What makes children learn how to swim? – health, lifestyle and environmental factors associated with swimming ability among children in the city of Malmö, Sweden

Background Swimming ability among children in the city of Malmö, Sweden is strongly affected by socioeconomic differences. We investigated to what extent mediating health and lifestyle factors, such as children’s eating, sleeping and physical activity habits, as well as the characteristics of the social and working environment at both school and home, could explain the socioeconomic gradient in swimming ability. Methods Our study population included children who started their first-grade school-year in 2012 or 2013 at any of the public primary schools of Malmö, Sweden. Cross-sectional, self-reported questionnaire-based data about health status and swimming ability in the fourth grade (age 10) were included from the Pupil Health Database (ELSA) for 3468 children. Results Children’s self-reported swimming ability was strongly associated with both individual- and school-based sociodemographic variables. Nine health, lifestyle and environmental variables were identified as potential mediators and included in the final model. Four of these variables, “Activity”, “Outdoor time”, “Social relationships at home and on the free time”, and “Positivity about future”, were significantly and positively associated with children’s ability to swim. Conclusions Social support, optimism for the future and an active lifestyle were positively associated with children’s swimming skills; however, compared to the socioeconomic factors, these health- and lifestyle factors contributed very little. It is possible, that interventions concerning children’s swimming ability in lower socioeconomic neighbourhoods, should in addition to children’s swimming lessons, target the whole families with the goal of increasing their possibilities for socialising and engaging in different kinds of recreational activities.

O BIBLIOTECÁRIO MEDIADOR E OS DESAFIOS PARA A COMPETÊNCIA EM INFORMAÇÃO DIANTE DA COVID-19: o caso de uma biblioteca universitária especializada em saúde

Este artigo tem por objetivo descrever o relato de experiência profissional do primeiro Programa de Capacitação que deu origem ao curso online “Aprendendo sobre normas da ABNT” oferecido por uma biblioteca universitária (BU) especializada em ciências da saúde, Programa implantado a partir do produto final de um projeto de pesquisa de mestrado. Aborda as ações que vem sendo trabalhadas pela biblioteca durante o período pandêmico, com o uso intensivo das redes sociais, e aprimoramento do profissional na competência em mídia. Mostra os desafios enfrentados pelo bibliotecário através dos trabalhos home office e como pensar em práticas para dar continuidade ao desenvolvimento da competência em informação dos usuários remotamente. A metodologia caracteriza-se como um estudo empírico e descritivo, de abordagem qualiquantitativa, utilizou-se como instrumento, o questionário pesquisa de satisfação, também realizou-se pesquisa do tipo revisão bibliográfica como base teórica para o presente estudo. Os resultados obtidos apontam que entre os participantes 62,5% sentiram-se satisfeitos com o curso. Em relação à duração da capacitação, 50% marcaram “excelente” para a carga horária. Quanto ao objetivo proposto pelo curso, 98,5% alegaram que o conteúdo estava de acordo com o estimado na divulgação. Diante das considerações finais, recomenda-se que atividades remotas sejam realizadas a fim de promover a competência em informação aos usuários das bibliotecas universitárias frente às práticas de isolamento social. A biblioteca em estudo pretende promover outros cursos, principalmente os voltados para o uso de ferramentas das bases de dados em saúde para uma melhor disseminação no uso e gestão da informação científico-técnica em saúde. Os estudo de Morigi e Souto (2005), Kern (2020), Santos e Paiva (2020) e Santos (2020) foram fundamentais para esta pesquisa, pois serviram como embasamento teórico para o desenvolvimento deste artigo.AbstractThis article aims to describe the professional experience report of the first Training Program that gave rise to the online course “Learning about ABNT standards” offered by a university library (BU) specialized in health sciences, Program implemented based on the final product of a master's research project. It addresses the actions that have been worked on by the library during the pandemic period, with the intensive use of social networks, and professional improvement in media competence. It shows the challenges faced by the librarian through home office work and how to think about practices to continue the development of users' information competence remotely. The methodology is characterized as an empirical and descriptive study, with a qualitative and quantitative approach, the satisfaction survey questionnaire was used as an instrument. A literature review was also carried out as a theoretical basis for the present study. The results obtained show that among the participants 62.5% felt satisfied with the course. Regarding the duration of the training, 50% scored "excellent" for the workload. As for the objective proposed by the course, 98.5% claimed that the content was in accordance with the estimated disclosure. In view of the final considerations, it is recommended that remote activities be carried out in order to promote competence in information to users ofuniversity libraries in the face of social isolation practices. The library under study intends to promote other courses, mainly those focused on the use of health database tools for better dissemination in the use and management of scientific and technical health information. The studies by Morigi and Souto (2005), Kern (2020), Santos and Paiva (2020) and Santos (2020) were fundamental for this research, as they served as a theoretical basis for the development of this article.

