness, (3) achievement and challenge, (4) flow experience, (5) perceived enjoyment, (6) social well-being, (7) perceived ease of use, and (8) continuance intention. The findings reveal that continuance intention impacts on social well-being. Moreover, the pivotal role of flow experience for continuance intention has been demonstrated. Additionally, continuance intention has been impacted by the perceived enjoyment, showing that it is a key construct for the acceptance of massively multiplayer online games. Thus, two contributions are highlighted. First, these results provide the gaming industry and software developer companies with considerations on gamers’ motivations in the online game design, in order to stimulate and incentivize its use. Second, the present study can be useful for academicians and practitioners to understand the online gamers’ emotions and well-being, showing some light over their psychology and mental health. Finally, limitations and future directions are exposed.
Examining Dementia Family Caregivers’ Forgone Care for General Practitioners and Medical Specialists during a COVID-19 Lockdown
Authors: Werner Perla , Tur-Sinai Aviad , AboJabel Hanan
Published: April 2021

The present study aimed to assess dementia caregivers’ reports of the prevalence and correlates of forgone care regarding visits to a general practitioner (GP) and to a specialist during the COVID-19 lockdown in Israel, using Andersen’s Behavioral Model of Healthcare Utilization. A cross-sectional study using an online survey was conducted with 73 Israeli family caregivers of persons with dementia residing in the community (81% Jews, 86% female, mean age = 54). Overall, one out of two participants reported having to delay seeking needed help from a GP or a specialist for themselves, as well as for their relatives with dementia, during the COVID-19 lockdown period. Among the predisposing factor, education was associated with caregivers’ reports regarding forgone care for themselves as well as for their loved ones. Living with the care-receiver and income level were the enabling factors associated with forgone care for caregivers. Finally, feelings of burden were associated with caregivers’ forgone care and feelings of loneliness and perceptions of the care-receiver’s cognitive functioning were associated with care-receivers’ forgone care. Our findings show that it is essential that this population receive appropriate practical and emotional support at times of distress and crisis to enable them to continue with their caregiving role.
Effect of Inquiry-Based Stress Reduction (IBSR) Intervention on Well-Being, Resilience and Burnout of Teachers during the COVID-19 Pandemic
Authors: Zadok-Gurman Tzofnat , Jakobovich Ronit , Dvash Eti , Zafrani Keren , Rolnik Benjamin , Ganz Ariel B. , Lev-Ari Shahar
Published: April 2021

Objective: The COVID-19 pandemic has had a major impact on teachers professional and personal lives. Our primary aim was to assess the effect of a blended Inquiry-Based Stress Reduction (IBSR), an emerging mindfulness and cognitive reframing intervention on teacher’s well-being. Our secondary aims were to assess the effect of IBSR on resilience, burnout, mindfulness, and stress among teachers during the COVID-19 pandemic. Methods: The study was a prospective controlled trial with an intervention group (N = 35) and a comparison control group (N = 32). The intervention took place in the Jerusalem District throughout the school year from November 2019 to May 2020. The sessions were conducted in blended learning that included traditional learning (face-to-face) and online learning. Data was analyzed on an intention-to-treat basis. Results: IBSR blended intervention enhanced the resilience and improved the subjective and psychological well-being of teachers in spite of the breakout of the COVID-19 pandemic and the first lockdown in Israel. Simultaneously the control group suffered from enhanced burnout levels and a decline in psychological and subjective well-being. Conclusions: Implementation of IBSR blended intervention during the school year may benefit teachers’ well-being and ability to flourish, even during stressful events such as the COVID-19 pandemic.
Healthcare Costs Associated with Complications in Patients with Type 2 Diabetes among 1.85 Million Adults in Beijing, China
Authors: Wu Jun-Hui , Wu Yao , Wang Zi-Jing , Wu Yi-Qun , Wu Tao , Wang Meng-Ying , Wang Xiao-Wen , Wang Si-Yue , Wang Jia-Ting , Yu Huan , Hu Yong-Hua
Published: April 2021

