Trust in the Healthcare System and Physicians in Croatia: A Survey of the General Population

Trust in healthcare systems and physicians is considered important for the delivery of good healthcare. A cross-sectional survey was conducted on a random three-stage sample of the general population of Croatia (N = 1230), stratified by regions. Of respondents, 58.7% displayed a high or very high level of trust in the healthcare system, 65.6% in physicians, and 78.3% in their family physician. Respondents’ views regarding patients’ roles in the discussion of treatment options, confidence in physicians’ expertise, and underlying motives of physicians were mixed. Respondents with a lower level of education, those with low monthly incomes, and those from smaller settlements had lower levels of trust in physicians and the healthcare system. Trust in other institutions, religiosity and religious beliefs, tolerance of personal choice, and experience of caring for the seriously ill and dying were predictors of trust in healthcare and physicians. Our findings suggest that levels of healthcare-related trust in Croatia are increasing in comparison with previous research, but need improvement. Levels of trust are lowest in populations that are most vulnerable and most in need of care and protection.

An Exploratory Study on the Acoustic Musical Properties to Decrease Self-Perceived Anxiety

Musical listening is broadly used as an inexpensive and safe method to reduce self-perceived anxiety. This strategy is based on the emotivist assumption claiming that emotions are not only recognised in music but induced by it. Yet, the acoustic properties of musical work capable of reducing anxiety are still under-researched. To fill this gap, we explore whether the acoustic parameters relevant in music emotion recognition are also suitable to identify music with relaxing properties. As an anxiety indicator, the positive statements from the six-item Spielberger State-Trait Anxiety Inventory, a self-reported score from 3 to 12, are taken. A user-study with 50 participants assessing the relaxing potential of four musical pieces was conducted; subsequently, the acoustic parameters were evaluated. Our study shows that when using classical Western music to reduce self-perceived anxiety, tonal music should be considered. In addition, it also indicates that harmonicity is a suitable indicator of relaxing music, while the role of scoring and dynamics in reducing non-pathological listener distress should be further investigated.

Fat-Free Mass and Skeletal Muscle Mass Gain Are Associated with Diabetes Remission after Laparoscopic Sleeve Gastrectomy in Males but Not in Females

Besides massive body weight loss, laparoscopic sleeve gastrectomy (LSG) causes massive lean mass, including fat-free mass (FFM) and skeletal muscle mass (SM) that present higher metabolic rates in males. This study examines sex differences in FFM and SM changes of type 2 diabetes (T2D) remission at 12 months post-LSG. This cohort study recruited 119 patients (53.7% females) with T2D and obesity (body mass index 42.2 ± 7.0 kg/m2) who underwent LSG. Fat-mass (FM) loss was higher in males than in females (−12.8 ± 6.2% vs. −9.9 ± 5.0%, p = 0.02) after one-year post-operation. Regardless of the weight-loss difference, males had higher FFM and SM gain than did females (12.8 ± 8.0 vs. 9.9 ± 5.0% p = 0.02 and 6.5 ± 4.3% vs. 4.9 ± 6.2%, p = 0.03, respectively). Positive correlations of triglyceride reduction with FM loss (r = 0.47, p = 0.01) and SM gain (r = 0.44, p = 0.02) over 12 months post-operation were observed in males who achieved T2D remission. The T2D remission rate significantly increased 16% and 26% for each additional percentage of FFM and SM gain one year after LSG, which only happened in males. Increased FFM and SM were remarkably associated with T2D remission in males, but evidence lacks for females.