Motor Development Problems in Infancy Predict Mental Disorders in Childhood: Longitudinal Child Cohort Study

The aim was to examine whether motor development problems in infancy predicted mental disorders later in childhood, taking a wide array of potential confounder variables into consideration. This longitudinal study included an unselected study population of 33,238 newborn children from the Copenhagen area in Denmark. Data on the predictor variable motor development problems at age 8-10 months was obtained from the community health nurses’ systematic evaluation of the child’s motor development problems during a home visit stored in the Child Health Database. Data on outcome, diagnosed mental disorders before age 8 years, was obtained from the Danish National Patient Register. The study included potential confounders obtained from the Child Health Database, the National Birth Register, and the Civil Registration System. The prevalence of motor development problems at age 8-10 months was 19.3% and the incidence of any diagnosed mental disorder from age 11 months to the 8th birthday was 4.0%. Motor development problems were associated with an overall increased risk of being diagnosed with a mental disorder before the 8th birthday, adjusted odds ratio (AOR) 1.47 (1.29-1.67), in particular diagnosed neuro-developmental disorders, AOR 1.77 (1.52-2.06), such as autism-spectrum disorders, AOR 1.63 (1.31-2.03), hyperactivity/ attention deficit disorders, AOR 1.29 (1.03-1.61) and disorders of intellectual disability, AOR 3.28 (2.39-4.49). Conclusion: Motor development problems as early at age 9-10 months are predictive of neurodevelopmental disorders at age 1-8 years. The findings call for clinical attention and more research in the preventive potentials in the community child health care.

Protection and waning of natural and hybrid COVID-19 immunity

BACKGROUNDInfection with SARS-CoV-2 provides substantial natural immunity against reinfection. Recent studies have shown strong waning of the immunity provided by the BNT162b2 vaccine. The time course of natural and hybrid immunity is unknown.METHODSData on confirmed SARS-CoV-2 infections were extracted from the Israeli Ministry of Health database for the period August to September 2021 regarding all persons previously infected or vaccinated. We compared infection rates as a function of time since the last immunity-conferring event using Poisson regression, adjusting for possible confounding factors.RESULTSConfirmed infection rates increased according to time elapsed since the last immunity-conferring event in all cohorts. For unvaccinated previously infected individuals they increased from 10.5 per 100,000 risk-days for those previously infected 4-6 months ago to 30.2 for those previously infected over a year ago. For individuals receiving a single dose following prior infection they increased from 3.7 per 100,000 person days among those vaccinated in the past two months to 11.6 for those vaccinated over 6 months ago. For vaccinated previously uninfected individuals the rate per 100,000 person days increased from 21.1 for persons vaccinated within the first two months to 88.9 for those vaccinated more than 6 months ago.CONCLUSIONSProtection from reinfection decreases with time since previous infection, but is, nevertheless, higher than that conferred by vaccination with two doses at a similar time since the last immunity-conferring event. A single vaccine dose after infection helps to restore protection.

