Structural Factors
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PLoS ONE ◽  
2021 ◽  
Vol 16 (9) ◽  
pp. e0256546
Arran J. Davis ◽  
Pádraig MacCarron ◽  
Emma Cohen

There is growing academic, civic and policy interest in the public health benefits of community-based exercise events. Shifting the emphasis from competitive sport to communal activity, these events have wide appeal. In addition to physical health benefits, regular participation can reduce social isolation and loneliness through opportunities for social connection. Taking a broad evolutionary and social psychological perspective, we suggest that social factors warrant more attention in current approaches to physical (in)activity and exercise behavior. We develop and test the hypothesis that social reward and support in exercise are associated with positive exercise experiences and greater performance outputs. Using a repeated-measures design, we examine the influence of social perceptions and behavior on subjective enjoyment, energy, fatigue, effort, and objective performance (run times) among a UK sample of parkrun participants. Social factors were associated with greater subjective enjoyment and energy. Higher subjective energy, in turn, was associated with faster run times, without any corresponding increase in perceived effort. No significant main effects of social factors on fatigue, performance or effort were detected. The role of social structural factors has long been recognized in public health approaches to physical activity. Our results indicate that there should be greater research attention on how positive and rewarding social behaviors and experiences—particularly subjective enjoyment and energy, and perceptions of community social support and belonging—influence exercise-related behavior, psychology and physiology, and promote health through collective physical activity. The research also supplements traditional emphases on social facilitation and team sport that have dominated sport and exercise psychology and offers new avenues for understanding the deep connections among psychological, social and physical function in everyday health.

2021 ◽  
Micael Santos ◽  
Xosé Antón Rodríguez ◽  
Ana Marta-Costa

Portugal is a country traditionally dedicated to viticulture and characterized by the production of wines of high quality. However, although it continues to be a major player in the world, both in the extension of vineyards and in the production of wine, it is certain that in recent years Portugal have lost market share in these areas. In this context, it is interesting to analyze if this situation could be related to the level of productive efficiency of vineyards. Therefore, the aims of this study are to analyse the farms that are efficiently allocating resources to achieve maximum production and to identify characteristics that make the farm more efficient. In addition, we want to analyse the productive efficiency of the farms from a regional perspective. To achieve this purpose, we use a database collected by face-to-face surveys from a sample of 154 wine-growing farms with specific input-output information from 2017. These farms are locating in the three regions of the North of Portugal (Minho, Douro and Trás-os-Montes), which represents more than 40% of the Portuguese vineyard area. To analyse the productive efficiency of the farms, we use the Stochastic Frontier Analysis (SFA). The results show that the efficiency level in the wine-growing farms from the North of Portugal is arround 67%, but with significant differences at regional level. Many of these discrepancies may be due to structural factors, such as the type of grape produced in each region. In conclusion, the findings make evident that the most efficient farms are not the most profitable due to the structure of the existing value chain.

2021 ◽  
Vol 5 ◽  
pp. 145
Fannie Kachale ◽  
Imelda Mahaka ◽  
Fatima Mhuriro ◽  
Mary Mugambi ◽  
Joseph Murungu ◽  

Background: Though substantial progress has been made to curb the HIV epidemic, high rates of new HIV infections persist among adolescent girls and young women (AGYW) in sub-Saharan Africa, reflecting critical gaps in reaching them with integrated HIV prevention and sexual and reproductive health (SRH) services. With the scale-up of oral pre-exposure prophylaxis (PrEP) and multiple novel HIV prevention products on the horizon, countries have a unique opportunity to expand innovative approaches to deliver comprehensive, integrated HIV/SRH services. Methods: This article is a comparative analysis of findings from rapid landscaping analyses in Kenya, Malawi and Zimbabwe to highlight cross-country trends and context-specific realities around HIV/SRH integration. The analyses in Kenya and Zimbabwe were completed by Ministries of Health (MOH) and the HIV Prevention Market Manager project and include 20 health facility assessments, 73 key informant interviews and six community dialogues. In Malawi, the analysis was completed by the MOH and Georgetown University Center for Innovation in Global Health and includes 70 key informant interviews and a review of national policies and program implementation in Blantyre. Findings were validated through a review of literature and policies in each country. Results: The policy environment in all three countries is conducive to HIV/SRH integration, though operationalization continues to present challenges, with most policies preceding and not accounting for oral PrEP rollout. National coordination mechanisms, youth-friendly health services and prevention of mother-to-child transmission programs are promising practices, while siloed and resource-constrained health systems, limited provider capacity, lack of support for demand generation and structural factors exacerbate barriers to achieving integration. Conclusions: As new HIV prevention products are introduced, demand for integrated HIV/SRH services is likely to grow. Investing in HIV/SRH integration can help to ensure sustainable, government-led responses to the HIV epidemic, streamline service delivery and improve the health outcomes and lives of AGYW.