We aimed to provide reliable regression estimates of expenditures associated with various complications in type 2 diabetics in China. In total, 1,859,039 type 2 diabetes patients with complications were obtained from the Beijing Medical Claim Data for Employees database from 2008 to 2016. We estimated costs for complications using a generalized estimating equation model adjusted for age, sex, and the incidence of various complications. The average total cost for diabetic patients with complications was 17.12 thousand RMB. Prescribed drugs accounted for 63.4% of costs. We observed a significant increase in costs in the first year after the onset of complications. Compared with costs before the incidence of complications, the additional costs per person in the first year and >1 year after the event would be 10,631.16 RMB and 1150.71 RMB for cardiovascular disease, 1017.62 RMB and 653.82 RMB for cerebrovascular disease, and 301.14 RMB and 624.00 RMB for kidney disease, respectively. The estimated coefficients for outpatient visits were relatively lower than those of inpatient visits. Complications in diabetics exert a significant impact on total healthcare costs in the first year of their onset and in subsequent years. Our estimates may assist policymakers in quantifying the economic burden of diabetes complications.
Telemedicine Chronic Viral Hepatitis C Treatment during the Lockdown Period in Romania: A Pilot Study
Authors: Doica Irina Paula , Florescu Dan Nicolae , Oancea Carmen Nicoleta , Turcu-Stiolica Adina , Subtirelu Mihaela-Simona , Dumitra Gindrovel , Rogoveanu Ion , Gheonea Dan Ionut , Ungureanu Bogdan Silviu
Published: April 2021

The COVID-19 pandemic is currently delaying the process of chronic hepatitis C (HCV) eradication, since most of the chronic diseases are neglected. Thus, there is a need for alternative programs for HCV therapy implementation and disease monitoring. Our aim was to provide a multidisciplinary approach, so that HCV-infected patients from distant locations may benefit from HCV antivirals during the COVID-19 outbreak and within the lockdown period in Romania. Previously diagnosed HCV patients willing to participate in this telemedicine pilot study were included. Patient characteristics and medical adherence were assessed and compared to the year preceding the pandemic. We proposed a multidisciplinary approach by using a telemedicine program for HCV therapy monitoring. Patients also received a satisfaction questionnaire after delivering the sustained virologic response (SVR) result. A total of 41 patients agreed to participate in this study. The medication adherence was 100% for patients included in the telemedicine group, with a statistically significant difference from the medication adherence of the patients treated in 2019. The satisfaction item score was 4.92 out of 5 and our results (r = −0.94, p < 0.0001) suggested that older patients embraced the telemedicine program less, but with the same success in terms of SVR (100%) and medication adherence (100%). Our pilot study offers the first example of a telemedicine program in Romania for HCV therapeutic management. During the lockdown period, telemedicine has served as a reliable tool and novel alternative for conventional monitoring of patients treated with direct antiviral agents and should be further considered even following the pandemic.
Gender Differences of Health Behaviors in the Risk of Metabolic Syndrome for Middle-Aged Adults: A National Cross-Sectional Study in South Korea
Authors: Yoon Jaehee , Kim Jeewuan , Son Heesook
Published: April 2021

This study examined gender differences in health behaviors for the risk of metabolic syndrome (MetS) among middle-aged adults using nationally representative data from the Seventh Korea National Health and Nutrition Examination Survey (2016–2018). The sample included data from 8677 middle-aged adults. The Health Practice Index measured health behaviors, including smoking, alcohol use, physical activity, sleeping, eating breakfast, working hours, nutritionally balanced diet, and mental stress. Complex sample multiple logistic regression analyses were conducted to determine the association between the Health Practice Index (HPI) and MetS. Men and women with poor or moderate HPI scores had significantly higher risks of having MetS than those with good HPI scores. Controlling for covariates, high-risk alcohol use (p < 0.001) and physical activity (p = 0.008) were associated with the risk of MetS in men and women, respectively. Men reporting alcohol use and women lacking a healthy diet were, respectively, 2.056 times (adjusted odds ratio (OR) = 2.056, 95% CI: 1.681–2.514) and 1.306 times (adjusted OR = 1.306, 95% CI: 1.075–1.587) more likely to have increased risks of MetS. Given these gender differences in health behaviors, developing tailored interventions could be beneficial in preventing MetS among middle-aged men and women.
Relationships between Maternal Dietary Patterns and Blood Lipid Levels during Pregnancy: A Prospective Cohort Study in Shanghai, China
Authors: Wang Na , Deng Zequn , Wen Liming , Ding Yan , He Gengsheng
Published: April 2021