Real world evidence of calcifediol or vitamin D prescription and mortality rate of COVID-19 in a retrospective cohort of hospitalized Andalusian patients

COVID-19 is a major worldwide health problem because of acute respiratory distress syndrome, and mortality. Several lines of evidence have suggested a relationship between the vitamin D endocrine system and severity of COVID-19. We present a survival study on a retrospective cohort of 15,968 patients, comprising all COVID-19 patients hospitalized in Andalusia between January and November 2020. Based on a central registry of electronic health records (the Andalusian Population Health Database, BPS), prescription of vitamin D or its metabolites within 15–30 days before hospitalization were recorded. The effect of prescription of vitamin D (metabolites) for other indication previous to the hospitalization was studied with respect to patient survival. Kaplan–Meier survival curves and hazard ratios support an association between prescription of these metabolites and patient survival. Such association was stronger for calcifediol (Hazard Ratio, HR = 0.67, with 95% confidence interval, CI, of [0.50–0.91]) than for cholecalciferol (HR = 0.75, with 95% CI of [0.61–0.91]), when prescribed 15 days prior hospitalization. Although the relation is maintained, there is a general decrease of this effect when a longer period of 30 days prior hospitalization is considered (calcifediol HR = 0.73, with 95% CI [0.57–0.95] and cholecalciferol HR = 0.88, with 95% CI [0.75, 1.03]), suggesting that association was stronger when the prescription was closer to the hospitalization.

Blockchain-based architecture design for personal health record (Preprint)

BACKGROUND The importance of blockchain-based architectures for personal health record (PHR) lies in the fact that they are thought and developed to allow patients to control and at least partly collect their health data. Ideally, these systems should provide the full control of such data for the respective owner. In spite of this importance, most of the works focus more on describing how blockchain models can be used in a PHR scenario than whether these models are in fact feasible and robust enough to support a large number of users. OBJECTIVE Toward a consistent, reproducible and comparable PHR system, we build a novel ledger-oriented architecture out of a permissioned distributed network, providing patients with a manner to securely collect, store, share and manage their health data. We also emphasize the importance of suitable ledgers and smart contracts to operate the blockchain network as well as discuss the necessity of standardizing evaluation metrics to compare related works. METHODS We adopted the Hyperledger Fabric platform to implement our blockchain-based architecture design and the Hyperledger Caliper framework to provide a detailed assessment of our system under workload, ranging from 100 to 2,500 simultaneous record submissions, and using throughput and average latency as primary metrics. We also create a health database, a cryptographic unit and a server to complement the blockchain network. RESULTS Smart contracts that write on the ledger have throughputs, measured in transactions per seconds (tps), in an order of magnitude close to 10^2 tps while those contracts that only read have rates close to 10^3 tps. Smart contracts that write also have latencies, measured in seconds (s), in an order of magnitude close to 10^1 s while that only read have delays close to 10^0 s. In particular, smart contracts that retrieve, list and view history have throughputs varying, respectively, from 1,100 to 1,300 tps, 650 to 750 tps and 850 to 950 tps, impacting the overall system response if they are equally requested under the same workload. CONCLUSIONS To the best of our knowledge, we are the first to evaluate, using Hyperledger Caliper, the performance of a PHR blockchain architecture and also the first to evaluate each smart contract separately. Nevertheless, blockchain systems achieve performances far below the traditional distributed databases achieve, indicating the assessment of blockchain solutions for PHR is a major concern to be addressed before putting them into a real production.