2021 ◽  
Vol 41 (3) ◽  
Thais Maria Moreira Valim ◽  
Barbara Marciano Marques ◽  
Raquel Lustosa

Over the past few months living and facing the COVID-19 pandemic, the fact that the virus and its spread are not democratic has already been proven: the most common profile among victims of the new disease are black, indigenous, and poor people. In addition, it is also racialized and people on the periphery have been experiencing the greatest economic and social impact of the pandemic. COVID-19, in this sense, seems to be consistent with other documented health crises, making its way along the wide avenues of inequality. In this article, we seek to describe how the paths of inequality traced by COVID-19 intersect with the paths of another epidemic, which is now almost invisible in the public eye: that of the Zika Virus. Based on field diaries from research carried out in Recife / PE between 2016 and 2020, we seek to show how families previously affected by Zika now face COVID-19, pointing to structural factors common to the two health crises that put the same people at greater risk of exposure.

2021 ◽  
Vol 12 (1) ◽  
Hung-Yu Yang ◽  
Xiaohan Yao ◽  
Vincent Plisson ◽  
Shirin Mozaffari ◽  
Jan P. Scheifers ◽  

AbstractWhereas electron-phonon scattering relaxes the electron’s momentum in metals, a perpetual exchange of momentum between phonons and electrons may conserve total momentum and lead to a coupled electron-phonon liquid. Such a phase of matter could be a platform for observing electron hydrodynamics. Here we present evidence of an electron-phonon liquid in the transition metal ditetrelide, NbGe2, from three different experiments. First, quantum oscillations reveal an enhanced quasiparticle mass, which is unexpected in NbGe2 with weak electron-electron correlations, hence pointing at electron-phonon interactions. Second, resistivity measurements exhibit a discrepancy between the experimental data and standard Fermi liquid calculations. Third, Raman scattering shows anomalous temperature dependences of the phonon linewidths that fit an empirical model based on phonon-electron coupling. We discuss structural factors, such as chiral symmetry, short metallic bonds, and a low-symmetry coordination environment as potential design principles for materials with coupled electron-phonon liquid.

2021 ◽  
Marie-Catherine Gagnon-Dufresne ◽  
Genevieve Fortin ◽  
Kirsten Bunkeddeko ◽  
Charles Kalumuna ◽  
Kate Zinszer

Background: In Uganda, almost half of children under 5 years old suffer from undernutrition. Community-based management of acute malnutrition (CMAM) is recognized as an effective strategy for tackling this important global health issue. However, evaluations of CMAM programs are inconsistent and largely based on biomedical and behavioral health models, failing to incorporate structural factors influencing malnutrition management. Using an intersectional lens would allow to investigate the complex social processes shaping children's care in CMAM programs. The aim of this evaluation was to understand and describe factors influencing malnutrition management in a CMAM program in rural Uganda, situating its findings within their social contexts using an intersectional approach. Methods: This evaluation used qualitative methods to identify determinants linked to caregivers (micro-level), healthcare (meso-level) and societal structures (macro-level) that can influence children's outpatient care. Data were collected from September to December 2019 at a community clinic through observations and interviews with caregivers of malnourished children. Data were coded in NVivo using thematic analysis. Intersectionality informed the interpretation of findings. Results: We observed 14 caregiver-provider encounters and interviewed 15 caregivers to assess factors hindering outpatient malnutrition management. Findings showed that caregivers had limited understanding of malnutrition and its mechanisms. The counselling offered was inconsistent and information given to caregivers about treatment preparation at home was insufficient. Gender inequality and poverty limited caregivers' access to healthcare and their ability to care of their children. Factors at the micro and meso levels intersected with structural factors to influence malnutrition management. Conclusion: Results suggest that CMAM programs would benefit from expanding support to caregivers by providing holistic interventions tackling structural barriers to children's care. Using an intersectional approach to program evaluation could support improvement efforts by moving beyond individual determinants to address the social dynamics shaping the outpatient management of malnutrition in low- and middle-income countries.

2021 ◽  
Vol 13 (17) ◽  
pp. 9907
Alejandra Engler ◽  
Marieke L. Rotman ◽  
P. Marijn Poortvliet

Changes in climatic conditions are unavoidable and irreversible and an early and effective adaptation in farming systems will be vital for resilient agriculture. Although the extant literature has described factors that explain climate change adaptation, the roles of proactive versus reactive adaptation related to perceived vulnerability are still underexplored. The aim of our study was to open a new angle of discussion by linking farmers’ perceptions of vulnerability with their adaptation response, and exploring the dynamic of such a relationship. Semi-structured interviews with farmers were held in the Maule Region of central Chile (n = 36). The interview included questions o about main agricultural challenges, perceptions of climate change and its impact, adaptation strategies, and perceptions of vulnerability, exposure, sensitivity, and ability to adapt. In order to interpret the interview data, a content analysis procedure was followed. The results indicate that farmers respond differently by either engaging in proactive or reactive adaptation behavior. Furthermore, the patterns of either proactive or reactive adaptation behavior can be explained by structural factors and social and human capital. While structural factors, such as production systems and financial capital, explain engaging in adaptation to climate change, social and human capital act as enhancing factors that explain proactive adaptation. Future policies on adaptation behavior should focus on promoting proactive forms of adaptation behavior by developing and enhancing social connections and access to information, as well as on the provision of financial schemes to enable efficient and effective adaptation within the agricultural sector.

