Prevalence and severity of differing dimensions of breathlessness among elderly males in the population

Breathlessness is common in the general population. Existing data were obtained primarily with the uni-dimensional modified Medical Research Council (mMRC) breathlessness scale that does not assess intensities of unpleasantness nor physical, emotional, and affective dimensions. The aim of this research was to determine the prevalence and intensity of these dimensions of breathlessness in elderly males and any associations with their duration, change over time, and mMRC grade. We conducted a population-based, cross-sectional study of 73-year-old males in a county in southern Sweden. Breathlessness was self-reported at one time-point using a postal survey including the Dyspnoea-12 (D-12), the Multidimensional Dyspnoea profile (MDP), and the mMRC. Presence of an increased dimension score was defined as a score≥minimal clinically important difference for each dimension scale. Association with mMRC, recalled change since age 65, and duration of breathlessness were analysed with linear regression. Among 907 men, an increased dimension score was present in 17% (D-12 total score), 33% (MDP A1 unpleasantness), 19% (D-12 physical), 17% (MDP immediate perception), 10% (D-12 affective), and 17% (MDP emotional response). The unpleasantness and affective dimensions were strongly associated with mMRC ≥3. Higher MDP and D-12 scores were associated with worsening of breathlessness since age 65, and higher MDP A1 unpleasantness was associated with breathlessness of less than one year duration. Increased scores of several dimensions of breathlessness are prevalent in 73-year-old males and are positively correlated with mMRC scores, worsening of breathlessness after age 65, and duration of less than one year.

Application of an Online Combination Exercise Intervention to Improve Physical and Mental Health in Obese Children: A Single Arm Longitudinal Study

Introduction: Childhood obesity has become a global public health concern in the past decade. The purpose of this study was to explore the effectiveness of an online combination exercise intervention in improving the physical and mental health of obese children.Methods: This study adopted a one-group pre-test and post-test research design. A total of 28 obese children from 6 elementary schools in Heze City, Shandong Province, China, were recruited. All participants received an 8-week online combination exercise intervention and were tested at a three-month follow-up. Participants were tested and surveyed regarding their demographic, feasibility, and obesity indicators using mental health and quality of life questionnaires. The data were statistically analyzed using a one-way analysis of variance with repeated measures.Results: A total of 26 obese children (Meanage = 10.15 years) completed the study. The retention rate was 92.9% for the entire trial (two obese children withdrew due to their inability to exercise) and no adverse events were reported. In addition, the obese children completed 25/32 (78.1%) of the online courses. After 8 weeks of the intervention, the changes in the body fat percentage of the obese children [mean difference (MD) = –3.126, p < 0.001, Cohen’s d = –1.777], thinking dimension score (MD = 1.654, p < 0.001, Cohen’s d = 0.603), total quality of life score (MD = 6.385, p < 0.05, Cohen’s d = 0.610), and work attitude dimension score (MD = 1.346, p < 0.001, Cohen’s d = 0.744) showed significant differences compared to the baseline. However, no significant differences were identified between the post-intervention and three-month follow-up measurements (p > 0.05), and we assumed that the intervention effect was maintained three months after the intervention.Conclusion: An online combination exercise intervention is a safe and feasible option to improve the mental health and quality of life of obese children and may have long-term health benefits.

Comparison of prevalence and risk factors of somatization between Chinese health care workers and non-health care workers during COVID-19 outbreak

Background This study aimed to compare prevalence and risk factors of somatization (SOM) between health care workers and non-health care workers during COVID-19 outbreak in China. Methods From 14 February to 29 March 2020, an online survey was performed in both 605 health care workers and 1151 non-health care workers. Based on the somatization dimension score of the Symptom Checklist-90, participants were divided into non-SOM group and SOM group. Results Health care workers had higher prevalence rate of SOM (p < 0.001) than non-health care workers, with an OR of 1.70 (95% CI, 1.22–2.36, p = 0.002). Multiple logistic regression analysis revealed that in non-health care workers, the risk factors of SOM included other ethnicities, insomnia, and suicide, while in health care workers, the risk factors included working 6–8 h per day, and working ≥10 h per day during COVID-19 outbreak. Conclusions Our research suggests that both non-health care workers and health care workers have a relatively high prevalence of somatization. However, the related factors for somatization in both groups are significantly different, showing that medical service-related factors are associated with somatization in health care workers, while demographic and clinical factors are associated with somatization in non-health care workers.