Prescription of Kampo Formulations for Pre-natal and Post-partum Women in Japan: Data From an Administrative Health Database

Introduction: Traditional Japanese (Kampo) medicines are often prescribed for women in Japan before, during, and after pregnancy. However, detailed information on the actual frequency of use and safety of Kampo preparations during pregnancy is lacking.Aim: To investigate the frequency of prescription of Kampo medicines for pregnant women in Japan.Methods: Information on Kampo medicines prescribed during outpatient care and hospitalization of selected mothers from January 2005 to August 2016 were extracted from the Japan Medical Data Center (Tokyo, Japan), which is a large claims database.Results: Of the 33,941 subscribers identified from the database, 16,294 (48%) received at least one prescription of a Kampo medicine. Kakkonto was the formula most prescribed during the study period, followed by shoseiryuto and tokishakuyakusan. In the 180 days before pregnancy, the most prescribed medicine was tokishakuyakusan, followed by kakkonto and shoseiryuto. Shoseiryuto, tokishakuyakusan, and kakkonnto were the formulae most prescribed during pregnancy. The most prescribed medicines during the 180 days postpartum were kakkonto, shoseiryuto, and saireito.Conclusions: Information in the Japanese insurance system shows that Kampo medicines are often prescribed during pregnancy. Most of these prescriptions are generally used for the treatment of common cold. Tokishakuyakusan in particular is usually used in the treatment of various symptoms of pregnancy. Further research is needed to clarify the relationship between the use of Kampo medicines during pregnancy and adverse events in infants in Japan.

Considerations of invasive mechanical ventilation in prone position. A narrative review

The evidence regarding logistic considerations and safety events associated with prone position ventilation (PPV) is summarized and a flow diagrama for safe provision of mechanical ventilation in the setting of the COVID-19 pandemic is proposed. A review of the literature was conducted in the Medline via Pubmed, Embase, and Lilacs databases, the Cochrane Database of Systematic Reviews, Cochrane Central Register of Randomized Controlled Trials, Cochrane Database of Abstracts of Reviews of Effects, ProQuest Nursing and Allied Health Database, and Google scholar. Overall, 31 articles were selected for the analysis. The incidence of PPV-related safety events varies between 1% and 11.9% and the most frequent complications are pressure ulcers and airway complications. Early initiation of enteral nutrition is recommended, and transfers are possible in patients on PPV. There is controversy regarding contraindications and recommendations for PPV. Recommendations for its safe provision are based on expert opinions and the establishment of protocols for healthcare staff training. Clinical studies are required to determine which are the recommendations that should be considered for safe and reproducible PPV use during this pandemic.

Assessment of urban tree condition using VTA at Urban Green Space of Mataram University Rectorate

Urban green spaces, including those in the University of Mataram, is all urban land covered by vegetation of any kind, which has aesthetic and recreation values and are important components in improving the ecosystem function. Many trees at the University of Mataram Rectorate Area have aesthetical and ecological values. These trees have not been subjected to health assessment, while various stressors may have impacted the trees in the past. There is no available previous assessment information regarding the tree’s health condition. The purpose of this study is to conduct a Visual Tree Assessment (VTA) to evaluate the 62 trees’ health condition at the Mataram University Rectorate Area. The target trees were ≥20 cm diameter at breast height (dbh) and poles (10-19 cm dbh). The assessment was carried out using the VTA method to the condition of the common defects of the tree. The results show that based on the condition of the common defects of the tree, it was found that 22% of the trees had dead trees, top, and branches; 21% had parasite or mistletoe; 19% had stem or branch decay; 13% had weak branch union; 10% had poor tree architecture; 6% had cracks; 4% had termite attack; 3% had cankers, and 2% trees had root problems. Based on the hazard category of targeted trees, 79,03% of the trees are in Low hazard conditions (sound), 19,35% were in Moderately hazardous conditions, and only 1,61% were in Highly hazardous conditions. This assessment should be continued with an in-depth investigation. Monitoring and evaluation of tree health assessment should be done at least once a year. It is very important to gather up-to-date information on health conditions in the trees. The evaluation results integrated into GIS will be used as a tree health database that can be updated continuously. This data is expected to reduce the risk of damage that can be caused by the trees.