Lonely societies: low trust societies? Further explanations for national variations in loneliness among older Europeans

Cross-national studies in Europe reveal sharp regional differences in the prevalence of loneliness among older adults, with the highest prevalence of loneliness in Eastern European countries. In this study, we investigate an alternative explanation for differences in loneliness prevalence based on differences in trust. Many of the Eastern European countries were ruled by totalitarian regimes that undermined people’s trust in other people and in the system, potentially leading to higher loneliness prevalence. Data are derived from the sixth round of the European Social Survey conducted in 2012, based on 12,042 respondents, of which 4827 live in post-totalitarian countries and 7215 in other European countries and Israel. We estimate a path model with trust in people, trust in the system, and social engagement included as latent variables and one dichotomous outcome (lonely or not). We control for age, gender, health limitations, marital status, income adequacy, and education. The results reveal that loneliness is partly constructed by the social–cultural and historical–political characteristics of the countries in which people live. The higher prevalence of loneliness in the Eastern-European post-totalitarian countries can be linked to a low level of trust in other people through social disengagement. Considering the role of trust in the creation of individuals feelings of loneliness contributes to the understanding of country variations in loneliness and opens a new perspective in loneliness research and the development of policies aimed at reducing loneliness.

Influence of occlusal reduction on pain after endodontic treatment: a systematic review and meta-analysis

The purpose of this systematic review was to analyze the influence of occlusal reduction on the postoperative pain levels after endodontic treatment (instrumentation and obturation of the root canal system). This review followed the PRISMA statement and was registered at PROSPERO (CRD42018107918). Two independent reviewers searched the Lilacs, Cochrane Library, PubMed (Medline), Web of Science, Scopus, Scielo, and ScienceDirect for articles published until April 2021. The research question was, "Does occlusal reduction decrease postoperative pain in endodontically treated teeth?". Only randomized clinical trials were included. The RevMan 5 program was used for meta-analysis, calculating the relative risk (RR) and 95% confidence interval (CI) of the dichotomous outcome (presence or absence of pain). The search strategies retrieved 4114 studies. Twelve studies were included for qualitative analysis and nine for quantitative analysis. The meta-analysis results did not reveal a significant difference in the reduction of postoperative pain levels for endodontic instrumentation at 6, 12, 24, 48 h and for endodontic obturation at 6 or 12 h after occlusal reduction. According to the GRADE tool, the analyzed outcome was classified as having a moderate level of certainty. It is concluded that occlusal reduction does not interfere with postoperative pain levels after endodontic treatment.

The ethics of experimental research employing intrusive technologies in tourism: A collaborative ethnography perspective

This study probes the ethics of intrusive technologies for experimental research in tourism, through the lens of collaborative ethnography. Amidst the increasing uptake of technology to assess participant responses, the role of ethics in an experimental setting has received scant attention in tourism and hospitality. While intrusive technologies such as eye tracking, skin sensors and neuroscience headgear become more ubiquitous, the ethical boundaries of using such equipment are increasingly blurred and inconsistently approved. Seeking convergence of ethics concerning intrusive technologies is complicated when framing political spaces, target audiences and management of data obtained. Rather than view the role of intrusive technologies as a dichotomous outcome of ethical or unethical approaches, this paper argues that ethics needs to be contextually embedded with increased collaboration and co-creation in the application preparation and approval process.

Physical Activity Patterns and Neighborhood Characteristics of First Generation Latina Immigrants Living in Arizona (Preprint)

BACKGROUND Metabolic disease conditions, including obesity and type 2 diabetes, are a major health concern for Latina immigrants. Regular aerobic physical activity (PA) is an independent risk factor for the prevention and control of these conditions. Yet, the PA levels of most Latina immigrants are below national guidelines; highlighting the need for effective efforts to reduce PA and metabolic health disparities in this population. OBJECTIVE This study explored PA patterns of first generation US Latina immigrants and examined how neighborhood environment factors influence these PA patterns. Findings will be used to inform development of a culturally tailored PA intervention for first generation Latina immigrants. METHODS Using a cross-sectional study design, 39 first generation Latina immigrants completed the International Physical Activity Questionnaire and the Mujahid Neighborhood Scales Questionnaire, which assessed 6 perceived neighborhood factors: walking environment, aesthetic quality, safety, violence, social cohesion, and activities with neighbors. Median self-reported MET-minutes/week of PA were used to summarize domain (i.e., work, domestic, household, leisure) and intensity (i.e., walking, moderate, vigorous, moderate-to-vigorous) specific PA patterns. Logistic regression examined associations between neighborhood factors and engaging in leisure-time PA (i.e., dichotomous outcome of some vs. no leisure-time PA), transportation PA (i.e., dichotomous outcome of some vs. no transportation PA), and meeting national PA guidelines (i.e., dichotomous outcome of meeting vs. not meeting guidelines). RESULTS Participants (age = 40.5 ± 4.3 years; length of US residency = 4.6 ± 1.0 years) reported engaging in a median of 4512 MET-minutes/week of total PA. The majority of their PA was acquired through domestic activities (2160 MET-minutes/week), followed by leisure (396 MET-minutes/week), transportation (198 MET-minutes/week), and work PA (0 MET-minutes/week). Intensity-specific PA patterns showed that participants engaged in a median of 594 MET-minutes/week of walking activity and 3500 MET-minutes/week of moderate-to-vigorous PA. Logistic regression models showed that neighborhood factors of walking environment, aesthetic quality, and safety were significantly associated with engaging in leisure PA (odds ratios of 5.95 [95% CI:1.49; 23.74], 2.45 [95% CI:1.01; 5.93] and 3.30 [95% CI:1.26; 8.67], respectively) and meeting national PA guidelines (odds ratios of 8.44 [95% CI: 1.63; 43.69] 11.99 [95% CI: 1.79; 80.29], and 3.54 [95% CI:1.21; 10.29] respectively). Neighborhood factors of violence, social cohesion, and activities with neighbors were not significantly associated with PA outcomes. CONCLUSIONS Although most participants engaged in PA at levels that met national guidelines, the majority of their PA was achieved through domestic activity, with limited leisure, transportation, and work PA. Given leisure PA, in particular, plays a significant role in improving health outcomes, findings suggest that many Latina immigrants could benefit from a leisure PA intervention. Such interventions should consider neighborhood environmental influences, as our data suggest these factors can serve as determinants to PA.