Comparison of prevalence and risk factors of somatization between Chinese health care workers and non-health care workers during COVID-19 outbreak

Background: This study aimed to compare prevalence and risk factors of somatization (SOM) between health care workers and non-health care workers during COVID-19 outbreak in China. Methods: From 14 February to 29 March 2020, an online survey was performed in both 605 health care workers and 1151 non-health care workers. Based on the somatization dimension score of the Symptom Checklist-90, participants were divided into non-SOM group and SOM group. Results: Health care workers had higher prevalence rate of SOM (p < 0.001) than non-health care workers, with an OR of 1.70 (95% CI: 1.22–2.36, p = 0.002). Multiple logistic regression analysis revealed that in non-health care workers, the risk factors of SOM included other ethnicities, insomnia, and suicide, while in health care workers, the risk factors included working 6-8 hours per day, and working ≥10 hours per day during COVID-19 outbreak. Conclusions: Our research suggests that both non-health care workers and health care workers have a relatively high prevalence of somatization. However, the related factors for somatization in both groups are significantly different, showing that medical service-related factors are associated with somatization in health care workers, while demographic and clinical factors are associated with somatization in non-health care workers.

Hofstede’s Culture Values Survey in Albania: How the cultural scores have shifted over time?

The purpose of this paper is to highlight the changes that Albanian cultural dimensions’ scores have undergone over time. Hofstede’s Value Survey Module 2013 (VSM, 2013) has been applied to examine the six dimensions of culture; power distance, individualism, masculinity, uncertainty avoidance, long term orientation and indulgence. The survey data (N = 387) was collected in the two largest private hospitals in Albania. Globalization, technological developments, economical flourishing and crisis, war and peace, influence the shifting of national cultural dimensions’ scores toward negative or positive values (Hofstede et al. 2010). In this study we aim to show the shifting of Albanian culture value scores in time, and compare the results with the ones predicted by the researchers of the field. The results obtained show a negative shift on Albanian culture dimension score of power distance, individualism, long term orientation and indulgence, and a positive shift on masculinity and uncertainty avoidance values. Implications for researchers of the field are discussed in the paper.

Readiness for Tobacco-Free Policy in a Statewide University System

Background. Almost 2,000 campuses have adopted tobacco-free (TF) policies across the United States. However, there is not a systematic process to help campuses implement successful policies. Readiness assessments can help provide assistance as campuses work to implement successful policies. Purpose. We assessed readiness for TF policies among campuses of a statewide university system and determined factors associated with readiness. Participants. Stakeholders from 23 campuses without 100% TF policies were invited to participate in an online survey. Method. System administrators provided contacts for five to eight stakeholders per campus. Included in the analysis were 10 of 23 campuses (43.5%) with at least three stakeholders completing the survey. Results. Of the 10 campuses, one was in Preplanning, five were in Preparation, and four were in the Initiation stage of readiness. Political Climate was the highest scored dimension on seven campuses (0.74–1.0); Resources was the lowest on eight campuses (0.0–0.67). Campus size and county rurality were each associated with one dimension score. Conclusions. Despite being part of a statewide university system, campuses are in varying stages of readiness for TF policies. Stage-based strategies to advance TF campus policies must be implemented to set campuses up for successful policies.

HOFSTEDE’S CULTURE VALUES SURVEY IN ALBANIAN PRIVATE HOSPITALS

The purpose of this paper is to highlight the changes that Albanian cultural dimensions’ scores have undergone over time. Hofstede’s Value Survey Module 2013 (VSM 2013) has been applied to examine the six dimensions of culture; power distance, individualism, masculinity, uncertainty avoidance, long term orientation and indulgence. The survey data (N=387) was collected in the two largest private hospitals in Albania. Globalization, technological developments, economical flourishing and crisis, war and peace, influence the shifting of national cultural dimensions’ scores toward negative or positive values [1]. In this study we aim to show the shifting of Albanian culture value scores in time, and compare the results with the ones predicted by the researchers of the field. The results obtained show a negative shift on Albanian culture dimension score of power distance, individualism, long term orientation and indulgence, and a positive shift on masculinity and uncertainty avoidance values. Implications for researchers of the field are discussed in the paper.