Impact of COVID-19 Pandemic Exacerbation of Depressive Symptoms for Social Frailty from the ORANGE Registry

Background: Recent longitudinal studies have reported proportion of frailty transition in older individuals during the COVID-19 pandemic. Our study aimed at clarifying the impact of social frailty in community-dwelling older adults during the COVID-19 pandemic and at identifying factors that can predict transition to social frailty. Methods: We performed this study from 2019 (before declaration of the state of emergency over the rising number of COVID-19 cases) to 2020 (after declaration of the emergency). We applied Makizako’s social frail index to our study subjects at the baseline and classified into robust, social prefrailty, and social frailty groups. Multiple logistic regression analysis was performed using robust, social prefrailty, or social frailty status as dependent variable. Results: Analysis by the Kruskal–Wallis test revealed significant differences in the score on the GDS-15 among the robust, social prefrailty, and social frailty groups (p < 0.05). Furthermore, multiple regression analysis identified a significant association between the social frailty status and the score on GDS-15 (odds ratio, 1.57; 95% confidence interval (95% CI), 1.15–2.13; p = 0.001). Conclusion: The increase in the rate of transition of elderly individuals to the social frailty group could have been related to the implementation of the stay-at-home order as part of the countermeasures for COVID-19. Furthermore, the increased prevalence of depressive symptoms associated with the stay-at-home order could also have influenced the increase in the prevalence of social frailty during the COVID-19 pandemic.

Understanding the Spectrum of Anxiety Responses to Climate Change: A Systematic Review of the Qualitative Literature

Background: Knowledge about climate change may produce anxiety, but the concept of climate change anxiety is poorly understood. The primary aim of this study was to systematically review the qualitative literature regarding the scope of anxiety responses to climate change. The secondary aim was to investigate the sociodemographic and geographical factors which influence experiences of climate change anxiety. Methods: A systematic review of empirical qualitative studies was undertaken, examining the scope of climate change anxiety by searching five databases. Studies were critically appraised for quality. Content analysis was used to identify themes. Results: Fifteen studies met the inclusion criteria. The content analysis was organised into two overarching themes. The scope of anxiety included worry about threats to livelihood, worry for future generations, worry about apocalyptic futures, anxiety at the lack of response to climate change, and competing worries. Themes pertaining to responses to climate change anxiety included symptoms of anxiety, feeling helpless and disempowered, and ways of managing climate change anxiety. Relatively few studies were identified, with limited geographical diversity amongst the populations studied. Conclusions: The review furthers understanding of the concept of climate change anxiety and responses to it, highlighting the need for high-quality psychiatric research exploring its clinical significance and potential interventions.

Biomechanical Characteristics of the Knee Joint during Gait in Obese versus Normal Subjects

Knee osteoarthritis (OA) is a growing source of pain and disability. Obesity is the most important avoidable risk factor underlying knee OA. The processes by which obesity impacts osteoarthritis are of tremendous interest to osteoarthritis researchers and physicians, where the joint mechanical load is one of the pathways generally thought to cause or intensify the disease process. In the current work, we developed a hybrid framework that simultaneously incorporates a detailed finite element model of the knee joint within a musculoskeletal model to compute lower extremity muscle forces and knee joint stresses in normal-weight (N) and obese (OB) subjects during the stance phase gait. This model accounts for the synergy between the active musculature and passive structures. In comparing OB subjects and normal ones, forces significantly increased in all muscle groups at most instances of stance. Mainly, much higher activation was computed with lateral hamstrings and medial gastrocnemius. Cartilage contact average pressure was mostly supported by the medial plateau and increased by 22%, with a larger portion of the load transmitted via menisci. This medial compartment experienced larger relative movement and cartilage stresses in the normal subjects and continued to do so with a higher level in the obese subjects. Finally, the developed bioengineering frame and the examined parameters during this investigation might be useful clinically in evaluating the initiation and propagation of knee OA.

The Effects of SARS-CoV-2 Infection on Female Fertility: A Review of the Literature

As the coronavirus pandemic is far from ending, more questions regarding the female reproductive system, particularly fertility issues, arise. The purpose of this paper is to bring light upon the possible link between COVID-19 and women’s reproductive health. This review emphasizes the effect of SARS-CoV-2 on the hormones, endometrium and menstrual cycle, ovarian reserve, follicular fluid, oocytes, and embryos. The results showed that endometrial samples did not express SARS-CoV-2 RNA. Regarding the menstrual cycle, there is a large range of alterations, but they were all reversible within the following months. The ovarian reserve was not significantly affected in patients recovering from both mild and severe infection in most cases, except one, where the levels of AMH were significantly lower and basal follicle-stimulating hormone (FSH) levels were increased. All COVID-19 recovered patients had positive levels of SARS-CoV-2 IgG in the follicular fluid. The amount of retrieved and mature oocytes and the fertilization rate were unharmed in three studies, except for one study, where the quantity of retrieved and mature oocytes was reduced in patients with higher levels of SARS-CoV-2 antibodies. The numbers of blastocysts, top-quality embryos, and euploid embryos were affected in most of the studies reviewed.