2021 ◽  
Vol 50 (Supplement_1) ◽  
Jesse Whitehead ◽  
Carole McMinn

Abstract Background The People’s Project (TPP) in Hamilton, NZ takes a Housing First approach to eliminate homelessness. A recent research collaboration provides epidemiological evidence regarding: the people served through TPP; their service engagement; pathways into homelessness; and lost opportunities for early intervention. Methods Data has been collected from a total of 755 TPP participants, including those from client registrations (July 2015-March 2017; n = 695) and a ‘pathways into homelessness’ questionnaire implemented in 2019. All participants were asked questions regarding their experiences of debt, levels of debt and the specific agencies and debtors involved. Results Common pathways into homelessness included individual factors (e.g. substance dependencies, family breakdown), structural factors (lack of suitable and accessible housing, deinstitutionalisation, service failures), and poverty exacerbated by debt. Of this cohort, 62% described current debt, and $2.8million (NZD) of debt was estimated (average of $10000 per person). Debts to government agencies were common and significant, including to Work and Income NZ, student loans, court costs and Housing NZ. Conclusions Financial difficulty, and particularly debt, is an important tipping point into homelessness. High levels of debt exclude people from permanent housing and challenge policies and practices aiming to end homelessness. Furthermore, debt to government agencies - required to invest in homelessness prevention and support - is a systems and policy failure. Key messages Financial difficulties, specifically debt, and systems failures are important tipping points for vulnerable populations into homelessness Debts owed to government agencies by the homeless population provide an opportunity to reorient the system to support homelessness prevention.

Tolga Aksu ◽  
Rakesh Gopinathannair ◽  
Serdar Bozyel ◽  
Kivanc Yalin ◽  
Dhiraj Gupta

Background: The contribution of autonomic influences to atrioventricular block (AVB) is unclear. Although cardioneuroablation has been used to treat cardioinhibitory vasovagal syncope, its role in treating functional paroxysmal and persistent AVB has not been formally evaluated. Methods: We used a stepwise protocol in 241 consecutive patients presenting with symptomatic AVB to identify 31 (12.9%) patients with functional or vagally mediated AVB. All patients had episode(s) of syncope in previous 12 months, and AVB was persistent in 17 (54.8%) patients. All 31 patients received targeted catheter-based cardioneuroablation, and their follow-up outcomes were evaluated with serial Holter monitoring. Results: Twenty-eight patients received biatrial or left-sided cardioneuroablation while 3 received only right-sided cardioneuroablation because of structural factors that precluded safe attempts at transseptal puncture. Procedural success, as defined as acute reversal of AVB and complete abolition of atropine response, was achieved in 30 (96.7%) cases, while the remaining patient received a pacemaker. Over a mean follow-up of 19.3±15 months, AVB episodes were observed in 2 (6.7%) of 30 cases, and 3 (9.6%) patients required pacemaker implantation during follow-up. Conclusions: Functional AVB can be identified in a minority of patients presenting with high-grade AVB. Cardioneuroablation for these patients results in encouraging medium-term outcomes.

2021 ◽  
Vol 50 (Supplement_1) ◽  
Gates Scholar Dorien Braam ◽  
Freya Jephcott ◽  
James Wood

Abstract Background Repeated spillover events of zoonotic diseases from animals to humans, in combination with unprecedented levels of forced migration, present a major challenge to the global health security agenda. Infectious disease risk is affected by a range of ecological, political and socio-economic drivers. Methods This study uses a qualitative case study methodology to determine how displacement affects the risks of zoonotic disease transmission. Based on key informant interviews and observational studies in Jordan and Pakistan, the study analyses social-structural factors impacting zoonotic disease transmission. Results The study shows that displacement may influence zoonotic disease transmission through its impact on environmental, socio-economic and behavioural factors, influenced by historical, political and socio-economic processes. Sporadic outbreaks of zoonoses including cutaneous leishmaniasis, rabies and Tuberculosis are reported among displaced populations. Risk factors include a decline in health services, increased population density, changes in environment, and reduced quality and availability of shelter, water and nutrition, in turn determining vulnerability to vectors and pathogens. Conclusions Risk factors affecting zoonoses in displacement are complex and interlinked. While the presence of animals may increase the risk in densely populated areas lacking hygiene, livestock may be beneficial to the health status of displaced by improving nutrition. Responses need to be interdisciplinary, multilevel and contextualized. Key messages To mitigate the risk of zoonotic disease transmission during displacement, responses need to include pathogen and vector control, as well as reducing vulnerability to disease, including through access to health and veterinary services and humanitarian assistance.

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