Recreational Travel Decisions: Push-Pull Dynamics on College Students

The purpose of this study is to examine the recreational tourism preferences of university students within the framework of their push and pull travel motivations. In addition, it was aimed to highlight how some variables and motivations affect tourism preferences in mutual interaction. Validity and reliability were obtained by &ldquo;Scale of Recreational Activities in Destination Choices&rdquo; (SRADC), &ldquo;Scale of Intrinsic Travel Motivations&rdquo; (SITM) and &ldquo;Scale of Extrinsic Travel Motivations&rdquo; (SETM) conducted by &Ouml;zdemir, Karak&uuml;&ccedil;&uuml;k, and B&uuml;y&uuml;k&ouml;zt&uuml;rk (2013). Descriptive statistics, independent sample t test, one way ANOVA and Univariate test were used for data analysis, for in-group comparisons Tukey (HSD-LSD) and Pearson Correlation test were used. In this study, it was determined that .85 for recreational activities in destination choices scale, .90 for SITM and .91 for SETM. While the push and pull travel motivation of the participants was above the mean values (123.96 &plusmn; 15.65; 121.35 &plusmn; 16.81), the highest subscale score in push travel motivation was obtained by the Exploring-Knowledge subdimension (39.01 &plusmn; 5.74). The highest sub-dimension score was obtained from the Escape sub-dimension (38.31 &plusmn; 5.98). In the pull travel motivation sub-dimensions, the highest sub-dimension score was the quality-atmosphere sub-dimension (39.29 &plusmn; 5.24), while the lowest sub-dimension score was obtained by the Natural Environment sub-dimension (19.98 &plusmn; 4.58). The findings of the study showed that the importance given to recreational activities was influenced by variables such as gender, year of study and perceived welfare, but also revealed differences in gender, field of study, year of study, and perceived welfare in push and pull travel motivations. In addition, there is a moderate positive relationship between recreational choices, push travel motivation and pull travel motivation. As a result, it has been determined that university students have high push and pull travel motivation and recreation preferences are differentiated between SITM and SETM by certain variables.

Relationship between Body Mass Index and the Sub-Dimensions of the Brief Pain Inventory in Chronic Pain Patients

Individuals with chronic pain find it hard to exercise which often results in an elevated Body Mass Index (BMI). Often these individuals only have mild to moderate structural or biomechanical reasons to explain their pain yet their fear of pain seems to influence their functional capacity before any biomechanical mechanism actually prevents them doing so.A retrospective analysis of 25 individuals with a diagnosis of chronic pain (>3 months duration) to establish anthropometric measures, pain severity and Brief Pain Inventory (BPI) questionnaire including the affective sub-dimension score (REM: relations with others, enjoyment of life, and mood) and the activity subdimension score (WAW: walking, general activity, and work) were assessed.BMI was shown to have a significant effect on the overall daily functional BPI score as assessed using ANOVA, F (4,110) = 29.4, p<0.05, with an effect size w = 0.5. Turkey HSD tests to compare all groups identified a significant relationship between BMI and (i) pain (p<0.05), (ii) REM (p<0.05), and (iii) sleep (p<0.05).These results would suggest that individuals who are overweight and who show higher REM scores on the BPI assessment may benefit from early psychological counselling rather than physical therapy.

Readiness to Adopt Physical Activity Policies in Rural Communities

The purpose was to explore community readiness to adopt physical activity (PA) policies by adapting and pilot testing an online survey (Physical Activity Readiness Survey [PARS]). PARS was adapted from the previously tested Community Readiness Survey-Short. In February/April 2016, key informants ( N = 17) involved in PA activities from two rural communities were invited to complete the PARS, representing six dimensions: knowledge, leadership, resources, community climate, existing voluntary PA policies, and political climate. First, participants were asked to respond to a presurvey to screen for overall readiness for up to four evidence-based PA policies. A main survey readiness score (0-6) was determined by averaging the key informants’ ratings across items: Raw scores were rescaled to range from 0 to 1, and dimension scores were summed. Participants identified two PA policies in the presurvey: neighborhood availability and point-of-decision prompts. For both policies, political climate had the highest dimension score (1.0) and the knowledge dimension scored lowest (0.05-0.38). Overall readiness scores ranged from 3.19 to 3.62, revealing the preparation stage for both policies. Readiness for the two PA policies were similar, but specific dimension scores varied by policy type and community, reinforcing the need for tailored interventions.