Postural Control in Unipedal Quiet Stance in Young Female Gymnasts and the Effects of Training with Consideration of Transient Behavior of Postural Sway

The purpose of this study was twofold: (a) to compare postural control between a group of young female gymnasts (n = 15; age: 11.2 ± 1.9 years) and non-trained peers (n = 15; age: 10.9 ± 2.0 years), and (b) to investigate the effect of an 8-week whole body exercise intervention program on postural control in young female gymnasts. Postural control was assessed by recording center of pressure (CoP) movements during unipedal quiet stance. Velocity and amplitude of CoP movement in anterior-posterior (AP) and medial-lateral (ML) directions were considered. In addition to common trial-averaged CoP outcomes, we also considered the transient behavior of CoP movements, by calculating relative differences between the 1st and 2nd, and the 1st and 3rd 10-s intervals within the whole trial (DIF_21 and DIF_31, respectively). The gymnast group had lower total CoP velocity (Cohen’s d = 0.97) and AP amplitude (Cohen’s d = 0.85), compared to their non-trained peers. The gymnasts also had lower CoP AP amplitude DIF21 (Cohen’s d = 0.73), with almost constant values across all intervals. After the training ML CoP velocity was reduced for 13.12% (Cohen’s d = 0.60), while ML CoP amplitude increased (Cohen’s d = −0.89).

Perception, Reaction, and Future Development of the Influence of COVID-19 on the Hospitality and Tourism Industry in China

The present study examined the perception, reaction (i.e., possible measures), and future development from the perspectives of hotel and tourism practitioners and experts to investigate the influence of coronavirus disease 2019 (i.e., COVID-19) on the hospitality and tourism industry in China. After conducting 58 in-depth interviews among hotel and tourism practitioners and experts, feasible and practical measures were proposed to reduce such influence and predict the future development of China’s hospitality and tourism industry. Findings indicate that the influence of COVID-19 on the industry is perceived mainly through the pandemic’s economic and social effects. Possible measures that can be adopted for the recovery of China’s hospitality and tourism industry include the following aspects: government financial support, employee relationship management and electronic (e)-training, business marketing management, and industry co-operation network. A Perception-Reaction-Predication (PRP) crisis model is also proposed.

The Efficacy of a New AMCOP® Elastodontic Protocol for Orthodontic Interceptive Treatment: A Case Series and Literature Overview

Background: Elastodontics is a specific interceptive orthodontic treatment that uses removable elastomeric appliances. They are functional appliances that produce neuromuscular, orthopedic and dental effects. Thus, these devices are useful in the developmental age, when skeletal structures are characterized by important plasticity and adaptation capacity, allowing to remove factors responsible for malocclusions. Elastomeric devices are generally well tolerated by patients requiring simple collaboration and management. This work can be useful to update all orthodontists already adopting these appliances or for those who want to approach them for the first time. This study aimed to describe four cases treated with new elastomeric devices called AMCOP Bio-Activators and to provide an overview of elastodontics, its evolution, indications and limits. Methods: A total of four clinical cases were presented after a treatment period of 16–20 months to evaluate the clinical and radiological effects of the elastodontic therapy. Results: The effectiveness of Bio-Activators on clinical cases was evidenced with a significant improvement in skeletal and dentoalveolar relationship, and malocclusion correction in a limited treatment period (16–20 months). Conclusions: The Bio-Activators showed clinical effectiveness to achieve therapeutic targets according to a low impact on the patient’s compliance.