The relationships between maternal dietary patterns and blood lipid profile during pregnancy have not been well understood. We aimed to analyze the dietary patterns of pregnant women and their associations with blood lipid concentrations during pregnancy. A cohort of 1008 Chinese pregnant women were followed from 10–15 weeks of gestation to delivery. Their dietary patterns were identified using a principal component analysis. The relationships between dietary pattern score and maternal blood lipid concentrations were assessed using both multivariate linear regression models and generalized estimating equation (GEE) models. Five different dietary patterns were identified. GEE showed that a high score for the fish-shrimps pattern was associated with higher concentrations of total cholesterol (TC) (β = 0.11), low-density lipoprotein cholesterol (LDL-C) (β = 0.07), and high-density lipoprotein cholesterol (HDL-C) (β = 0.03), with all p values < 0.001. In contrast, a high tubers-fruit-vegetables pattern score was associated with lower concentrations of TC (β = −0.12), LDL-C (β = −0.07), and HDL-C (β = −0.03), with all p values < 0.001. In addition, dietary protein, carbohydrate, and cholesterol intake significantly contributed to the associations between the fish-shrimps dietary pattern and blood lipid concentrations. Predominant seafood consumption is associated with higher cholesterol concentrations, whereas predominant tuber, fruit, and vegetable consumptions are associated with lower cholesterol concentrations during pregnancy.
Empirical Insights from a Study on Outlier Preserving Value Generalization in Animated Choropleth Maps
Authors: Traun Christoph , Schreyer Manuela Larissa , Wallentin Gudrun
Published: April 2021

Time series animation of choropleth maps easily exceeds our perceptual limits. In this empirical research, we investigate the effect of local outlier preserving value generalization of animated choropleth maps on the ability to detect general trends and local deviations thereof. Comparing generalization in space, in time, and in a combination of both dimensions, value smoothing based on a first order spatial neighborhood facilitated the detection of local outliers best, followed by the spatiotemporal and temporal generalization variants. We did not find any evidence that value generalization helps in detecting global trends.
On the Use of ‘Glyphmaps’ for Analysing the Scale and Temporal Spread of COVID-19 Reported Cases
Authors: Beecham Roger , Dykes Jason , Hama Layik , Lomax Nik
Published: April 2021

Recent analysis of area-level COVID-19 cases data attempts to grapple with a challenge familiar to geovisualization: how to capture the development of the virus, whilst supporting analysis across geographic areas? We present several glyphmap designs for addressing this challenge applied to local authority data in England whereby charts displaying multiple aspects related to the pandemic are given a geographic arrangement. These graphics are visually complex, with clutter, occlusion and salience bias an inevitable consequence. We develop a framework for describing and validating the graphics against data and design requirements. Together with an observational data analysis, this framework is used to evaluate our designs, relating them to particular data analysis needs based on the usefulness of the structure they expose. Our designs, documented in an accompanying code repository, attend to common difficulties in geovisualization design and could transfer to contexts outside of the UK and to phenomena beyond the pandemic.
Spatiotemporal Evolution and Determinant Factors of the Intra-Regional Trade Community Structures of the Indian Ocean Region
Authors: Yuan Lihua , Chen Xiaoqiang , Song Changqing , Cao Danping , Yi Hong
Published: April 2021

The Indian Ocean Region (IOR) has become one of the main economic forces globally, and countries within the IOR have attempted to promote their intra-regional trade. This study investigates the spatiotemporal evolution of the community structures of the intra-regional trade and the impact of determinant factors on the formation of trade community structures of the IOR from 1996 to 2017 using the methods of social network analysis. Trade communities are groups of countries with measurably denser intra-trade ties but with extra-trade ties that are measurably sparser among different communities. The results show that the extent of trade integration and the trade community structures of the IOR changed from strengthening between 1996 and 2014 to weakening between 2015 and 2017. The largest explanatory power of the formation of the IOR trade community structures was the IOR countries’ economic size, indicating that market remained the strongest driver. The second-largest explanatory power was geographical proximity, suggesting that countries within the IOR engaged in intra-regional trade still tended to select geographically proximate trading partners. The third- and the fourth-largest were common civilization and regional organizational memberships, respectively. This indicates that sharing a common civilization and constructing intra-regional institutional arrangements (especially open trade policies) helped the countries within the IOR strengthen their trade communities.
BIM Adoption in the Cambodian Construction Industry: Key Drivers and Barriers
Authors: Durdyev Serdar , Mbachu Jasper , Thurnell Derek , Zhao Linlin , Hosseini M. Reza
Published: April 2021