Dengue and post-infection fatigue: findings from a prospective cohort—the Colombo Dengue Study

Background Previous studies on post-infection fatigue in dengue are few but suggest that up to 25% of dengue patients may suffer from fatigue. This study aimed to evaluate the prevalence and associations of post-infection fatigue in dengue patients compared with non-dengue fever patients. Methods Post-infection fatigue and its demographic and clinical associations were assessed in adult dengue and non-dengue fever patients 2 months after the acute infection in a prospective cohort study in Sri Lanka. Fatigue at 2 months (primary endpoint) was assessed with the fatigue questionnaire as a dichotomous outcome based on a pre-recommended cut-off (score ≥4) and as the total score from the questionnaire (higher score indicates more fatigue). Results Of 260 patients, 158 had dengue and, of these, 51 (32%) had fatigue at 2 months. Risk was higher in dengue patients (vs non-dengue; relative risk [RR] 4.93 [95% confidence interval {CI} 2.3 to 10.4]) and more so in female dengue patients (vs male dengue patients; RR 2.45 [95% CI 1.24 to 4.86]). Severe dengue patients had a higher mean fatigue score (p=0.024). Conclusions Post-infection fatigue is an underappreciated burden of this widely prevalent infection. Our findings are useful to triage patients at risk of fatigue for follow-up.

Validation and reproducibility of the lung function questionnaire (LFQ) for the diagnosis of COPD in Colombia

IntroductionThe development of clinical prediction scales and their use can reduce under-diagnosis and increase early detection of chronic obstructive pulmonary disease (COPD). The performance of clinical prediction scales in Colombia is unknown. The objective of this study is to evaluate the validity and reproducibility of the lung function questionnaire (LFQ) in Colombia.MethodA cross-sectional study was performed, with analysis of diagnostic validity and reliability in people over 40 years of age who underwent a spirometry test. The LFQ questionnaire was applied. To assess reproducibility, the test was carried out at two time points: first at the initial consultation; and then 1 day to 1 week after the previous application. Spirometry was performed immediately after the initial questionnaire, meeting the American Thoracic Society criteria.ResultsAmong the 1996 subjects included in the analysis, the average age was 65 years (SD: 11.97 years), prevalence of COPD was 21.3%, the intra-class correlation coefficient between the two time points was 0.844 (95% CI: 0.863–0.901) (p < 0.001), and kappa was 0.797 for the dichotomous outcome ≤18 COPD risk points (p < 0.001), validity analysis using the area under the receiver operating characteristic curve for the population evaluated was 0.715 (95% CI: 0.685–0.745); the dichotomous outcome of the questionnaire ≤18 points was as follows: sensitivity – 91.18% (95% CI: 88.0–94.3); specificity – 32.41% (95% CI: 29.8–35.0); positive predictive value – 26.7% (95% CI: 24.1–29.3); negative predictive value – 93.15% (95% CI: 90.7–95.6); likelihood ratio (LR) +: 1.34 (95% CI: 1.28–1.42), LR– 0.27 (95% CI: 0.19–0.39); number needed to diagnose: 4; number needed to misdiagnose: 2 (p < 0.001).ConclusionThe LFQ questionnaire has good performance for the diagnosis of COPD, especially in populations without previous respiratory symptoms or usual risk factors, optimising the use of spirometry to increase its detection.

Association of BMI and Obesity with Composite poor outcome in COVID-19 adult patients: A Systematic Review and Meta-Analysis

AimThis study aimed to evaluate the association between obesity and composite poor outcome in coronavirus disease 2019 (COVID-19) patients.MethodsWe conducted a systematic literature search from PubMed and Embase database. We included all original research articles in COVID-19 adult patients and obesity based on classification of Body Mass Index (BMI) and composite poor outcome which consist of mortality, morbidity, admission of Intensive Care Unit (ICU), mechanical ventilation, Acute Respiratory Distress Syndrome (ARDS), and severe COVID-19.ResultsNine studies were included in meta-analysis with 6 studies presented BMI as continuous outcome and 3 studies presented BMI as dichotomous outcome (obese and non-obese). Most studies were conducted in China (55.5%) with remaining studies from French, Germany, and United States (US). COVID-19 patients with composite poor outcome had higher BMI with mean difference 0.55 kg/m2 (95% CI 0.07–1.03, P=0.02). BMI ≥30 (obese) was associated with composite poor outcome with odds ratio 1.89 (95% CI 1.06–3.34, P=0.03). Multivariate meta-regression analysis by including three moderators: age, hypertension, and Diabetes Mellitus type 2 (DM type 2) showed the association between obesity and composite poor outcome was affected by age with regression coefficient =-0.06 and P=0.02. Subgroup analysis was not performed due to the limited number of studies for several outcomes.ConclusionObesity is a risk factor of composite poor outcome of COVID-19. On the other hand, COVID-19 patients with composite poor outcome have higher BMI. BMI is an important routine procedure that should be assessed in the management of COVID-19 patients and special attention should be given to patients with obesity.