Critical issues surrounding the promotion and adoption of building information modeling (BIM) for construction projects are largely country-specific due to contextual socio-cultural, economic, and regulatory environments impacting construction operations and outcomes. There is little information on BIM adoption issues specific to the Cambodian construction industry (‘the industry’). This paper aims to narrow existing knowledge by investigating key drivers for, and barriers to the adoption of BIM in the industry. Using descriptive survey method, feedback was received from contractors and architects that were registered with their respective trade and professional associations in the industry. The multi-attribute method and the Statistical Package for the Social Sciences (SPSS)-based Kendall’s coefficient of concordance (W) test were used to analyze the empirical datasets. Results showed that out of the 13 significant drivers identified in the study, the most influential comprised the technology’s ability to remarkably enhance project visualization and schedule performance; this is followed by awareness that the technology is redefining how project information is created and shared among stakeholders and therefore the future of the industry that cannot be ignored. On the other hand, the most constraining barrier to the adoption of the technology, out of 19 significant barriers, related to strong industry resistance to change, especially reluctance to change from 2D drafting to 3D modeling; other highly rated barriers included the high initial cost of the software and the shortage of professionals with BIM skills. Implementation of the study findings could support greater uptake of the technology and the leveraging of its key benefits to improving project success and the growth of the Cambodian construction industry, as well as those of other developing economies that share similar socio-cultural, economic, and regulatory environments.
Improved Indoor Positioning by Means of Occupancy Grid Maps Automatically Generated from OSM Indoor Data
Authors: Graichen Thomas , Richter Julia , Schmidt Rebecca , Heinkel Ulrich
Published: April 2021

In recent years, there is a growing interest in indoor positioning due to the increasing amount of applications that employ position data. Current approaches determining the location of objects in indoor environments are facing problems with the accuracy of the sensor data used for positioning. A solution to compensate inaccurate and unreliable sensor data is to include further information about the objects to be positioned and about the environment into the positioning algorithm. For this purpose, occupancy grid maps (OGMs) can be used to correct such noisy data by modelling the occupancy probability of objects being at a certain location in a specific environment. In that way, improbable sensor measurements can be corrected. Previous approaches, however, have focussed only on OGM generation for outdoor environments or require manual steps. There remains need for research examining the automatic generation of OGMs from detailed indoor map data. Therefore, our study proposes an algorithm for automated OGM generation using crowd-sourced OpenStreetMap indoor data. Subsequently, we propose an algorithm to improve positioning results by means of the generated OGM data. In our study, we used positioning data from an Ultra-wideband (UWB) system. Our experiments with nine different building map datasets showed that the proposed method provides reliable OGM outputs. Furthermore, taking one of these generated OGMs as an example, we demonstrated that integrating OGMs in the positioning algorithm increases the positioning accuracy. Consequently, the proposed algorithms now enable the integration of environmental information into positioning algorithms to finally increase the accuracy of indoor positioning applications.
Towards an Operative Predictive Model for the Songshan Area during the Yangshao Period
Authors: Yan Lijie , Lu Peng , Chen Panpan , Danese Maria , Li Xiang , Masini Nicola , Wang Xia , Guo Lanbo , Zhao Dong
Published: April 2021

The literature in the field of archaeological predictive models has grown in the last years, looking for new factors the most effective methods to introduce. However, where predictive models are used for archaeological heritage management, they could benefit from using a more speedy and consequently useful methods including some well-consolidated factors studied in the literature. In this paper, an operative archaeological predictive model is developed, validated and discussed, in order to test its effectiveness. It is applied to Yangshao period (5000–3000 BC) in the Songshan area, where Chinese civilization emerged and developed, and uses 563 known settlement sites. The satisfactory results herein achieved clearly suggest that the model herein proposed can be reliably used to predict the geographical location of unknown settlements.